Osteochondropathy spine – a pathological condition of the bone, cartilage. The official medicine has adopted a number of other names of the disease. This pathology is often called the disease of Chairman Mau, aseptic necrosis of vertebral bodies epifizov, juvenile kyphosis. The main category of patients with such problems – boys teenage or adolescence, 11-18 years. Hereditary manifestations of the disease occur in children at an earlier age. Favorable conditions for the development of such pathological States creates a damp, cold climate on the territory of residence of the patient.
The most common form of the disease affects the vertebrae, discs, zamechatelnye plates of the thoracic. In children with weak development of the musculoskeletal system on the background of heavy loads, lack of necessary minerals, vitamins, nutrients, may occur damage of the lumbar and chondropathy of the knee joint, hip joint osteochondropathy. Usually affects the discs of the vertebrae 7-10. Osteochondropathy spine is a rare, difficult-correction condition with unexplored until the end etiology.
Varieties of pathological conditions
The disease may manifest in children in several different ways.
|Disease Kümmel.||The inflammatory process involves the vertebral body (most often the damage is post-traumatic in nature);|
|Disease Of The Calve.||A decrease in height of vertebrae, their extension, the protrusion of the spinous process, the pain from touch.|
|Disease Chairman Mau.||Accompanied by a bending back of the spine (the development of kyphosis), inflammatory processes in muscles, region of attachment to the thoracic vertebrae, the deformation of vertebrae and the formation of a wedge-shaped structure.|
In children, adolescents, youths can develop various deformities of a specific part of the spinal column, if they are engaged in heavy sports, suffer from hypogonadism, adiposogenital dystrophy, and other hormonal disorders. The disease may be the consequence of locally disturbed microcirculation. Scientific medical literature mentions cases of the disease due to hereditary factor dominant type.
For any variety of osteochondropathy slow to develop, signs of muscle asymmetry, hypotonia. The initial stage of the disease occurs on the background of fatigue, minor vertebral pain. It is advisable for such symptoms immediately to show the child the doctor.
As the disease evolves
Early stage, diffuse pain that passes after the dream, replaced by the more acute and painful period. Active growth of the child progressive osteochondropathies is accompanied by enhanced pain. Sometimes the patient complains of appearing pain in the spinous processes. This means that the spine is twisted, begin to form a steady kyphotic deformity, produces anomalous structural arc.
Further, the curvature leads to a shift of the top of the arc to the tenth thoracic vertebrae, appears the syndrome of «flat back.» Underlying medical conditions can be:
- neurological disorder;
- varus deformity of the tibia;
- sternal funnel-shaped deformation;
- radicular syndrome;
- flattened chest.
Damage to the lumbar can be difficult to recognize, as the child often did not complain of pain with this complication. But if damaged cervical vertebra when tilting the head forward, a sharp pain between the shoulder blades. Structural changes of the spine, reducing the height of the discs provide a barrier to the movements of the back.
Symptoms may indicate advanced disease. But to determine the degree of its development will be possible only then, when anatomical growth period of the spine.
The difficulty of determining the presence of diseases makes use of the main diagnostic method is radiography. But this procedure does not give a clear answer, so when the characteristic symptoms requires careful differential diagnosis. On the radiograph, the physician can consider such features as:
- multiple schmorl’s nodule;
- vertebrae with reduced height;
- calcification of the intervertebral discs.
After the analysis of the image conducted a secondary contact examination of the patient, palpation of painful areas to determine the severity of the disease. It turns out, how much spread a destructive process which areas of the musculoskeletal system affected, are limited to how vertebrates function as schmorl’s nodule is present in a patient. While the patient is asked to perform certain movements.
Osteochondropathy have a lot of similar symptoms with other disorders. Therefore, comparative diagnosis to exclude congenital fibrosis of Gunta discs, compression fracture of a vertebral body, disease Calvet. You should also check on the disease Calvet and spondyloepiphyseal dysplasia. With the disease often have a young child affects only one vertebra, and kyphosis affects the youth more.
