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(1) development of cervical spinal stenosis
due to the development of cervical, the cellar than normal cervical spinal stenosis. Spinal cord cross-sectional, and both sides of the central position of the season in the adult spinal cord around the central axis of 8-10MM. Drive around the canal is too narrow as it can directly spinal cord compression, nerve root and dural dominated part of the soft tissue fibers also tend to be sympathetic to the oppression caused vasospasm. Developmental cervical canal stenosis is the main cause of cervical spondylotic myelopathy factors. In young patients, although the development of cervical spinal stenosis, but compensatory function. generally no obvious clinical symptoms; adult, because cervical degenerative and often traumatic head or neck injury. This will gradually some symptoms of spinal cord, the spinal X-ray films, the majority of patients with cervical good order, no margin of the vertebral body or hyperostosis displaced, mainly around the performance of spinal stenosis. cervical spinal stenosis in the lower level were heavier.
Asymptomatic adults, the anteroposterior diameter of the cervical spinal canal 2-7 in the following fall 14.5MM developmental spinal stenosis.
(2) spinal stenosis osteitis
patients aged 40 or above, Because cervical disc degeneration, Posterior edge Hyperosteogeny caused various degrees around the spinal canal stenosis. For the most common type of nerve root and spinal vertebral artery or the incidence of cervical syndrome, 4-6 cervical spinal stenosis of the cervical spine, and some patients in the cervical three or cervical 7. Spinal stenosis can also arise because the symptoms of spinal cord compression.
Clinical many adults and the elderly, although the vertebral bone hyperplasia. However, because of its larger canal diameter, and have no symptoms.
(3) failure spinal stenosis
mostly middle-aged and older patients with unstable cervical spine due to cervical disc. organizations such as ligament and joint degeneration or injury; younger patients because of the neck injury Erzhi cervical subluxation; a few patients with cervical spondylosis after the surgery, because the adjacent cervical compensatory activities increased instability, cervical flexion injury patients As atlantal ligament injury, before meandering forward displacement of the atlas. Reached 3-10MM atlantoodontoid interval, the range of activities that can transposition 1-4MM cervical instability. geopolitical shift after the next after the next cervical vertebral arch on the margin of cervical spinal stenosis, with severe symptoms, activities are often limited posterior neck, neck muscle tension or muscle cramps, and some patients for neck extension activities. limbs and trunk are numbness, which may be lower limb muscle twitch. This is because the spinal cord compression by the pathological phenomenon.
(4) cervical ossification of the posterior longitudinal ligament "behind" body after learning of cervical ligament attachment. ossification of the ligamentum flavum due to its size, it will trail after spinal canal stenosis, cervical neck lesions often Carotid-4 Carotid 5-under cervical carotid 6. Wide upper cervical spinal canal, ossification of the posterior longitudinal ligament lesion not cause obvious symptoms of spinal cord compression. Ossification of the case more fully, partial lifting of the dynamics of the disease, with mild symptoms, Drive after spinal stenosis, although 10-11MM conspicuous, but not a serious spinal cord injury phenomenon.
(5) compensatory spinal stenosis
cervical lordosis and performance curves can be represented as spinal lesions compensatory lesions, as the following types of clinical disease and can cause excessive neck extension song change.
① vertebral axial and transverse ligament injury with odontoid hypoplasia, the atlas often dislocation; atlanto-occipital vertebral fusion congenital malformation, a narrow foramen magnum Department changed, the upper cervical cord and lower medulla which suffered oppression. By the body to ease the nerve tissue injury, was compensatory hyperextension cervical posture, neck and shoulder muscle tension.
Second, to maintain a normal anatomy and physiology of Body Balance, cervical, thoracic, lumbar curve has certain physiological. Thoracic kyphosis deformation due to some disease, patients can have a compensatory excessive extension of cervical curve. Some patients with decompensated cervical extension of the gravity of the cervical spine X-ray film of arch obvious overlap, on the margin of arch protruding into the spinal canal, the anteroposterior diameter of the spinal canal stenosis was changed.
(6) rheumatoid lesions Erzhi atlantoaxial subluxation cervical rheumatoid arthritis may be involved, longer duration, older patients with atlantoaxial subluxation can be patient symptoms after shoulder and neck pain; Atlas forward led atlas narrow spinal canal diameter obviously there will be symptoms of spinal cord compression.
