Osteochondrosis of the spine is a complex of dystrophic and degenerative changes in the intervertebral discs and adjacent surfaces of the vertebral bodies associated with the destruction of tissues and the disruption of their structure. Depending on the level of the lesion, cervical, thoracic and lumbar osteochondrosis can be distinguished.
Symptoms
The main signs by which the presence of osteochondrosis of the cervical spine can be assumed is a local change in the configuration of one of the parts of the spine (development of lordosis, kyphosis or scoliosis) - a clear visual curvature of the vertebraeor transverse plane. The second most common symptom is pain syndrome, which can be located not only in the area of the vertebrae, but also given to areas of the body that are innervated by the corresponding nerve root. Another complaint of these patients is the feeling of discomfort and fatigue in the neck.
With cervical osteochondrosis, the pain usually manifests itself in the neck area and can be given to the shoulder and scapula, it can be confused with pain in the myocardial infarction, as it has similar symptoms. Also, cervical osteochondrosis may be accompanied by frequent headaches, dizziness. When the arteries that supply the brain are constricted (compressed), there may be signs of brain dysfunction (neurological symptoms): fainting, nausea, tinnitus, mood swings, anxiety and more.
Depending on the severity of the pain, they are divided into 3 degrees:
- The pain appears only with intense movements in the spine.
- The pain is relieved by a specific position of the spine.
- The pain is permanent.
Printed matter
Depending on the syndromes caused by osteochondrosis, there are:
- Compression syndromes - occur with compression (root disease - compression of nerve roots, myelopathy - compression of muscles, neurovascular - compression of blood vessels and nerves).
- Reflex (myotonic, neurodystrophic, neurovascular);
- Myoadaptive syndrome (overexertion of healthy muscles when they take over the functions of the affected muscles).
Causes
The mechanism of development of the disease is the damage of the intervertebral disc for various reasons and its displacement with the loss of the damping functions (moderate pressure) of the spine. The immediate cause of disc damage can be age-related degenerative changes associated with reduced blood flow to the intervertebral discs, mechanical injuries from injury, and severe physical exertion on the spine - for example, being overweight.
An important role in the development of osteochondrosis is played by a sedentary lifestyle, in which a violation of the blood supply and the function of the intervertebral joints develops. The mechanism of development of the disease is as follows: if the fibrous ring connecting the vertebral bodies is damaged, the intervertebral disc is pushed back and forth - in the lumen of the spine, or laterally - with the formation of middle and lateral disc herniations. The disc can be pushed into the body of the vertebrae itself with the formation of Schmorl's hernia - tiny fractures of the cartilaginous tissue of the intervertebral disc into the spongy tissue of the vertebral bone. In the event of a posterior dislocation of the disc, it is possible to compress the spinal cord and the roots extending from it, developing a typical pain syndrome.
Diagnostics
The diagnosis of osteochondrosis of the spine is made on the basis of complaints, memory data, clinical examination and methods of examination with organs. Diagnostic measures are to discover the reasons that led to the development of neurological symptoms.
From the history, it is possible to determine the presence of injury, the nature of work - constant physical overload (weight lifting), poor posture, peculiarities of work and the position of the spine on the table and when walking, the presence of infections.
General clinical studies (clinical blood test, general urine analysis), biochemical blood test have no independent value. They are prescribed for the evaluation of the current condition, the diagnosis of the underlying disease and the emerging complications.
The diagnosis is based on the clinical picture of the disease and is made by the method of sequential exclusion of diseases similar in clinical signs. Of the instrumental diagnostic methods, the most common and available is radiography (spondylography is a study without contrast). It reflects the narrowing of the spaces of the intervertebral joints and allows you to identify osteophytes (bone growths) in the vertebral bodies, but gives only indirect information about the degree of damage to the intervertebral discs.
An accurate diagnosis can be made with computed tomography and magnetic resonance imaging (computed tomography and magnetic resonance imaging), even at an early stage of the disease. Computed tomography allows you to identify minimal abnormalities in the bones and cartilage tissues, MRI - to perform details of soft tissue structures and to determine the location of the disc herniation.
