Spondylosis of the spine: causes, types, symptoms. Methods of treatment
Spondylosis of the spine: clinical picture and treatment
Spondylosis deformans of the spine is a disease of a chronic nature, due to what is happening in the fibrous tissue of the intervertebral disks of degenerative change, leading to their extrusion outside the vertebral bodies and the growth of bone tissue.
As a result, spondylopathy (or osteophytes), greatly limiting the mobility of the drive.
Experts believe the next stage of spondylosis degenerative disc disease.
The development of the disease
Spondylosis deformans is the result of a violation of metabolic processes in the fibrous ring of the intervertebral discs (it surrounds purposee -) and extending along the spinal longitudinal ligament.
At an early stage spondylosis develops as a compensatory reaction of the organism increased load on the vertebral bodies. Changes occur in areas of maximum congestion. Compensatory growth of bone tissue contributes to the reduction of the degree of adverse impact. At the same time there is spasm surrounding the affected area of muscle fibers.
Prolonged stress leads to a transition compensatory reactions to pathological stage, whereby the area of contact gradually increases, the bone becomes a kind of “skirt” — sometimes of enormous size. At this stage in the pathological process is often involved and anterior longitudinal ligament of the spine. Spondylopathy can compress the nerve roots extending from a segment of the spinal cord, and even spread to the substance of the spinal cord or its membranes.
At the same time changing the structure of the affected disk as a result of its dehydration (fluid loss), so that the height of the disk continues to decrease, which leads to an increase in the severity of the clinic. The progression of the disease causes the development of intervertebral hernia. At this stage, the disk is flattened between the vertebrae, and the cartilage is squeezed out beyond the surface of the vertebral body.
The causes that provoke the development of disease
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The main difference between spondylosis from osteoarthritis is to lose the outer part of the disk. Osteochondrosis degenerative changes begin with purposes part.
The development of the disease of the spine with spondylosis is due to several factors (internal and external):
- metabolic disorders;
- age-related changes;
- irrational load on the spine causing persistent muscle spasms;
- direct and indirect injuries of a traumatic nature that affect the ligaments and muscles of the spine;
- the static load on the spine (eg, prolonged stay in physiologically irrational position;
- short-term stress around the spine of muscle fibers in severe inactivity;
- genetic or constitutional predisposition;
- infectious diseases;
- the presence of tumors.
The overall clinical picture
The most common symptom of spondylosis is pain:
- at an early stage it is intermittent, often appears while driving, increases during day, can spontaneously disappear;
- the intensity of the pain increases due to sharp movements or by changes in the weather;
- depending on the lesion it may radiate to the lower or upper extremities;
- palpation of the spinous processes and beating them provoke increased pain (what distinguishes spondylosis from osteoarthritis).
As the progression of the pathological process to some extent (depending on the severity of illness) restricted mobility of the spine in a specific Department.
Types and symptoms
Specific localization of degenerative changes is the basis for the separation of pathology into three types:
- spondylosis of the cervical spine;
- spondylosis of the thoracic spine;
- spondylosis of the lumbosacral spine.
The clinical picture varies to some extent depending on the specific species.
This type is the most common. Its main symptoms are:
- pain in back of neck and nape, aggravated by head movements;
- the pain may spread to the shoulders, shoulder blades, hands;
- lack of motion in the cervical spine;
- decreased vision and hearing;
- ringing and buzzing in the ears;
- sleep disturbance (usually due to the presence of pain).
Spondylosis deformans of the cervical spine can trigger the development of humeroscapular periarthritis characterized by significant limitation of mobility of the shoulder joint and the presence of shoulder pain.
Spondylosis of the thoracic
Lose the breast – the most rare type of this disease. The cause often lies in a sedentary lifestyle, so the disease is mainly diagnosed in people of intellectual professions. Its main manifestations:
- unilateral pain localized in the middle and lower sections, often extending to chest;
- the intensity of pain in extension, lateral bending;
- disruption of the normal functioning of internal organs.
Lumbar spondylosis deformans type
This kind of popularity takes the second place after a neck caused by a significant load, which is subjected to a lumbar region. Mainly affects the fourth and fifth vertebrae.
With the simultaneous emergence of osteochondrosis of lumbar spondylosis often leads to pinching of nerve roots and the manifestation of sciatica in the lumbar region.
With this type of disease develops following clinical picture:
- the signs of the nerve fibers and symptoms of radicular syndrome;
- the symptoms of inflammation in the lumbar-sacral plexus;
- weakness of the lower extremities;
- pain in the legs, resulting in false intermittent claudication;
- the pain does not disappear in a state of physical rest;
- it often radiates to the lower limbs (thigh and tibia) or buttocks;
- possible reduced sensitivity or numbness of the feet;
- the pain syndrome is reduced when the front slope and climbing stairs, because in these cases the area of the affected disk is increased.
Complex diagnostics of the disease
The diagnosis is based on:
- A comprehensive neurological examination of the patient.
- Radiography of the spine, through which it is possible to visualize the osteophytes, to assess the condition of the vertebrae, the degree of thickening of the joints and reduce the distance between the adjacent vertebrae. As well as to detect the displacement and abnormal mobility of the spine, its individual elements with an extreme degree of extension and flexion.
- Computed tomography (CT) allows obtaining a detailed image of the spine to detect narrowing (stenosis) of the canal, its degree, determine the height of intervertebral discs.
- Magnetic resonance imaging (MRI) is the most informative method of research, as it enables visualization of soft tissue (discs, nerves, ligaments) and the detection of compression of nerve fibers. In most cases using this method are able to detect the true cause of manifestation of pain syndrome with spondylosis.
- Electroneuromyography (ENMG) is assigned to confirm the presence of nerve damage. The method allows to determine the conduction and the specific degree of damage of the fibers.
- Radioisotope scanning is based on the difference in the degree of absorption by the tissues with different metabolic rate of the radioactive material. In the case of presence of inflammatory process or tumor in the specific area of bone tissue accumulates greater amount of the isotope.
The purposes and methods of treatment of the disease
Occurring in spondylosis degenerative processes are irreversible, therefore, the overall goal of the treatment of all types of spondylosis (thoracic, cervical and lumbar spine):
- elimination of pain and inflammation;
- relieving of muscle spasm;
- improved local blood circulation and nutrition of the discs;
- normalization of metabolic processes and slowing down of degenerative changes in the affected tissues.
Use the following methods for the treatment of spondylosis of the spine:
- nonsteroidal anti-inflammatory drugs (NSAIDs) for relief of pain (NOVALIS, ibuprofen, naproxen);
- muscle relaxants for treating muscle spasms (tizanidine, some cyclobenzaprine);
- analgesics to eliminate pain (tramadol or drug);
- antidepressants for the elimination of chronic pain (doxepin, amitriptyline, DULOXETINE, containing capsaicin ointment).
2. Physiotherapy reduces pain, improves conductivity of nerve fibers, local metabolism and blood circulation. Use the following procedures:
- ultrasonic influence on the affected region of the spine;
- electrophoresis with novocaine;
- diadynamic currents;
- Physical therapy to strengthen the muscular frame of his back.
3. Tibetan medicine offers to treat spondylosis by:
- magnetic-vacuum therapy;
- the stone therapy.
4. The introduction of steroids into trigger points, epidural space, joints and significantly reduces pain.
5. Operation is assigned:
- in the presence of spinal stenosis;
- the manifestation of cauda equina syndrome;
- with significant compression of the nerve root osteophytes.
Surgery is an extreme measure and is carried out with the severity of neurological symptoms and ineffective conservative therapeutic measures.