Treatment of instability of the cervical spine. Instability of the cervical spine in adults and children - symptoms and treatment Instability of the cervical vertebrae c4 c5 treatment

instability cervical The spine is called a condition in which the neck cannot independently maintain its position. The condition is not pathological, but leads to neurological damage to a person and can cause dangerous pain syndromes.

The spine contains 33-35 vertebrae, which make up the vertebral column. The cervical region contains 7 vertebrae, numbered from the first vertebra, which connects the spine to the skull. The first vertebra is called the atlas, the second is called the axial, both have an atypical structure. There are ligaments between the vertebrae and intervertebral discs that make up the ligamentous apparatus of the spine.

The vertebrae are surrounded by a layer of muscle that keeps them upright and provides support for nearby nerves and arteries. All vertebrae form a spinal column, which contains the spinal cord, which performs a reflex and conductive function. It transmits impulses from the skeletal muscles to the brain and vice versa, and is also independently responsible for the functioning of internal organs - it carries out autonomic regulation.

What is instability

There are two terms - neck instability and hypermobility of an individual vertebra. Instability of the cervical vertebrae is a non-pathological process in which the vertebrae are unable, under the pressure of the head, to maintain their shape without pain. The magnitude of the pain corresponds to the magnitude of the load and how far the instability of the cervical spine is developed.

Hypermobility is called diagnostic feature, which means increased mobility of the articular surfaces of the vertebra, which in turn lead to the development of instability. Hypermobility may not always lead to instability, and instability does not always occur due to hypermobility.

Development of symptoms

Instability of the cervical spine is divided into the following types:

Post-traumatic;
Dysplastic;
degenerative;
Postoperative.

Read also:.

Post-traumatic instability is a consequence of the impact of a large force on the spine. As a rule, injuries are obtained during an accident or intense activity during sports associated with a high injury rate. Impact leads to destruction normal joints spine and expansion of the ligamentous planes of the disc.

With a single injury, such a violation will always make itself felt and manifest itself with repeated displacements. The articular plane loses its rigidity and cannot independently maintain its shape under load.

Dysplastic refers to disorders of bone formation. Most often, the disease manifests itself in the juvenile period, during the most active osteogenesis. This instability of the vertebrae of the cervical spine is due to the downed processes of formation of the honeycomb structure of the intervertebral joints.

Degenerative instability is found in the diagnosis of osteochondrosis changes and is a consequence of the degeneration of the articular surfaces. Osteochondrosis is essentially an overgrowth of cartilage tissue and its partial replacement with cartilage. The surfaces on the vertebrae become wider, the ligaments may begin to attach to the cartilage and lose their stability.

Read also: ?

Sometimes the process may go to reverse side, while growing bone tissue, and the process of immobilization of the cervical region will be observed - the vertebrae will not have enough space for movement, which will cause pain and stiffness. The functional part of the spine suffers, tangible neurological problems will be observed.

Postoperative may develop as a result of radical surgical interventions, for example, removal of a segment of the vertebral arch to release spinal nerve from pressure. There is a violation of the supporting complex of the spine, which leads to excessive mobility of the neck. Naturally, for the formation of postoperative mobility, prerequisites are needed, for example, the presence of injuries and diseases of the vertebrae.

The spine is the basis of the human skeleton and any disorders that limit its functions can significantly reduce the quality of human life at any age. Instability of the vertebrae in the cervical region refers to reversible disorders, which, if diagnosed and treated in time, may well be eliminated with little or no consequences.

The cervical region, like the lumbar, is one of the most mobile segments of the spine. Thanks to the unique design of the neck, a person has the ability to perform a variety of tilts and rotations of the head.

Moreover, in addition to providing mobility, the task of maintaining a certain stability is also assigned to the cervical spine, which prevents various injuries and deformations with various kinds of physical impact on the spinal column.

As a result of a number of reasons, which will be discussed below, hypermobility of the vertebrae of the neck occurs. In this case, there is reason to talk about its instability, which is also called functional or segmental. Most often, pathology is recorded in adolescents and the elderly. This is due to the presence of processes that depend on age-related changes.

Schematic representation of the cervical region with vertebral instability

This problem can manifest itself as an increase in amplitude when performing traditional movements of the neck and head, accompanied by a shift of the vertebrae and, accordingly, pain.

Causes and classification of the disease

The classification of spinal instability is based on the causes that cause it. Depending on them, specialists distinguish the following types of pathology:

Degenerative instability is the result of negative processes leading to the destruction/change of the vertebral bodies as a result of internal causes(hereditary predisposition, osteochondrosis of the cervical vertebrae, osteoporosis), and external (excessive physical activity or, on the contrary, physical inactivity, an unbalanced diet that promotes calcium leaching from the body);

Dysplastic instability - develops due to factors that negatively affect the state of the connective tissues of the joints spinal column, intervertebral ligaments, discs, etc. This type of pathology can lead to systemic inflammatory diseases, as well as infections that destroy the vertebrae, joints and ligaments;

Post-traumatic instability - a consequence of injuries of the spinal column - bruises, dislocations, fractures;

Postoperative instability due to surgical operation on this segment of the spine.

