Pathology of the cervical spine. Cervical spine instability

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The human spine is the basis of the musculoskeletal system. At the same time, it not only performs a supporting function and provides the ability to walk upright, but also represents a fairly flexible axis of the body, which is achieved due to the mobility of the vast majority of its individual parts. In this case, the anterior part of the spine participates in the formation of the walls of the thoracic and abdominal cavities. But one of its most important functions is to ensure the safety of the spinal cord that runs inside it.

Features of the structure of the cervical spine

The human spine consists of 24 vertebrae and four sections . Each of them has significant differences in its structure and number of vertebrae. In the thoracic region they are largest in size.

In the lumbar region they are located very close to each other, and as they approach the coccygeal area they become fused. The cervical spine is considered the most fragile, but it is its thin structure that ensures the quality of mobility and allows you to make a variety of head movements.

The cervical region consists of seven vertebrae . Each of them is different in its structure. Due to their small size and weakness of the neck muscles, this section is often subject to injury.

The cervical spine consists of seven vertebrae

The peculiarity of the structure of the cervical vertebrae is significant differences from the vertebrae of all other parts of the spine . Most vertebrae consist of an anterior section called the vertebral body, which is cylindrical in shape; the spinal cord, located inside the spine at the back and limited by the vertebral arch; they also have spinous processes pierced by openings for blood vessels.

The structure of the cervical vertebrae is different, which is due to the peculiarities of their functions, including attachment to the skull, protection of the spinal cord, providing nutrition to the brain and performing various head movements.

What to do if a vertebra protrudes?

Excessive protrusion of the 7th vertebra is popularly called “dower’s hump.” In fact, it is an accumulation of adipose tissue, which is localized in the projection of this part of the cervical spine. The protrusion of the seventh vertebra creates not only an aesthetic defect.

Pathological growth of adipose tissue leads to compression of the carotid artery, which supplies brain tissue. The result of this problem is dizziness, headache attacks, periodic loss of consciousness, and unstable intracranial pressure.

The method of getting rid of excessive protrusion of the 7th vertebra depends on the reasons that provoked its growth with fat.

In most cases, the following methods of health therapy are used:

• compliance with the norms of an “anti-fat” diet, when a person completely refuses to eat fats of animal and plant origin;
• daily massage of the cervical spine with direct impact on the surface of fat deposits;
• physiotherapy with ultrasound and weak impulses of electric current;
• performing morning exercises, which includes active warm-up of the cervical spine;
• taking estrogen-based medications if the formation of a “dower’s hump” is caused by a decrease in the natural level of estrogen after menopause.

A radical way to get rid of the effect of the bulging 7th vertebra is to perform a surgical operation to remove excess fatty tissue. In this case, the liposuction method is used.

Structure and functions of the cervical vertebrae

The very first vertebra of this section, located at the top, is called “atlas” . It is axial and does not have a body or spinous process. In this area, it allows you to connect the spinal column with the occipital bone, as well as the brain and spinal cord with each other.

These tasks determine its structure : it consists of two arches that border the spinal canal. The anterior arch forms a small tubercle. Behind it there is a depression combined with the odontoid process of the second vertebra.

On the posterior arch there is a groove where the vertebral artery is located. The articular part of the “atlas”, located on top, has a convex shape, and the bottom is flat. This structural feature is due to the intermediate position of the vertebra between the spine and the head.

The second vertebra, called the "axis" , is also distinguished by its shape, which resembles a pointed "tooth". It functions as a “hinge” that ensures rotation of the first vertebra of the atlas along with the skull, as well as the ability to tilt the head in different directions.

There is no intervertebral disc in the space between the atlas and axis . Their connection is formed like a joint. It is this factor that causes a high risk of injury.

The structure of the atlas and axis

The cervical vertebrae from the third to the sixth are small . Each of them has a fairly large hole, similar in shape to a triangle. Their upper edges protrude slightly, which is why they are compared to “sides.” Their articular processes are short and located at a slight angle.

The vertebrae from the third to the fifth also have small transverse processes that are split at the edges. These processes contain openings through which blood vessels pass. This is where the main vertebral artery that supplies the brain is located.

