How to treat upper cervical instability?

summary

The upper cervical spine includes the first and second cervical vertebrae, namely atlas and axis. Instability of upper cervical spine refers to the pathological changes of atlanto occipital joint or atlanto axial joint, resulting in joint dysfunction and (or) nerve compression due to trauma, inflammation, tumor and congenital malformation. When the upper cervical spine is unstable, the atlas can be rotated forward, backward or dislocated, resulting in compression of the upper cervical spinal cord. In severe cases, the patient may suffer from quadriplegia or even respiratory muscle paralysis and die. So how to treat upper cervical instability?

How to treat upper cervical instability?

First, the treatment methods include non-surgical treatment and surgical treatment. Non operative treatment methods include traction, external fixation and functional exercise. Surgical treatment often includes decompression and reduction and internal fixation and fusion. The common surgical approaches include posterior approach, anterior oropharyngeal approach, anterior cervical approach, and combination of anterior and posterior approaches.

Second, the choice of treatment depends on the type of instability of the upper cervical spine, etiology and complications of nerve injury. The procedure of treatment is traction first to judge whether the dislocation is reducible, difficult or irreducible. For reducible dislocation, posterior atlanto fusion is necessary. In the case of hard reduction, anterior release and posterior atlantoaxial reduction and fusion were performed. For irreducible dislocation, posterior occipitocervical fixation and fusion is usually performed.

Third: Patients with severe traumatic instability of upper cervical spine are prone to sudden death due to respiratory dysfunction. It is very important to immobilize the head and neck during on-site treatment to prevent further spinal cord injury. First, the cervical spine was immobilized in the neutral position. If necessary, tracheal intubation was used to maintain ventilation. Tracheotomy was performed after admission. The occipital neck should be fixed as soon as possible after the respiratory circulation is stable, and the reduction should be made as far as possible. Traction reduction is controversial. This kind of injury is extremely unstable, and traction will increase longitudinal dislocation. Manual traction is not recommended, and it is recommended to gently traction reduction under close monitoring. Children were treated conservatively, and halo vest immobilization was used to produce strong fiber healing. In adults, conservative treatment is not easy to achieve stability, and surgery is needed for atlantooccipital or occipito axial fusion.

matters needing attention

At work, you should choose a chair that is more suitable for you, which can support the curvature of the lumbar spine and cervical spine, so that the waist is not too tired. At ordinary times, you should also pay attention to not having a posture too long when you go to work. You should get up in an hour and exercise properly when you have time. Swimming on the horizontal bar is more suitable for you. You'd better not do unilateral sports such as badminton and table tennis, You'd better not sleep in a soft bed. You can put a towel 2-3cm wide on your waist to sleep. Keep your waist bent. The pillow can't be too high. Generally, it's as high as your fist. You should put it under your cervical spine. Don't eat hot and sour beer or drink carbonated drinks, Can be appropriate pot point Bujin Huoxue medicated diet conditioning body.