Osteocondrosis is a degenerative dystrophic spinal disease, whose base is the damage to intervertebral discs.The development of a degenerative disease of the spine is facilitated by prolonged microtraumatization, static and dynamic excessive load, hereditary predisposition, advanced age.The most frequent location of the injury is the cervical and lumbar column.This is due to their greatest mobility and load.
General concept of osteochondosis
Over time, the intervertebral disc loses its liquid and loses its shock function.It becomes less resistant to physical effort.The fibrous ring, which is located on the outskirts of the disc, is gradually thinner, cracks are formed.The Polpic nucleus moves along the periphery in the cracks and forms formedProtub(local protrusion, 1 degree).Due to the intense physical activity, the protrusion can be spasmodically increasing and move to the lumen of the vertebral canal.In this case, they speak of the disc of the disc (2 degrees).Sometimes free fragments of the nucleus can form -Seizures.
In the initial stages of the disease, pain can be explained by overloading the fibrous ring and irritation of the rear longitudinal ligament.The pain can be located locally in the rear or neck, as well as in remote areas.With cervical osteochondrosis, the pain can be reflected in the back of the head, the blade and the area of the eternal, the bearer of the shoulders and the hand.
The pain is accompanied by spasm reflection of the segmental muscles.This phenomenon has a protective nature and stabilizes the defined part of the spinal column.Over time, muscle contraction becomes an independent source of pain.When moving towards the intervertebral hole, the hernia holds the close nerve roots.Radical pain has a shot and permeable character, clearly located during the innervation of the nerve.It is accompanied by appropriate neurological manifestations:
- decrease in sensitivity;
- bankruptcy of reflections;
- muscle weakness.
The degeneration of the disc violates the normal anatomical relationship between the components of the spinal column: discs, vertebrae, joints and ligaments.The gradual reduction in the height of the intervertebral disc leads to a change in the joint bonds and the formation of subluxation and disputes of the vertebrae.This fact indicates the instability of the spinal column and reduces the resistance to the lesions, which can lead to the exacerbation of the osteocondrosis.
With the age, the stability of the spine is restored due to the formation of osteophytes, hypertrophy of joint processes, fibrosis discs, inspection of ligaments and joint capsules.The final phase of the pathological process is called Spondilosis.Pain at this moment they subside.
The main symptoms of cervical osteochondosis
At the level of cervical segments, nerve roots and arteries, the spinal cord and its vases and spinal arteries can be subjected to compression.The compression of the spinal cord is possible due to the rear intervertebral or rear osteophytes.People with a narrow vertebral canal are particularly predisposed to this.With an hernia, the signs of compression of the cervical osteocondrosis develop quite quickly and the symptoms of the cerebrospinal river current block are softer.
It is very difficult to clinically distinguish the compression of the spinal cord with a tumor and hernia.The osteochondrosis of the cervical column manifests itself from a spastic paresis of the legs, disorders of the conduct of sensitivity, pain and weakness in the hands.In some cases, the signs of compression are combined with signs of ischemia of the substance of the spinal cord who presented themselves due to the compression of the spinal artery and the root vessels.
The symptoms of damage to the front horns and ventral departments can suddenly develop with the involvement of pyramidal paths (the flow of blood to the front spinal artery).The front spinal syndrome occurs: slow paresis of the arms, spastic paresis of the legs, altered sphincter functionality.Sometimes the symptoms of the serious violation of the profound sensitivity in the hands develop.After 2-3 weeks, the signs of a spinal race begin to regress.In terms of volume of pathological attention, we can say about the gravity of the residual phenomena.
Cervical myelopathy
Myelopathy is a chronic ischemization for cervical osteochondosis.An important role in the development of this syndrome is played by the compression of the blood vessels.The most characteristic is the defeat of the ventral parts of the side pillars and the front horns.A spastic paresis of the legs, a violation of the deep sensitivity of the legs (classic triad) is manifested by a spastic paresis of the arms.
