Osteochondrosis is a degenerative-dystophical spinal disease, whose base is damage to intervertebral discs.The development of a degenerative disease of the spine is facilitated by prolonged microtherumatization, excessive static and dynamic load, hereditary predisposition, advanced age.The most frequent location of the lesion is the cervical and lumbar column.This is due to its greater mobility and load.
General concept of osteochondrosis
The intervertebral disk over time loses its liquid and loses its shock absorption function.Becomes less resistant to physical effort.The fibrous ring, which is found on the periphery of the album, is gradually thinner, cracks are formed in it.The pulp core moves along the periphery in the cracks and formed formsProtuber(Local protrusion, 1 grade).Due to intensive physical activity, protuberance can increase spaspically and change towards the light of the vertebral channel.In this case, they talk about the hernia of the album (2 degrees).Sometimes free fragments of the nucleus can be formed -Kidnappings.
In the initial stages of the disease, pain can be explained by exceeding the fibrous ring and the irritation of the posterior longitudinal ligament.The pain can be located locally on the back or neck, as well as in remote areas.With cervical osteochondrosis, pain can be reflected in the back of the head, the blade and the area between spaces, shoulder and hand carrier.
The pain is accompanied by spasm reflex of the segmental muscles.This phenomenon has a protective nature and stabilizes the definite part of the spine.Over time, muscle contraction becomes an independent source of pain.When changing to the intervertebral hole, the hernia squeezes the neighboring nerve roots.Roodular pain has a shooting character, clearly located during nerve innervation.It is accompanied by appropriate neurological manifestations:
- decrease in sensitivity;
- reflex failure;
- Muscle weakness
The degeneration of the disk violates the normal anatomical relationship between the components of the spinal column: discs, vertebrae, joints and ligaments.The gradual decrease in the height of the intervertebral disc leads to a change in joint ties and the formation of subluxation and dislocations of the vertebrae.This fact indicates the instability of the spine and reduces resistance to injuries, which can cause exacerbation of osteochondrosis.
With age, the stability of the column is restored due to the formation of osteophytes, hypertrophy of articular processes, disc fibrosis, thickening of the ligaments and joint capsules.The final stage of the pathological process is called spondylosis.Pain at this time decreases.
The main symptoms of cervical osteochondrosis
At the level of cervical segments, nerve roots and their arteries, spinal cord and its glasses and spinal arteries can be subjected to compression.Spinal cord compression is possible due to posterior intervertebral hernia or rear osteophine.People with a narrow vertebral channel are especially predisposed to this.With a hernia, the compression signs of cervical osteochondrosis develop quite quickly, and the symptoms of the cerebrospinal cerebrospinal block are softer.
It is very difficult to clinically distinguish compression of the spinal cord with a tumor and hernia.The osteochondrosis of the cervical column is manifested by a spastic paresis of the legs, sensitivity driving disorders, pain and weakness in the hands.In some cases, compression signs are combined with signs of ischemia of the spinal cord substance that arose as a result of the compression of the spinal artery and the root vessels.
Symptoms of damage to the previous horns and ventral departments can suddenly develop with the affectation of pyramid roads (blood supply to the anterior spinal artery).The anterior spinal syndrome occurs: slow pairs of the arms, spastic pairs of the legs, function of the deteriorated sphincter.Sometimes the serious violation symptoms of deep sensitivity in the hands are developed.After 2-3 weeks, the signs of a spinal stroke begin to go back.In terms of the volume of the pathological approach, we can say about the seriousness of residual phenomena.
Cervical myelopathy
Myelopathy is a chronic ischemization for cervical osteochondrosis.An important role in the development of this syndrome is played by the compression of blood vessels.The most characteristic is the defeat of the ventral parts of the side pillars and the front horns.It is manifested by a spasticophical paresis of the arms, a spastic paresis of the legs, a violation of the deep sensitivity of the legs (classic triad).
In several patients, the Lermitta symptom appears: a feeling of passing the electric shock along the entire spine with irradiation of pain in the hands and legs when heading.It is possible to develop lateral amyotrophic sclerosis in which there are no bulbar symptoms.
