What kind of tests do you need to do if you have cervical spondylosis?

I, cervical spine test examination The test examination of cervical spondylosis is a physical examination, without the use of instruments, which includes: 1. Forward flexion neck rotation test: make the patient's neck forward flexion, and ask him to rotate to the left and right activities. If there is pain in the cervical vertebrae, it indicates that the small joints of the cervical vertebrae have degenerative changes. 2. Intervertebral foraminal compression test (pressure top test): the patient's head to the affected side, the examiner's left palm on the top of the patient's head, the right hand clenched fist gently knocking the back of the left hand, there will be radiating pain or numbness in the limbs, indicating that the force is transmitted to the intervertebral foramen to become smaller, there is radicular damage; for radicular pain is very strong, the examiner overlap the two hands on the top of the head, the interferential downward pressure, which can induce or exacerbate the symptoms. When the patient's head is in the neutral position or the posterior extension position, the positive pressure test is called Jackson positive head pressure test. 3. Brachial plexus pulling test: the patient lowers the head, the examiner holds the patient's head and neck with one hand, and holds the wrist of the affected limb with the other hand, and pushes and pulls in the opposite direction to see whether the patient feels radiating pain or numbness, which is called Eaten's test. If pulling and forcing the affected limb to do internal rotation, it is called Eaten's strengthening test. 4. Upper extremity backward stretching test: the examiner puts one hand on the healthy shoulder to play a fixed role, and the other hand holds on the patient's wrist, and makes it gradually backward and outward stretching, in order to increase the cervical nerve root pulling, if the affected limb has radiating pain, it indicates that the cervical nerve root or the brachial plexus has been compressed or damaged. Second, X-ray examination of cervical spondylosis, normal men over 40 years old, women over 45 years old, about 90% of the existence of cervical vertebrae bone spurs. Therefore, there are changes in the X-ray film, but not necessarily clinical symptoms. The X-ray findings related to cervical spondylosis are summarized as follows: Orthostatic: Observe whether there is dislocation of the pivot joints, fracture or absence of the odontoid process. The transverse process of the seventh cervical vertebra is overgrown, and there are no cervical ribs. The hook and cone joints and the intervertebral space are widened or narrowed. Third, lateral position 1. Alteration of curvature: straightening of the cervical vertebrae, disappearance of physiologic anterior protrusion or reverse curvature. 2. Abnormal mobility: in the lateral X-ray film of cervical hyperextension and hyperflexion, the elasticity of the intervertebral disc can be seen to be changed. 3. Osteochondrosis: Osteochondrosis and ligamentous calcification can be produced in the vertebral body in the front and back of the vertebral body close to the intervertebral disc. 4. Narrowing of the intervertebral space: the intervertebral disc can be thinned due to the herniation of the nucleus pulposus and the reduction of the water content of the intervertebral disc, which is manifested as narrowing of the intervertebral space on the X-ray film. 5. Semi-dislocation and small foramen: After the degeneration of the intervertebral disc, the stability between the vertebrae is low, and the vertebrae tend to be semi-dislocated, or called slipped vertebrae. 6. Calcification of the collateral ligament: calcification of the collateral ligament is one of the typical lesions of cervical spondylosis. Oblique position: The oblique position of the spine is taken to observe the size of the intervertebral foramina and the osteophytes of the hook vertebral joints. Electromyography of cervical spondylosis The electromyography of cervical spondylosis and cervical disc herniation is due to the fact that both cervical spondylosis and cervical disc herniation can cause the nerve roots to be denatured due to long-term compression and thus lose their inhibitory effect on the innervated muscles. Thus, muscle fibers that have lost their innervation can produce spontaneous contractions due to the stimulation of small amounts of acetylcholine in the body. As a result, fiber potentials and occasionally a few fascicular fibrillation potentials appear in one or both upper limb muscles. During small forceful contractions, the polyphasic potentials are normal and no giant potentials appear. During large force contractions, the phase was completely in perturbation. The average time frame and average potentials of motor unit potentials were normal. The amplitude was 1 to 2 millivolts. Cervical spondylosis is caused by extensive degeneration of the intervertebral disc, resulting in osteophytes. Damage to the nerve roots is more extensive and more muscles appear to be denervated. In the advanced stage of the lesion and patients with a long course of the disease, a decrease in the number of waves and a decrease in the amplitude of waves can occur during active self-contraction. While cervical disc herniation is often a single disc herniation, the change is mostly for one side of the upper limb, and the range of the denervated muscle is obvious segmental distribution. CT examination of cervical spondylosis CT has been used to diagnose vertebral arch closure insufficiency, osteophytes, vertebral body fracture, ossification of posterior longitudinal ligament, spinal canal stenosis, spinal cord tumors caused by the enlargement of the vertebral canal or bone destruction, and to measure bone mineral density in order to estimate the degree of osteoporosis. In addition, the soft tissues inside and outside the dural sheath and the subarachnoid space can be clearly seen due to the transverse tomography image. Therefore, it can correctly diagnose push disk herniation and neurofibroma. Cavitation of the spinal cord or medulla oblongata is valuable for the diagnosis and differential diagnosis of cervical spondylosis. Clinical examination Includes the following aspects. (1) Pressure point paravertebral or spinous process pressure pain, pressure pain location is generally consistent with the affected segment. (2) Range of motion of the cervical spine, i.e., anterior flexion, posterior extension, lateral flexion and rotation. Nerve root-type cervical spondylosis patients have more obvious limitation of neck movement, while vertebral artery-type cervical spondylosis patients may have vertigo when moving in a certain direction. (3) Intervertebral zipper compression test allows the affected person. The patient's head is tilted to the affected side, the examiner's left palm is placed flat on the top of the patient's head, and the right hand holds the palm and lightly knocks the dorsal side of the left arm, such as the appearance of radicular pain or numbness is positive. In the nerve root symptoms are more serious, then both hands can be light pressure on the head can appear pain, numbness performance or aggravation. (4) Intervertebral tie separation test for suspected radicular symptoms, the patient sitting position, hands on the head and upward traction, such as the appearance of upper extremity pain and numbness reduction is positive. (5) Nerve root pulling test. Also known as the brachial plexus pull test, the patient is seated, the head is turned to the healthy side, the examiner one hand against the back of the ear, one hand holding the wrist to the opposite direction of the pull, such as the emergence of numbness or radiating pain in the limbs that is positive (6) Hoffman signs check the right hand gently resting on the patient's forearm, one hand in the middle of the forefinger clamped on one of the fingers, with the thumb to knock on the nail part of the middle finger, if there is a positive that is, the four-fingered flexion reflex, which is an indication of the pre-part of the spinal cord, nerve injury. (7) Rotary neck test, also known as vertebral artery twisting test, the patient sitting position, do active rotation of the neck activities, repeated several times. If there is vomiting or sudden fall, the test is positive, suggesting vertebral artery-type cervical spondylosis. (8) Sensory impairment examination of cervical spine patients to do skin sensory examination helps to understand the degree of lesions. Different parts of the sensory impairment can determine the segment of the diseased cervical vertebrae; pain usually occurs in the early stage, numbness has entered the middle stage, and the sensation completely disappears in the late stage of the lesion. (9) the examination of muscle strength cervical spondylosis injury to the nerve roots or spinal cord, muscle strength are reduced, if the loss of innervation, muscle strength can be zero. According to the different nerves innervated by each muscle, you can determine the location and segment of nerve injury.