Vertebral disease

　　1. Incorrect posture, such as: sitting posture, standing posture, lying posture, and long-term work in the same posture at the desk or other labor.

　　2. Unreasonable bedding can cause excessive tension of the ligaments and muscles, leading to fatigue, herniated intervertebral discs, and dysfunction of the small joints.

　　3. Attacks of wind and cold, dampness, affecting local blood circulation, accelerate tissue degeneration.

　　4. Trauma can worsen the condition, and chronic injury gradually leads to exacerbation of the disease.

　　5. Psychological factors and poor overall health may cause or worsen the symptoms of vertebral disease.

　　(1) Dysphagia: It is characterized by a feeling of obstruction during swallowing, a foreign body sensation in the esophagus, and some may experience nausea, vomiting, hoarseness, dry cough, oppression in the chest, and other symptoms. This is due to the narrowing of the esophagus caused by direct compression of the posterior wall of the esophagus by the anterior edge of the vertebral body, or it may be caused by a rapid formation of osteophytes, which stimulates the surrounding soft tissue of the esophagus.

　　(2) Visual impairment: It manifests as a decrease in vision, eye pain, photophobia, lacrimation, unequal pupil size, and even narrowing of the visual field and sharp decrease in vision. Some patients may even go blind. This is related to the ischemic damage to the occipital lobe of the brain caused by autonomic nervous system disorder and insufficient blood supply from the vertebral basilar artery due to cervical spondylosis.

　　(3) Cervical heart syndrome: It manifests as chest pain, oppression, arrhythmia (such as mid-diastolic), and changes in the ST segment of the electrocardiogram, which is easily misdiagnosed as coronary artery disease. This is caused by the stimulation and compression of the cervical dorsal root by cervical osteophytes.

　　(4) Hypertensive cervical spondylosis: It can cause an increase or decrease in blood pressure, with an increase in blood pressure being more common, known as 'cervical hypertension'. Since both cervical spondylosis and hypertension are common diseases in middle-aged and elderly people, they often coexist.

　　(5) Chest pain: It manifests as chronic, unilateral pain in the pectoralis major muscle and breast, with tenderness in the pectoralis major muscle during examination. This is related to the compression of the C6 and C7 nerve roots by cervical osteophytes.

　　(6) Paraplegia: Early symptoms include numbness, pain, and limping in the lower limbs. Some patients may feel as if they are walking on cotton, and some may also experience urinary and fecal incontinence, such as frequent urination, urgency, difficulty in urination, or incontinence of stools and urine. This is due to the stimulation or compression of the lateral column of the vertebral body by cervical osteophytes, leading to motor and sensory disorders in the lower limbs.

　　(7) Sudden collapse: It often occurs when suddenly turning the head while standing or walking, causing the body to lose support and collapse. After falling, consciousness can be quickly recovered, without any loss of consciousness or sequelae. Such patients may have symptoms of autonomic nervous system dysfunction, such as dizziness, nausea, vomiting, sweating, etc. This is due to the compressive change of the cervical spine causing basilar artery blood supply disorders, leading to temporary insufficient blood supply to the brain.

　　Vertebral disease is closely related to osteophytes. Osteophytes, also known as bone spurs, are often considered 'bad things', but some of these understandings are one-sided. The formation of osteophytes is a kind of compensatory function of the human body. The osteophytes that have grown limit the range of movement of the bone joints, thereby reducing joint wear and preventing excessive joint movement from causing new injuries, which objectively plays a protective role for the joints and is beneficial to the human body. However, the formation of osteophytes also causes joint pain and limited movement, and a few patients may appear pathological symptoms caused by compression of surrounding blood vessels or nerves, known as osteophyte syndrome. This is not beneficial to the human body.

     Osteophytes mainly occur in joints that bear a large amount of weight and are highly active in the human body, such as the cervical spine, lumbar spine, hip joint, knee joint, and heel, with the cervical spine, lumbar spine, and knee joint being common. The development process of vertebral disease is gradually worsening. For example, in cervical spondylosis, the symptoms of patients are not obvious at the beginning, just existing neck muscle injury, myofascialitis, and small joint dislocation. Gradually, intervertebral disc prolapse occurs, leading to symptoms such as neck and shoulder pain, headache, dizziness, numbness of hands and feet, memory loss, and 'half-body sweating and half-body dryness'. Cervical spondylosis can lead to insufficient blood supply to the brain, causing 'cervical-gastric syndrome' and 'cervical-cardiac syndrome', and severe cases can lead to the loss of working ability.

　　(1) The pillow should not be too high or too hard, and the height should be about 10 centimeters. A high pillow can cause the cervical spine to over-curve at night. When sleeping, it is recommended to use a soft and hard suitable lumbar support mattress, which can support and assist the growth of the spine to effectively suppress hunchback. A hard mattress is easy to cause the spine to lose its curve, and a soft mattress is easy to cause hunchback.

