Osteochondrosis of the spine is a chronic disease in which occur degenerative changes of the vertebrae and are located between them and the intervertebral discs. Depending on the location of spinal cord injuries are: back pain, cervical, low back pain chest and back pain the lumbar. For the diagnosis of osteoarthritis of the spine necessary to perform an x-ray, and in case of complications (e.g., hernia of intervertebral disk) - magnetic RESONANCE imaging of the spine. In the treatment of degenerative disc disease of the spine together with the methods of the medicine are widely used, reflexology, massage, manual therapy, physiotherapy and curative physical education.
The etiology and pathogenesis
In a different degree, osteochondrosis of the spine develops in all the people of age and is one of the aging processes of the body. Sooner or later in the intervertebral disc changes occur atrophic, however, of injury, of disease and of different overload of the vertebral column contribute to an earlier onset of degenerative disc disease. The most frequent back pain, cervical and back pain the lumbar spine.
Developed by about 10 theories of degenerative disc disease: vascular, hormonal, mechanical, genetic, infectious diseases and allergies and other. But none of them gives a complete explanation of changes occur in the spine, rather, they are complementary.
Considering that the main point in the case of degenerative disc disease is a constant overload on vertebral segment skeletal, consisting of two adjacent vertebrae. This overload can occur as a result skeletal stereotyped posture, individual way of sitting, and walking. Incorrect posture, sitting in a wrong posture, walk with an irregular spine mail will cause an additional workload for the disks, ligaments and muscles of the spine. The process may worsen because of the structural characteristics of the vertebral column, and failure trophic its tissues, due to genetic factors. Often the defects in the structure are located in the cervical region and lead to vascular disorders and early onset of signs of arthrosis of the cervical spine.
Appearance the degenerative disease of the lumbar disc is most often associated with its overload when the slopes and climbs, gravity. A healthy intervertebral disc can withstand considerable loads due hydrophilicity is located at its center of the pulposus the kernel. The nucleus contains a large amount of water and liquids, as is well known, little compressed. The gap in a healthy intervertebral disc can occur when the compression force of more than 500 kg, while changed as a result of degenerative disease of the disc is ripped with a compression force of 200 kg. Load 200 kg experiences a lumbar spine of a person weighing 70 kg, when you hold the 15 pounds of weight in a position of inclination of the torso forward to 200. What is a lot of pressure due to the small value of the pulposus the kernel. With the increase of the inclination up to 700 load on the intervertebral discs will be 489 kg. So often the first clinical manifestations of the degenerative disc disease of the lumbar occur during or after lifting weights, do house work, weeding in the garden, etc
The destruction of the connective tissue ring of fibrous of the disc, the ligaments and capsules of the articular facets causes a reaction of the immune system and the development of inflammation aseptic swelling of the articular facets and their tissues. Because of the movement of the vertebral bodies occurs traction capsules, articular facets, and changed the intervertebral disc is not so firmly the body adjacent vertebrae. It is formed by instability of the vertebral segment. Due to the instability in possible violation root of a spinal nerve with the development of create the syndrome. Osteochondrosis of the cervical spine is often occurs when you turn your head, osteochondrosis of the lumbar — during the inclination of the trunk. Perhaps the formation of the functional block of the segment skeletal. It is due to wear reduction of vertebrate muscle.
A herniated disc occurs when the disc shifts back, occurs the rupture of the posterior longitudinal ligament and protrusion of disk into the spinal canal. If in the spinal canal squeezed the nucleus of the disc, such a hernia is called broken. The severity and duration of pain in the hernia much more than when unexploded. The herniated disc can cause create or syndrome from compression of the spinal cord.
Osteochondrosis occurs an excessive growth of bone with formation of osteophytes — bony protuberances on the bodies and processes of the vertebrae. Osteophytes can also cause compression of the spinal cord or cause the development to create the syndrome.