To diagnose osteochondropathy doctors have for a relatively long period. Based on the obtained x-ray structural changes are studied in the dynamic development. Fear of dangerous radiation, not all parents agree on repeated x-rays. Such a faulty position can lead to a running condition of the disease.
Prevention and treatment
Preventive measures against this unpleasant pathology is necessary to apply since early childhood. Useful swimming lessons, active movement without strong physical activity that develops coordination of movements of the game. Adult patients prescribed prophylactic administration of startrate, struktum, teraflex, alflutop, other medications to strengthen the cartilage. Is assigned a special mode that restricts active movement, which excludes jumps back strain when lifting weights, lying on an uncomfortable soft surfaces.
To stop the constant pain is conservative treatment. Its main task is to restore mobility of the spine, correct posture. The patient is recommended to wear a special corset, make traction of the spine sloped installed unit, prescribe physical therapy exercises and swimming. The sessions in the pool can be combined with stretching underwater, the procedure gives a significant improving effect, helping to stop severe pain.
The number prescribed for this pathology of drugs – neostigmine, drugs to improve vascular health, vitamins, systemic enzymes (dosage form phlogenzyma and wobenzyme). To eliminate the hearth of inflammation and pain shows the use zaldiar, paracetamol, or other analgesic. Patients prescribed treatment celebrexa, Nise, nimesilom, deksalgin, Agartala, other drugs of the NSAID group.
If the patient asked for help at the initial stage of the process, vertebral deformation will stop. In neglected diseases, the development of severe forms of spinal osteotomy, in cases of wedge resection for a fixed kyphosis surgical intervention is necessary. Practice shows efficient results of operations from the bulk of examined patients.
Recreational activities in children’s hospitals
To prevent early development of osteoarthritis it is reasonable to conduct active medical-gymnastic and orthopedic interventions in institutions. It may be private clinics, dispensaries, children’s medical centers. During the day required multiple sessions of physical therapy. Their goal is to gradually implement reclinate kyphosis, if any, and to form a lordosis, if it is not.
A set of exercises is chosen individually, depending on condition severity osteochondropathy. If the child is not found radicular syndrome, there is not difficulty bending forward of the body, it does not feel pain, allow it to rolling classes.
It is particularly useful to conduct such courses of outdoor activities in summer camps. The time allotted for recreational activities, evenly distributed between outdoor games, swimming, water treatments, games in the water with balls and other projectiles. A contraindication to such pursuits is a radicular syndrome. Trainers and doctors ensure that the group does not have physical overload. Effective results are obtained by a long walk with felinious stick, fixed elbow bends behind.
To sleep after lunch and at night, the children settling beds. They have a rigid smooth bed (a wooden Board), covered with orthopedic mattress. Seating for dining and study table used chairs with tall straight backs and ergonomically curved forward in the area of thoracolumbar vertebral zone. Recommended part of the training home load (for example, defined reading class or science class) to cook in the supine position. If the child has all the signs of a sustainable secondary radicular syndrome, intervertebral discs are flattened, fragile, between them, narrowed the distance, you need to wear a corset.
For young patients who are diagnosed with radicular syndrome, provides orthopedic hospitals. Sick children shows the use of loop Gleason and pelvic girdle. The procedure of stretching is performed only when constant wearing of hard leather belt or belt lifter. Tight fixation of the waist prevents the subsidence of the vertebrae and deterioration of neurological symptoms.
Observed diet, a diet with carotene and vitamin A, are physiotherapy treatments diathermy, electrophoresis, ultrasound. Children injections of vitamins, every day, doing massage on the muscles of the back, treated with acupuncture.
The course of treatment in the orthopedic hospital – 3.5 months. During this time, the main functions of the spine are restored, are dural and radicular symptoms, decreases the risk of developing early osteoarthritis. The physiotherapy sessions continue after discharge from the hospital, at home. It is useful each year to visit motels and resorts with warm water treatments, swim.