In addition, specialists also distinguish between open and latent (hidden) instability of the cervical vertebrae, in which the symptoms can be quite blurred, which makes it difficult timely diagnosis diseases.

Nerve root entrapment due to vertebral instability

It should be noted that this pathology dangerous, first of all, because it can lead to infringement spinal cord in the spinal canal, not to mention the fact that it can significantly complicate the patient's life.

How the disease manifests itself: symptoms

As in many other similar cases, early detection of the disease will allow you to start timely treatment and get a good result. Instability of the cervical spine manifests itself with the following symptoms:

pain in the neck, aggravated by physical exertion and any movements, limiting their amplitude;

feeling of tension and constant fatigue in the cervical spine;

possible loss of sensation in separate small areas skin neck;

forced position of the neck with a tilt to the side to reduce pain;

a feeling of numbness in the hands, weakness in the grip of the fingers, pain when lightly touching the skin of the neck;

fluctuations in blood pressure;

dizziness, tinnitus, loss of visual acuity as a result of compression vertebral artery.

Pain when turning the head is one of the main symptoms of instability of the cervical vertebrae.

Diagnosis of the disease

To establish the correct diagnosis and differentiation of the disease with intervertebral hernia, osteochondrosis, etc., the following examinations are necessary:

external examination of the patient and analysis of his complaints, on the basis of which the initial diagnosis is established;

radiography - allows you to assess the condition of the vertebrae and intervertebral discs and find the affected area;

MRI (magnetic resonance imaging) - expands the possibilities of diagnosis by providing information about the state of the connective and nervous tissue of the spine.

MRI examination of the cervical spine

Treatment of pathology

In most cases, instability of the cervical spine is treated conservatively, surgery is rarely used.

It is important to know that self-medication and the use of traditional medicine in this case is strongly discouraged!

Medical therapy

Via drug therapy it is quite possible to eliminate the disease, especially in the early stages of development. The following drugs are commonly used to treat instability of the cervical vertebrae:

muscle relaxants - to relieve spasms of the cervical muscles and unblock strangulated nerve roots (Mydocalm);

anti-inflammatory drugs, both nonsteroidal and steroidal, and analgesics that relieve pain syndrome(Movalis, Naklofek, Denebol, Ketanov, Kenalog, Hydrocortisone, Diprospan);

novocaine blockade;

chondroprotectors that restore damaged cartilage tissues(Teraflex, Chondroitin);

vitamins D and B, restoring bone and nervous tissue.

Massage and manual therapy

A qualified massage can significantly affect the healing process, because common cause hypermobility of some vertebrae is the stiffness of others located in the neighborhood. Overloaded vertebrae become loose over time and become unstable. Properly performed massage allows you to form a muscular corset that supports the movable vertebrae and thus remove excess load from them. In addition, it can be used to strengthen weakened musculoskeletal paravertebral structures.

Massage allows you to create a muscular corset that supports the vertebrae in the correct position

Usage manual therapy helps to develop stiff vertebrae and increase their functionality, which will reduce the load on the unstable segment of the cervical region.

Therapeutic exercise (LFK)

It should immediately be emphasized that it will be much better if the complex therapeutic exercises will be selected by a specialist taking into account the individual characteristics of the patient. The basis of exercise therapy is the observance of the basic rule, which consists in a gradual increase in loads. Here is an example elementary complex therapeutic gymnastics. The recommended exercises are quite simple and do not require any special equipment. You need to perform them several times a day:

Tilt your head forward while resisting and pressing your hands on your forehead. Hold at the bottom for 3-5 seconds.

Tilt your head back, pressing your palms on the back of your head, with a similar delay in muscle tension.

Make lateral tilts of the head, pressing with your hand on the temporal region from the side of the slope. Hold your head for 3-5 seconds in an inclined position.

Slow turn of the head to the left, holding it at this point for several seconds.

Similar turn of the head to the right.

Physiotherapy

Physiotherapeutic methods are designed to improve the blood supply to the damaged segment and stop the inflammatory process in it. For this, electrophoresis is used. medicines, which actively penetrate into the focus of inflammation, as well as magnetotherapy, which acts on the affected area using a magnetic field.

In addition, the patient is recommended to wear a special corset for some time - the Shants collar, which helps to support the weakened spine. Moreover, you need to know that prolonged wearing of the collar is not recommended, since it can lead to a weakening of the muscular corset, which can further aggravate the patient's condition.

The Shants collar allows you to temporarily fix the affected spine

When is surgical treatment necessary?

