Osteochondrosis of the spine is a chronic disease in which occur degenerative changes of the vertebral column and lying between the two intervertebral discs. Depending on the location of the lesion of the vertebral column can be distinguished: osteochondrosis of the cervical spine, low back pain and thoracic and osteochondrosis of the lumbar region. For the diagnosis of degenerative disc disease of the spine necessary to conduct an x-ray, and in the event of complications (for example, a disc herniation) - MRI of the spine. In the treatment of degenerative disc disease of the spine with the medicinal drugs and methods are widely used, reflexology, massage, manual therapy, physio and remedial physical education.
The etiology and pathogenesis
To a certain extent, osteochondrosis of the spine develops in older people and is one of the aging process of the body. Sooner or later the intervertebral disk changes occur atrophic, however, the injuries, the diseases and the different overloads of the spine contribute to the early onset of the degenerative disease of the disc. Most often, osteochondrosis of the cervical spine and osteochondrosis of the lumbar spine.
Designed around a 10-theories of the degenerative disc disease: vascular, hormonal, manual, genetics, infectious diseases-allergic and other. But none of them does not give a full explanation occurring in the vertebral column changes, they are complementary.
It is believed that the fundamental point in the development of degenerative disc disease is a constant overload of the vertebral skeletal segment, which consists of two adjacent vertebrae. This overload may occur because of an engine of a stereotype, posture, how to sit and walk. The violation of posture, sitting in a poor posture, walking with uneven vertebrate post cause an additional load on the disks, ligaments, and muscles of the spine. The process may worsen due to the characteristics of the structure of the spine and of the insufficiency trophic its tissues due to hereditary factors. The most often defects in the structure occur in the cervical region and lead to a vascular violations and early onset of signs of degenerative disc disease of the cervical spine.
The onset of degenerative disc disease, lumbar spine is more often linked to its overload of flexion and climbs of gravity. A healthy intervertebral disc can withstand heavy loads thanks to the hydrophilicity located in the center of the nucleus pulposus. The kernel contains a large amount of water and liquid, as is well known, a little compressed. The rupture of an intervertebral disk healthy may occur when the compression force of more than 500 kg, while that changed as a result of degenerative disc disease, the disc is broken when the power of the lodges to 200 kg Load 200 kg experiences a lumbar spine of a human with a body weight of 70 kg, when it holds 15 pounds of the cargo in the position of tilt of the trunk toward the front on the 200. A lot of pressure is due to a low amplitude of the nucleus pulposus. When the slope increase up to 700, the load on the intervertebral discs will be 489 kg, Therefore, often the first clinical manifestations of the degenerative disc disease of the lumbar spine occur during or after the lifting of heavy loads, household work, weeding the garden, etc
The destruction of the connective tissue and the fibrotic ring of the disc, ligaments and facet joint capsules causes a reaction of the immune system and the development of inflammation aseptic with the swollen facet joints and the surrounding tissues. Due to the shift of the vertebral bodies occurs a sprained facet joint capsules, and changed the intervertebral disc protrudes up already firmly holds the bodies of adjacent vertebrae. Formed at the unstable spinal segment. Because of the instability may be an infringement of the strain of the spinal nerve with the development of a syndrome root. Osteochondrosis of the cervical spine this occurs frequently during the rounds of the head, osteochondrosis of the lumbar — when the inclinations of the trunk. Perhaps the formation of the functional unit of the vertebral skeletal segment. It is subordinated to the compensatory decrease in vertebrate muscles.
The herniated disc is formed when the disc moves to the rear, there is a rupture of the back of the ligament longitudinal and the protrusion of a portion of the disc into the spinal canal. If, in the spinal canal is pressed in the nucleus of the disc, this hernia is called broken. The severity and duration of the pain when the herniation a lot more than if unexploded. A herniated disc can be the cause of nerve root or compression syndrome of the spinal chord.
