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 disruption of their structure. Depending on the level of lesion, a distinction is made between cervical, thoracic and lumbar osteochondrosis.
Symptoms
The main signs by which one can assume the presence of osteochondrosis of the cervical spine is a local change in the configuration of one of the segments of the spine (the development of lordosis, kyphosis orscoliosis) - a clear visual curvature of the spine in the longitudinal or transverse plane. The second most common symptom is pain syndrome, which can be localized not only in the region of the vertebrae, but also in areas of the body innervated by the corresponding nerve root. Another complaint from these patients is a feeling of discomfort and a feeling of fatigue in the neck.
With cervical osteochondrosis the pain usually manifests in the neck area and can be given to the shoulder and scapula, it can be confused with myocardial infarction pain because it has similar symptoms. Also, cervical osteochondrosis can be accompanied by frequent headaches, dizziness. When the arteries supplying the brain are compressed (squeezed), 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:
- Pain occurs only with pronounced movements of the spine;
- The pain is relieved by a certain position of the spine;
- The pain is permanent.
Shapes
Depending on the syndromes caused in osteochondrosis, there are:
- Compression syndromes - occur with compression (radiculopathy - compression of nerve roots, myelopathy - muscle compression, neurovascular - compression of blood vessels and nerves);
- Reflex (muscle-tonic, neurodystrophic, neurovascular);
- Myoadaptive syndrome (overexertion of healthy muscles when they take over the functions of 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 depreciating functions (alleviating pressure) of the spine. The immediate cause of disc damage may be age-related degenerative changes associated with insufficient blood supply to the intervertebral discs, mechanical damage due to injury and heavy physical strain on the spine - for example, in case of overweight.
A sedentary lifestyle, in which a violation of the blood supply and the functioning of the intervertebral joints develops, plays an important role in the development of osteochondrosis. 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 - into the lumen of the spinal canal, or laterally - with the formation of amedian and lateral disc hernias. The disc can be pushed into the body of the vertebra itself with the formation of Schmorl's hernia - microscopic ruptures of the cartilage tissue of the intervertebral disc into the spongy tissue of the vertebral bone. In the case of posterior displacement of the disc, compression of the spinal cord and the resulting roots is possible, with the development of a typical pain syndrome.
Diagnostic
Diagnosis of osteochondrosis of the spine is carried out on the basis of complaints, anamnesis data, clinical examinations and methods of instrumental examination. Diagnostic measures consist of finding out the reasons that led to the development of neurological symptoms.
From the anamnesis it is possible to find out the presence of an injury, the nature of the work - constant physical overload (lifting weights), poor posture, peculiarities of work and the position of the spine at the table andwhen walking, the presence of infections.
General clinical studies (clinical blood test, general urinalysis), biochemical blood test have no independent value. They are prescribed to assess the current condition, diagnose the underlying disease and emerging complications.
Diagnosis is based on the clinical picture of the disease and is carried out by the method of sequential exclusion of similar diseases in clinical signs. Among the instrumental diagnostic methods, the most common and available is X-ray examination (spondylography is a study without contrast). It reflects the narrowing of the intervertebral joint spaces and allows you to identify osteophytes (bone growths) on the vertebral bodies, but only gives indirect information on the degree of damage to the intervertebral discs.
An accurate diagnosis can be made by CT and MRI (Magnetic Resonance and Computerized Imaging) imaging diagnostics, even at an early stage of the disease. Computed tomography allows you to determine the minimum abnormalities in bone and cartilage tissue, MRI - to perform the detail of soft tissue structures and determine the localization of the herniated disc.
A duplex ultrasound of the cerebral arteries is performed if there is a suspicion of a violation of the blood supply to the brain.
Differential diagnosis is carried out with diseases having similar clinical manifestations: pathologies resulting in pain radiating to the shoulder and the scapular region (diseases of the liver, gallbladder, pancreatitis - inflammation of the pancreas); cervical lymphadenitis - increase in cervical lymph nodes, rheumatoid arthritis; oncological diseases (tumors of the vertebrae, roots, spinal cord and membranes), tumors of the pharynx and pharyngeal space, Pancost cancer (compression of the brachial plexus in cancer of the upper lobe of the lung), metastases in thecervical region; tuberculous spondylitis - an inflammatory disease of the spine caused by Mycobacterium tuberculosis; arachnoid cysts; pseudocysts of the dura mater; vertebral abnormalities; fibromyalgia is a disease that causes pain in muscles, ligaments and tendons, thoracic outlet compression syndrome - a disorder caused by excessive pressure on the neurovascular bundle passing between the anterior and middle scalene muscles, on the formerrib and under the clavicle, myofascial muscle of the neck syndrome and shoulder girdle - a chronic pathological condition caused by the formation of local muscle spasms or seals, represented by painful spots.
The main laboratory tests used:
- Clinical blood test;
- Blood chemistry.
The main instrumental studies used:
- X-ray of the spine (spondylography);
- Magnetic resonance imaging (MRI);
- Computed tomography (CT);
- Duplex ultrasound of the arteries of the brain (if a violation of the blood supply to the brain is suspected).
Additional instrumental studies used:
- Densitometry - measurement of bone density (as indicated).
Processing
Treatment of osteochondrosis of the spine depends entirely on the stage and degree of development of osteochondrosis. At the initial stage, it is possible to use preventive measures, physiotherapy exercises, exercises on simulators and fitness. With severe pain syndrome, the patient needs physical rest. Anti-inflammatory and antispasmodic drugs are prescribed. It is possible to perform paravertebral blockages with anesthetics in order to open the pathological circle, when the pain causes muscle spasms, while the intervertebral disc is compressed more strongly, which, in turn, increases the pain itself. same.
Warming ointments are applied topically to the skin of the spinal region to improve local blood supply and reduce tissue edema. These patients are shown wearing a corset. In patients at the initial stage of development of osteochondrosis, chondroprotectors are effective - drugs that improve the restoration of cartilage tissue, as well as drugs that improve local blood supply, venotonics, vitamins of group B. Incases where the pain syndrome does not stop medically for a long time and there is a clinic of compression of the roots of the spinal cord with intervertebral hernia, the surgical removal of the damaged intervertebral disc is shown. In case of total compression of the spinal cord by a disc, early surgery is indicated.
You should not wait for a person to start urinating or defecating spontaneously - in this case, the damage to the spinal cord may already be irreversible. As physiotherapy procedures, magnetotherapy, ultrasound, massage, manual therapy, acupuncture and physiotherapy exercises are prescribed.
Complications
Possible vegetative-vascular dystonia and heart disturbance, stroke, hypotension and hypertension (decrease and increase in blood pressure), vestibular disturbances (impaired coordination of movements), vertebral artery syndrome (a disease caused bynarrowing of the vertebral artery), periarthrosis (disease of reduced mobility) shoulder joint.
Prophylaxis
For the prevention of osteochondrosis, it is necessary to treat the factors that provoke it, namely: avoiding injury to the spine, stress on the spine (lifting weights), and combating overweight. For people who already suffer from the initial stage of osteochondrosis, it is recommended to wear corsets at home and during physical exertion. In order for the spine to rest during sleep, it is recommended to sleep on orthopedic mattresses and pillows.
What questions should you ask your doctor
Are there any exercises to relieve the symptoms?
What drugs will help to cope with osteochondrosis of the cervical spine?
What will happen if you do not start treating the disease on time?
Advice to patients
Exercise, weight loss in the presence of excess weight, the use of cold or hot compresses help to relieve the symptoms of osteochondrosis of the thoracic spine. It's also important to eat well, watch your spine, treat chronic illnesses, and avoid injury.