Surgical treatment is used in extreme cases when there is a serious destruction of the vertebrae and there is a threat of damage to the spinal cord in the spinal canal. In such a case, spondylodesis is performed - bone grafting using a natural or artificial graft, which allows you to create immobility by turning several adjacent vertebrae into a monolith. As a result, the cervical segment of the spine acquires additional stability.

Features of pathology in children

The main difference between spinal instability in childhood is a significantly greater amplitude of vertebral mobility than in adult patients. This happens because the child intervertebral discs almost equal in height to the vertebrae. In addition, in newborns, the body of the cervical vertebrae has a mutually convex shape. As they grow older, the height of the discs gradually decreases, and the double-convex shape gradually transforms into a rectangular one. Instability of the cervical spine can result in acute torticollis.

In addition, being in the wrong position, the intervertebral discs are constantly injured, and therefore wear out quickly, which causes the development of intervertebral hernias.

Torticollis in a child and violation of facial symmetry due to instability of the cervical spine

A child suffering from instability of the cervical vertebrae may experience the following symptoms:

pain in the neck after waking up, when tilting the head and when sitting at a desk;

unstable position of the neck;

curvature of the neck;

sleep disturbance, drowsiness, irritability, lethargy;

frequent headache, dizziness;

complaints of blurred vision.

facial asymmetry.

Parents should pay attention to the condition of the child and immediately seek medical advice in order to start treatment as soon as possible.

Prognosis, possible complications and prevention of pathology

The prognosis will be favorable if the patient consulted a doctor in a timely manner and started treatment in a timely manner. If the disease is advanced and spondylolisthesis is formed, i.e. posterior or anterior displacement of a vertebra in relation to the rest, the prognosis is much more serious and will depend on whether this vertebra has “slipped” somewhat significantly and deviated from the axis of the spine.

The most serious complication of instability of the cervical spine is compression of the spinal cord with impaired blood circulation. This leads to damage to the conductive nerve fibers, resulting in paresis (paralysis) of the upper, and then lower extremities, violation skin sensitivity and functions of the pelvic organs.

spinal cord injury - serious complication instability of the cervical spine

Compression of the vertebral artery causes malnutrition (ischemia) of the brainstem and posterior segments of the brain, causing panic attacks, leading to a disorder in the coordination of the body and provoking the development of ischemic stroke in these areas.

Prevention consists in taking the following measures:

timely treatment of osteochondrosis and osteoporosis;

limiting excessive physical activity;

proper selection of pillow height;

treatment of inflammatory and infectious diseases, destroying bone structures skeleton, as well as its ligamentous apparatus;

training of the muscular corset of the cervical spine;

avoiding situations in which neck injuries are possible;

providing right position a child in bed during sleep and at a desk during classes.

Traumatologist-orthopedist talks about what pathology is (video)

Instability of the cervical spine is a disease that is quite rare and, moreover, successfully treated. The main thing is to pay attention to the symptoms in time, which may indicate the development of this unpleasant disease, consult a doctor and start treatment in a timely manner.

My name is Yelena. By education - a nurse. I specialize in the field of medicine and health, but also have knowledge in the field of literature and psychology.

In our time, a fairly common pathology is the instability of the cervical spine, the symptoms and treatment of which can only be determined by your doctor. The phenomenon is quite common, but unpleasant, characterized by excessive mobility between two or more vertebrae. Such violations can drastically affect a person's life, change it not by the most in the best way. But if the disease is defined as early stage development, correctly diagnose and prescribe adequate treatment the situation can be corrected.

The cervical region provides for a certain number of vertebrae, which are assigned the functions of mobility and stability. Due to this, a person easily tilts his head in any direction, bending and unbending his neck. This is about mobility, thanks to the stability between the vertebrae, balance is maintained, so they are completely protected from deformation. Instability of the cervical spine develops after injury or osteochondrosis against the background of increased mobility.

Due to the disturbed distance between adjacent vertebrae, the amplitude increases, and thus instability appears, which often manifests itself along with displacement. To determine the disease, it is enough for the doctor to understand that the vertebrae have moved forward by 4 mm.

Medicine distinguishes several types of the disease, given the circumstances that caused violations above the spine in the neck.

Degenerate. The form that develops after suffering osteochondrosis, due to the destruction of the tissues of the discs and the fibrous ring. Degenerative-dystrophic changes lead to the fact that the holding and supporting functions weaken.
Post-traumatic. Instability in the cervical spine due to trauma, in children it can be postpartum trauma, which is common.
Postoperative. A form of spinal disease that worries the patient after surgery. This suggests that the condition of the supporting elements of the spine was disturbed during the operation.
Dysplastic instability of the vertebrae. According to medical definitions dysplasia is a generalized term that means abnormal development. Violations can affect tissues or the body as a whole, the size, shape or structure of the cell changes. As for dysplastic instability in the cervical region, in this case we are talking about the joints and intervertebral ligaments, as well as discs or the body itself. In most cases, this form of the disease develops against the background of a dysplastic syndrome.

