Osteochondrosis of the spine is a chronic disease in which degenerative changes in the vertebrae and the intervertebral discs between them occur.Depending on the damage to the spine, they differentiate: osteochondrosis of the cervix region, osteochondrosis of the lumbar region.To diagnose the osteochondrosis of the spine, it is necessary to radiography and in the case of its complications (e.g. hernia of the intervertebral disc) - MRI of the spine.When treating osteochondose of the spine and drug methods, it is widespread, reflex zone massage, manual therapy, physiotherapy and physiotherapy exercises.
Etiology and pathogenesis
Osteochondrosis of the spine develops into one or the other degree in all people in old age and is one of the methods of aging the body.Sooner or later, atrophic changes occur in the intervertebral disc.However, injuries, diseases and various overloads of the spine contribute to the earlier occurrence of osteochondrosis.The most common osteochondrosis of the cervix region and osteochondrosis of the lumbar spine.
About 10 theories of osteochondrosis have been developed: vascular, hormonal, mechanical, hereditary, infectious allergy sufferers and others.But none of them give a complete explanation of the changes in the spine, but they are complementary together.
It is believed that the main point when osteochondrosis occurs is the constant overload of the vertebral engine segment, which consists of two neighboring vertebrae.Such an overload can occur due to a motor stereotype - an individual way of sitting and walking.Poster diseases that sit in the wrong pose and go on foot with an uneven spine lead to an additional load on the panes, ligaments and muscles of the spine.The process can worsen due to the properties of the structure of the spine and the insufficiency of the trophism of its tissue due to hereditary factors.The most common vice is in the structure in the cervix region and lead to vascular disorders and to the early occurrence of signs of osteochondrosis of the cervical spine.
The occurrence of osteochondrosis of the lumbar region is more often associated with its overload during the tendencies and the severity stays.A healthy intervertebral disc can withstand considerable stress due to the hydrophilia of the pulpoose nucleus, which is located in its center.The core contains a large amount of water and liquids, as you know, are not very compressed.The dismantling of a healthy intervertebral disc can occur with a compression of more than 500 kg, while the hard drive changed due to the osteochondrosis, which is torn with a compression of 200 kg.In a 200 kg load, a lumbar of the spine of a person with a weight of 70 kg will occur if it contains a 15 -kilogram load in the body's inclination position before 200.Such a great pressure is due to the small size of the cellulist core.With an increase in inclination to 700, the strain on the intervertebral discs is 489 kg.Therefore, the first clinical manifestations of osteochondrosis of the lumbar spine often occur during or after lifting weights, housework, weeds in the garden, etc.
The destruction of the connective tissue of the fiber ring of the disc, the ligaments and capsules of the facet joints leads to the reaction of the immune system and the development of aseptic inflammation with the swelling of the facet joints and their surrounding tissue.Due to the shift of the vertebral bodies, the capsules of the facet joints are stretched and the changed intervertebral disc is not determined so firmly by the body of neighboring vertebrae.The instability of the spine segment is formed.Due to the instability, violations of the spine nerve with the development of the radicular syndrome is possible.With osteochondrosis of the cervical spine, this often occurs during the bodies with osteochondrosis - during the bodies.It is possible to form a functional block of the vertebral engine segment.This is due to the compensation of the spine muscles.
The hernia of the intervertebral disc is formed when the window is moved back, the rear longitudinal band rupture and the lead of the disc in the vertebral canal are carried out.If the core of the pane is pressed out in the Cerebrospinal Canal at the same time, such a hernia is described as exploding.The severity and duration of the pain with such a hernia is much larger than not exploded.The hernia of the disc can cause radicular syndrome or compression of the spinal cord.
In the case of osteochondrosis, bone tissue growth in the formation of osteophytes occurs - bone growth on the bodies and processes of the vertebrae.Osteophytes can also cause compression of the spinal cord or the development of the radicular syndrome.
