颈椎病患者为什么会出现一些特别症状?

某些颈椎病患者除了上述各种各样的症状之外,还会出现一些如血压升高或降低、心绞痛、心律失常、视力下降、视野缩小、听力障碍、乳房疼痛、吞咽困难等特殊症状。这些症状有时被冠之为“颈性血压异常”、“颈性心绞痛”、“颈性吞咽困难”等,使得本来就较为复杂多样的颈椎房临床表现更显得扑朔迷离(哪些人易患颈椎病?)。
因为这些特别症状有时可由其它各种各样的病症所引起,所以在考虑是否由颈椎病引起时,首先要经过颇为严格细致病史询问、体格检查和必要和辅助检查手段,反复分析、鉴别之后方可下结论。
一般而言,这些症状往往伴有颈椎病的其它症状和体征,X线片上有较为典型的颈椎病表现,症状的产生和严重程度与头颈部的活动、位置、颈椎病的轻重程度有较密切的关联;而反过来,产生这些症状本身的脏器并无器质性的异常,也无其它原因可循。例如“颈性视力障碍”,单纯眼科检查查不出原因,眼部症状与颈椎病症状相继出现,二者病情变化关系密切,眼科治疗手段无效,而这种症状与头颈部姿势改变有明显关系,在某一个特殊头位时,眼部症状和颈椎病症状可同时缓解,而其它姿势时,则可能二者均加重。按照颈椎病治疗,视力可有不同程度的改善。
颈椎病的这些特殊症状往往与颈椎病的病理改变有密切关系。血压异常往往是颈椎病所致椎-基底动脉供血不足,颈部交感神经或支配横膈及心包的颈4神经根受累所致;视力障碍则与颈椎病造成的槙物神经功能紊乱、椎-基底动脉供血不足有关;乳房疼痛则可能为支配的神经根受累产生;吞咽困难则为椎体前缘骨刺的直接压迫所致。
过去,这些特别症状很少被考虑为颈椎病的症状,往往仅是在颈椎病治疗过程中缓解了才被认识。这几年来,随着对颈椎病的进一步研究和深入探讨,这些特别症状才不断被重视,从而避免了许多诊断、治疗上的弯路。当然,值得再次着重提出的是必须与引起上产下状的其它原因作严格的鉴别后方可下结论,以防误诊误治。

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