Symptoms

As a rule, instability of the cervical vertebrae is characterized by signs:

pain in the neck, which will increase during physical activity;
pain with slight turns of the neck;
tone increases muscle mass, thus appears fast fatiguability and overvoltage;
after some time, the neck muscles weaken and pain is felt even during probing;
during compression of the vessels of the spinal cord, the patient has a headache, he is disturbed by dizziness and jumps in blood pressure;
some more complex cases are accompanied by disorders associated with sensitivity, weakness in the limbs, sometimes you can observe the development of complete or partial paralysis.

A large list of symptoms complicates local diagnostics therefore, patients are often misdiagnosed. Most often, doctors rely on signs of pain and discomfort in the neck above the spine, treatment based on the information received and prescribe. This is due to the fact that the vertebrae are displaced and compress the nerve endings of the spinal cord, in addition, the spinal bed narrows. The pain is so severe that the patient is looking for a comfortable position in which it will be comfortable, and tries to hold his head that way. But such a position cannot be natural, as a result, the neck muscles quickly get tired, blood circulation in the region of the department is disturbed, and soon they cannot withstand even a small load for the whole day.

The most important indicator is the displacement of the vertebrae in the neck, a rather serious violation that requires treatment. In order to put accurate diagnosis the doctor needs an X-ray, but a vertebral displacement of 4 mm is already considered unstable.

Treatment

Therapy involves two main methods, these are pills or surgery, if the situation is very bad. Instability of the cervical spine, the symptoms and treatment of which depend on the individual characteristics of the patient's body, responds well to conservative therapy according to qualified experts. Surgery is not required, as medications help to get high results in treatment, but there are also indicators that indicate that surgery is necessary.

The conservative methodology provides:

Using a special head holder, there are two kinds, soft and hard.
Experts recommend novocaine blockades if the pain in the neck increases.
Non-steroidal anti-inflammatory drugs are prescribed.
Physiotherapy is prescribed.
Therapeutic complex massage, but it is allowed to attend cupping, acupuncture or acupressure.
Reflexology is carried out on the basis of acupuncture or cryotherapy.
Ability to heal exercise.
Stretching of the spine.

Surgical intervention is necessary in case of instability of the cervical spine in especially difficult situations, when not only the spine itself is affected, but also internal organs. There are certain indications for the operation:

There was a subluxation against the background of instability.
The weakening of the disease in a short period of time or the manifestation of frequent exacerbations.
Individual intolerance of the patient, as a rule, occurs as a result of one of the methods of conservative treatment.
Persistence of signs of instability due to more serious diseases. For example, a disc herniation or compression of a nerve ending.

During the operation, the surgeon fixes the vertebrae with a special plate, which prevents their displacement in the future, but at the same time, retains mobility. As a rule, the plate is fixed from the side of the back, after a certain period of time the graft can dissolve or a joint is formed in its place, which is called a false joint in medical language.

Instability in the cervical region is quite serious problem, a pathology that needs to be studied from all sides. In addition, it is important to correctly diagnose and prescribe effective, timely treatment. Help to avoid the most difficult violations preventive measures, complex rehabilitation measures, they preserve the patient's ability to work, provide a high quality of life.

Orthopedist-traumatologist of the first category, specialist in foot surgery, PFUR, 2008

The cervical spine is the most mobile part of it. Thanks to anatomical features In this part of the spine, a person can turn his head in different directions without experiencing discomfort during movements.

There is a pathology medical nature, in which the neck part becomes too mobile. This condition may cause various complications accompanied by unpleasant symptoms. The disease is called instability of the cervical vertebrae.

The physiological mobility of the neck is achieved due to the features anatomical structure this area.

Axis and atlas - first and second cervical vertebrae- in their structure they are very different from other fragments of the cervical spine. Their main task is to hold the skull and spinal column together. Attached, these two vertebrae form the atlantoaxial-occipital complex. This complex contains 3 articular joints, due to which the skull and the atlas attached to it can rotate.

The articular bags located in the region of the atlantoaxial-occipital complex have a weak tension. This provides about half of the basic movements of the neck. Due to the peculiarities of the fit of the vertebrae to each other and the presence of natural curvatures, the spine combines the following properties:

Stability, expressed in the ability to maintain pressure and a certain degree of compression between the vertebrae. Thus, a position is provided in which during movements the column will not be deformed, the person does not experience discomfort. Stabilization is ensured by properly functioning ligamentous apparatus, fibrous and pulpous elements of the intervertebral disc;
Mobility - the ability to temporarily change the curvature and position of the neck, to show flexibility and mobility. Thanks to the mobility of the cervical region, a person can effortlessly perform various sports elements, bend and rotate the neck, and take the desired body position.