In the next area, where the sixth and seventh vertebrae are located, the spinal column has a slight expansion . This is where salt deposition most often occurs. The sixth vertebra is called “carotid” because its tubercle, located in front, is located near the carotid artery. It is against this that the artery is pressed to stop the bleeding.

The largest in the last section of the cervical region here is the seventh vertebra . This is what you can feel with your hands if you tilt your head forward. For the same reason, he is also called a speaker. In addition, it serves as the main guideline when counting vertebrae. The lower part of this vertebra has a depression.

Here is where it connects with the first rib. A special feature of the seventh vertebra is the holes in the area of ​​the transverse processes, which can be very small in size or completely absent. It has the longest spinous process, without divisions into parts.

Each of the cervical vertebrae is responsible for a specific function.

When they are damaged, unpleasant phenomena occur that correspond to each specific vertebra, such as:

Modern methods of treating pathologies of the 7th vertebra

To treat diseases of the seventh vertebra, medications, physical therapy and surgery are used. For each patient, an individual treatment regimen is drawn up, which is developed based on the results of a diagnostic examination.

Medicines

The use of drug therapy is aimed at reducing the inflammatory process in the bone and connective tissue of the 7th vertebra and restoring normal mobility of the cervical spine.

Chondroprotectors

Chondroprotectors are a separate category of drugs that are available in the form of capsules, tablets, ointments, injection solutions or bulk powder. Most drugs in this category contain the active substance chondroitin sulfate.

This component prevents further progression of degenerative and atrophic processes and acts as a means to prevent the destruction of intervertebral disc tissue. Chondroprotectors are actively used to treat joints, but also support the health of the spine.

Patients with pathologies of the 7th vertebra can be prescribed the following drugs in this category:

• Artrakam;

• Don;
• Artradol;
• Rumalon;
• Artra;
• Structum;
• Chondrogard.

Maximum therapeutic effectiveness from treatment with drugs from the group of chondroprotectors is achieved if they are prescribed with simultaneous treatment with anti-inflammatory drugs.

Nonsteroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs are drugs that suppress acute and chronic inflammation in the tissues of the 7th vertebra, and also eliminate pain. Medicines in this category are produced in the form of ointments, capsules, tablets, injection solutions and rectal suppositories.

The mechanism of action of non-steroidal anti-inflammatory drugs is to inhibit the synthesis of prostaglandin hormones, the increase of which leads to the development of inflammation and pain.

Patients with pathologies of the seventh vertebra can be prescribed the following medications of this group:

• Ketoprofen;
• Piroxicam;
• Diclofenac;
• Nimesulide;
• Ibuprofen;
• Napraxen.

For successful treatment with nonsteroidal anti-inflammatory drugs, it is necessary to eliminate the underlying cause that causes the pathological condition of the 7th vertebra of the cervical spine.

Otherwise, taking drugs from this group will only lead to temporary relief.

Non-drug methods

Non-drug methods of treating diseases of the 7th vertebra of the cervical spine include the following types of physiotherapeutic procedures:

• performing applications based on therapeutic mud;
• reflexology using weak pulses of electric current;
• exposure of biologically active points with needles;
• removal of salt deposits in the area of ​​the 7th vertebra using therapeutic massage;
• taking mineral baths;
• warming up the collar area using electrophoresis.

A non-drug method of treating pathological conditions of the 7th vertebra is determined by a physiotherapist, surgeon or rehabilitation specialist, depending on the type of diagnosed disease. Dislocation or displacement of this part of the cervical spine can be eliminated using manual therapy techniques. In this case, the chiropractor adjusts the seventh vertebra, restoring its anatomically correct location.

Surgery

Surgery is a radical method of treating pathologies of the 7th vertebra of the cervical spine. A similar method of therapy is used for patients with a herniated disc, which is localized in this part of the musculoskeletal system.

The algorithm for this operation is as follows:

1. The patient receives general anesthesia.
2. The surgeon makes a small tissue incision above the 7th vertebra.
3. A hernia is detected using an operating microscope.
4. The hernial formation is removed.
5. The wound surface is sutured.

Depending on the severity of the pathology, after removal of the hernia, the patient may require prosthetic replacement of the injured 7th vertebra.