The symptoms of arthritis of the spine
The main symptom of degenerative disc disease of the spine is the pain. The pain can be sharp with high intensity, is enhanced with the slightest movement in the affected segment, and then forces the patient to take a forced position. So, osteochondrosis of the cervical spine, the patient keeps the head in a less painful installation and can not turn, osteochondrosis of the thoracic pain intensifies with a deep breath, and with osteochondrosis of the lumbar the patient difficult to sit, stand and walk. This syndrome is characterized by compression of a root of a spinal nerve.
About 80% of the cases it is observed a dull pain permanent in nature and of moderate intensity. In such cases, during the medical examination is necessary to differentiate the manifestations of arthritis of the spine to lumbar muscles of the back. A dull ache in osteochondrosis is due to excess of muscular tension, held hit the spine segment of the skeletal, the inflammatory changes or significant elongation of the intervertebral disc. In patients with the syndrome of pain stimulated the location is not present, but it reveals a limitation of movement and physical activity. Patients with osteochondrosis cervical spine to avoid the hairpin turns and tilts the head, with osteochondrosis lumbar - slowly stand up and sit down, avoid the inclination of the trunk.
Complications of degenerative disc disease of the spine
Complications of degenerative disc disease associated with herniated intervertebral disc. He refers to compression of the spinal cord, which is characterized by numbness, weakness of some muscle groups of the limbs (depending on the compression level), related to the birth of paresis, atrophy of muscles, changing reflexes of tendons, disorders of urination and defecation. Herniated disc can cause compression on the artery, the spinal cord, with the formation of ischemic areas stages (infarction of the spinal cord) with the death of nerve cells. This is manifested by the appearance of neurological deficits (violation of movements, loss of sensation, trophic disturbances), corresponding to the level and the prevalence of ischemia.
The diagnosis of osteoarthritis of the spine
The diagnosis of osteoarthritis of the spine plays the neurologist, vertebrologist. In the initial phase to produce x-ray of the spine in 2 projections. If necessary, they can make the shot of a single segment of the spine and the acquisition of more projections. For the diagnosis of disc herniation, assessment of the state of the spinal cord and to identify complications of degenerative disc disease used magnetic resonance imaging (mri of spine). Plays an important role magnetic RESONANCE imaging in the differential diagnosis of degenerative disc disease and other disorders of the spine: ankylosing tuberculosis, osteomyelitis, tumors, disease of Bechterew, rheumatism, infectious diseases defeat. Sometimes in cases complicated degenerative disease of the cervical disc is necessary to the exception of syringomyelia. In some cases, when the impossibility to perform magnetic RESONANCE imaging shows myelography.
Air research affected intervertebral disc, possibly with the help of the discography. Electrophysiological studies used to determine the degree and location of the lesion of the nerve pathways, to monitor the recovery process in the course of therapy.
The treatment of degenerative disc disease of the spine
In the acute phase is shown in the peace of the affected vertebral motor segment. With this purpose, with osteochondrosis of the cervical spine is used, the fixing collar of the Pit, osteochondrosis lumbar spine bed rest. Fixing it is necessary and when osteochondrosis cervical vertebral instability segment.
In the medical therapy of degenerative disc disease used nonsteroidal anti-inflammatory drugs (NSAIDS): diclofenac, nimesulide, lornoxicam, meloxicam. In the case of intense, painful syndrome this analgesics, for example, an analgesic with central action flupirtine. To relieve the muscle tension, use of muscle relaxants — tolperison, tizanidine. In some cases, it is recommended the assignment anticonvulsants carbamazepine, gabapentin); antidepressants, including the preference serotonin reuptake inhibitors (sertraline, paroxetine).
In the case of the creation of the syndrome, the patient describes the treatment in a hospital. Perhaps the local introduction of glucocorticoids, the therapy against the swelling, the application of discharge. In the treatment of degenerative disc disease is widely used in physiotherapy, reflexology, massage, physiotherapy exercises. The application of the manual therapy requires a clear respect for the technical execution and particular caution in the treatment of osteoarthritis of the cervical spine.
The operation in the back, showing first of all with a significant compression of the spinal cord. Consists in the removal of hernia of the intervertebral disc and decompression of the spinal canal. It is possible to organize microdiscectomy, laser reconstruction of the disc, the replacement of the affected disk in the system, the stabilization of the segment.