What is “cervical spondylosis”?

What is cervical spondylosis?

When seeing patients in the outpatient clinic, we often meet patients who ask: "Doctor, I have cervical spondylosis and I feel dizzy. How can I treat it?" Then, are you really suffering from cervical spondylosis? Please read this article carefully to learn about the causes and consequences of cervical spondylosis. It may help you with your condition.

Cervical spondylosis is also called cervical syndrome. Why is it called syndrome? It turns out that the cause, pathology, and classification of cervical spondylosis are relatively complex. Cervical spondylosis is just a general term for all types of cervical spondylosis. The causes are probably nothing more than cervical degeneration, which is what we often call aging, congenital developmental abnormalities, chronic strain, congenital malformations, etc. The most common one is of course chronic strain. The detailed causes and pathology are too professional, so I will not go into details here. Please see the classification of cervical spondylosis:

Who is prone to cervical spondylosis?

The elderly, those who work with their heads down for a long time, those who sleep in an improper posture, those with a history of head trauma, and those with congenital cervical vertebrae deformities. With the popularity of smartphones, the incidence rate among more and more young people and students is increasing year by year.

What are the clinical manifestations?

The clinical symptoms of cervical spondylosis are relatively complex. They mainly include neck and back pain, upper limb weakness, finger numbness, lower limb weakness, difficulty walking, dizziness, nausea, vomiting, and even blurred vision, tachycardia, and dysphagia. The clinical symptoms are related to the site of the lesion, the degree of tissue involvement, and individual differences.

1. Radiculopathy: It has typical radicular symptoms (numbness, pain), and the range is consistent with the area innervated by the cervical spinal nerves. It excludes diseases outside the cervical spine such as thoracic outlet syndrome, carpal tunnel syndrome, cubital tunnel syndrome, frozen shoulder, etc., which mainly cause upper limb pain.

2. Spinal cervical spondylotic myelopathy: clinical manifestations of cervical spinal cord damage, excluding amyotrophic lateral sclerosis, spinal cord tumors, spinal cord injury, multiple peripheral neuritis, etc.

3. Vertebral artery type cervical spondylosis: There have been cataplexy attacks. Accompanied by cervical vertigo. Often accompanied by sympathetic nerve symptoms. Exclude ocular and otopathic vertigo. Exclude basilar artery blood supply insufficiency caused by compression of vertebral artery segment I (vertebral artery segment before entering the transverse foramen of C6) and vertebral artery segment III (vertebral artery segment before leaving the cervical vertebrae and entering the skull).

4. Sympathetic cervical spondylosis: manifested by a series of sympathetic nerve symptoms such as dizziness, blurred vision, tinnitus, numbness of hands, tachycardia, precordial pain, etc. X-ray shows instability or degeneration of the cervical spine. Vertebral artery angiography is negative.

5. Cervical spondylosis: Also known as local cervical spondylosis, it is the most common and mildest type of cervical spondylosis in clinical practice, mainly characterized by neck pain and discomfort, without other associated symptoms. There are no obvious abnormalities on X-rays, but there may be changes in the physiological curve of the cervical spine and mild bone hyperplasia.

6. Mixed cervical spondylosis is a type of cervical spondylosis in which two pathogenic factors exist at the same time. The symptoms vary and require diagnosis by a professional physician.

How to diagnose cervical spondylosis?

A professional physician is required to confirm the diagnosis based on clinical manifestations, physical examination, and auxiliary examinations such as X-rays, CT, MRI (nuclear magnetic resonance imaging), electromyography, and vascular B-ultrasound.

What complications may occur if you have cervical spondylosis?

1. Swallowing disorders

There is a feeling of obstruction when swallowing and a foreign body sensation in the esophagus. A few people experience nausea, vomiting, hoarseness, dry cough, chest tightness, etc. This is due to the direct compression of the posterior wall of the esophagus by the front edge of the cervical spine, causing esophageal stenosis. It may also be caused by the rapid formation of bone spurs, which causes irritation of the soft tissue around the esophagus.

