Radicular and vascular syndromes of cervical osteochondrosis

These neurological disorders are associated with discogenic damage and occur in the form of cervicobrachialgia. They are characterized by pain and hypesthesia in the radicular zone of innervation, hypotrophy and weakness of the corresponding muscles, a decrease or absence of reflexes. Often the development of radicular syndrome is preceded by zone paresthesia. More often the roots of the spinal nerves Cvi and Cvii suffer, combined lesions of several roots, as well as a combination of radicular syndromes with others can be observed.

When Ciii root is affected, the pain is localized in the corresponding half of the neck and tongue. With damage to the root of the spinal nerve Civ, pain appears in the shoulder girdle, clavicle. Atrophy of the back muscles of the neck develops, their tone decreases. With irritation of the roots of the spinal nerves CIII – CIV, the tone of the diaphragm increases. With the loss of function of roots CIII – Civ, diaphragm relaxation is noted, which leads to subdiaphragmatic accumulation of gas in the stomach and intestines, raising the diaphragm on the affected side. Hiccups, dysphagia appear.

The most common is the defeat of the roots of Cvi — Cvii. All these phenomena are amplified by head movements. Hypesthesia in the dermis of the Cvi atom, weakness and hypofunction of the biceps muscle, a decrease or absence of the flexion elbow reflex are revealed. This pain is aggravated by head movements.

In case of damage to the root of the spinal nerve CVIII, pain from the neck radiates to the ulnar edge of the forearm and to the little finger, hypalgesia is noted in the innervation zone of the CVIII root, a decrease or loss of spinoradial and instep reflexes. Vegetative-vascular syndromes are manifested by vascular and autonomic disorders in the innervation zone of the corresponding roots.

Vascular syndromes of cervical osteochondrosis

In essence, these are reflex and compression syndromes with craniocerebral and visceral disorders. With the fixation of vertebral arteries in the canal, the unevenness of their caliber, trauma to the sympathetic plexus, neurovascular intracerebral disorders develop, which are especially pronounced with a combination of cervical osteochondrosis with atherosclerosis, arterial hyper- or hypotension with cerebrovascular insufficiency.

Of the neurological syndromes, the most common posterior cervical sympathetic syndrome (vertebral artery or vertebral nerve syndrome) is Barre Lieu, which is characterized by pain in the back of the head and vasomotor disorders, pain and tinnitus, dizziness, eye symptoms (eye pain, decreased vision), laryngeal and pharyngeal symptoms (dysphonia, dysphagia, pharyngeal paresthesia). Bertsha-Rocher called this symptom complex “cervical migraine syndrome”, since it is accompanied by hemicranialgia or pain localized in the back of the head, frontal region, face, and other manifestations of cervical osteochondrosis (A. Yu. Ratner).

The disease occurs after an injury to the cervical spine and is characterized by remitting or progressive course. Hematrophy of the tongue associated with impaired function of the hyoid nerve, epileitis-shaped disorders in the form of short-term loss of consciousness, bouts of narcolepsy, and sometimes convulsive seizures are observed. Patients may develop hypochondriacal conditions. The pathology of the cervical sympathetic formations violates the innervation of the heart, receiving impulses from the cervical sympathetic nodes.

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