2023-05-28 21:30:00
Ultrasonic guided injection was performed on the swollen fifth nerve root of the cervical spine and the herniated intervertebral disc. (Photo courtesy/Xu Youjun)
Text/Xu Youjun
Mr. Deng suffered from neck pain and numbness in his left hand a few years ago. He has tried rehabilitation exercises, manual therapy, and cervical traction. Although it has improved, it is easy to induce it once more as long as he keeps his head down and works for a while. After cervical MRI examination, it was found that there was disc herniation in the 5th and 6th segments of the cervical spine, which compressed the nerve root of the 5th segment on the left side. Some doctors suggested that an artificial disc replacement might be performed, but he was really terrified. In the end, he chose to treat the swollen fifth nerve root of the cervical spine with ultrasound-guided injection first, and at the same time treat the herniated intervertebral disc with high-concentration platelet plasma, and the symptoms were well relieved.
Clinically, cervical disc herniation combined with compression of cervical nerve roots is very common. Patients may experience neck pain, difficulty turning their head, numbness and swelling in one or both hands, and often feel discomfort of electric current. Moderate heat therapy, electrotherapy and traction have the opportunity to reduce the compression of intervertebral discs and bone spurs, and are actually quite effective treatment options if the diagnosis is correct. For excessive muscle tension and severe myofascial pain, dry needling and hyperplasia are also very effective.
For the problems of nerve root and intervertebral disc herniation, high-resolution ultrasound guidance can greatly improve the safety and accuracy of injection, and with appropriate drug selection, such as high-concentration platelet plasma or amniotic membrane extract, it can be used as a pre-operative injection. Conservative therapy of last resort. If there is significant muscle weakness and atrophy in the upper limbs, surgical treatment and artificial disc replacement should be clearly considered.
Occasionally, the effect of surgical treatment is not as expected, or the upper and lower ganglion nerves at the surgical site also appear compression symptoms following several years. At this time, traditional instrument treatment is regarded as a contraindication, and the surrounding tissue adhesion and scar hyperplasia will make the method of body surface positioning injection dangerous and difficult. Surgical sets are more important under careful disinfection and positioning.
All in all, everyone should pay attention to posture and adjust habits as soon as possible to reduce muscle tension and nerve compression caused by long-term bad posture. No matter following hyperplasia treatment, nerve unclothing, or intervertebral disc injection, follow-up manual exercise therapy intervention is required to reduce recurrence.
(The author is concurrently the attending physician of the North Nursing Branch of National Taiwan University Hospital and the director of the Shun Hsin Rehabilitation Clinic)
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