Osteochondrosis is a chronic disease in which degenerative changes in the vertebral bodies and the intervertebral discs between them. Depending on the location of the lesion of the spine, the cervical spine, osteochondrosis of the thoracic and osteochondrosis of the lumbar spine differences: osteochondrosis. For the diagnosis of osteochondrosis of the spine is necessary for the implementation of x-ray diagnostics and in the event of complications (eg, herniated intervertebral disc) MRI of the spine is. In the treatment of osteochondrosis of the spine, together with pharmaceutical methods, reflexology, Massage, manual therapy, physiotherapy and exercise therapy are widely recognized,.
Etiology and pathogenesis
In varying degrees, osteochondrosis of the spine develops in all people over the age and is one of the aging processes of the organism. Sooner or later, in the intervertebral disc atrophic changes occur, however, injuries, diseases, and different overload of the spine are to be worn to an earlier emergence of osteochondrosis. Most often, osteochondrosis of the cervical spine and osteochondrosis of the lumbar spine.
Developed by about 10 theories of intervertebral disc degeneration: vascular, hormonal, mechanical, hereditary, infectious, allergic, and other. But none of them complement a full explanation of the changes occurring in the spine, rather, they are to each other.
It is believed that the decisive point in the development of osteochondrosis is the constant overload on vertebral body of the skeleton Segment consisting of two adjacent vertebrae is. Such an overload can occur as a result of the patterns of movement, posture, to sit with the individual style and to go. Disorders of posture, sitting in the wrong Position, Nordic uneven vertebrates column cause an additional load on the discs, ligaments and muscles of the spine. The process can be enhanced by because of the peculiarities in the structure of the spine, and failure of trophic its tissues by hereditary factors. The most common malformations in the structure occur in the neck area and lead to circulatory disorders, and signs of an early onset of degenerative disc of the neck, diseases of the spine.
The emergence of osteochondrosis of the lumbar spine is more common due to its overload when bending and severe gradients. A healthy disc can heavy loads to resist the hydrophilicity is located in the center of the nucleus pulposus. The core contains a large amount of water and liquids, as you know, a little compressed. Rupture of a healthy disc can occur when the force of compression of more than 500 kg, while the modified as a result of osteochondrosis disc ripped with the force of the compression load: 200 kg 200 kg undergoes the lumbar spine of a Person with a weight of 70 kg, when he is holding the 15-pound charge in a reclining Position, the torso to the front on the 200. Thus, a large pressure due to the small size of the nucleus pulposus. With increasing inclination up to 700 load on the intervertebral discs is 489 kg. Therefore, often the first clinical Manifestation of osteochondrosis of the lumbar spine occur during or after the lifting of heavy weights, the execution of the work to home, weeding in the garden, etc.
The destruction of the connective tissue fiber ring disc, ligaments and capsules of the facet joints leads to a reaction of the immune system and the development of aseptic inflammation with swelling of the vertebral joints and the surrounding tissue. Due to the displacement of the vertebrae, the elongation of the capsules of the facet joints and changes in the intervertebral disc is fixed to the body of the adjacent vertebrae, is so hard. Instability of the vertebral Segment formed. Due to the instability may be the impairment of the spinal nerves of the spine with the development of the arrangement of the edge syndrome. In the case of osteochondrosis of the cervical spine is generated during the cornering of the head, in the case of osteochondrosis of the lumbar, it is often the while the inclinations of a trunk. Perhaps the formation of the function block vertebrae of the skeleton Segment. He is due to the terminating resistance to the contraction of the muscles of vertebrates.
A herniated disc occurs when the disc is moved, there occurs fracture of the posterior longitudinal ligament and part of the disc bulging into the spinal canal. If in the spinal nucleus of the disc, squeezed then this hernia is called a broken. The intensity and duration of pain in the case of diaphragmatic hernia logged considerably more than in the case of rupture. Herniated disc you cause the arrangement of the edge syndrome, or compression of the spinal cord.
In the case of osteochondrosis overgrowth of bone tissue occurs with the formation of osteophytes — bony outgrowths on the body loops and eddy. Osteophytes can also cause compression of the spinal cord or cause the arrangement of the edge of the development of the syndrome.