　　(2) Long-term work or study in one posture can cause the muscles to become tense. At this time, it is recommended to do some 'anti-functional position' exercises. For example, you can do more 'kite flying' type tilting movements; after bending forward to work, you can do backward bending exercises to maintain the balance between nerves, muscles, and soft tissues.

　　(3) Pay attention to keeping the neck warm. The blood circulation of the neck muscles is slow, and the excretion of metabolic substances is also slow. Not paying attention to neck protection in autumn and winter can easily lead to coldness in the cervical spine, increasing the risk of disease.

　　(4) When making a phone call, do not use your neck to hold the phone to free up your hands. Holding the phone between the chin and shoulder is a very difficult action for the neck and shoulders, with one side of the muscle stretched and the other side contracted, which will cause the cervical spine to be very tired, and some blood vessels and nerves will be compressed, leading to inflammation and pain.

　　(5) Do not carry a heavy backpack, read while sitting, and keep the book at an angle of 10 to 30 degrees to prevent cervical fatigue.

　　(6) It is not advisable to face the direction of the car's movement when riding in a car. Otherwise, when an emergency brake is applied, the body will suddenly move forward, causing the cervical and lumbar vertebrae to possibly dislocate forward and backward under the force, resulting in a transverse spinal cord injury. It is recommended to adopt a side seat or semi-side seat posture to avoid causing significant damage to the cervical spine.

　　(7) Avoid obesity. Obesity can place excessive load on the spine, and due to relaxed abdominal muscles, it cannot support the spine, leading to a potbelly that can force the spine to deform.

　　(8) Learn to relax. Tension can increase hormones in the blood, causing the intervertebral disc to swell and leading to lower back pain. Therefore, a cheerful mood is also a good way to prevent and treat vertebral disease.

　　(9) Correct sitting posture. If the body bends forward while sitting or standing, it will cause the nerves and muscles in the lumbar and back to be stretched, leading to pain. Therefore, try to keep the back close to the chair back while sitting or standing to relax and rest the lumbar muscles. Writing and stopping, extending the waist backward is also a good way to prevent lower back pain.

　　(10) Choose appropriate exercises. Swimming is an effective exercise to strengthen the lumbar and back muscles, and it has a good therapeutic effect on cervical spondylosis, neck and shoulder pain, and lumbar and knee joint pain. However, diving, playing baseball, golf, or doing gymnastics can increase the risk of lower back pain. Contracting the abdominal muscles, stretching the lumbar muscles, and walking, swinging the waist, and cycling can prevent and alleviate lower back pain.

　　(11) When overworked, take a hot bath at home or do relaxing exercises (such as front and back shoulder rotation, patting the shoulders and back, stretching, etc., which can be self-invented and practiced). This helps to relieve fatigue and reduce chronic injury.

　　Intervertebral Foramen Compression Test, Brachial Plexus Stretch Test, Spinal X-ray, Cervical CT Examination

　　Electromyography

　　Cervical Spine Test Examination

　　The test examination for cervical spondylosis is a physical examination that does not require the use of instruments. It includes:

　　(1) Forward Flexion and Neck Rotation Test: Instruct the patient to flex their neck forward and rotate it to the left and right. If pain occurs in the cervical spine, it indicates degenerative changes in the cervical spine joints.

　　(2) Intervertebral Foramen Compression Test (Cranial Pressure Test): Instruct the patient to tilt their head to the affected side. The examiner places their left palm on the top of the patient's head and their right fist gently taps the back of their left hand. If radiation pain or numbness in the limbs occurs, it indicates that the force is transmitted downward to the narrowed intervertebral foramen, suggesting radicular damage. For patients with severe radicular pain, the examiner can place both hands on top of the head and apply pressure downward to induce or exacerbate the symptoms. A positive Jackson's craniocervical compression test is when the patient's head is in a neutral or extended position and a compression test is positive.

　　(3) Brachial Plexus Stretch Test: The patient tilts their head down, and the examiner supports the patient's neck and head with one hand while holding the patient's affected wrist with the other. The examiner performs opposite-direction push-pull movements to see if the patient feels radiation pain or numbness, which is called the Eaten test. If, at the same time, the examiner forces the affected limb to perform an internal rotation, it is called the Eaten strengthened test.

　　(4) Upper Limb Extension Test: The examiner places one hand on the healthy shoulder to stabilize it, and the other hand holds the patient's wrist, gradually extending it backward and outward to increase the traction on the cervical nerve roots. If the affected limb experiences radiation pain, it indicates that the cervical nerve roots or brachial plexus are compressed or damaged.

　　CT Examination

　　About 90% of men over 40 years old and women over 45 years old have osteophytes in the vertebral bodies of the cervical spine. Therefore, there may be changes in X-ray films, but not necessarily clinical symptoms. The following is a description of the X-ray findings related to cervical spondylosis:

　　Frontal Position

　　Observe for any subluxation of the atlantoaxial joint, odontoid fracture or absence. Whether the transverse process of the seventh cervical vertebra is elongated, and whether there is a cervical rib. Whether the uncinate process and vertebral space are widened or narrowed.