Inspection found neck rotation restricted to the side of the upper cervical spine movement tenderness; greater occipital nerve passed through from the Ministry of atlantoaxial arch tenderness, or showed signs of pyramidal tract damage. Such patients have a long history of rheumatoid-news section. 颈椎由于发育因素，各颈椎的椎管窖较正常狭窄。颈髓横断面，中央部较厚而两侧较薄，在成人的颈髓中部前后径为8－10MM，椎管前后径如过于狭小，可以直接压迫颈髓、神经根及硬膜，支配部分软组织的交感神经纤维也容易被压迫而引起血管痉挛。颈椎管发育性狭窄是引起脊髓型颈椎病的主要因素。 病人在青少年时期，虽然有颈椎椎管发育性狭窄的现象，但由于代偿功能，一般都没有明显的临床症状；成年以后，因为颈椎发生退变，而头颈部经常受到外伤或劳损，这样可逐渐出现一些脊髓症状，颈椎的X线片检查，多数病人颈椎排列良好，无明显的椎体的后缘骨质增生或移位，主要表现为椎管前后狭窄，在颈椎中下部椎管狭窄的程度较重。%26;#13;%26;#10; 无症状的成年人，颈椎2－7椎管的前后径在14．5MM以下属于发育性椎管狭窄。%26;#13;%26;#10; （2）骨质增生性椎管狭窄%26;#13;%26;#10; 病人年龄为40岁以上，由于颈椎椎间盘退变，椎体后缘骨质增生，引起椎管前后呈不同程度的狭窄。为临床上常见的神经根型，椎动脉型或脊髓型颈椎综合征的发病原因，椎管狭窄部位在颈椎4－颈椎6，部分病人在颈椎3或颈椎7。椎管狭窄还可以因为压迫脊髓而出现症状，%26;#13;%26;#10; 临床上不少成年人或老年人，虽然椎体骨质增生明显。但因为其椎管前后径较大，而没有任何症状。%26;#13;%26;#10; （3）失稳性椎管狭窄%26;#13;%26;#10; 颈椎失稳多为中年以上的病人，因颈椎间盘，韧带及关节囊等组织退变或损伤造成；年纪较轻的病人可因为颈部外伤而致颈椎半脱位；少数病人因颈椎病手术之后，相邻颈椎因为代偿性活动增大而失稳，颈椎屈曲性损伤的病人，由于寰椎横韧带损伤，前曲时寰椎向前移位。寰齿间距达3－10MM，后伸活动时，失稳颈椎可后移位1－4MM，后移颈椎的椎体下后缘下一颈椎椎弓上缘形成椎管狭窄区，症状较重者，颈部后侧活动常常限，后颈部肌张力增高或肌肉痉挛，部分病人作颈部后伸活动时，肢体和躯干部有麻木感，下肢可出现肌肉抽搐。这是因为颈髓受压迫的病理现象。%26;#13;%26;#10; （4）颈椎后纵韧带骨化%26;#13;%26;#10; 颈椎体体后面有后绷韧带附着，其韧带骨化后由于体积增大，可使椎管前后径狭窄，上颈段病变常常累及颈2－颈4，下颈段累及颈5－颈6。上颈椎椎管较宽，后纵韧带骨化病变多不引起明显的脊髓压迫症状。骨化较完全的病例，局部稳定，解除了动态的致病的因素，症状较轻者，椎管彰后径狭窄程度虽然达10－11MM，但大都不出现严重的脊髓损伤现象。%26;#13;%26;#10; （5）代偿性椎管狭窄%26;#13;%26;#10; 颈椎生理前凸曲线可以由于脊柱的病变而表现为代偿性的病变，临床上可以因为以下几种病因而引起颈曲过度后伸改变。%26;#13;%26;#10; ①椎横韧带损伤和枢椎齿状突有发育不全时，寰椎常发生前脱位；寰枕椎有先天性融合畸形，枕骨大孔部有窄变，而使延髓下部及上颈髓部受压迫。机体为缓解上以的神经组织损伤，呈代偿性颈椎过伸体位，颈、肩部肌张力增高。%26;#13;%26;#10; ②适应正常生理解剖和保持人体重心平衡，颈、胸、腰椎具有一定的生理曲线。胸椎因某些病变后凸变形，病人可以出现代偿性颈椎过度后伸曲线。部分病人代偿性颈椎后伸的程度严重，在颈椎X线侧位片可见椎弓明显重叠，椎弓上缘可突入椎管，该椎管的前后径呈狭窄性改变。%26;#13;%26;#10; （6）类风湿性病变而致寰枢椎半脱位类风湿性关节炎可累及颈椎，病程长，年龄大的病人可合并寰枢椎半脱位，病人症状为后颈部及肩疼痛；寰椎前移导致寰椎椎管前后径明显这窄者可出现脊髓压迫症状.%26;#13;%26;#10; 检查时发现颈部旋转运动受限，上颈椎向一侧移位，压痛；枕大神经从寰枢椎椎弓穿出部压痛，或呈锥体束损害体征，这类病人有长期的类风湿性闻节炎病史。" name=content>
This article was posted on 2007-02-27
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