In the cervical region, mobility and stability of the position are simultaneously maintained. It is very important that these two indicators are complementary.

In the case of instability of the cervical region, there is a rapid increase in the index of mobility of the spine in relation to stability. It ceases to be a reliable support for the whole body and, under the influence of physical activity or other similar factors, begins to “walk”. The local amplitude of movements increases, as a result of which there is excessive freedom in the movements of the neck.

The stability of the location of the vertebrae relative to the articular axis changes, due to which the vessels passing between the fragments, nerves and adjacent soft tissues can be deformed, their functionality is impaired.

Instability of the cervical spine may occur due to the influence of various factors. Depending on them, pathology is classified in different ways, subdivided into several types:

Degenerate. It develops due to the influence of internal and external factors. Internals include:
- Osteochondrosis. The vertebrae are destabilized due to partial or complete degenerative-dystrophic destruction of the fibrous ring or the disc itself. As a result, the vertebra ceases to occupy a certain, fixed position, and the cervical part of the spine loses its cushioning properties;
- Osteoporosis. Against the background of bone destruction general anatomy and the position of the cervical spine changes;
- Regular physical activity of high intensity. Excessive passion for sports can cause a violation of the integrity of the ligaments and other supporting elements;
- Unhealthy lifestyle and unhealthy diet. These factors often contribute to the appearance of problems with bones and joints.
Dysplastic. Dysplasia can affect the intervertebral joints and discs, the ligamentous apparatus, and even the vertebra itself. Dysplasia refers to several pathological processes that occur due to abnormalities in the structure or development of tissues and organs. Dysplastic instability may occur due to infectious diseases accompanied by purulent-necrotic processes, and due to past systemic inflammatory diseases;
genetic predisposition. A person may have hereditary anomalies of the ligamentous apparatus, a violation of the formation or development of the vertebrae.

TO external factors relate:

Post-traumatic. Occurs during damage to the ligaments and muscles of the neck due to injury. Such instability is often diagnosed in newborns;
Postoperative. It develops if during the surgical intervention the structures supporting the cervical part of the spinal column were damaged. Most often, postoperative instability occurs when the ligamentous apparatus is damaged.

In case of instability of the cervical spine, different degrees gravity. The condition is determined by the attending physician, who takes into account the degree of destabilization, the neglect of the injury or other pathological process that caused the violation.

Symptoms of the disease

The main symptoms of instability of the cervical spine are:

Spasm of the neck. The muscles of the cervical spine are located in constant voltage, against which the patient quickly begins to feel tired, heaviness. In moments of hypertonicity, numbness of the skin on the neck can be felt;
Pain. Periodic pain tends to increase during sports or standard head movements, such as flexion and extension, rotation. The intensity of pain decreases significantly when the head is tilted sideways towards the shoulder. On palpation of the neck, the patient feels a burning pain. In some cases, the pain may acquire a shooting character;
Violation of the bearing function of the spine. With pathology, it becomes very difficult to keep the head straight;
Visually noticeable deformation of the spine. The patient has a stable forced posture with his head slightly inclined to his shoulder. During movements, if you look at the back, you can notice with the naked eye a strong mobility of the vertebrae;
neurological disorders. Patients develop weakness and paresis upper limbs feeling of numbness, paresthesia. It is also possible the appearance of uncontrollable twitches and sensations of stirring on the torso and arms;
Other symptoms. due to nerve compression and blood vessels patients have tinnitus, impaired vision and breathing, dizziness may begin, increased arterial pressure. Due to persistent discomfort, patients often experience sleep problems.

In newborns, cervical instability can occur as a result of the following reasons:

Wrap around the neck with the umbilical cord. It is quite thick and elastic, therefore, when entangled, the umbilical cord can significantly squeeze the neck and thereby cause displacement of its segments;
Difficult childbirth. If the baby was removed by physical pulling by hand, vacuum extraction, or caesarean section, he may develop a birth injury of the cervical region;
Prolonged childbirth. Damage to the fetal neck occurs mainly due to weak labor activity. The birth canal does not contract sufficiently, causing the head to get stuck. As a result, there is a lot of pressure on the head and neck;
Rapid delivery. This situation is exactly the opposite of protracted labor. Labor activity and contractions are very intense, because of which the pressure on the fetus is uneven. The elements of the child's neck can receive various microtraumas, which often become the causes of cervical instability.

Due to the fact that newborns begin to hold their heads only some time after birth, it is difficult to immediately recognize the symptoms of a disorder in them. Because of this, the diagnosis of instability is difficult. Most often, pathology is detected only by 3 years.

The result of untreated cervical instability can be compression and dystrophy of the spinal cord, compression of the nerve roots and disorders of the central and autonomic nervous system.