The seventh vertebra is located in the lower part of the cervical spine. This is the largest structural element of the spinal column and serves as a support for all the other 6 vertebrae of the neck. This area of ​​the human musculoskeletal system is considered the most vulnerable to traumatic injuries and is prone to the development of degenerative and inflammatory processes.

The healthy state of the 7th vertebra allows a person to quickly turn his head in different directions, bend, and change body position. Inflammation of the bone and connective tissue in the area of ​​the 7th vertebra leads to the development of pain, stiffness of movement, attacks of dizziness and migraines.

Paravertebral muscles of the cervical spine

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The muscle tissue of this part of the spine is divided into two parts: posterior and anterior. The muscles located in the front are divided into superficial, deep and medial.

The muscular apparatus of the cervical spine ensures that the head is held and rotated. The main functions of the tissues of the neck muscles are as follows:

• maintaining the skull in balance;
• ensuring head movement: rotation and tilting;
• ensuring swallowing processes and voice function.

The muscle tissues of the cervical region are connected using special fascia and blood vessels, which serve as natural boundaries for different areas.

There are several main muscle groups:

• subcutaneous muscles;
• muscles covering the surface of the neck;
• The scapuloclavicular muscles are necessary to create space for placing muscle tissue above the chest.

The muscles located inside the neck are made up of visceral plates that are needed to line the organs inside the neck. They form the areas in which the veins and carotid artery are located. The plate placed in front of the vertebra is needed to create an area for deep muscles.

Treatment of C6-C7 hernia without surgery

If the hernia has not yet reached a large size and has not undergone sequestration, treatment always begins with the use of conservative methods. With the correct selection of treatment strategy, it is often possible to achieve good results and significantly improve the patient’s condition.

Almost always, conservative treatment is complex. But exactly which components will be used in a particular case, the doctor determines individually based on the size, location of the hernia and the severity of neurological disorders.

Components of conservative therapy may include:

• drug therapy;
• osteopathy;
• manual therapy;
• massage;
• physiotherapy (phonophoresis, carboxytherapy, ozone therapy);
• individual sessions with a rehabilitation doctor.

Patients are definitely advised to change their lifestyle and habits. Thus, for office workers and representatives of other “sedentary” professions, it is recommended to take a break from work every hour and do a light warm-up or at least walk for 5-15 minutes. If, on the contrary, a person is engaged in heavy physical labor, it is worth considering the possibility of reducing the load on the neck or changing the type of activity.

If you are overweight, it is recommended, together with a nutritionist, to develop a diet that will ensure that the body receives all the necessary substances, but will not be high in calories. With the help of a properly designed diet, it is possible not only to gradually reduce weight, but also to maintain it at the desired levels without making much effort.

In some cases, the neurologist recommends wearing a special neck brace - the Chance collar. It will reduce the load on the neck muscles and create conditions for the restoration of the affected C6-C7 disc.

Drug therapy

The main objectives of drug treatment are to eliminate pain, inflammation and create conditions for the natural processes of disc restoration to take place fully. Therefore, patients are prescribed a complex of medications, including drugs from the following groups:

• NSAIDs are medications designed to reduce the severity of pain and have an anti-inflammatory effect;
• muscle relaxants – a group of drugs that reduce increased muscle tone, which is the body’s reflex response to pain and increases it;
• corticosteroids – drugs with pronounced anti-inflammatory properties, prescribed in short courses;
• B vitamins – improve the conductivity of bioelectric impulses along nerve fibers;
• chondroprotectors are drugs that promote the restoration of cartilage tissue, but the effectiveness of their use for intervertebral hernias is highly questionable.

If the patient suffers from severe pain in the neck, they can be quickly relieved with the help of blockades. The procedure involves injecting anesthetic solutions along with corticosteroids directly into the area where the pinched nerve fibers pass. It is performed only in a medical facility by experienced specialists, as it requires specific knowledge and skills. An error by medical staff when performing a blockade can result in disastrous consequences for the patient.

