Osteochondrosis of the spine is a chronic disease, in which occur degenerative changes of the vertebrae and are located between the intervertebral disc. Depending on the location of lesions of spine can be distinguished: osteochondrosis of the cervical spine, osteochondrosis of the department and the country of osteochondrosis of the lumbar. For the diagnosis of osteoarthritis of the spine is necessary to conduct x-ray, while in case of complications (e. g., disc herniation) - MRI of the spine. In the treatment of degenerative disc disease of the spine, along with drugs and methods that are widely used, reflexology, massage, manual therapy, physiotherapy and therapeutic exercise..
Etiology and pathogenesis of
To one degree or another, osteochondrosis of the spine develops in all age people and is one of the processes of aging of the organism. Earlier or later in the intervertebral disc resulting atrophic changes, however, injuries, diseases, and various overload of the spine contribute to a more early-onset degenerative disc disease. It is more common osteochondrosis of the cervical spine and osteochondrosis of the lumbar spine.
Developed by about 10 theories of degenerative disc disease: vascular, hormonal, manual, hereditary, infectious-allergic and other. But none of them gives a complete explanation that occur in the vertebral column changes, rather, are complementary to each other.
It is considered, that the climax of the occurrence of degenerative disc disease is a constant overload of the vertebral motor segment consists of two adjacent vertebrae. The overload may be caused as a result of musculoskeletal stereotype — attitude of the body, private way to sit and walk. Incorrect posture, the seat in a wrong posture, walking with an uneven spine position can cause extra pressure on the discs, ligaments and muscles of the spine. The process can be aggravated due to the nature of the structure of the spine and deficiency of trophic tissues, are due to hereditary factors. Often defects in the structure, there are for and lead to the vascular disorder and the early appearance of signs of degenerative disc disease of the cervical spine.
Show degenerative disc disease of the lumbar spine is often associated with overload during bending and lifting weight. Sound the intervertebral disc can withstand considerable load thanks to hydrophilicity is located in the centre pulpous nucleus. The core contains a large amount of water and fluids, as is well known, a little constricted. The gap healthy intervertebral disc can occur with the force of the compression more than 500 pounds, while, as amended, as a result of degenerative disc disease disc has broken with the power of compression to 200 kg Load 200 kg experiences the lumbar spine person weighing 70 kg, when he's holding a 15 kg load in place of tilting the torso forward at 200. It's a lot of pressure due to the small size pulpous nucleus. With the increase of the slope up to 700 load on the intervertebral disks decreases 489 pounds. Therefore, it is often the first clinical manifestations of degenerative disc disease of the lumbar spine occur during or after the weight lifting, the execution of the work of the house, weeding the garden, etc.
The destruction of the connective tissue of fibrous ring of the disc, the ligaments and capsules of the rear hinge causes the reaction of the immune system and the development of aseptic inflammation with swelling of the posterior joints and surrounding tissues. Due to the displacement of the body of the vertebrae is made of stretch capsules of the posterior joints, and the modified intervertebral disk is already not so firmly locks the body of the adjacent vertebrae. Formed the instability of the spinal segment. Due to the instability that may violate root of the spinal nerve with the development of radicular syndrome. When osteochondrosis. cervical spine is often occurs during turns the head, when osteochondrosis. lumbar spine — during tilting of the torso. Perhaps forming a functional unit of the vertebral motor points. It is due to compensation for the reduction of vertebral muscle.
Herniation of intervertebral disk, which is formed, when the tray moves back, the gap in the back longitudinal the bunch and fig part of the disc in the spinal canal. If the spinal canal displaced from the core of the disc, then the hernia is rupture. The severity and duration of pain, when is the herniation a lot more than when you don't have to explode. Herniated disc may cause radicular syndrome or compression of the spinal cord.
When osteochondrosis. occurs overgrowth of bone with formation of osteophytes bone spines in the bodies and processes of vertebrae. Osteophytes can also cause compression of the spinal cord or to cause the development of radicular syndrome.
