Injury of the cervical spine

Damage to the cervical spine, which is a "receptacle" and a defense for the spinal cord, is very dangerous for these extremely important structures. Injury of the cervical thickening of the spinal cord and motoneurons in the anterior horns leads to the development of flaccid paraparesis or paralysis of the upper limbs, damage to the hindbones - to a violation of sensitivity. However, the greatest danger to human life and the state of the brain is associated with the trauma of two of the four main blood vessels that supply blood to the brain. Details find out in the article on "Injury of the cervical spine."

This close interposition of the artery and its nervous system makes it very vulnerable, even with minor changes in the bone-cartilaginous structures of the spine. Neuropathologists call it "an intracranial artery in extracranial conditions." Traumatization of the nerve plexus is possible due to mechanical damage, muscle and muscle blockages, unco-vertebral growths, subluxation and anterior proliferation, as well as intervertebral joint anomalies.

I identified three possible mechanisms of the influence of the altered spine on the neurovascular formations and cerebral circulation:

1) irritation of the neurovascular bundle (without its traumatization and compression), which causes a variety of reflex reactions;

2) gross direct effects on the vessel, its compression or disruption of integrity, preventing normal blood flow and, consequently, affecting the state of circulation;

3) prolonged traumatic effects on the vessel, which contributes to the development of an atherosclerotic process with the formation of plaques, which, in turn, affect the circulatory system in the vessels of the brain.

With mechanical stimulation of the proximal part, a spasm develops in the axillo-atlanto-occipital region. This department, which is normally at its highest burden, is a spasmogenic zone. In the mechanism of vascular disorders, it is necessary to take into account the compensatory possibilities of the collateral blood supply of the brain. Deficiency of blood flow, resulting from clamping, can be compensated by:

1) increased blood flow through the contralateral artery;

2) retroastoidal anastomosis;

3) through the posterior connecting arteries of the Willis circle.

Compensatory blood flow is not in all cases equally possible because of the wide individual anatomical and functional variations in the structure of the vessels. A lot of research has been devoted to the problem of brain damage since the century before last. Researchers emphasize the particular vulnerability in the process of labor in the cervical spine. When the fetus is removed, a very heavy load falls on it. This is facilitated by features of the methods: head rotations with fixed fetal shoulders, pulling the head under the same conditions, protecting the perineum against the backdrop of continuing attempts, extruding the fetus. No less dangerous was the moment of perineum insurance against the backdrop of continuing attempts. But this moment in childbirth often leads to stretching of the cervico-occipital ligaments in the child! And even if the organism of the born person cope with this minimal complication, after 6-8 years after childbirth, when the child begins to spend more time in the posture with anteflexia of the head, when the child starts to prepare for school and performs any other precision work, it turns out that the cervical spine is insolvent !! Muscles at this age are still weak, and cervico-occipital ligaments are stretched, and as a result - the cervical vertebrae will begin to mix with each other. In X-ray examination, this is manifested by the staircase-like slipping of the cervical vertebrae in the form of pseudospendilolisthesis. All this, even with such minimal complications, creates the risk of delayed spinal injury that occurs in the canal of the transverse processes of the cervical vertebrae.

Due to exceptionally developed compensatory mechanisms, vertebrobasilar vascular insufficiency can be partially compensated for a considerable time due to blood flow from the system. However, at any time under the influence of mental overstrain, physical stress, stressful situations, decompensation of cerebral hemodynamics may occur. In mild cases, it manifests itself as headaches, various vegetative-vascular paroxysms, vestibular disorders that fit into the symptom-complex of chronic cerebral vascular insufficiency. In more severe cases, failure to compensate for cerebral hemodynamics can lead to acute impairment of cerebral circulation up to the development of cerebral ischemic stroke.

Even the course of physiological births, due to the peculiarities of the method of obstetrics, can be complicated by stretching the ligamentous apparatus of the cervical spine, which subsequently leads to instability of the cervical vertebrae. In these cases, the danger may lurk even in a minor domestic trauma or mild physical exertion, leading to subluxation of the vertebrae and compression of the PA. Clinically, this manifests itself as a spinal stroke or compression of the spinal cord. Often, such a subluxation can occur in a dream, with a sharp unconscious turn of the head or after another somersault over the head in a physical education lesson. In more mild cases, there is an asymmetric infringement of the innervation of paravertebral muscles at the level of the injured vertebrae, which leads to the development of a flaccid paresis of the arm and shoulder girdle, accompanied by a lag in the muscles in growth. There is a shortening of these muscles in comparison with the muscles of the healthy side, which is manifested by the asymmetry of the standing of the shoulder blades and the shoulder girdle with the subsequent formation of scoliosis.

The weakness of the ligamentous apparatus of the cervical spine and the development of degenerative disorders in the intervertebral discs, at the level of traumatized vertebrae, lead to early cervical osteochondrosis. To identify children at risk for possible delayed birth complications, you need to know a number of symptoms, combined in the syndrome of peripheral cervical insufficiency (CMS) and miatonic syndrome. It is extremely important that they appear as a result of cervical injury and remain for life, being an indicator of damage to the cervical spine. The first symptom complex - the CMS syndrome, in essence, is a reduced flaccid paraparesis of the upper limbs and develops as a result of a non-rough lesion of the cervical thickening of the spinal cord. Thus, the use of clinical, radiological, syphomiographic, REG and DG-methods makes it possible to accurately diagnose, even in the case of non-structured subclinical forms of the suffered neck injury.

The role of neck trauma in the pathogenesis of eye disorders

The concept proposed by her associated the weakness of the ciliary muscles, which are known to have parasympathetic and sympathetic innervation, with ischemia of the higher autonomic center in the region of the posterior hypothalamus, on the one hand, and on the other hand, with a secondary disturbance of hemodynamics in the basin and orbital arteries affecting blood supply of the accommodative muscles themselves. To clarify the pathogenesis of accommodation disorders, we studied the blood flow in the VBB and in the ICA in near-sighted children with various impairments of accommodative function. The mean values ​​of the volume blood flow of the carotid basin were significantly lowered in children of all three groups. Now you know what is the trauma of the cervical spine.