At an older age, instability of the cervical vertebrae in children is manifested by neurological disorders (irritability, developmental delay, restlessness), pain in the neck, bad memory, distraction. Children with this disorder begin to speak late and often cannot concentrate on anything in particular.

Instability of the cervical spine in children lends itself well to correction. But this is on the condition that the violation was noticed on time, and the treatment was comprehensive and professional.

If during childbirth the child received a birth injury of the neck, during the first few years of life it should be regularly examined by doctors. Such a measure will allow to identify all the consequences of the injury in a timely manner.

What is the danger of pathology

As a result prolonged squeezing nerve roots passing between the vertebrae, the patient may develop permanent neurological disorders. As a result, the activity of visceral organs of different localization is disturbed, the sensitivity of the skin to external influences, partial or complete paralysis of the limbs develops.

Instability of the cervical region also stimulates the occurrence of osteoporosis and osteochondrosis. Another complication of the disorder is a steady decrease in the mobility of the cervical spine. This is due to the gradual growth of osteophytes.

Diagnosis and treatment methods

To determine cervical instability and confirm the diagnosis, doctors first take an anamnesis. This allows you to carefully study clinical picture violations and initially determine the degree of instability. After that, the patient is sent for x-rays and MRI.

Instrumental diagnostic methods allow you to visually familiarize yourself with the state of the cervical spine, identify the presence of compression of nerves, blood vessels and other nearby structures.

Treatment for cervical spine instability depends on the degree of the disorder. Most often, conservative therapy is carried out, consisting of several stages. It is indicated for minor instability, which is not characterized by radicular and spinal symptoms. The goal of this treatment is to gradually influence the intervertebral discs of the neck so that they take the correct position.

The first stage is medical treatment. The patient may be prescribed one specific drug, or several at once. Often the doctor prescribes the following drugs:

Muscle relaxants - eliminate the symptoms of the disorder by relieving muscle spasm;
Chondroprotectors - do not allow articular surfaces and synovial discs to collapse, enhance regenerative processes in cartilage and bone tissues;
NSAIDs and anesthetics - help to minimize the inflammatory process and relieve pain;
Multivitamin complexes - a lot of emphasis is placed on products with vitamins D- and B-groups, as they have a beneficial effect on the condition of nerves, blood vessels, strengthen joints and bones.

In rare cases, novocaine blockades are used. They are used when the pain is very severe. Wherein drug therapy combined with surgical treatment, this approach is used with a high degree of instability.

The second stage is maintenance therapy. It is aimed at restoring regenerative processes, relieving spasm and eliminating symptomatic manifestations violations. At this stage, the following measures of influence can be prescribed:

Physiotherapy. Most often, patients are prescribed electrophoresis, magnetotherapy, ultrasound, acupuncture, phonophoresis, shock wave therapy, reflexology;
Massage. Massage procedures must be carried out by a specialist. Incorrect neck massaging technique can lead to aggravated instability;
Osteopathy;
Wearing a special collar. Shants collars and similar fixing corsets allow you to keep your neck in a certain position, which contributes to the inhibition of the progressive.

The last step conservative therapy aimed at treating instability of the cervical spine is exercise therapy. The complex of trainings should be selected individually for each patient.

When developing it, the age of the patient, the degree of pathology, the presence of background diseases and other nuances are necessarily taken into account. The active period of treatment with exercise therapy can last up to six months. After the main period, the maintenance period begins, which lasts for several more years.

The first workouts aimed at treating instability of the cervical spine should be carried out strictly under the supervision of a trainer. He will be able to explain in detail to the patient the technique of performing exercises and monitor its observance.

Proper work on the condition of the spine is capable of short term bring good results. Over time, it is possible to transfer training to home conditions - the patient will do gymnastics on his own. Such a decision is made taking into account how the disease proceeds and what changes in the patient's condition.

Surgery to treat cervical instability

The main goal of surgical treatment is to stabilize the cervical spine and eliminate compression of nerves, blood vessels and soft tissues. The operation is indicated in such cases:

The pain is persistent, the remission period is too short;
In a situation with a particular patient, the use of conservative treatment methods may be contraindicated;
There is a subfolding of one or more vertebrae;
The use of conservative therapy did not bring the desired result;
There are persistent radicular and spinal symptoms due to hypertrophy of the yellow ligament, compression of the nerves, or the occurrence of a hernia.

During the operation, the cervical vertebrae are fixed with a special plate, the task of which is to prevent further deformation and restore neck mobility.

The most commonly performed anterior intervention surgery has a number of advantages:

The risk of hernias is minimized;
Compression of the nerve root is eliminated by increasing the intervertebral window;
Rapid postoperative recovery and low risk of postoperative trauma.

