Diagnosis and treatment of spinal diseases. Anatomy and function of spine; There are 33 vertebrae, including 7 cervical vertebrae (indicated by C), thoracic vertebrae 12 (indicated by T), lumbar vertebrae (indicated by L), sacral vertebrae 1 (indicated by S, 5 in childhood) and coccyx vertebrae 1 (4 in childhood).
1. Typical vertebrae are: vertebral body, pedicle, lamina, foramen, spinal canal, spinous process, articular process (facet joint, posterior joint).
2. The characteristics of cervical vertebra: the ring vertebra, axis vertebra and spinous process are bifurcated (the transverse process mouth is connected with blood vessels).
3. Thoracic vertebrae; Vertebral process inclines downward, and the transverse process of vertebral body has articular surface.
4. Lumbar spine: The spinous process is stretched horizontally, and the third transverse process is the longest.
5. Sacrum: there are sacral hiatus and vertebral foramen before and after.
Second, the spine has a certain natural curvature curve.
Anatomy and function of intervertebral disc: upper and lower cartilaginous plates, peripheral fibrous rings, nucleus and nucleus pulposus (water 80%, collagen 20%) can do variant exercise. Protrude; Injury of intervertebral ligament will form spur. Disc herniation less than 3MM will not cause symptoms and pain.
Four, the muscles and ligaments of the neck and waist:
1. The cervical ligament starts from the occipital region and ends at the cervical vertebra, and its function is to prevent the head from leaning forward excessively (it will be strained after a long time, and one action cannot exceed one hour).
2. Anterior and posterior ligaments begin at the occipital region and end at the sacrococcygeal region. The front of the vertebral body is broad and firm, and the back is wide at the top and narrow at the bottom. Disc herniation is always outward. Spinal canal stenosis can be treated by acupuncture, traditional Chinese medicine and massage therapy.
3, trapezius muscle, starting from the occipital-cervical ligament, the thoracic vertebra process ends at the acromion of the scapula. Injury to trapezius muscle can lead to shoulder fracture.
4. levator scapulae starts from C2\C3\C4 spinous process of neck and ends at the upper angle of scapula. If the first and second cervical vertebrae protrude or spur, it will affect levator scapulae's pain and the opposite pathological reaction.
5. The sternocleidomastoid muscle starts from the sternocleidomastoid joint and ends at the mastoid (high bone behind the ear).
6. The piriformis begins at the upper end of ilium and sacrum and ends at the upper end of femur.
Introduction of cervical spondylosis 1, concept: degeneration of cervical intervertebral disc itself and a series of secondary diseases, such as joint instability, loosening, nucleus pulposus protrusion, vertebral marginal hyperplasia, ligament deformation and hypertrophy and secondary spinal stenosis, stimulate or oppress adjacent blood vessels and nerves, causing a series of symptoms and signs.
2. Etiology: Internal degeneration of intervertebral discs, bones and joints, external trauma and chronic strain.
3. Typing:
(1) nerve root type: The symptoms are pain and numbness in the back of the neck and one upper limb, and you can feel electric shock at any time. Sometimes the pain is relieved after lifting, and the long-term muscle atrophy is not good.
Signs: there are tender points near the spinous process of cervical spine, numbness of the arm in the top-hitting test and numbness of the brachial plexus traction test.
Differential diagnosis: 1, brachial plexus injury, you can do an electromyogram. 2, weekend syndrome (falling asleep after drinking, holding the nerves below the shoulder joint, the onset time is relatively short). 3. Lung apex tumor. 4. Gangxia inflammation (below Tianzong point).
(2) Vertebral artery type: The symptoms are headache, dizziness, and even nausea and vomiting (structural changes). The dizziness is aggravated by turning around, and even suddenly faints.
Differential diagnosis: brain tumor with hypertension, Meniere's syndrome (dizziness and vomiting in the car).
(3) Spinal cord type: the symptoms are unstable walking, weakness of both lower limbs, easy to fall down when walking on cotton piles (treatment should be cautious), and the body feels nervous.
Signs: Hyperreflexia of knee tendon, obvious convulsion test and increased muscle tension.
Differentiation: spinal stenosis, spinal tumor, spinal lesion. (To see cervical spondylosis, you must watch the film first.)
(4) Sympathetic nerve type: tinnitus, dry eyes, chest tightness, shortness of breath, palpitation, insomnia, dreaminess, hypertension, arrhythmia and other symptoms.
Signs: ECG shows bloody changes. Differentiation and menopause.
(5) Mixed type: Two or more types of symptoms appear at the same time.
(6) Neck type: The symptoms are neck, shoulder, back pain and uncomfortable plate tightening. Differentiation from cervical facet syndrome and neck-shoulder syndrome.
4. Imaging examination of cervical spondylosis: X-ray film, CT film, magnetic resonance imaging, angiography and electromyography.
Diagnostic criteria of cervical spondylosis: symptoms+signs+films = diagnostic symptoms+signs. . . No piece = suspected treasure. No symptoms+no signs+films = excluding diseases.
5, the treatment of cervical spondylosis: manipulation, torsion, tension and compression, traction (angle in 15-30? ), acupuncture, cupping, Chinese herbal medicine, small needle knife.
Treatment prescription of cervical spondylosis 1), Sichuan aconite porridge
Radix Aconiti 12g, fragrant rice 50g, simmered, ginger juice 1 teaspoon, honey 3 tablespoons, evenly stirred, taken on an empty stomach, can dispel cold and stop arthralgia, and is suitable for cervical spondylosis with meridian block.
2) Hang Shao Ren Tao porridge.
20g of radix paeoniae alba, 0g of peach kernel15g, and 6g of japonica rice. First, 500 ml of Radix Paeoniae Alba is boiled in water, then the peach kernel is washed and mashed into mud, and water is added to grind the juice to remove residue, and the two juices are cooked with japonica rice. Drinking this porridge can promote blood circulation, nourish blood and dredge collaterals, and is suitable for cervical spondylosis of qi stagnation and blood stasis type.
3), Pueraria Wu Jia porridge
50g of kudzuvine root, 50g of coix seed, 50g of japonica rice and 50g of acanthopanax senticosus15g. Clean all the raw materials, chop up Radix Puerariae, fry Radix Acanthopanacis Senticosi to get juice, put it in a pot with other raw materials, and add appropriate amount of water. Boil with strong fire, simmer into porridge, add appropriate amount of rock sugar, and season. It can dispel wind, remove dampness and relieve pain. It is suitable for cervical spondylosis of wind-cold-dampness arthralgia type.
4) Papaya Chen Pizhou