Neurology: symptoms and signs of spinal osteochondrosis
Osteochondrosis is one of the most common diseases on the planet, but not everyone knows that science, which studies low back pain – neurology. This disease is characterized by an initial lesion of the intervertebral disc, which further extends to the surrounding vertebrae, muscles and ligaments. Depending on the extent of involvement of the vertebrae depends on how pronounced the symptoms and syndromes.
The prevalence of such lesions of the spine is very large: it reaches 70 %. It is worth noting that every tenth patient with spinal osteochondrosis is disabled. A significant problem is the diagnosis of osteochondrosis of different localization. Its symptoms and syndromes can mimic the clinical picture of myocardial infarction, acute abdomen, lesions of the biliary tract and urogenital system.
The mechanism of occurrence of the disease
The occurrence of osteochondrosis of the cervical, thoracic or lumbar begins with damage to the intervertebral disc. The intervertebral disc consists of the nucleus pulposus, which is surrounded by a fibrous ring. It provides the connection of the vertebral body, the mobility of the spine, its protection for injuries and overload of the depreciation expense. The appearance of the disease begins with lesions of the nucleus pulposus, which is dehydrated, loses elasticity and begins to disintegrate into fragments.
Gradually the pathological process goes to the shell of the intervertebral disc fibrous ring. It becomes more fragile and on its surface occur the radial discontinuities and delaminations. Normally, the fibrous ring keeps the extended purposee — axial load, when you defeat each extension of the kernel leads to an increasing destruction of the ring. First, the fragments of the core penetrate into cracks and delaminations, and eventually break the hyaline sheath of the annulus and form a schmorl’s nodule. The greatest danger of a hernia that is directed posteriorly where the spinal cord, because they can cause compression of neurovascular structures and characteristic symptoms. These changes are characteristic of stable forms of low back pain.
In its final stage, this process can be solved in several ways: the development of immobility between the vertebrae due to proliferation of fibrous tissue, independent reduction of the nucleus pulposus or the total defeat of the fibrous ring with the formation of the unstable form of degenerative disc disease. Spinal instability is characterized by excessive movement of one vertebra in relation to another, which leads to violation of durability of the entire spine. Excessive mobility of the vertebrae in the background of the damaged intervertebral disc leads to their trauma, and their constant friction begins to scar (sklerozirovanie). To reduce the pressure on these places, vertebra increases its area due to bone growths – osteophytes.
Changes that occur in the intervertebral disc and the vertebrae, cause neurological manifestations of osteochondrosis.
Manifestations of lesions in the neck and chest
The main symptoms of cervical osteochondrosis is a constant aching or shooting pain, tension of the neck muscles, a feeling of stiffness of the neck. The pain is usually localized in the neck, but may extend toward the occipital or parietal region, and to cover the anterior chest wall. For degenerative disc disease of the cervical is also characterized by the following syndromes:
- vertebral artery syndrome.
It is important not to confuse symptoms and syndromes. Symptoms are some manifestations of the disease. Syndromes are complexes of certain symptoms.
Kardialgichesky syndrome is a neurological manifestation of osteochondrosis. Its main manifestation is pain in the region of the heart, sternum and over her. In this regard, be sure to conduct a comparative diagnosis of cervical degenerative disc disease with angina or myocardial infarction.
Vertebral artery syndrome includes a complex of neurovascular symptoms that occur when irritation of the nerve plexus of the vertebral artery or stricture in the region of the cervical spine. It is manifested by pain, discomfortable sensations in the cervical-occipital region with distribution on the back of the head, fainting, nausea, noise in ears and “flies” before the eyes.
Only all symptoms and syndromes suggests osteochondrosis of the cervical or thoracic spine.
Signs of damage to the lumbar
For stage I, degenerative disc disease characterized by pain in the lumbar region. It can be acute (lumbago), the type of backache that occurs when lifting heavy objects or coughing, and constant nagging (lumbalgia). These pain syndromes vary greatly in their nature and intensity. The pain is a constant dull nature, but is enhanced when changing body position or walking. During the inspection it is noted flattening of the lumbar curvature of the spine, limitation of motion and light pain at palpation.
Osteochondrosis stage II is characterized by protrusion of the annulus which might compress the nerve roots of spinal nerves. Patients increases the intensity and severity of lumboischalgia, but the pain even after a long rest does not pass, unlike the I stage. Enhanced strain of lumbar muscles and lumbar spine to become even smoother. Patients complain of numbness of the lower extremities or a decrease in their sensitivity. An objective study noted the reduction or absence of reflexes and muscle strength.
For stage III is characteristic of this neurological manifestation of osteochondrosis, as the compression radicular syndrome.
Pain syndrome of lumboischialgia first increased and after 2-3 weeks significantly reduced or completely disappears. Remain pain in the lower extremities. The patient during the examination is determined by the distinct tone of the lumbar muscles and signs of spinal curvature (scoliosis). All motion in the lumbar spine is severely limited.
The treatment of the disease
Treatment of degenerative disc disease of the cervical, thoracic or lumbar spine should be aimed at all parts of its mechanism of development. You should also consider the site of the lesion, after treatment of degenerative disc disease of the cervical and lumbar significantly different. Only combined therapy with the use of various drugs and physical therapy methods gives positive results. Treatment is mainly oriented to pathological syndromes.
|In pathological manifestations||Recommended|
|In severe pain.||Assigned analgesics, antipsychotics, tranquilizers. Much easier to pain the electrophoresis with anesthetics in the area of the lesion. Of physiotherapeutic methods positive effect also provides local heat and segmental massage cervical. Also improves the condition of patients passed the course of physical therapy under the supervision of a doctor-rehabilitologist.|
|Orthopedic impairments such as instability or functional unit.||Spend immobilization (limitation) of the spine or extension.|
|To eliminate microcirculatory disorders that manifest in the form of edema, reduced blood circulation and delivery of oxygen to the tissues.||Prescribed antiedematous means, ganglionic (ganglion) and antispasmodics (nikoshpan).|
|To relax the muscles.||Osteochondrosis of the cervical, thoracic or lumbar is always accompanied by muscular-tonic violations. What should I do to relax the muscles? This is ideal heat treatments, massage, tranquilizers and muscle relaxants.|
|In case of violation of nerve conduction.||Such a violation is accompanied by pronounced pathological changes. To restore use antiholinesteraznae drugs, vitamins of group B, massage and various biostimulants.|
In extremely severe cases need surgery. To eliminate the compression is carried out decompression operations. They remove factors that lead to compression of neurovascular structures.
Stabilizing intervention is necessary in cases when the displacement of the vertebrae leads to traumatization of the surrounding tissues and deterioration of health of the patient. To stabilize the vertebrae of the cervical, thoracic or lumbar spine between themselves, produce a block of one or several joints that are located between them.