Magnetic resonance and TC play an important role in confirmation of myalopathy, which reveal the compression of the shell bag with osteophytes and an thickened yellow group.
Root compression signs
Since the underlying discs are wearing faster, spondilartrosis develops in the corresponding segments.Osteophytes strengthen intervertebral holes and tightens the roots (at the most frequently lumbar level a compression of the album's hernia in the epidural space).When moving the growth head, the column is injured, which causes the formation of edema, which further reduces the intervertebral hole.Develop reactive inflammatory reactions.
Clinical manifestations:
- C3 -Koreshok (below 2 cervical vertebra, occurs quite rare) - pain in the corresponding half of the neck, a sensation of tongue swelling, a feeling of coma in the throat;
- C4 -KORESHOK: Pain in the appropriate shoulder, clavicle, trapezoid muscle atrophy, a decrease in the tone of the neck muscles (irritation of 3 and 4 cervical roots increases the tone of the diaphragm, which leads to a change in the liver and appearance of angina dust pain);
- C5 -Cor - Neck pain and outer surface of the shoulder, hypotrophy of the deltoid muscle;
- C6 -Koreshok (one of the most common locations): neck pain, blades, shoulder, the radial surface of the forearm extends to 1 finger, parepezesia in the hands, weakness of the biceps of the muscle of two heads;
- C7-Koreshok-Pain extends to 2-3 fingers, accompanied by paresthesia, weakness of the three-headed muscle;
- C8 -Koreshok: the pain extends to the surface of the forearm elbow to the 5th finger, accompanied by parstesthesia.
Cervical reflex syndromes
The vertebral syndrome is manifested by acute cervical pains (bastards, cervical), less frequently chronic or subacute pain.The main sources of pain syndrome are a fibrous ring, the rear longitudinal ligament, the joint capsule, tense muscles.Krivosheya is not as pronounced as the curvature of the spine at the lumbar level.
The pains are hurt, irradiate to the back of the head.Intensify when driving or extending to remain in a position.In the palpation, the pain of the thorny processes and the capsules of the joints on the sore side (along the posterior surface of the 3-4 cm neck is lateral that the spicy processes).Participation in the process not only of the back, but also of the front muscles of the spine (anterior staircase, etc.) is characteristic.
Anterior staircase syndrome
The muscle tension of the staircase often occurs with cervical osteochondrosis.The muscle is determined by the muscle side in the form of a stressful, dense and increased size of size compared to the healthy side.Due to the voltage, the compression of the supravic vessels is produced, which is accompanied by pain and swelling in the hand, altered sensitivity and motor activity (along the elbow nerve).The pain intensifies in a horizontal position.
Small chest muscle syndrome
The development mechanism is similar to the previous one.The compression of the vascular freezing beam occurs between the muscle and the shoulder bone (or Corve process) under conditions of greater abduction of the hand.It is accompanied by chest pain, shoulder blade, hand.
The existing characteristics are often considered pain in the heart with VSD (there are no acute attacks, the effect of taking nitroglycerin or sedatives is not an increase in symptoms during the movement and palpation of weak points).
The rear syndrome
Dysótic vasomotor disorders that occur as a result of the irritation of the sympathetic plexus of the vertebral artery are characteristic.Plexus branches are found in brain and skull tissues.It is clinically manifested by dizziness, a sound in the ears, spectacular disorders, anxiety.
The compression of the vertebral arteries with osteophytes emanating from the joint spinal column joints, in combination with the atherosclerotic damage to these vessels, is an important pathogenetic factor in the development of the insufficiency of the brain arteries and the spinal cord.
Conclusion
In most cases, pain in the hands and neck is associated with cervical osteochondrosis.In some patients, pain is caused by the hernia of the intervertebral disc, in others: osteophytes and osteoarthritis of the spine joints.Each of these options can cause local or reflected pain, root syndrome and myelopathy.When examining patients with neck pain, it is necessary to exclude pathologies such as:
- column tumors;
- epidural abscess;
- spondylitis;
- subarachnoid hemorrhage;
- meningitis;
- Hall abscess;
- stratification of the carotid artery;
- Fracture of the cervical vertebrae.