2. Stewed fish head with gastrodia elata: gastrodia elata 10g, fresh bighead carp 1, and 3 slices of ginger. Put gastrodia elata, bighead carp and ginger in a saucepan, add appropriate amount of water, stew in water and season. This product can tonify liver and kidney, dispel wind and dredge collaterals. Suitable for cervical spondylosis. 1. Most patients are between 40 and 60 years old, with more males than females.
2. Patients have neck, shoulder and arm pain, finger numbness and other symptoms, and some patients may be complicated with vertigo caused by cervical spondylosis of vertebral artery type.
3. The patient's neck rotation or backward extension is restricted.
4. The patient's displaced spinous process and joint capsule have obvious tenderness.
5. The lateral X-ray films of some patients can show the displacement changes of the affected vertebrae; In the normal or oblique position, the posterior edge of vertebral body and uncinate joint show hyperosteogeny, or the anatomical position of the affected vertebra changes. Combined with clinical symptoms and signs, these X-ray changes are of great significance for localized diagnosis. Experts believe that some physiological lordosis of cervical vertebra disappears, and even kyphosis appears. The intervertebral space is narrowed, and there is osteophyte hyperplasia near the vertebral body. There may be cervical spondylolisthesis, calcification of nuchal ligament or calcification of posterior longitudinal ligament. The uncinate joint has osteophyte process to intervertebral foramen, and the intervertebral foramen becomes smaller.
6. Test and inspection
① Brachial plexus traction test was positive: the examiner held the affected side of the patient's head with one hand and the upper limb with the other hand, and pulled it 90 degrees in the opposite direction. If there is radiation pain or numbness, it is positive.
② Positive neck compression test: The patient sat up straight, with his neck extended backward and inclined to the affected side. The patient is positive when the examiner holds the mandible with his left hand and gradually presses his right hand down from the top of his head, or when the examiner puts his palm on the top of his head and presses along the longitudinal axis.
③ The intervertebral foramen compression test was positive: the patient's head deviated to the affected side, and the operator put his left palm on the patient's head, clenched his fist with his right hand and tapped the back of his left hand lightly. Patients with radiation pain in limbs are positive. 1. Cervical spondylotic myelopathy: The typical clinical manifestations of cervical spondylotic myelopathy are mainly the damage of motor neurons in the lower limbs and the damage of motor neurons in the lower limbs. The former mainly reflects the severity of compressed spinal cord injury, while the latter is caused by the simultaneous involvement of corticospinal tract and spinothalamic tract. When the lesion only involves the central gray matter of the spinal cord, especially the anterior horn and/or posterior horn of the spinal cord, the clinical manifestations are mainly paralysis of motor neurons in the lower limbs and weakening or disappearance of tendon reflex, but there is no abnormality in the examination of the lower limbs. This special type of cervical spondylotic myelopathy is rarely mentioned in the previous literature, but in fact this special type of cervical spinal cord injury is not uncommon. Cervical spondylotic myelopathy is easy to be confused when it shows symptoms of one upper limb. At this time, the information provided by MRI is often of great value. Cervical spondylotic radiculopathy can also coexist with cervical spondylotic myelopathy.
2. Occipital and atlantoaxial diseases: Occipital and neck injuries often cause greater occipital neuralgia. The greater occipital nerve is a sensory nerve composed of the posterior branch of the cervical nerve 2, which is difficult to distinguish from the pain caused by the damage of the cervical nerve root 3. Imaging examination is helpful to clarify the cause, and cranial nerve and cerebellar function and fundus examination should be carried out when necessary.
3. Other cervical diseases: such as spinal stenosis, ossification of posterior longitudinal ligament, infection, tumor, etc. Imaging examination can make a definite diagnosis.
4. Lung and mediastinal tumors: For example, tumors in the superior sulcus of the lung can invade the brachial plexus and cause shoulder and arm pain. Physical examination can touch the mass in the supraclavicular fossa, and imaging examination can determine the location and scope of the tumor.
5. Thoracic outlet syndrome: The main causes are cervical spine assist, hypertrophy of anterior scalene muscle, abnormal healing or nonunion of clavicle, coracoid process of scapula or rib 1, etc. The most common symptoms are upper limb pain, numbness or fatigue, followed by shoulder and scapula pain, and then neck pain. According to the different compression components, nerve, artery or vein compression symptoms can be the main symptoms, most of which are mainly manifested as nerve compression symptoms, especially the lower trunk of brachial plexus, so it is often manifested as ulnar nerve innervation damage symptoms. The common physical examination methods are Molly test, Adelson test, Wright test, Eden test and Ruth test. The diagnosis of this disease should be comprehensively judged according to the clinical symptoms and the above-mentioned examination results, and X-ray plain film should be taken routinely. Angiography and electrophysiological examination of blood vessels or brachial plexus are feasible if necessary.
6, brachial plexus neuritis: acute or subacute onset, the first symptom is severe pain in one shoulder and upper limbs, and may be accompanied by fever and other systemic symptoms.
7. Shoulder diseases: such as scapulohumeral periarthritis and rotator cuff injury. Shoulder pain and dyskinesia are prominent symptoms, and they can coexist. Shoulder arthrography and MRI are helpful for definite diagnosis.
8. Neck-shoulder-arm syndrome: The main symptom is radiation pain from neck to shoulders, arms and fingers, which is related to muscle fatigue caused by poor posture of cervical spine.
9. Neck-shoulder-hand syndrome: also known as Steibrocker syndrome, characterized by abnormal autonomic nerve function of upper limbs. In addition to shoulder and finger pain, there are finger swelling, color and temperature changes, and then osteoporosis occurs.
10, upper limb peripheral nerve compression: such as carpal tunnel syndrome, ulnar tunnel syndrome and delayed ulnar nerve injury. According to the corresponding symptoms, signs and neurophysiological examination, the diagnosis can be made. It should be pointed out that patients with cervical spondylosis can be combined with upper limb peripheral nerve compression at the same time.