Spinal osteochondrosis is a complex of dystrophic and degenerative changes in the intervertebral disc and adjacent surfaces of the vertebral body associated with tissue destruction and structural disorders. Depending on the degree of damage, cervical, thoracic and lumbar osteochondrosis can be distinguished.
symptoms
The main sign by which one can assume the presence of osteochondrosis of the cervical spine is a localized change in the configuration of one of the segments 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 area, but also assigned to areas of the body defined by the corresponding nerve roots. Another complaint of this patient was discomfort and a feeling of tiredness in the neck.
With cervical osteochondrosis, pain, as a rule, manifests itself in the neck area and can be given to the shoulders and scapula, it can be confused with pain in myocardial infarction, as it has similar symptoms. Also, cervical osteochondrosis can be accompanied by frequent headaches, dizziness. When the arteries that supply the brain are compressed (squeezed), there may be signs of brain damage (neurological symptoms): fainting, nausea, tinnitus, mood swings, anxiety, and others.
According to the severity of the pain, they are divided into 3 degrees:
- Pain occurs only with marked movement in the spine;
- Pain is relieved with a certain position of the spine;
- The pain is permanent.
Forms
Depending on the syndrome caused by osteochondrosis, there are:
- Compression syndrome - occurs with compression (radiculopathy - nerve root compression, myelopathy - muscle compression, neurovascular - compression of blood vessels and nerves);
- Reflex (muscle-tonic, neurodystrophic, neurovascular);
- Myoadaptive syndrome (fatigue of healthy muscles when they take over the function of the affected muscles).
Cause
The mechanism of development of this disease is damage to the intervertebral disc due to various causes and its displacement with loss of depreciation (reducing stress) function of the spine. The immediate causes of disc damage can be age -related degenerative changes associated with impaired blood supply to the intervertebral disc, mechanical damage due to injury and vigorous physical exercise on the spine - for example, being overweight.
An important role in the development of osteochondrosis is played by an inactive lifestyle, in which violations of blood supply and function of the intervertebral joints develop. The mechanism of disease progression is as follows: if the fibrous ring connecting the vertebral body is damaged, the intervertebral disc is pushed back and forth - into the lumen of the spinal canal, or laterally - with the formation of median and lateral discs. hernia. The disc can be pushed into the vertebral body itself with the formation of a Schmorl hernia - a microscopic rupture of the cartilage tissue of the intervertebral disc into the sponge tissue of the vertebral bone. In the case of posterior displacement of the disc, compression of the spinal cord and the roots extending from it is possible, with the development of a typical pain syndrome.
Diagnostics
The diagnosis of spinal osteochondrosis is carried out on the basis of complaints, anamnestic data, clinical examination and instrumental examination methods. Diagnostic measures are to find out the causes that lead to the development of neurological symptoms.
From the anamnesis, it is possible to know the presence of injuries, the nature of work - constant physical load (lifting weights), poor posture, peculiarities of work and position of the spine on the table and during walking, the presence of infections.
General clinical studies (clinical blood tests, general urine analysis), biochemical blood tests have no independent value. They are set to assess the current condition, diagnose the underlying disease and emerging complications.
Diagnosis is based on the clinical picture of the disease and is carried out with the method of sequential exclusion of diseases similar in clinical signs. Of the instrumental diagnostic methods, the most common and available is X-ray examination (spondylography is a non-contrast study). It reflects the narrowing of the intervertebral joint space and allows you to identify osteophytes (bone growths) on the vertebral body, but only provides indirect information about the degree of damage to the intervertebral disc.
Accurate diagnosis can be made with CT and MRI diagnostic imaging (magnetic resonance imaging and computation), even in the early stages of the disease. CT allows you to determine the minimum anomalies in bone and cartilage tissue, MRI - to carry out details of the structure of soft tissue and determine the localization of disc herniation.
Duplex ultrasound scan of the cerebral arteries is performed if there is a suspicion of a violation of the blood supply to the brain.