A double ultrasound scan of the cerebral arteries is performed if a violation of the blood supply to the brain is suspected.
The differential diagnosis is made with diseases that have similar clinical manifestations: pathologies that progress with pain that radiates to the shoulder and shoulder area (diseases of the liver, gallbladder, pancreatitis - inflammation of the pancreas). cervical lymphadenitis - enlargement of the cervical lymph nodes, rheumatoid arthritis. oncological diseases (tumors of vertebrae, roots, spinal cord and membranes), tumors of the pharynx and pharynx, Pancost cancer (compression of the brachial plexus in cancer of the upper lobe of the lung), metastases in the cervical region. Tuberculous spondylitis - an inflammatory disease of the spine caused by the mycobacterium tuberculosis. arachnoid cysts; pseudocysts of the meninges. abnormalities of the spine; Fibromyalgia is a disease that causes pain in the muscles, ligaments and tendons, chest compression syndrome - a disorder caused by excessive pressure on the neurovascular bundle that runs between the anterior and middle steps, above the first side and belowfrom the key, myoperitoneal syndrome of the neck and shoulder girdle - a chronic, pathological condition caused by the formation of local muscle spasms or seals, represented by points of pain.
The main laboratory tests used:
- Clinical blood test?
- Blood chemistry.
The main organic studies used:
- X-ray of the spine (spine);
- Magnetic resonance imaging (MRI);
- Computed tomography (CT);
- Double ultrasound scan of the arteries of the brain (if there is a suspicion of a violation of the blood supply to the brain).
Additional organic studies were used:
- Densitometry - measurement of bone density (according to indications).
Treatment
The treatment of osteochondrosis of the spine depends entirely on the stage and degree of development of osteochondrosis. In the initial stage, it is possible to use preventive measures, physiotherapy exercises, exercise in simulators and physical condition. With severe pain syndrome, the patient needs physical rest. Anti-inflammatory and anticonvulsant drugs are prescribed. It is possible to perform paravertebral blockades with anesthetics to open the pathological cycle, when the pain causes a muscle spasm, while the intervertebral disc is compressed more intensely, which in turn increases the pain itself.
The heating ointments are applied topically to the skin of the spinal area to improve the local blood supply and reduce tissue swelling. These patients are shown to wear corsets. In patients with early-stage osteochondrosis, chondroprotective drugs are effective - drugs that improve the repair of cartilage tissue, as well as drugs that improve local blood supply, phlebotonics, B vitamins. In cases where the pain syndrome for medicalfor a long time and there is a clinic of compression of spinal cord roots with intervertebral hernia, the surgical removal of the damaged intervertebral disc is seen. In cases of total compression of the spinal cord from a disc, early surgery is indicated.
You do not have to wait until a person starts urinating or defecating spontaneously - in this case, the spinal cord injury may already be irreversible. Physiotherapy procedures include magnetotherapy, ultrasound, massage, manual therapy, acupuncture and physiotherapy exercises.
Complications
Possible vegetative-vascular dystonia and heart disorder, cerebrovascular accident, hypotension and hypertension (decrease and increase in blood pressure), vestibular disorders (movement coordination disorder), vertebral artery syndrome (disease caused by arthritis)a disease with reduced mobility) shoulder joint.
Prophylaxis
To prevent osteochondrosis, it is necessary to deal with the factors that cause it, namely: to avoid injuries to the spine, strain on the spine (weight lifting) and fight against excess weight. For people who already suffer from the initial stage of osteochondrosis, the use of corsets at home and during physical exercise is recommended. To rest the spine during sleep, it is recommended to sleep on orthopedic mattresses and pillows.
What questions should you ask your doctor?
Are There Exercises That Help Relieve Symptoms?
What medications will help treat osteochondrosis of the cervical spine?
What happens if you do not start treatment on time?
Patient advice
Exercise, weight loss in the presence of excess weight, the use of cool or warm pads help relieve the symptoms of osteochondrosis of the thoracic spine. It is also important to eat right, monitor your spine, treat chronic conditions and avoid injuries.