This is the 4708th article of Da Yi Xiao Nursing
In daily life, many friends sometimes trip while walking, which is a normal life phenomenon, but if it happens frequently, it is necessary to pay attention to:
Do you have cervical spondylosis?
Aunt Xu, 67 years old, from Yichun City, Jiangxi Province, has been prone to stumbling when walking on flat ground for a year, and she has always thought it was a knee problem and did not pay attention to it. In the past 1 month, I felt frequent tripping, and even felt like I was going to fall, and I went to the local hospital to check the knee joint and found no obvious problems, and the oral knee arthritis medication did not improve, so I came to the provincial hospital for treatment. After listening to Aunt Xu's description, Dr. Duan gave her a simple physical examination, flicked her middle finger a few times, and found that the rest of the fingers retracted unobediently - medically known as Hoffmann's positive sign, which is an abnormal manifestation. Dr. Duan highly suspected that Aunt Xu was suffering from cervical spondylosis, so he asked Aunt Xu to go for a cervical magnetic resonance imaging (MRI), and the results confirmed the doctor's diagnosis: MRI images showed that 5/6 cervical intervertebral discs were herniated, which obviously compressed the cervical spinal cord.
The cervical spine is an important bone and bone joint structure of our human body, which has the role of supporting the skull and protecting the spinal cord. If a disease occurs in the cervical spine, it can have a serious impact on our normal life and even threaten our lives.
What are the characteristics of the cervical spine that make it susceptible to disease?
There are three main aspects:
1. The cervical vertebral body is small, and its intervertebral foramen is also relatively small, which is easy to press the nerve roots that pass through it, which is the cause of radicular pain, which is what we often call arm pain and shoulder and back pain.
2. The spinal canal is the place where the spinal cord passes, and once its volume is narrow due to bone hyperplasia or intervertebral disc herniation, it is easy to squeeze the spinal cord and produce spinal cord compression symptoms of unstable walking.
3. The intervertebral disc is an important structure for the stability and buffering of the cervical spine, and its nutrition and metabolism mainly depend on the penetration of surrounding tissues. As we age, the intervertebral disc nutrition declines, so it is more prone to degeneration, and bone hyperplasia also appears.
What are the characteristics of cervical spondylosis?
Cervical spondylosis is mainly divided into radiculotype and spinal cord type. Different types of cervical spondylosis have different clinical manifestations.
Radiculotype
Soreness, numbness, swelling, and pain in one or both upper limbs are characterized by radicular pain.
Spinal type
Soreness, numbness, swelling or weakness in the upper or lower limbs, unsteady walking, stumbling or stepping on cotton, fine motor disorders in both hands, and later dysfunction of urine and urine.
If middle-aged and elderly friends are prone to stumbling when walking on flat ground, they may have something wrong, such as cervical myelopathy. When the cervical spinal cord is compressed and stimulated, there will be increased muscle tone in the limbs and a significant decrease in muscle strength. The lower limbs have difficulty walking, the lower limbs are weak and weak, unable to walk in a straight line, prone to stumbling and even wrestling. Some patients will also feel like they are stepping on a pile of cotton when walking. At this time, electromyography examination, neck CT film, and MRI film can be taken to identify the specific symptoms.
The early symptoms of cervical myelopathy are not very obvious, so they are often ignored by the majority of friends, or mistakenly thought for other diseases such as knee arthritis. If you have symptoms such as unsteady holding of chopsticks, unsteady walking, numbness of hands and feet, or feeling of stepping on cotton, you should seek medical attention as soon as possible, and the doctor will choose the appropriate treatment plan according to the clinical manifestations and imaging reports.
How to treat cervical myelopathy?
Cervical myelopathy generally has a slow onset and gradually worsens. Patients with short course of disease and mild symptoms can be treated conservatively (bed rest, non-steroidal anti-inflammatory analgesics, reducing cervical spine weight-bearing, cervical circumference brace fixation, etc.), and massage treatment is not suitable to avoid further injury to the cervical spine and worsening the condition. When the symptoms are aggravated and there is frequent stumbling and stepping on cotton, you should seek medical attention immediately and fix the neck with a neck brace to avoid secondary injury to the cervical spine. Once cervical myelopathy is diagnosed, patients should be treated with surgery as soon as possible. There are two main surgical methods: one is anterior approach surgery, which is mostly chosen for patients who compress the front of the spinal cord, which has the advantages of less trauma, less bleeding, easy exposure, good decompression effect (because of the direct removal of compression), and is conducive to restoring normal cervical curvature and inner diameter of the spinal canal. The other is posterior approach surgery, which is mostly selected for patients with developmental cervical spinal stenosis, multilevel cervical myelopathy, and ossification of the posterior longitudinal ligament, which is characterized by direct enlargement of the spinal canal to directly relieve the compression of the posterior spinal cord, and indirect decompression of the anterior spinal cord through the posterior drift of the spinal cord.
Therefore, if middle-aged and elderly friends often stumble when walking, they should seek medical attention as soon as possible and choose a treatment method that suits them according to the doctor's advice to avoid serious consequences.
Preoperative MRI and CT of the cervical spine showed C5/6 bone hyperplasia, focal posterior longitudinal ligament ossification, and obvious compression of the cervical spinal cord.
Anterolateral cervical spine X-ray after microscope-assisted C5/6 ACDF
Author: Department of Spine Surgery, Orthopaedic Hospital, First Affiliated Hospital of Nanchang University
Duan Pingguo, Huang Jiahao
Review: Institute of Medical Science, Fudan University
Zhongshan Hospital Affiliated to Fudan University
Dong Jian
Some of the pictures are taken from the Internet, if there is any infringement, please inform us and delete it.
所有人名和地名均为化名，如有雷同，纯属巧合。