Osteochondrosis occurs a proliferation of bone with formation of osteophytes — bony growths on the body and the shoots of the spine. Osteophytes can also cause compression of the spinal cord or cause the root development of the 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 sharp with a high intensity, it is strengthened at the slightest movement in ravaged by a segment and thus requires the patient to take distress. Thus, osteochondrosis of the cervical spine, the patient keeps the head at least a position that is painful and can not rotate, low back pain and thoracic pain intensifies even when breathing deep, and osteochondrosis of the lumbar spine and division of the patient is difficult to sit, stand and walk. Such a pain syndrome is characteristic to the compression of the strain of the spinal nerve.
Approximately 80% of cases there is a dull pain is permanent in nature and of moderate intensity. In such cases, during the examination, the doctor needs to differentiate between the manifestations of the degenerative disc disease of the spine, of myositis in the muscles of the back. A dull pain low back pain is due to excessive muscle tension of retaining the affected vertebral motor segment, inflammatory, or of significant change in stretching of the intervertebral disc. In patients with the syndrome of distress, but reveals a limitation of movements and physical activity. Patients with osteochondrosis of the cervical spine to avoid the tight turns and slopes of the head, with osteochondrosis lumbar - slowly sit down and get up, avoid the slopes of the torso.
The complications of degenerative disc disease of the spine
The complications of degenerative disc disease related to a herniated disc. They include a compression of the spinal cord, which is characterized by numbness, weakness of some muscle groups of members (depending on the compression level), leading to the appearance of paresis, muscle atrophy, alteration of tendon reflexes, disorders of urination and defecation. Intervertebral disc herniation may cause compression of the arterial supply of the spinal cord, with the formation of ischemic plots (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 sensitivity, trophic disorders), corresponding to a prevalence level of ischemia.
The diagnosis of degenerative disc disease of the spine
The diagnosis of degenerative disc disease of the spine, proceeds to a neurologist or spine. The initial phase will produce x-rays of the spine in 2 projections. May, if necessary, to take pictures of individual vertebral segment and additional pictures projections. For the diagnosis of intervertebral hernia, the evaluation of the state of the spinal cord and to identify complications of degenerative disease of the disk to apply a magnetic (MRI of spine). Plays a role of MRI in the differential diagnosis of degenerative disc disease and other diseases of the spine: tuberculous spondylitis, osteomyelitis, tumors, Ankylosing spondylitis, rheumatism, lesions, infectious. Sometimes in cases of complications of degenerative disc disease of the cervical spine, you need to the exception of syringomyelia. In some cases, the inability of the MRI shows the myelography.
The study says farms intervertebral disc may be using the discography. The electrophysiological studies used to determine the degree and location of injury of the nerve pathways monitoring of recovery process in the course of treatment.
The treatment of degenerative disc disease of the spine
In the acute phase of an illustrious tranquility in hit spinal from the engine of the segment. To this end, osteochondrosis of the cervical spine to apply the fastener to the aid of a collar Gap, osteochondrosis of the lumbar — rest in the bed. The fastening is necessary, and osteochondrosis cervical instability spinal segment.
The drug treatment of degenerative disc disease apply nonsteroidal anti-inflammatory drugs (NSAIDS): diclofenac, nimésulide, lornoxicam, meloxicam. In the case of a strong pain syndrome view of the analgesics, for example, an analgesic central action flupirtine. To relieve tension muscle use muscle relaxants — tolperison, tizanidine. In some cases, the designation of anticonvulsants - carbamazepine, gabapentin; antidepressants, among which is the preference to give to inhibitors of serotonin re-uptake inhibitors (sertraline, paroxetine).
If you are experiencing a syndrome root canal patient shows a treatment in the hospital. Perhaps the local administration of glucocorticoid therapy, anti-oedema, the application of traction. In the treatment of degenerative disc disease is widely used in physiotherapy, reflexology, massage, physiotherapy. The application of manual therapy and requires strict adherence to the technical and particular caution in the treatment of degenerative disc disease of the cervical spine.
Surgery of the spine shows first with a compression of the spinal cord. It consists of removing the herniated disc and decompression of the spinal canal. It is possible to organize microdiscectomy, laser, reconstruction of the disc, the replacement of the farms of the disk of the implant stabilisation of the vertebral segment.