In a number of patients, the symptom of Lentitta appears: a feeling of passing the electric discharge along the entire spine with irradiation of pain in the hands and legs during the direction.It is possible to develop the side of the side side of the side where there are no Bulbari symptoms.
An important role in confirmation of my allaopathy is played by MRI and CT, which reveal the compression of the shell bag with osteophytes and an inspected yellow group.
Signs of root compression
Since the records below consume faster, spondularosis develops in the corresponding segments.Osteophytes narrow intervertebral holes and squeeze the roots (on the lumbar level more often a compression of the disc of the disc in the epidural space).When the head of growth moves, the spine is wounded, which causes the formation of edema, which further narrows the intervertebral hole.Develop reactive inflammatory reactions.
Clinical events:
- C3 -Koreshok (under 2 cervical vertebra, it occurs quite rarely) - pain in the half corresponding of the neck, a feeling of swelling of the tongue, a feeling of coma in the throat;
- C4 -Soreshok - pain in the appropriate shoulder flow, clavicle, atrophy of the trapezoid muscle, 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 movement of the liver and the appearance of papardic pain of the angina);
- C5 -Decor - neck pain and external surface of the shoulder, hypotrophy of the deltoid muscle;
- C6 -Koreshok (one of the most common locations) -Color in the neck, blades, shoulder, the radial surface of the forearm spreads to 1 finger, the Parepezia in the hands, the weakness of the two -debt muscle biceps;
- C7-Koreshok-Pain spreads to 2-3 fingers, accompanied by the wall, weakness of the three-headed muscle;
- C8 -Koreshok - Pain extends to the surface of the avoccaccio elbow in the 5th finger, accompanied by the paresthesia.
Cervical reflection syndromes
The vertebral syndrome occurs from acute cervical pain (bastards, cervical), less often chronic or subacute pain.The main sources of pain syndrome are a fibrous ring, the rear longitudinal ligament, joint capsule, tense muscles.Krivosheya is not as pronounced as the curvature of the spine at the lumbar level.
The pains are painful, they radiate in the back of the head.Intensify while driving or prolonged stay in a position.On palpation, the pain of the thorny processes and joint capsules on the sore side (along the rear surface of the 3-4 cm neck is determined the spicy processes).The involvement in the process not only of the rear part, but also of the front muscles of the spine (front scale, etc.) is characteristic.
Front scale syndrome
The tension of the staircase muscle occurs very often with cervical osteochondrosis.The muscle is determined from the side of the Sternum -shaped muscle in the form of a stressful degree, dense and increased size compared to the healthy side.Due to the tension, the compression of the supervic vessels occurs, 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 radius of vascular frazy occurs between the muscle and the shoulder bone (or the process of courage) in conditions of increase in the kidnapping of the hand.It is accompanied by chest pain, shoulder, hand.
The existing characteristics are often considered pain in the heart with VSD (there are no acute attacks, the effect of taking nitroglycerin or sedative is not, increased symptoms during the movement and palpation of the weak points).
The cute rear syndrome
They are characteristic disorders and vasomotor disorders that occur due to the irritation of the sympathetic plexus of the vertebral artery.The branches of the plexus are found in the fabrics of the brain and the skull.It is clinically manifested by dizziness, a sound in the ears, spectacular disorders, anxiety.
The compression of the vertebral arteries with osteophytes that emanates from the joints of the spinal column, 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 spinal cord.
Conclusion
In most cases, pain in the hands and neck is associated with cervical osteochondosis.In some patients, the pain is caused by the hernia of the intervertebral disc, in others - osteophytes and arthrosis of the joints of the spine.Each of these options can lead to local or reflection pain, root syndrome and myelopathy.When examining patients with neck pain, it is necessary to exclude these pathologies such as:
- spine tumors;
- Epidural abscess;
- spondylitis;
- Subaracnoid hemorrhage;
- meningitis;
- Room abscess;
- stratification of the carotid artery;
- Fracture of the cervical vertebrae.