What are the diagnostic criteria for cervical spondylosis?

The diagnostic criteria for cervical spondylosis are:

(1) A diagnosis can be made if the clinical manifestations match the imaging findings.

(2) For patients with typical clinical manifestations of cervical spondylosis and normal imaging findings, attention should be paid to excluding other patients before diagnosing cervical spondylosis.

(3) Cervical spine should not be diagnosed if there are only imaging abnormalities and no clinical symptoms of cervical spondylosis.

 

The diagnostic criteria are:

 

(1) Neck shape:

① The chief complaint is abnormal sensations such as head, neck, and shoulder pain, accompanied by corresponding tenderness points.

② The cervical spine on X-ray shows changes in curvature or instability of the intervertebral joint.

③ Other neck diseases should be excluded, such as neck pain caused by neck rest, shoulder periarthritis, rheumatic myofibrositis, neurasthenia, and other non intervertebral disc degeneration.

 

(2) Neural root type:

① Has typical root symptoms (numbness, pain), and the scope is consistent with the area innervated by the cervical spinal nerve.

② Positive results in head compression test or brachial plexus traction test.

③ The imaging findings are consistent with clinical manifestations.

④ Pain point blockade has no significant effect (those with a clear diagnosis may not undergo this test).

⑤ Excluding diseases mainly caused by upper limb pain due to external cervical lesions (thoracic outlet syndrome, tennis elbow, carpal tunnel syndrome, cubital tunnel syndrome, shoulder periarthritis, biceps tendonitis, etc.).

 

(3) Spinal type:

① Clinically, there are manifestations of strong damage to the cervical spine.

② The X-ray shows bone hyperplasia and spinal stenosis at the posterior edge of the vertebral body. Imaging confirms the presence of spinal cord compression.

③ Excluding amyotrophic lateral sclerosis, spinal cord tumors, spinal cord injuries, secondary adhesive arachnitis, and multiple peripheral neuritis.

 

(4) Vertebral artery type:

The diagnosis of vertebral artery type cervical spondylosis is a problem that needs further research.

① There has been a sudden onset of illness. Accompanied by cervical vertigo.

② Positive neck rotation test.

③ The X-ray shows segmental instability or osteophyte in the axial joint.

④ Often accompanied by sympathetic symptoms.

⑤ Excluding ocular and otogenic dizziness.

⑥ Excluding basilar artery insufficiency caused by compression of the vertebral artery segment I (before entering the transverse foramen of the sixth cervical vertebra) and the vertebral artery segment I (before exiting the cervical vertebra and entering the skull).

⑦ Vertebral artery angiography or digital subtraction angiography (DSA) is required before surgery.

 

Source: Internet