Symptoms of the spine osteochondrosis
The main symptom for osteochondrosis of the spine is pain.The pain can be acute with high intensity, intensify with the slightest movement in the affected segment and therefore sets the patient to take up a forced position.With osteochondrosis of the cervical spine, the patient holds his head in the least painful pose and cannot turn it.The pain increases with osteochondrosis of the chest region, even if they breathe deeply, and with osteochondrosis of the lumbar region, it is difficult to push, climb and go.Such pain syndrome is characteristic of the compression of the spine back.
In about 80% of the cases there is a blunt pain of constant nature and moderate intensity.In such cases, the doctor must distinguish the manifestations of osteochondrosis of the spine from the myositis of the muscles of the back when examining.Stupid pain in osteochondrosis is due to excessive muscle tension that the affected vertebral engine segment, inflammatory changes or a significant stretching of the intervertebral disc.In patients with such pain, there is no forced position, but the restriction of movements and physical activity is uncovered.Patients with osteochondrosis of the cervical spine avoid sharp curves and tendency with their heads, whereby osteochondrosis of the lumbar region slowly sit down and get up, avoid tilting the body.
Complications of osteochondrosis of the spine
Complications of osteochondrosis are connected to the hernia of the intervertebral disc.This includes the compression of the spinal cord, which is characterized by deafness, the weakness of certain muscle groups of the extremities (depending on the level of compression), which leads to the occurrence of paresis, muscle atrophy, a change in tendon reflexes, urine and loyalty.Intermediate vertebrae can cause compression of the artery that feeds the spinal cord with the formation of ischemic areas (infarction of the spinal cord) with the death of nerve cells.This shows the appearance of a neurological deficit (impaired movements, sensitivity, trophic disorders) that correspond to the level and prevalence of ischemia.
Diagnosis of osteochondrosis of the spine
The diagnosis of osteochondrosis of spinale spine is carried out by a neurologist or vertebrologist.In the initial phase, the radiography of the spine is carried out in 2 projections.If necessary, you can shoot a separate spine segment and shoot in additional projections.The assessment of the state of the spinal cord and the detection of complications of osteochondrosis, magnetic resomography and resonance imaging (MRI of the spine) is used to diagnose vaulting braler heroes.MRI plays an important role in the differential diagnosis of osteochondrosis and other spine diseases: tuberculosis spondylitis, osteomyelitis, tumors, ankylosing spondes, rheumatism, infectious lesions.Sometimes the exclusion of syringomyelia is required for complicated osteochondrosis of the cervical spine.In some cases, myelography is shown when the MRI is impossible.
A targeted examination of the affected intervertebral disc is possible with discography.Electrophysiological studies are used to determine the degree and the location of damage to the nerve paths to monitor the process of their restoration during therapy.
Treatment of osteochondrosis of the spine
In acute time, peace in the affected vertebral engine segment is shown.For this purpose, the fixation is used for osteochondrosis of the cervical spine using a Chantzhalribig with osteochondrosis of the lumbar bed chest.The fixation is also required for the osteochondrosis of the cervix region with instability of the vertebrae segment.
In the drug therapy of osteochondose, non -steroid inflammatory drugs (NSAIDS) are used: Diclofenac, Nimesulid, Lornoxicam, Meloxicam.In intensive pain syndrome, analgesics are shown, for example, an analgesic central effect of fluportin.To alleviate muscle tension, muscle relaxants are used - tolperison, thizanidine.In some cases it is advisable to prescribe anticonvulsant medication - carbamazepine, gabapentin;Antidepressants under which the inhibitors of the reverse edging of serotonin (ceraline, paroxetine) are given.
In a radicular syndrome, stationary treatment is displayed.It is a possible local introduction of glucocorticoids, treatment against edema, use of traction.In the treatment of osteochondrosis, physiotherapy, reflex zone massage, massage, physiotherapy exercises are widespread.The use of manual therapy requires a clear compliance with the technology of your implementation and special care in the treatment of osteochondrosis of the cervical spine.
The spine operations are mainly displayed with a significant compression of the spinal cord.It is to remove the hernia of the intervertebral disc and the decompression of the vertebral canal.It is possible to carry out a microdiscomy, the laser conference of the hard disk, the replacement of the disked disk through an implant and stabilization of the spine segment.