Exercise therapy

Therapeutic exercise is widely used in the treatment of intervertebral hernias C6-C7. Exercises specially selected taking into account the size, location of the protrusion and the level of physical development of the patient help strengthen the neck muscles, which creates reliable support for the spine. Exercise therapy also activates blood circulation and increases the intensity of metabolic processes.

But for each patient, a set of exercises must be developed strictly individually by a rehabilitation physician in strict accordance with his diagnosis. Moreover, the first classes are conducted under the supervision of a specialist who will help you master the correct technique for performing each exercise and will outline a program for further increasing the load.

When practicing physical therapy, it is important to perform all movements slowly, avoiding sudden jerks and turns. If you experience discomfort or pain in the neck, you should immediately consult your doctor.

Physiotherapy

To reduce the severity of the inflammatory process, pain, activate blood circulation and improve the general condition of patients, courses are prescribed:

• electrophoresis;
• laser therapy;
• ultrasound therapy;
• traction therapy (spinal traction);
• UHF.

Traction therapy or spinal traction may also be used. The essence of the method is to use a special device that creates a tensile load on the spine, as a result of which the distance between the vertebral bodies increases and the pressure on the C6-C7 intervertebral disc decreases. This not only creates conditions for effective disc restoration processes, but also helps reduce pain.

Physiological curves of the cervical spine

The cervical spine has a natural curve directed forward . It's called lordosis. This bending is compensated by kyphosis, another curve directed backwards in the thoracic region. Such curves give the spine elasticity and allow it to withstand the daily loads caused by upright walking.

Spinal curves are not congenital. In order for them to form correctly, appropriate care and lifestyle are necessary.

Cervical lordosis up to 40 degrees is considered physiological . If the angle exceeds this figure, pathological lordosis is diagnosed. A person with such a pathology can be easily noticed by his head sharply pushed forward, which is set quite low.

Cervical lordosis may be:

1. primary, which appeared as a result of previous tumors, inflammation, posture disorders;
2. secondary, developing as a result of injury.

Video: “Structure of the cervical spine”

Pay attention to the anatomy of other parts of the spine:

• Structure of the lumbar spine
• To find out the structural features of the sacrum and coccyx in men and women, follow this link
• You can learn more about the anatomy of the deep and superficial back muscles in the following article

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Common pathologies of the cervical spine

You should be concerned and undergo a diagnostic procedure in cases where the following symptoms of pathology in the cervical spine have been noticed::

• 
  Pay attention to the most common neck diseases; poor posture;

• frequent headaches, tinnitus, dizziness;
• pain in the neck area;
• deterioration in performance, disturbed sleep;
• loss of appetite, nausea;
• changes in blood pressure;
• decreased immunity;
• deterioration in the functioning of the upper extremities, as well as hearing and vision.

Diseases of the cervical spine are possible due to various injuries after a strong blow or due to a fall. In some cases, the danger of injury exists even with a sharp tilt or turn of the head, for example, when diving into water.

The most common pathologies in the cervical spine are::

• ruptures of ligaments and intervertebral discs;
• subluxations and dislocations of the vertebrae;
• vertebral displacement;
• fractures.

Serious injuries to this section are dangerous because they can affect the spinal canal. The consequence may be paralysis, cardiac dysfunction or death. The danger of such injuries is also due to the fact that the seriousness of the situation cannot always be assessed immediately. At first, only pain during movement or swelling may indicate pathology. .

Methods for diagnosing the 7th vertebra

Diagnosis of pathological conditions of the seventh vertebra of the cervical spine is carried out using hardware examination methods. The table below describes the main ways to determine diseases and traumatic injuries of this part of the musculoskeletal system.

In the presence of uncomplicated diseases associated with damage to the structure of the seventh vertebra, standard radiography, MRI or CT diagnostics are prescribed. Using these examination methods, it is also possible to exercise effective control over the dynamics of the disease and adjust the therapeutic process.

Intervertebral discs

Intervertebral discs are a complex anatomical formation. They are located between the vast majority of vertebral bodies and play a large role in maintaining the musculoskeletal function of the spine.

Intervertebral discs account for 1/3 of the total volume of the spine. They bear all the load on the spine and at the same time they also ensure its flexibility and mobility. Therefore, the condition of the entire spine largely depends on the mechanical properties of these cartilaginous structures.