　　Scoliosis of the spine

　　(1) Change in curvature: The cervical spine becomes straight, the physiological forward bulge disappears, or it becomes hypercurved.

　　(2) Abnormal mobility: In the lateral oblique X-ray film of the cervical spine, changes in the elasticity of the intervertebral disc can be seen.

　　(3) Osteophytes: Osteophytes and ligament calcification can occur at the areas near the intervertebral disc on both sides of the vertebral body.

　　(4) Narrowing of the vertebral space: The intervertebral disc can become thinner due to the protrusion of the nucleus pulposus, the reduction of water content in the disc, and the fibrous degeneration, which is manifested on X-ray films as narrowing of the vertebral space.

　　(5) Subluxation and narrowing of the intervertebral foramen: After disc degeneration, the stability between vertebral bodies is reduced, and vertebral bodies often undergo subluxation, or what is called spondylolisthesis.

　　(6) Calcification of the nuchal ligament: Calcification of the nuchal ligament is one of the typical changes in cervical spondylosis.

　　Oblique Position

　　Obtaining lateral oblique X-rays of the spine is mainly used to observe the size of the intervertebral foramen and the condition of osteophytes in the uncinate process.

　　Electromyogram Examination

　　The electromyogram of muscle in patients with vertebral disease and cervical disc herniation is due to the fact that both cervical spondylosis and cervical disc herniation can cause long-term compression of the nerve roots, leading to degeneration and losing the inhibitory effect on the muscles they支配.

　　Balanced Diet: Dietary balance is essential and should not be one-sided. Foods are generally divided into two categories: one is staple food, which mainly provides energy, such as rice and noodles; the other is supplementary food, which can regulate physiological functions, such as beans, fruits, and vegetables. The nutrients in staple foods vary, and both coarse and fine foods should be eaten together, without being one-sided. A balanced diet with a combination of coarse and fine, dry and wet, and main and supplementary foods can meet the needs of the human body and promote the recovery of patients and maintain the normal needs of the human body.

　　Dietary Treatment: As cervical spondylosis is caused by conditions such as vertebral hyperplasia and osteoporosis, patients with cervical spondylosis should focus on a diet rich in calcium, protein, vitamin B complex, vitamin C, and vitamin E. Calcium is the main component of bones, and is abundant in milk, fish, pork tails, soybeans, and black beans. Protein is an essential nutrient for the formation of ligaments, bones, and muscles. Vitamins B and E can alleviate pain and relieve fatigue. Additionally, if the cervical spondylosis is due to damp-heat blocking the meridians, it is recommended to eat more fruits and vegetables such as kudzu root, bitter melon, and loofah to clear heat and relieve muscle tension. If it is due to cold-damp blocking the meridians, it is recommended to eat more foods like dog meat and lamb to warm the meridians and dispel cold. If it is due to blood deficiency and qi stagnation, it is recommended to eat more foods like rooster, crucian carp, and black beans. In summary, proper dietary treatment can benefit the recovery of patients with cervical spondylosis.

　　Moderate Diet: The diet of patients with spinal diseases should be moderate, and they should not overeat. The yin and yang of the human body are balanced. Overeating or excessive coldness and heat in diet can lead to disharmony of yin and yang and damage the internal organs. Long-term consumption of cold and cool foods can damage the Yang of the spleen and stomach, leading to endogenous cold and dampness, thereby aggravating the symptoms of cervical spondylosis.

　　Clinically, the treatment of spinal diseases mainly adopts two methods, namely surgical treatment and non-surgical treatment. Surgical treatment is mainly for patients with severe symptoms, who have been ineffective after strict non-surgical treatment and can still tolerate surgery, and non-surgical treatment commonly used clinical methods include the following:

　　1) Traction: By external force or the body's own gravity, the gap between the vertebral bodies is widened, which is conducive to the recovery of the nucleus pulposus, the restoration of normal vertebral alignment, the relaxation of ligament tension, and thus the reduction of pressure and stimulation on the spinal cord and spinal nerve roots.

　　2) Minimally Invasive Therapy: 'Hook Activity Technique', this therapy is safe and effective. It uses the principles of traditional Chinese medicine to relieve the pressure and tension around the lesion, release the adhesions of tissues, muscles, ligaments, and fascia to achieve the effect of immediate balance, and finally achieve the purpose of curing the disease.

　　Stabilization and Bracing: By using定型 pillow, neck collar, and lumbar belt to stabilize and brace the cervical and lumbar vertebrae, it can reduce further injury and is conducive to the repair of the injury.

　　Manual Massage and Acupressure: By special techniques, the vertebrae and small joints are restored to their normal physiological position and normal physiological curve, thus achieving the purpose of rehabilitation.

　　3) Physical Therapy: By various physical factors acting on the human body (such as infrared rays, magnetism, electricity), it plays the role of anti-inflammatory, analgesic, and accelerating recovery, which is very effective for improving clinical symptoms.

　　4) Closure: The drug is distributed locally to the patient, with a relatively obvious effect, but it is not suitable for long-term use