90% of cervical spondylosis does not require surgery. What should we pay attention to in conservative treatment?

Author: Zhang Zhihai, Chief Physician of Orthopedics, Guang'anmen Hospital, China Academy of Chinese Medical Sciences

Reviewer: Ren Dajiang, Chief Physician of the Seventh Medical Center of PLA General Hospital

Cervical spondylosis has now become an occupational disease. Working at a desk with your head down for a long time, or looking at a computer in one posture for a long time, can easily cause cervical spondylosis.

There are two main treatment methods for cervical spondylosis: conservative treatment and surgical treatment. 90% of cervical spondylosis does not require surgical treatment and can be treated conservatively.

Conservative treatment includes massage, traction, drug therapy, functional exercise, physical therapy, etc. Conservative treatment can bring certain relief to cervical spondylosis, especially mild and moderate cervical spondylosis.

1. What should patients with cervical spondylosis pay attention to in daily life?

Patients with cervical spondylosis should pay attention to functional exercise. Functional exercise is very important. People who work at a desk for a long time should take a one-minute break every hour and move their cervical spine, moving it back and forth, left and right, including rotation. For example, put both hands behind the neck, contract the antagonistic neck muscles, and do antagonistic exercises to the left and right. This can increase muscle strength and is very helpful for cervical spondylosis.

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Patients with cervical spondylosis should pay attention to protecting their necks, such as avoiding collisions with their necks and avoiding collision-related sports, such as boxing, judo, and wrestling, which can easily injure the cervical spine. Running, swimming, mountain climbing, kite flying, badminton, and table tennis, etc., do not have much impact on the cervical spine.

Patients with cervical spondylosis also have certain requirements for pillows. Try not to use high pillows, because the cervical spine of patients with cervical spondylosis is in a flexed state, so the muscles, ligaments and spinal canal behind the cervical spine are under greater pressure. Therefore, patients with cervical spondylosis are generally recommended to choose a pillow that they feel comfortable, or use a towel roll of appropriate height to pad behind the neck, which is good for restoring the normal physiological curvature of the neck. In addition, the pillow should be slightly harder, such as buckwheat husk. If it is too soft, the head will sink into it, and the neck will always be in a tense state, which will also be uncomfortable.

2. Can I do massage and traction if I have cervical spondylosis?

When you have symptoms of cervical spondylosis, you should be careful when massaging your neck. Massaging your neck when you have symptoms is likely to aggravate the compression of the nerve roots, the herniation of the cervical disc, and the neurological symptoms. Therefore, you should never do heavy-handed massage when you have symptoms.

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There are no neurological symptoms, just a little soreness in the neck muscles. Massage can relax the muscles and reduce the inflammation of the muscles.

Traction is effective in acute attacks of cervical spondylosis. It can reduce local inflammation, stabilize the spine, and relieve symptoms. The force of traction should not be too strong, as it may aggravate neurological symptoms and neck pain.

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If there are no symptoms, there is no need for any traction. Instead, traction will aggravate cervical spondylosis.

In addition, traction and massage must be performed under the guidance of a professional spinal surgeon. It is not recommended to use home traction equipment at home.

3. Is there any specific medicine for cervical spondylosis?

There is no specific medicine for cervical spondylosis.

Cervical spondylosis is mainly caused by degeneration. Current drugs only provide symptomatic treatment, such as relieving pain, reducing inflammation, and eliminating nerve root edema, but cannot cure cervical spondylosis.

4. Under what circumstances should surgical treatment be considered for cervical spondylosis?

If the condition seriously affects daily life and conservative treatment is ineffective for more than six to eight weeks, surgical treatment can be considered.

Surgery for cervical spondylosis is relatively safe when performed by a professional spine surgeon. Three to six months after the surgery, patients can basically resume normal life and work.

There are many surgical methods, including minimally invasive surgery, open surgery, anterior approach surgery, and posterior approach surgery.

So, can surgery cure cervical spondylosis?

After surgery for cervical spondylosis, for example, surgery on the 5-6 cervical segments, this segment will no longer cause neurological symptoms, but other segments that have not undergone surgery may further degenerate with age and cause symptoms.

So can cervical spondylosis be cured? It should be said that the segment with problems can be cured through surgery. Generally speaking, the segment after surgery rarely relapses.

Cervical spondylosis is mainly caused by degeneration, but it can also be prevented and the onset of degeneration can be delayed. People who work at a desk for a long time or look at a computer in one position for a long time must pay attention to the prevention of cervical spondylosis and pay attention to neck exercises.