There are a total of 24 intervertebral discs in the human body. Their size increases as you move down the spine and as a result, the lumbar discs reach 45 mm in the anteroposterior direction and 64 mm in the transverse direction, and their thickness is about 11 mm. Nerve endings are present only in the outer part of the intervertebral disc, and blood vessels are completely absent in them.

The thickness of the intervertebral disc is variable. It may fluctuate during the day and increase after a night's sleep and decrease in the evening. Therefore, daily fluctuations in the length of the spine are observed, up to 2 cm.

The structure of all intervertebral discs, unlike vertebrae, is the same. Each of them is cartilage of a complex structure, in which 3 sections are distinguished:

• The nucleus pulposus is a jelly-like mass consisting of 77% water, 14% proteoglycans and 4% collagen fibers (mainly type II). This is an elastic structure that provides shock-absorbing properties to the disc and flexibility to the spine due to the ability to compress in different directions. The nucleus pulposus is largest in youth, and over the years it loses moisture and gradually decreases in volume, which leads to the development of osteochondrosis with all the ensuing consequences and complications in the form of protrusion, herniated disc, spondylosis, etc.
• The fibrous ring is the outer shell of the disc, ensuring the constancy of its shape and limiting the much more liquid nucleus pulposus. It has a hard, fibrous structure and is composed of 70% water, 15% collagen (mostly type I) and only 5% proteoglycans. The fibers that form the annulus fibrosus are densely intertwined with each other in different directions, which provides it with the ability to withstand high loads when the disc is compressed by the bodies of neighboring vertebrae during physical work, especially flexion and twisting.
• The cartilaginous (endplate) is a thin layer of hyaline cartilage formed by water (55%), collagen (25%) and proteoglycans (8%). It is located along the lower and upper borders of the disc and separates it from the vertebral bodies.

Proteoglycans are high-molecular compounds formed by proteins and glycosamines, in intervertebral discs they are mainly represented by chondroitin, which forms the so-called aggrecan.

Thus, the intervertebral disc, like most other cartilage, consists of water and collagen fibers, which are immersed in a proteoglycan gel. The ratio of these components varies not only in different parts of the disk, but also changes depending on the age of the person and even the time of day, not to mention the presence of diseases. Therefore, with age, the disc becomes harder, and the difference between the annulus fibrosus and the nucleus pulposus decreases.

It should be noted that in the matrix formed by proteoglycans there are cells whose task is to produce the components of the intervertebral disc. The proteoglycans themselves, represented mainly by aggrecan (a large molecule having a protein core with glycosaminoglycan groups attached to it), carry a large number of negative charges, which allows them to attract water molecules and provoke swelling of the disc, which is extremely important for its proper functioning. In addition, they affect metabolic activity. Proteoglycans with a relatively small molecular weight are able to bind mediators of cellular activity, in particular growth factors, and release them when needed.

Water is the main component of the intervertebral disc. But its content in it is subject to fluctuations, including depending on the time of day. Thus, in the absence of physical activity, especially after a night's rest, the water content in the disk reaches a maximum, and during the day it gradually decreases.

The quality of the disc's functioning largely depends on the balance between water pressure and disc swelling. This is determined by the number of attracted ions by proteoglycans carrying a negative charge, i.e. the percentage of proteoglycans has a direct impact on the quality of the disk. When the load on the cartilage of the spine increases, the water pressure inside it increases and the balance is disrupted. To equalize the pressure, a certain volume of water is “squeezed out” from the disk, which leads to an increase in the concentration of proteoglycans. This process continues until balance is restored or the load is removed.

Metabolism in intervertebral discs

Absolutely all intervertebral discs are devoid of their own blood vessels, and the metabolism in them is carried out by a diffuse mechanism. In other words, they receive nutrition from the blood vessels of nearby tissues, the distance to which can reach 7-8 mm.

When a load is applied to the disc, for example during walking, and it is compressed, fluid is “squeezed out” and a gradient of nutrient concentration is created. The fluid released from the disc is saturated with nutrients and, when the load is removed and, accordingly, the disc is “straightened,” it is sucked back.