When performing power manipulations on the cervical spine, it should be remembered that vital centers are located here and that with rough manipulations, especially those carried out by novice specialists, you can not only not help the patient, but also cause serious complications, sometimes irreversible.

It is necessary to conduct a thorough clinical and radiological examination of the state of the cervical vertebrae with an analysis of neurological disorders, comparing these disorders with existing radiological changes..

It should be emphasized that the vertebral artery passes through the canal of the transverse processes of the cervical vertebrae..

At level III of the cervical vertebra, curving outward, the artery goes to the foramen magnum and supplies blood to the stem occipital regions of the brain and cerebellum.. The clinical picture of osteochondrosis of the cervical spine is characterized by a variety of symptoms, which is due to the anatomical and physiological characteristics of this segment.

The literature presents several classifications of syndromes in cervical osteochondrosis (I. Popelyansky, 1966; Dinaburg and others. , 1967; E C. Yumashev, M. Furman, 1973, etc..

According to the classification G. Yumasheva and M. Furman, the symptoms are divided into three large groups:.

1) radicular (cervicalgia, dyskalgia, anterior scalene syndrome, humeroscapular periarthritis, shoulder-hand syndrome);

2) vegetative-dystrophic, manifested by craniocerebral disorders (vertebral artery syndrome); 3) spinal, causing visceral disorders (cardiac syndrome, etc..

Clinical Syndromes.

A variety of clinical syndromes in cervical osteochondrosis are caused by subluxations of the cervical vertebrae, narrowing of the intervertebral foramina, uncovertebral arthrosis, compression of the roots, vertebral artery and intervertebral ganglia, reflex spasm of the anterior scalene muscle due to pathological impulses from the corresponding affected cervical segment, etc..

Stenosis and occlusion of the vertebral artery lead to circulatory disorders in the cerebellar, stem and occipital regions of the brain with subsequent development of vertebrobasilar insufficiency.

Most often, the degenerative-dystrophic process affects the discs at the level of the vertebrae CIV-CV, CV-CVI, CVI-CVII, CVII-TI.

After the examination and treatment in the thoracic and lumbar spine is completed in the supine position, the cervical spine is examined in the standing position. If it is inconvenient for the doctor to examine and treat the patient while standing, then this can be done in a sitting position..

By palpating the spinous processes in the mid-physiological position, with the head tilted forward, backward and rotational movements, they determine the relationship between them, deviations, depressions (protrusions, as well as increased clinical manifestations in some types of movements, search for pain segments and points. Along with this, hypermobility and restriction of rotation are detected with the establishment of the localization of the affected segment..

Manipulations in the cervical spine are carried out very carefully, directing efforts perpendicular to the axis of the spine.. In this case, one should not strike the spinous processes: this can lead to a concussion, increased pain, lower blood pressure and loss of consciousness..

Manipulations in the cervical spine begin with the mobilization of the spinal segment. This is achieved by performing a series of slowly repetitive passive rotational movements until a feeling of stop appears, followed by a return to the starting position.. It is advisable to carry out a light vibrating massage.

To perform manual therapy, the left hand is positioned in such a way that the III and IV fingers cover the spinous processes of the CV-CVII and TI vertebrae on the sides and carefully light blows are applied to them with the palmar surface of the wrist of the right hand (Fig.. 13. 15). The number, strength and nature of the blows depend on the severity of the process and the severity of the pain syndrome (an average of 3-5 blows with an impact force of 1 to 5 kg).

The next manipulation is traction along the axis of the cervical spine, which is carried out in a certain sequence: the doctor is located behind the patient, depending on the height of the doctor and the patient, who either sits on a chair, leaning on its back, or stands.

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