Symptoms of osteochondrosis of the spine
The main Symptom of osteoarthritis of the spine is pain. The pain can be acute with high intensity, is worse at the slightest movement in the affected Segment and, therefore, take forces the patient's predicament. So in the case of the osteochondrosis of the cervical spine, the Patient holds the head in the least painful pose, and you can't turn, in the case of the osteochondrosis of the thoracic spine, the pain intensifies when taking a deep breath, and in osteochondrosis of the lumbar spine in the sit down with the patient hard to get up and go. This is typical of the pain syndrome of compression of the spinal nerves of the spine.
About 80% of cases occurs a dull ache of duration and moderate in intensity. In such cases, must at the time of examination, the doctor differentiate manifestations of osteochondrosis of the spine, of Myositis of the back muscles. Dull pain in osteochondrosis, due to the excessive effort of the muscles in the affected spine-Motor Segment, inflammatory changes, or a significant stretching of the intervertebral disc. In patients with this pain syndrome forced not be present, but masked restrictions on movement, and physical activity. Patients with osteochondrosis of the cervical spine and avoid sudden twists and tilts of your head osteochondrosis of the lumbar slowly to avoid tilting of the trunk, sit down and stand up.
Complications of osteochondrosis of the spine
Complications of degenerative disc disease associated with disc herniation. To compression of the spinal cord, the numbness, weakness of certain muscle groups of the extremities (depending on the amount of compression), what let to the emergence of paresis, muscle atrophy, alteration of tendon reflexes, disturbances of urination and defecation include. Foramina hernia cause compression of the artery, the spinal cord, with the formation of the ischemic Phase (infarction of the spinal cord) with the death of the nerve cells. This is manifested in the emergence of neurological deficits (violation of movements, loss of sensitivity, trophic disorders), according to the degree and extent of ischemia.
Diagnosis of osteochondrosis of the spine
Diagnosis of osteochondrosis of the spine leads to a neurologist or wertebrolog. In the initial phase of the x-ray to produce images of the spine in 2 projections. If necessary, the camera at each vertebral Segment and the inclusion in the additional tabs can. For the diagnosis of a hernia, assessment of the spinal cord and the revealing of complications of osteochondrosis used magnetic resonance imaging (MRI of the spine). A large role MRI plays in the differential diagnosis of degenerative disc disease and other diseases of the spine: tuberculous Spondylitis, Osteomyelitis, tumors, ankylosing spondylitis, rheumatism, infections. Sometimes, in complicated cases of degenerative disc disease of the cervical spine to exclude syringomyelia. In some cases, if it is impossible to have a MRI-myelography shows.
Targeted investigation of the affected intervertebral disc is through the discography. Electrophysiological studies used for the determination of the extent and localization of lesions of the nerve pathways, the observation of the process of the restoration during therapy.
The treatment of osteochondrosis of the spine
In the acute Phase of the peace shows in the affected kidney bearing Segment. With this goal in osteochondrosis of the cervical spine, the fixation with the help of the collar of a trench, in osteochondrosis of the lumbar spine bed rest apply. The fixation is required and in the case of osteochondrosis of the cervical spine with instability of the vertebral Segment.
In the drug therapy of osteochondrosis nonsteroidal anti-inflammatory drugs (NSAIDs): diclofenac, nimesulide, lornoxicam, Meloxicam. In the case of intensive pain syndrome, analgesics shows, for example, centrally acting analgesic flupirtine. Muscle tension muscle use relaxants — tolperisone, tizanidine. In some cases, it is advisable the appointment of anticonvulsants - carbamazepine, gabapentin; antidepressants, among which preferred are Serotonin re-uptake inhibitors (sertraline, paroxetine).
If they do occur, the arrangement of the edge-syndrome of the Patient to the hospital for treatment. Maybe a local initiation of glucocorticoids, treatment for edema, application routes. In the treatment of degenerative disc disease physiotherapy is widely used in physiotherapy, reflexology, Massage,. Application of the manual therapy requires strict adherence to the technique of their execution, and special caution in the treatment of degenerative disc of the neck, diseases of the spine.
Operations on the spine, especially with a significant compression of the spinal cord. It consists in the removal of the herniated disc and decompression of the spinal canal. Maybe a micro-discectomy, Laser reconstruction of the hard drive, the replacement of the affected disk implant, stabilization of the vertebral Segment.