2. Visual impairment

Symptoms include decreased vision, eye pain, fear of light, tearing, different pupil sizes, and even narrowing of the visual field and sharp decrease in vision. Some patients may even go blind. This is related to ischemic lesions in the visual center of the occipital lobe of the brain caused by autonomic nerve disorder caused by cervical spondylosis and insufficient blood supply to the vertebral-basilar artery.

3. Cervical heart syndrome

Symptoms include precordial pain, chest tightness, arrhythmia (such as premature beats), and ST segment changes on the electrocardiogram, which can be easily misdiagnosed as coronary heart disease. This is caused by the stimulation and compression of the cervical spine nerve roots by the cervical vertebrae spurs.

4. Hypertension and cervical spondylosis

It can cause blood pressure to rise or fall, with the most common being high blood pressure, which is called "cervical hypertension". Since cervical spondylosis and hypertension are both common diseases among middle-aged and elderly people, the two often coexist.

5. Chest pain

The symptoms are slow onset, persistent unilateral pectoralis major and breast pain, and tenderness in the pectoralis major muscle during examination. This is related to compression of the C6 and C7 nerve roots by cervical vertebrae spurs.

6. Paralysis of lower limbs

The early symptoms are lower limb numbness, pain, and lameness. Some patients feel like they are walking on cotton when walking. Some patients may also have bowel and urination disorders, such as frequent urination, urgency, difficulty urinating, or incontinence. This is because the vertebral lateral bundle is stimulated or compressed by the pressure-causing object, resulting in lower limb movement and sensory disorders.

7. Cataplexy

Often when standing or walking, the patient suddenly turns his head and loses support, causing sudden collapse. After falling, he can quickly wake up without consciousness disturbance or sequelae. Such patients may have symptoms of autonomic dysfunction such as dizziness, nausea, vomiting, and sweating. This is due to the compression of the vertebral artery by the hyperplastic changes in the cervical spine, which causes blood supply obstruction in the basilar artery and leads to temporary cerebral insufficiency.

How to treat cervical spondylosis?

1. Drug treatment can selectively use analgesics, sedatives, vitamins (such as B1, B12), etc., which have a certain effect on relieving symptoms.

2. Exercise therapy

During the acute onset of symptoms, local rest is recommended, and exercise stimulation should not be increased. Exercise is contraindicated when there are obvious or progressive symptoms of spinal cord compression, especially cervical spine backward movement. In the case of vertebral artery type cervical spondylosis, neck rotation exercise should be gentle and slow, and the amplitude should be appropriately controlled.

3. Traction therapy

It used to be one of the preferred methods for treating cervical spondylosis. This type of treatment is not recommended at present, but it is not explicitly prohibited. Traction therapy should be used with caution.

4. Manual massage therapy

It is a relatively effective treatment measure for cervical spondylosis. Its therapeutic effect is to relieve the tension and spasm of the neck and shoulder muscles and restore the activity of the cervical spine. Gravity massage and repositioning are generally prohibited for spinal cervical spondylosis, otherwise it is very easy to aggravate the symptoms and even lead to paraplegia. Even if the early symptoms are not obvious, surgical treatment is generally recommended.

5. Physical therapy can play multiple roles in the treatment of cervical spondylosis.

6. Warm compresses can improve blood circulation, relieve muscle spasms, and eliminate swelling to alleviate symptoms. Hot towels and hot water bottles can be used for local application. Warm compresses should not be used for patients in the acute stage when the pain symptoms are severe.

7. Surgery

For patients with severe radiculopathy and myelopathy, whose clinical symptoms are typical and seriously affect their normal life and whose spinal cord is compressed and degenerated as shown by imaging, early surgical intervention is recommended to avoid catastrophic consequences caused by serious complications. Please consult a specialist for the choice of surgical method and listen to the opinions and arrangements of professional doctors.

How to prevent cervical spondylosis?

Changing bad work and life habits, avoiding bad postures that increase the load on the cervical spine, such as high pillows, long hours of sitting at a desk, and long hours of lowering the head, etc., proper neck exercises and correct sleeping postures can delay or prevent the occurrence of cervical spondylosis. Of course, degenerative cervical spondylosis is a natural degeneration process and cannot be prevented from happening. All we can do is delay it.

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