Disease Legg calve of pertusa and calve disease: treatment and symptoms
Disease Calvet: the complexity of diagnosis and treatment
Calve’s disease, or aseptic necrosis of a vertebral body, belongs to a group of diseases that are referred to in the orthopedics dissecans.
This pathology was first described in 1925 by the French scientist Jean Calvet, in whose honor it was named.
After several years of research, Calvet began to receive new information about this disease. In detail it was studied in 1938 by Dr. Massari in the study of the body of child who died from diphtheria.
The histological data that he received as a result of the work confirmed the assumption that the disease is osteochondropathy.
What kind of disease is this?
Disease Calvet is a non – infectious (aseptic) necrosis of a vertebral body, or in other words, its immobilization, which is non-infectious in nature.
The disease is characterized by bulging of the spinous process of the vertebra, the voltage paravertebral muscles, tenderness, and limitation of motion in the affected area of the spine.
A distinctive feature of osteochondropathy is that it is diagnosed in children and in adolescence. Of them she’s usually in boys aged 4-7 years old.
Typically, the disease affects the thoracic vertebrae, which is the highest point of the kyphosis.
It carries the greatest load. Much less frequently avascular necrosis is diagnosed in the lumbar spine.
Sometimes the affected just two of the vertebra next door or one healthy.
Non-infectious necrosis can affect not only the spine, but the head of the femur. This pathology is known under the name of the disease, Legg-calve-Perthes.
By their nature, the two diseases are identical and differ only in the location: Calw affects the vertebrae, and Legg-calve-Perthes – the head of the femur.
The distinctive features can be attributed to the causes of the development: if the first occurs because of impaired blood supply, causes of Calvet are not clear.
The causes of the disease
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Consensus about the nature of disease no, but most scientists believe that it develops due to eosinophilic granuloma.
In the result of a lesion of bone formed on it an infiltrate with a large number of eosinophilic red blood cells. They then lead to the development of necrosis of a vertebral body.
When the presence of granulomas is not confirmed, doctors are considering other reasons:
- abnormal development of the embryo;
- injury or disease of the spine;
- metabolic disorder of bone tissue;
- Hodgkin’s disease;
- Gaucher disease;
- aneurysmal bone cyst;
- insufficient blood supply to the bone tissue.
Necrotic processes, which are characteristic of osteochondropathy lead to changes in the device of the vertebra.
Under the power of the neighboring vertebrae, it becomes thinner and the adjacent intervertebral discs were thicker. These changes are clearly visible on x-ray image of the affected area.
After some time in a sick vertebra begins rebuilding and bone structure is gradually recovering.
Depending on the reasons for the development of aseptic necrosis, the disease is divided into two types: genuinny disease (is caused eosinophilic granuloma) and symptomatic (when the disease is a symptom of another pathology, for example, injuries range).
Symptoms and diagnosis
Typically, the disease often has an inconspicuous beginning, and only in rare cases may increase in temperature to 37-38. The main symptom of the disease is pain in the back, but also may display other symptoms:
- fatigue in the area of the back;
- pronounced kyphosis;
- the limit in muscle tension;
- the limitation of the functioning of the spine in the upright position of the body;
- the protrusion of the spinous process.
Very often aseptic necrosis revealed by an orthopedist or traumatologist accidentally during radiography of the spine. This type of diagnostics is the most informative, if you take pictures in side view. But even then, the x-ray does not give an exhaustive answer.
To study in detail what is happening to the vertebrae changes, the patient is examined by conventional or spiral CT.
It should be noted that this is a fairly rare disease, so it can easily be confused with a fracture of the spine, tuberculosis of the spine, ankylosing spondylarthritis, some deviations of the ridge.
Diagnosis of aseptic necrosis requires a high level of professionalism.
Treatment noninfectious necrosis of a vertebral body is carried out by conservative methods.
This includes the discharge mode of the spine (the patient must be in a horizontal position), restorative measures, conducting physical exercises, acupuncture, magnetic therapy, therapeutic massage.
Correction of deformity of the vertebra is performed using a plaster bed. As soon as he is restored to 2/3 of its height, the patient is allowed to get out of bed.
Such treatment may take several years. Monitoring results is carried out every 6 months by conducting a radiography.
If conservative treatment fails and the disease often develops further, it is performed surgery. Its aim is to stop distortion of the vertebral method of fixing the spine.
Is used some surgical methods: fixing brackets or plates, the method interbody fusion and others.
They all have great efficiency, however, to restore the vertebra to 100% not.
Complications of the disease
As a rule, the disease often assumes great danger to human life, but sometimes can cause complications.
When not treated result in deformation of the bone tissue, which sets in motion a degenerative process. He, in turn, leads to microfractures of the bone.
Another complication osteochondropathy vertebral body is an obvious kyphosis is a curving of the upper spine.
Moreover, neither conservative nor surgical treatment method is not able to cure the disease completely. Therefore, with age, the person may develop osteoarthritis.
Prevention of the disease
Prevention of disease Calvet is a daily exercise for building muscle mass. Strong muscle is, first and foremost, the key to a healthy spine.
Also to improve the local blood circulation is necessary to strengthen blood vessels. This well help massage, swimming, douche.
In addition, the period of greatest likelihood of disease development, namely, 7-12 years are encouraged to limit physical activity.
Heavy loads on the spine at this age is strictly prohibited. These are the most important recommendations for the prevention osteochondropathy. As such, a single accepted system of preventive measures no.
Despite the fact that the disease often requires long and difficult treatment of the spine, in most cases the outcome is favorable. Over time, dead portions of the vertebrae are subjected to restructuring and fully restored.
Sometimes the disease resolves on its own without any treatment.
At the same time, it is worth considering the fact that aseptic necrosis of vertebral body is a rare pathology. It is practically not diagnosed in adults and rarely in adolescent girls.
To cases of necrosis were still less should regularly carry out prevention of the disease. It’s enough to exercise, avoid excessive exercise, maintain a healthy lifestyle.