The symptoms of degenerative disc disease of the spine
The main symptom of degenerative disc disease of the spine is the pain. The pain can be acute with high intensity, it intensifies with the slightest movement in the injured of the section and thus forces the patient to take a forced position. So, when osteochondrosis. whiplash, the patient keeps the head in a less painful position and can't turn it around, when osteochondrosis. the department of pain intensifies even and with a deep breath, and in the osteochondrosis. lumbar spine the patient is difficult to sit, stand and walk. It's like this: pain syndrome typical for sdavljenia root of the spinal nerve.
Approximately 80% of the observed cases of dull pain of a permanent nature and of moderate intensity. In such cases, during the examination, your doctor needs to differentiate the manifestations of degenerative disc disease of the spine, of myositis in the muscles of the back. Dull pain in osteochondrosis. it is caused by excessive tension of muscles which hold the affected spinal motor segment, inflammatory changes or significant distension of the intervertebral disc. In patients with pain syndrome forced position does not exist, but it's the restriction of movement and physical activity. Patients with osteochondrosis. cervical spine to avoid the sharp turns and tilts her head, with osteochondrosis. lumbar spine - slowly sitting and rising, to avoid the tilt of the torso.
Complications osteoarthritis of the spine
Complications of degenerative disc disease associated with κήληth intervertebral disc. To them, it belongs to compression of the spinal cord, characterized by numbness, tingling, weakness of certain muscle groups of the limbs (depending on the level of compression), resulting in the appearance of paresis, muscle atrophy, change in deep tendon reflexes, disturbances in urination and defecation. Intervertebral hernia can be the cause of artery compression, the power of the spinal marrow, with the formation of ischemic areas (infarction of the spinal cord) with the death of nerve cells. This is manifested by the appearance of neurological impairment (violation of movements, loss of sensitivity, trophic disorders), corresponding to the level and prevalence of ischemia.
A diagnosis of osteoarthritis of the spine
A diagnosis of osteoarthritis of the spine conducts a neurologist or spine. In the initial stage of producing x-rays of the spine in 2 projections. If necessary, you may download a single section of the spine and taking in additional provisions. For the diagnosis mocrowave a hernia, the assessment of the situation of the spinal marrow and the detection of complications of degenerative disc disease used magnetic resonance imaging (mri of spine). Plays a big role mri in the differential diagnosis of osteoarthritis and other diseases of the spine: tb spondylitis, osteomyelitis, tumor, bechterew's disease, rheumatism, infections. Sometimes, in cases of complicated degenerative disc disease of the cervical spine have the exception of syringomyelia. In some cases, the inability to participate in MRI shows myelography.
Observation study of the intervertebral disc can by using the discography. Electrophysiological study is used to determine the extent and location of damage to the nerve pathways, monitoring the recovery process during treatment.
Treatment of osteoarthritis of the spine
In the acute period occurs peace to the exposed spinal motor section. With that goal in osteochondrosis. cervical spine is used the lock through the collar Trench, when osteochondrosis. lumbar — rest in the bed. The consolidation is necessary and when osteochondrosis. injuries with instability of the spinal segment.
In pharmaceutical treatment of degenerative disc disease using non-steroidal anti-inflammatory drugs (NSAIDS): diclofenac, nimesulide, lornoxicam, meloxicam. With a strong bolevom syndrome appear analgesics, for example, analgesic central action of flupirtine that. To relieve the intensity of the muscle use muscle relaxants — tolperisone, tizanidine. In some cases, it is appropriate that the appointment of anticonvulsants - carbamazepine, gabapentin; antidepressants, among which priority is given to the serotonin reuptake inhibitors (sertraline, paroxetine).
When presented with radicular syndrome, the patient appears to inpatient treatment. Maybe the local introduction of glucocorticoids, treatment of edema, the application of traction. In the treatment of degenerative disc disease are widely used physiotherapy, reflexology, massage, physiotherapy. Application therapy requires a clear compliance with the technique of execution and special attention during the treatment of the osteoarthritis of the cervical spine.
Surgery on the spine occur mainly with significant compression of the spinal cord. It lies in the removal of the herniated intervertebral disc and decompression of the spinal canal. Maybe the microdiscectomy, laser redevelopment of the disc, disc replacement implant, the stabilization of the spinal segment.