Differential diagnosis is carried out with diseases that have similar clinical manifestations: pathology that continues with pain radiating to the shoulder and scapular area (liver disease, gallbladder, pancreatitis - inflammation of the pancreas); cervical lymphadenitis - an increase in cervical lymph nodes, rheumatoid arthritis; oncological diseases (tumors of the vertebrae, roots, spinal cord and membranes), tumors of the pharynx and pharyngeal space, Pancost cancer (compression of the brachial plexus in cancer of the upper lobes of the lungs), metastases in the cervical region; tuberculous spondylitis - an inflammatory disease of the spine caused by mycobacterium tuberculosis; arachnoid cyst; pseudocysts dura mater; spinal anomalies; fibromyalgia is a disease that causes pain in muscles, ligaments and tendons, chest outlet compression syndrome - a disorder caused by excessive pressure on the neurovascular bundles that pass between the anterior and middle lateral muscles, above the first ribs and below the collarbone, myofascial neck musclessyndrome and shoulder girdle - a chronic condition, the pathology of which is caused by the formation of local muscle spasms or seals, represented by pain points.
The main laboratory tests used:
- Clinical blood tests;
- Blood chemistry.
The main instrumental studies used:
- X-ray of the spine (spondylography);
- Magnetic resonance imaging (MRI);
- Computed tomography (CT);
- Duplex ultrasound scanning of cerebral arteries (if suspected violation of blood supply to the brain).
Additional instrumental studies used:
- Densitometry - measurement of bone density (according to instructions).
Treatment
Treatment of spinal osteochondrosis depends entirely on the stage and stage of development of osteochondrosis. In the early stages, it is possible to use preventive measures, physiotherapy exercises, exercise on a simulator, and fitness. With severe pain syndrome, patients need physical rest. Anti-inflammatory and antispasmodic medications are prescribed. It is possible to perform a paravertebral block with an anesthetic to open the pathological circle, when pain causes muscle spasm, while the intervertebral disc is compressed more strongly, which in turn, increases the pain itself.
Warming ointment is applied topically to the skin in the vertebral area to increase local blood supply and reduce tissue edema. This patient is shown wearing a corset. In patients with early stages of development of osteochondrosis, chondroprotectors are effective-drugs that enhance the recovery of cartilage tissue, as well as drugs that increase local blood supply, venotonics, vitamins of group B. In cases where the pain syndrome does not stop. medically for a long time and there is a root compression spinal cord clinic with intervertebral hernia, surgical removal of the damaged intervertebral disc is indicated. In the case of total spinal cord compression by the disc, early surgery is indicated.
You shouldn’t wait until someone starts urinating or defecates spontaneously - in this case, the damage to the spinal cord may already be irreversible. As physiotherapeutic procedures, magnetotherapy, ultrasound, massage, manual therapy, acupuncture and physiotherapy exercises are prescribed.
Complications
Possible vegetative-vascular dystonia and heart disorders, cerebrovascular accidents, low blood pressure and hypertension (decreased and increased blood pressure), vestibular disorders (impaired movement coordination), vertebral artery syndrome (diseases caused by narrowing of vertebral arteries), periarthrosis (disease with impaired movement) of the shoulder joint.
Prophylaxis
For the prevention of osteochondrosis, it is necessary to address the factors that cause it, namely: avoid spinal injuries, pressure on the spine (weight lifting), and fight against excess weight. For people who already have the early stages of osteochondrosis, it is recommended to wear a corset at home and while doing physical exercise. In order for the spine to relax during sleep, it is recommended to sleep on orthopedic mattresses and pillows.
What questions should you ask your doctor
Is there exercise to help relieve symptoms?
What medications will help to overcome cervical spine osteochondrosis?
What will happen if you don’t start treating the disease on time?
Patient advice
Exercise, weight loss in the presence of excess weight, the use of cold or warm compresses help relieve the symptoms of osteochondrosis of the thoracic spine. It is also important to eat properly, monitor your spine, treat chronic conditions, and avoid injury.