Instability of the cervical spine in adults and children

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

What are the symptoms and why is the treatment of cervical spine instability (NSPI) needed? How does this state affect the quality of life?

The spine is a part of the human musculoskeletal system, the main part of the frame, which provides him with the opportunity to be in an upright position.

If the relationship between the vertebrae is disturbed in the cervical region, the amplitude of movement increases, pains appear in the neck, which radiate to the shoulders, back, head, and blood supply to the brain becomes difficult. The latter causes mental retardation in children and vascular hardening in adults.

Treatment of instability of the cervical spine can be carried out by conservative and surgical methods, depending on the general condition and stage of the disease.

Features of the anatomical structure of the neck

The cervical spine has increased mobility - it can bend up to 95º and rotate 80-90º. There are 7 cervical vertebrae in total, and two of them - atlas and epistrophy - have structural features.

1. Atlant. Its components are two bone arches connected in a ring at the place of thickening. The atlantoaxial joints are placed on the sides, with the help of which the vertebrae are fastened to the occipital bone - it is easier to say, the head is attached to the body.
2. The epistrophy has a dentate process at the junction with the atlas, it is this connection that ensures the mobility of the head and turns of the neck.

The rest of the vertebrae have a typical structure: a body with a cylindrical thickening, adjacent arcs, with outgoing bony processes, to which ligaments and muscles are attached. Compared to the thoracic or lumbar region, the cervical components look "graceful" - this is due to the low load.

In infants, the cervical region is almost straight, and bends only by 3 months, when babies begin to confidently hold their head. These are the first manifestations of physiological lordosis. Later - when babies begin to sit down and get up - lordosis of the lumbar and kyphosis of the thoracic region appears.

Symptoms of the instability of the cervical spine

The main elements of the spine, which ensure its stability and physiological proportions between the vertebrae, which protect it from deformation that causes pain, are:

• ligaments;
• fibrous ring;
• the nucleus of the intervertebral disc, which consists of the pulp;
• capsule of intervertebral joints.

The individual vertebrae are separated by intervertebral discs; and each of them has support complexes that provide a stabilization function.

Types of support complexes:

1. anterior, consisting of 2 parts of the annulus fibrosus - anterior and posterior, 2 halves of a vertebra - also anterior and posterior, longitudinal ligaments also of 2 groups;
2. the structure of the posterior stabilizing complex: ligaments - adostatic and interspinous, the capsule of the intervertebral joint, the arch of the vertebra and the yellow ligament.

Holdsworth created a similar classification, but there is also Denis's classification.

Symptoms of instability of the cervical spine in infants may not immediately be, if torticollis is not pronounced, then pediatricians note weakness and limited range of motion of the upper limbs and shoulder girdle. If the diagnosis is not made at the age of up to a year, reflex and mental underdevelopment may be observed in the future, the child does not start talking for a long time, complains of frequent headaches.

Diagnosis of the disease in adults is difficult, since the symptoms of instability also resemble other pathological changes in the cervical spine and cerebral vessels.

As characteristic features can be distinguished:

• pain that increases after increased physical exertion and sudden movements;
• chronic muscle tension;
• irritation of the lining of the spinal cord;
• violation of the blood supply to the vessels of the brain.

When the condition worsens, the spinal canal narrows. This organic formation contains the spinal cord.

Types of instability and its causes

In adults, depending on the causes of the disease, the following types of instability are shared:

1. Degenerative. Its occurrence provokes osteochondrosis, since with degenerative changes the fibrous ring and disc tissue are deformed. Depreciation properties are lost, fixation is broken;
2. Post-traumatic form - the name speaks for itself;
3. Postoperative instability;
4. Dysplastic changes - these disorders occur at the level of intrauterine development. Due to improper formation of the structures of the tissues of the skeletal system or violations of the proportions of the joints of the spine and vertebrae.

In children, instability appears due to impaired intrauterine development, but in most cases it is caused by birth trauma:

• fast delivery;
• protracted labor activity;
• manipulation of the obstetrician - the imposition of forceps or the implementation of manual rotation.

The NSHOP clinic caused by birth trauma can manifest itself in children under 5 years of age.

Treatment of the manifestation of NSHOP

They try to resort to surgical intervention if it is not possible to get rid of pain caused by instability of the cervical spine for more than 2 months, at the slightest turn of the head, subluxation, radicular and spinal symptoms appear.

First, a course of conservative therapy is always carried out, in which the patient is recommended:

1. adhere to a sparing regimen;
2. wear a head holder of various designs to fix the position of the head and stop the constantly progressive displacement of the vertebrae and deformation of the annulus fibrosus;
3. spinal traction;
4. physiotherapy.

In case of instability of the cervical spine, perform exercises after relieving pain, the patient is recommended to perform a complex of exercise therapy, even when wearing a fixator.

If physiotherapy exercises are not included in the rehabilitation process, the fixator will have to be used all life, and because of this, the condition will only worsen, as the muscles will weaken.

For the treatment of children, special exercises and massage effects are also combined. Of course, in early childhood, parents have to do gymnastics with kids. They need to mobilize - be patient and connect imagination, so that massage and gymnastics will deliver only pleasant sensations to children.

One of the complexes of physiotherapy exercises with instability of the cervical spine is performed according to the following algorithm.

It is necessary to make a special device to ensure the fixation of the cervical spine and protect yourself from injury. The rubber bandage is tied into a two-layer ring, bending it twice in half - in the center and again, having already folded it in half. One end is fixed to the support at the height of the eyes, the second is covered with the head at the level of the forehead. Sit down steadily;

• They perform head vibrations, gradually, every week, increasing the number of exercises and range of motion;
• You need to start the number of nods in different directions from 3, gradually increasing to 25;
• As soon as you can complete 3 sets of 25 bends in different directions per day, you should increase the layer of rubber bandage to increase muscle strength.

During gymnastics, the neck and head should move in a single ligament, smoothly and slowly.

The rubber bandage is an exercise machine for the home. In a gym, experts will help you choose a special trainer to strengthen your neck muscles.

Yoga classes with instability of the cervical spine help not only to strengthen the muscles of the cervical spine, but also to improve blood circulation, which helps to restore the quality of cartilage tissue.

Yoga begins with breathing exercises, which contributes to the complete relaxation of the skeletal muscles. These classes teach you how to control your own body. But without medical advice and an accurate diagnosis, self-treatment can cause serious harm.

The SNOP treatment method is chosen depending on the patient's condition and the type of disease. The combination of different approaches and different techniques helps to stabilize the condition in the shortest possible time.