Conclusion

Instability of the cervical spine is a disease in which the index of mobility of a section of the spinal column exceeds the index of stability. This pathology leads to increased mobility of the vertebrae, resulting in compression of the spine and structures adjacent to it.

To fight the disease, you need to see a doctor. A competent specialist is able to choose an adequate treatment, which, with the right attitude to the process, will be able to quickly return the neck to function properly.

Instability is manifested by pain, coordination, neurological and sensory disorders, limited mobility of the neck and spasm of local muscles.

After a thorough diagnosis and treatment, a patient with instability of the cervical spine is prescribed a conservative or surgery. You should not engage in determining the available measures of influence on your own - the situation can only be aggravated in this way.

The cervical spine has properties that are directly opposite to each other.

On the one hand, mobility, which allows you to make circular movements of the head, tilt, extension and flexion of the neck.

On the other hand, stability, due to which, during physical exertion, the ratio between is maintained, which protects the spine from painful manifestations and various kinds deformations.

Instability of the cervical spine occurs when various pathologies that disrupt the proper functioning of this zone

Degenerate.
Postoperative.
Dysplastic.
Post-traumatic.

Causes of pathology:

Various types of injuries (after accidents, during sporting events, after falls);
Anomalies in the development of intervertebral discs;
Complications after various types of operations on the spine;
Serious degenerative-dystrophic changes that progress in the upper spine.

signs

The proportions and ratio between adjacent vertebrae are violated, which leads to pain, increased range of motion in this area.

Excessive mobility of the cervical vertebrae is manifested in their displacement.

After a CT scan or x-ray it is found that sections of adjacent vertebrae are located closer than expected relative to each other.

The discomfort that occurs with spinal instability leads to disruption of the entire body.

One of the first signs of the development of the disease are:

Myelopathy that progresses rapidly;
The appearance of neurological disorders;
radicular syndrome;
Dyscalgia in the cervical area;
spinal syndrome.

Symptoms

Excessive mobility of the cervical region causes patients a lot of suffering:

Arise occasional pain in the neck that become longer and more intense during exercise. The reason is spasms of the neck muscles and irritation nerve centers located in the affected area;
, discomfort often accompany even minor movements in the cervical area;
Movements in the neck become less controlled, there is decline motor activity joints;
Radiculitis and lumbago- companions of radicular syndrome;
The tone of the muscles located in the cervical region increases, which leads to their overstrain and fatigue. Decreased blood supply to the muscles, which can lead to the neck not performing its supporting functions. Often there is a need to wear a special supporting corset;
When the spinal cord is compressed, sensitivity is disturbed, feeling of weakness in the limbs, involuntary twitches and paresis begin.

Consequences

Consequences of misdiagnosis timely treatment can be very serious:

Headaches get worse;
Cervical-collar zone remains stiff or, conversely, hypermobile;
Sleep is disturbed;
There is irritability, excessive anxiety;
Lethargy and drowsiness interfere with productive work;
There is visual impairment, hearing loss;
There is a lack of coordination, and staggering appears during walking.

Timely diagnosis is important dangerous disease, the progression of which can lead to disability.

Instability of the cervical spine in children

As a result of the research work of a group of scientists, it was found that pathologies of the spine in its cervical region in children in most cases appeared during childbirth.

A clear relationship has been proven between the complicated course of childbirth and the risk of injury and damage.

The most common reasons are:

Rotation of the fetal head around the axis by almost 180 degrees;
Rapid childbirth;
The use of special obstetric forceps;
Excessively intense sipping of the fetus over the head area, which in most cases is accompanied by a characteristic crackling of the vertebral discs;
large fruit(more than 3600g);
The presence of narrow birth canal;
Childbirth with transverse, pelvic, oblique presentation;
Weak labor activity.

At a later age, the cause of the pathology becomes:

Falls;
Injuries;
Blows.

If parents notice change in the child's motor activity, they should carefully observe it and identify what deviations have arisen.

Adults should look out for the following signs of spinal instability in their child:

Pain, which appear immediately after sleep, during the performance of sudden movements or after school;
Torticollis when the head involuntarily leans to one side. At the same time, the ears are different levels;
During adolescence, there headaches;
The child is lethargic, he is quite tired, sometimes irritated for no reason;
Getting noticed asymmetry in the face, which affects paired organs: eyes, ears, eyebrows, cheeks;
The child does not sleep well. Sleep is often interrupted and disturbing.

How to improve the condition of the child in violation of the functions of the spine?

It is important to avoid:

Those poses and physical exercises where there is an impact on the cervical region and head: "Birch", headstand, all kinds of somersaults and jumps. It is unacceptable to overcome obstacles that can lead to serious injury;
Captures for the neck and head area;
Sports where blows to the head, falls, sharp turns of the head, as well as the entire body are possible: boxing, football, volleyball, basketball, acrobatics and others;
Sleep, both on a flat and high pillow;
Drafts, which can lead to hypothermia and inflammation of the muscles and nerve endings;
Massage and manual therapy techniques, especially in early childhood in the neck.

