Osteochondrosis of the spine is a complex of dystrophic and degenerative lesions of the intervertebral discs and adjacent surfaces of the vertebral bodies, accompanied by tissue destruction and disruption of their structure. Depending on the degree of damage, osteochondrosis of the neck, chest, and lumbar can be distinguished.
Symptoms
The main signs that suggest the presence of osteochondrosis of the cervical spine are a local change in the configuration of one segment of the spine (development of lordosis, kyphosis or scoliosis) - 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 vertebral region but also in areas of the body innervated by the corresponding nerve root. Another complaint of these patients is a feeling of discomfort and fatigue in the neck.
In cervical osteochondrosis, the pain usually manifests itself in the neck area and can be given to the shoulder and shoulder blade, confused with pain in a myocardial infarction because it has similar symptoms. In addition, cervical osteochondrosis can be associated with frequent headaches and dizziness. When the arteries that supply the brain constrict (constrict), signs of brain dysfunction (neurological symptoms) may occur: fainting, nausea, tinnitus, mood swings, anxiety, and so on.
According to the severity of the pain can be divided into 3 degrees:
- Pain occurs only with pronounced movements in the spine;
- The pain is relieved by a certain position of the spine;
- The pain is lasting.
Forms
Depending on the syndromes caused by 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-toned, neurodystrophic, neurovascular);
- Myadaptive syndrome (overload of healthy muscles when they take over the functions of the affected muscles).
Cause
The mechanism of the disease is the damage and displacement of the intervertebral disc due to various causes with the loss of the damping (pressure-reducing) functions of the spine. Disc damage can be a direct cause of age-related degenerative lesions associated with impaired blood supply to the intervertebral discs, mechanical damage from injuries, and severe physical exertion of the spine, such as overweight.
An sedentary lifestyle plays an important role in the development of osteochondrosis, in which disorders of blood supply and intervertebral joints develop. The mechanism of the disease is as follows: if the fibrous ring connecting the vertebral bodies is damaged, the intervertebral disc moves back and forth - into the lumen of the spinal canal or laterally - with the formation of median and lateral disc. hernias. The disc can be pushed into the body of the vertebra itself with the formation of a Schmorl hernia - microscopic fractures of the cartilaginous tissue of the intervertebral disc into the spongy tissue of the vertebrae. With posterior displacement of the disc, compression of the spinal cord and the roots protruding from it is possible, with the development of a typical pain syndrome.
Diagnostics
Diagnosis of spinal osteochondrosis is based on complaints, medical history, clinical examination, and instrumental examination methods. The purpose of diagnostic measures is to explore the causes that lead to the development of neurological symptoms.
The anamnesis reveals the existence of the injury, the nature of the work - constant physical overload (weight lifting), poor posture, the peculiarities of work and the position of the spine at the table and while walking, the presence of infections.
General clinical trials (clinical blood test, general urine test), biochemical blood test have no independent value. It is prescribed to assess the current condition, to diagnose the underlying disease and the complications that arise.
Diagnosis is based on the clinical picture of the disease and is performed by the method of sequential exclusion of similar diseases in clinical symptoms. Of the instrumental diagnostic methods, X-ray examination (spondylography is a non-contrast examination) is the most common and available. This reflects the narrowing of the intervertebral joint spaces and allows the identification of osteophytes (bone outgrowths) on the vertebral bodies, but provides only indirect information on the extent of damage to the intervertebral discs.
Imaging CT and MRI (computer and magnetic resonance imaging) diagnostics can make an accurate diagnosis in the early stages of the disease. CT allows the determination of minimal anomalies in bone and cartilage tissues, MRI - the specification of soft tissue structures and the localization of the disc herniation.
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 made with diseases with similar clinical manifestations: pathologies associated with pain radiating to the shoulder and shoulder region (liver, gallbladder, pancreatitis - inflammation of the pancreas); cervical lymphadenitis - growth of cervical lymph nodes, rheumatoid arthritis; oncological diseases (tumors of the vertebrae, roots, spinal cord and membranes), tumors of the pharynx and pharynx, Pancost cancer (compression of the brachial plexus in the cancer of the upper lung of the lung), metastases in the neck region; spondylitis tuberculosis - an inflammatory disease of the spine caused by mycobacterium tuberculosis; arachnoid cysts; pseudocysts of the dura mater; spinal anomalies; Fibromyalgia is a disease that causes muscle, tendon and tendon pain, chest discharge compression syndrome - a disorder caused by excessive pressure of the neurovascular bundle passing between the anterior and middle scaly muscles, above the first rib and below the collarbone, between the myofascial neck muscle. syndrome and shoulder girdle - a chronic, pathological condition caused by the formation of local muscle cramps or seals, represented by pain points.
Main laboratory tests used:
- clinical blood test;
- Blood chemistry.
The main instrumental tests used are:
- X-ray of the spine (spondylography);
- Magnetic resonance imaging (MRI);
- computed tomography (CT);
- Ultrasound duplex scanning of the arteries in the brain (if a violation of the blood supply to the brain is suspected).
Other instrumental tests used:
- Densitometry - measurement of bone density (according to indications).
Treatment
The treatment of spinal osteochondrosis depends entirely on the stage and stage of development of osteochondrosis. In the initial phase, it is possible to use preventive measures, physiotherapy exercises, exercises on simulators and fitness. In the case of severe pain syndrome, the patient needs physical rest. Anti-inflammatory and antispasmodic drugs are prescribed. There is a possibility of paravertebral blockages with anesthetics to open the pathological circle when the pain causes muscle cramps while the intervertebral disc is compressed more strongly, which in turn intensifies the pain itself.
Warming ointments are applied topically to the skin of the vertebral region to improve local blood supply and reduce tissue edema. These patients wear corsets. Chondroprotectors are effective in patients with early-stage osteochondrosis - drugs that improve cartilage tissue repair, as well as drugs that improve local blood supply, venotonia, and B vitamins. In cases where the pain syndrome does not resolve medically for a long time and there is a clinic with root compression spinal cord with intervertebral hernia, surgical removal of the damaged intervertebral disc is seen. Early surgery is recommended for complete compression of the spinal cord by the disc.
You should not wait for a person to start urinating or defecating spontaneously - in which case the damage to the spinal cord may already be irreversible. Physiotherapy procedures include magnetotherapy, ultrasound, massage, manual therapy, acupuncture, and physiotherapy exercises.
Complications
Possible vegetative-vascular dystonia and cardiac dysfunction, cerebrovascular accident, hypotension and hypertension (decrease and increase in blood pressure), vestibular disorders (disorder of movement coordination), vertebral artery syndrome (arteriosclerosis).
Prophylaxis
In order to prevent osteochondrosis, the factors that cause it need to be addressed, namely: avoiding spinal injuries, spinal stress (lifting weights), and fighting obesity. For those who are already suffering from the initial stages of osteochondrosis, it is recommended to wear a corset at home and during physical exertion. In order for the spine to rest during sleep, it is recommended to sleep on an orthopedic mattress and pillow.
What questions should your doctor ask
Are there exercises to relieve symptoms?
What medications help cope with osteochondrosis of the cervical spine?
What happens if you do not start treating the disease on time?
Patient advice
Exercising, losing weight in the presence of excess weight, and applying a cool or warm compress will help relieve the symptoms of osteochondrosis of the thoracic spine. It is also important to eat properly, monitor your spine, treat chronic diseases and avoid injuries.