Health|Cervical spondylosis diagnosed as depression? Sympathetic cervical spondylosis is easily misdiagnosed

New Express News 46-year-old Ms. Chen developed neck and shoulder stiffness for unknown reasons a month ago, and dizziness and bloating. In severe cases, she was accompanied by blurred vision, palpitation, nausea, walking shaking, and loss of balance. After seeing a doctor at a local hospital, “cervical spondylosis, depression” was considered, and physical therapy and antidepressant treatment were given.

After more than a month of treatment, there was still no improvement. After being referred to the Department of Orthopedics and Traumatology of the Hospital of Integrated Traditional Chinese and Western Medicine of Southern Medical University, a cervical MRI examination was performed. After excluding spinal cord and discogenic lesions, the sympathetic type was considered. Cervical spondylosis is a series of sympathetic disorder symptoms such as neck and shoulder stiffness, dizziness, bloating, palpitation and nausea caused by sympathetic nerve stimulation.

The symptoms of sympathetic cervical spondylosis are varied and easily misdiagnosed as depression

In the beginning Ms. Chen, who was treated in the hospital, was regarded as depression. Why is sympathetic cervical spondylosis easily misdiagnosed as depression? Li Jianxuan, the chief physician of the department of orthopedics in the hospital, pointed out that cervical spondylosis is divided into cervical type, nerve root type, vertebral artery type, sympathetic type, spinal cord type, etc. Most cervical spondylosis is easy to diagnose, as long as early diagnosis and standardized treatment can be carried out, The effect will be very good. However, 10% of sympathetic cervical spondylosis is particularly complex, and the symptoms are often varied. Some people do not even show symptoms such as neck and shoulder pain, but instead experience other symptoms such as vision loss, palpitation, chest tightness, dizziness and nausea.

He said that the sympathetic nervous system is very complex, it can not only cause the acceleration of heart fluctuations, but also dilate the pupils, reduce the secretion of digestive glands, and constrict blood vessels in the abdominal cavity and peripheral skin. To ensure that the human body is in a relatively tense state, and the parasympathetic nerves of the human body are in a state of mutual restraint and competition. If the sympathetic nerves are excited for some reason, the human body will be in a state of overexcitation, which is pathological and abnormal. , in the long run, it will lead to various complex symptoms, and these complex symptoms are similar to some symptoms of depression, so it may be misdiagnosed as depression.

How to prevent sympathetic cervical spondylosis? Li Jianxuan suggested that there are a few points to pay attention to in daily work and life: First, avoid prolonged sitting and maintain a good posture for the neck; second, pay attention to self-protection of the neck, do not do excessive flexion, extension and swing, and avoid heavy objects on top of the head; third It is necessary to pay attention to keeping the neck warm, avoid direct blowing of air conditioners or fans in summer, and protect the neck with scarves when going out in winter; fourth, correct bad habits such as high pillow sleep;

Learn more about the stellate ganglion block with good curative effect

Combining with Ms. Chen’s symptoms, the hospital’s orthopaedic and trauma department decided to treat the stellate ganglion block. After a course of treatment, Ms. Chen’s symptoms completely disappeared, and she has been discharged from the hospital and returned to her normal life.

Li Jianxuan pointed out that the stellate ganglion is located on both sides of the human neck, and it is named as the stellate ganglion because it is shaped like a star. It belongs to the sympathetic chain of the autonomic nerves and is mainly composed of the fusion of the seventh and eighth sympathetic ganglia and the first thoracic sympathetic ganglia. It is the main sympathetic ganglion that innervates the head, face, neck, upper chest and upper limbs.

Stellate ganglion block is the precise injection of local anesthetics around the stellate ganglion to paralyze the ganglia, so as to treat some diseases of the head, face, neck, upper limbs and upper chest, such as insomnia, dreaminess , rhinitis, tinnitus, migraine, tension headache, cerebrovascular disease, cervical spondylosis, postherpetic pain, frozen shoulder, upper arm numbness, as well as palpitation, chest tightness, menopausal syndrome, dysmenorrhea, irregular menstruation and many other diseases , the curative effect is very good.

“The use of an appropriate amount of local anesthetic can block the stellate ganglion, which can inhibit cardiovascular movement, glandular secretion, muscle tension, bronchoconstriction, and pain conduction.” Li Jianxuan said that the star Ganglion block is often used to treat some diseases of the head, neck, upper limbs, shoulders, heart and lungs, such as various headaches, herpes zoster neuralgia, sudden deafness, tinnitus, rhinitis, phantom limb pain, angina pectoris, etc. . It can also regulate the function of the body’s autonomic nervous system, endocrine system and immune system, maintain the stability of the body’s internal environment, and be used to treat anxiety, insomnia, dysmenorrhea, menopausal syndrome, premenstrual tension, gastrointestinal disorders, skin pruritus pain, chronic fatigue syndrome, hyperhidrosis, etc.

Stellate ganglion block may also have certain side effects, including the normal post-sympathetic nerve block reaction: one-sided miosis, ptosis, sunken eye, nasal congestion, conjunctival hyperemia, facial microscopic Redness, no sweat, warm feeling, can be relieved spontaneously after the effect of local anesthetic subsides; combined with blockade of other nerves: hoarseness, cough, asthma, dyspnea, chest tightness, etc., can be relieved by itself after the effect of local anesthetic subsides; puncture Complications caused by the procedure: pneumothorax, hemothorax, nerve injury, spinal cord injury, vascular injury, etc. These complications can be significantly reduced by a rigorous mastery of operational norms and skills. “Those with bleeding tendency should use stellate ganglion block with caution; observe for 10-15 minutes after the block, and leave without adverse reactions; do not block bilateral stellate ganglia at the same time.” Li Jianxuan emphasized.

Written by: New Express reporter Liang Yu