After injury ( acute period) it is undesirable to move the head, neck, muscles of the shoulder girdle in order to prevent further mixing of the vertebra and not to injure the spinal cord.

It is important to immobilize the cervical region using the Shants collar and orthopedic pad so that the head can assume a stable mid-position.

Immobilization is needed during the recovery period.

How can you help your child cope with illness?

The most important point is the application of a whole range of measures that will allow to remove unnecessary muscle tension joints, muscles and an extensive vascular system of the cervical-collar zone: phonophoresis, inductothermy, interstitial stimulation, electrophoresis, neuromyostimulation;
It is necessary to strengthen the nutrition of the affected tissues in the cervical region with the help of: laser therapy, magneto- and EHF-therapy, stimulation of nerve endings;
To restore a full-fledged blood supply to the brain, laser puncture is used, which acts on BAP (biologically more active point);
It is necessary to strengthen the muscles of the neck and shoulder. This requires myostimulation;
To eliminate looseness in the joints of the shoulder and upper limbs, the method of paraffin therapy and EPS is used;
Exercise therapy in children and a special massage will help to correct movement disorders in a sick child.

Treatment

This pathology is dangerous because there is its hidden form, when the symptoms are not so obvious and are very similar to the manifestations of other diseases of the spine.

In some cases, even an x-ray cannot give a complete picture for making a correct diagnosis.

If excessive mobility of the cervical vertebrae appears without borderline convergence, it can be very difficult to determine the cause of pain and symptoms.

Only a comprehensive examination of the patient and observation of the course of the disease will make it possible to determine the most effective ways and methods of treatment.

Manifestations of instability of the cervical spine are treated conservatively and surgically.

Conservative therapy:

To prevent displacement of the vertebrae, it is recommended wearing a special supportive corset;
The use of drugs that relieve pain ( antispasmodics, painkillers);
Manual therapy techniques to be carried out by a qualified person. Improper activities can worsen the course of the disease;
Spinal traction;
Massotherapy and complex special exercises physiotherapy exercises;
Physiotherapy procedures: magnetotherapy, electro- and phonophoresis, myostimulation, paraffin and laser therapy, inductothermy.

Surgery

It is carried out if after a month or two the pain syndrome does not go away, and some drugs or procedures are poorly tolerated by the patient. Additional indications to surgery: subluxation of the vertebra due to hypermobility, as well as the preservation of radicular and spinal syndromes.

To stabilize the spine, a special method is used: spinal fusion. There are two options: anterior and posterior fusion.

The essence of the method is to attach a plate from the front or back of the vertebrae, which will help to reduce the subluxation and reduce pressure on the nerve endings.

Both types of fusion are often combined, of which the anterior one is less traumatic. After such surgical intervention the patient recovers faster than after lamyectomy with posterior access to the vertebrae. Complications (graft resorption or pseudoarthrosis) occur less frequently after anterior access.

To choose a method of surgical treatment, consider various factors: the severity of the disease, the amount of displacement, muscle tone, type of instability of the cervical vertebrae.

exercise therapy

With hypermobility of the spinal column in the cervical-collar zone, an excessive increase in the amplitude of movements occurs. the main objective application of a complex of special exercises - to stabilize the position of the cervical vertebrae.

Doctors developed effective exercises that need to be performed in the treatment center on a special simulator. At home, you can make a similar simulator yourself.

You need to take a rubber bandage, fold it in half, and securely fix the ends on the wall. Fixation should be carried out at eye level so that a person sitting on a chair can perform the exercise correctly.

The bandage is a limiter. He should grab his head at forehead level and support it. Tilts in such a simulator to the left and right, as well as forward and backward, are done as accurately as possible. The number of repetitions depends on the condition of the patient, on average, from 10 to 20.

Prevention

To prevent the development of instability of the spine in its cervical region, it is recommended to follow certain rules:

Minimize risk of domestic and sports injuries. Unfortunately, no one is immune from road accidents;
Avoid sudden hypothermia to prevent inflammation of the nerve endings;
exercise aimed at strengthening the arms and shoulder girdle;
Control the course of diseases of the spine and treat them in a timely manner to prevent complications;
Maintain occupational health and safety so that the shoulder girdle and the upper section of the spinal column do not overstrain;
Avoid sudden and strong head movements.

Parents need to notice the slightest changes in the movements of the child in order to timely identify signs of a developing pathology.

Instability of the cervical vertebrae is a serious pathology that requires a comprehensive study and timely treatment. It is important to correctly diagnose the disease in order to choose the appropriate method of treatment. Appropriate measures should lead to positive changes.

Preventive measures and a set of restorative measures will help maintain working capacity and ensure a decent quality of life.