Osteochondrosis of the spine is a chronic disease in which degenerative changes in the vertebrae and intervertebral disks appear between them.Depending on the spine damage, they differ: osteochondrosis of cervix, osteochondrosis of the thoracic region and osteochondrose of the lumbar region.To diagnose the osteochondrose of the spine, it is necessary to implement radiography and in the case of its complications (for example, an intervertebral disk hernia) - the maR spine.In the treatment of osteochondrose spine, along with drug methods, used, reflexology, massage, manual therapy, physiotherapy and physicality exercises.
Etiology and pathogenesis
Until one degree, osteochondrose of the spine is developing in all people and is one of the body aging process.Earlier or later, atrophic changes arise on the intervertebral disk, however, injuries, diseases and various impairment contributions to an earlier occurrence of osteochondrose.The most common osteochondrosis of the cervical region and osteochondrosis of lumbar spine.
About 10 osteochondrose theories were developed: vascular, hormonal, mechanical, hereditary, contagious-allergic and others.But none of them gives a complete explanation of changes that take place in the spine, but are complementary to each other.
The main point is believed to be osteochondrose constant overloading the gardening gardens consisting of two adjacent vertebrae.Such overload can occur as a result of motor stereotypes - posture, individual ways of sitting and walking.Poster disorders, sitting in the wrong pose, walking with an uneven spinal column cause additional load on discs, ligaments and muscles of the spine.The process can worsen due to the characteristics of the structure of the spine and insufficiency of the trophy of its tissues due to the hereditary factors.Most often, vices in the structure are in the cervical region and water to vascular disorders and early appearance of the signs of osteochondrose cervix.
The occurrence of osteochondrose of the lumbar region is more often associated with overload during the preference and elevator of severity.A healthy interverter disc can withstand significant loads due to the hydrophilicity of the pulposis nucleus that is located in your center.The core contains a large amount of water and liquid, as you know, are compressed.The distribution of a healthy interverter bracket can appear from compression more than 500 kg, while the disc has changed as a result of osteochondrose torn with a compression of 200 kg.The burden of 200 kg is experiencing a lumbar spine that weighs 70 kg, when having a load of 15 pounds in the body slope in front of 200. Such high pressure is due to the low size of the nucleus.In addition to increasing the preference of 700, the load on intervebrebral discs will be 489 kg.Therefore, often the first clinical manifestations of osteochondrose of the lumbar spine appear during or after the weight is raised, household performance, root in the garden, etc.
Destruction of connective tissue of the fibrous ring, ligaments and capsules of flirts from the parties causes the reaction of the immune system and the development of aseptic inflammation with the swelling of the aspect and their surrounding tissues.Due to the displacement of vertebral bodies, the capsules of appeal joints, and the modified interverter disc is not so tightly secured by the body of neighboring vertebrae.The instability of the spine segment was formed.Due to instability, a breach of the spinal nerve is possible with the development of radio culinary syndrome.With osteochondrose of cervix, this often happens during the turn of the head, with a lumbar osteochondrose - during the body slope.It is possible to form a functional block of the engine segment in the vertebral.This is due to reducing the compensation of vertebral muscles.
The interverter disc hernia is formed when the disc moves, the last longitudinal robination of the ligament and the disk protraction in the spinal channel appear.If at the same time, the disk core is squeezed in the cerebrospinal channel, then such a herd is called exploded.The weight and duration of pain with such a kilia is much higher than in unexploded.The hernia disk can cause radicular syndrome or spinal cord compression.
With osteochondrose, bone tissue growth occurs with the formation of osteophytes - bone growth on the bodies and processes of vertebrae.Osteofiti can also cause to compress the spinal cord or cause development of radicular syndrome.
Symptoms of spine osteochondrosis
The main symptom of osteochondrose spine is pain.Pain can be acute with high intensity, intensifies with the smallest movement in the affected segment and therefore makes a patient forced position.So with osteochondrose cervix, the patient keeps his head in the least painful pose and cannot turn it, with osteochondrosis of the thoracic region, it hurts even with osteochondrose of the lumbar region to sit, get up, get up and walk.Such a pain syndrome is characteristic of compressing the spine of the spinal nerve.
In approximately 80% of cases, there is a blunt pain of permanent nature and moderate intensity.In such cases, after the examination, the doctor must distinguish the manifestations of osteochondrose spine from the mirror of the rear muscle.Stupid stupid pain is due to excessive muscle tension, holding the affected segment of the engine vertebrae, inflammatory change or significant stretching of the intervertebral disk.In patients with such pain, the forced position is absent, but the restriction of movement and physical activity is revealed.Patients with osteochondrose of the spine of cervix, avoid sharp turns and slope with the head, with osteochondrose of the lumbar region - slowly sit and get up, avoid tilting the body.
Complications of osteochondrose spine
Osteochondrose complications are related to the intervertebral disk kilina.These include the compression of the spinal cord, which characterizes numbness, the weakness of certain muscle groups of extremities (depending on the level of compression), leading to the appearance of paresis, muscle atrophy, the change of tendon reflexes, urination and defecation.INTERVERTEBRAL HERNIA can cause an artery compression that feeds on the spinal power with the formation of ischemic areas (spinal infarction) with the death of nerve cells.This manifests the appearance of neurological deficit (disturbed movements, sensitivity, trophic disorders) that suits the level and prevalence of ischemia.
Diagnosis of osteochondrose spine
Diagnosis of osteochondrose spine performs a neurologist or vertebrate.In the initial phase of spine radiography, it is done in 2 projections.If necessary, I can shoot a special spinal segment and recording in additional projections.For the diagnosis of intervertebral hernia, it is estimated the state of the spinal cord and reveals the complications of osteochondrose, magnetic and resonant tomography (MRI spine).MRI plays an important role in differential diagnosis of osteochondrose and other spine diseases: tuberculosis spondylitis, osteomyelitis, tumors, anilosation of spondel, rheumatism, infectious lesions.Sometimes in cases of complicated osteochondrosis of cervix, the exclusion of syringomia is necessary.In some cases, if MRI is impossible, myelography is displayed.
Targeted research of the affected interverter disc is possible using the discography.Electrophysiological studies are used to determine the degree and localization of damage to nervous roads, for monitoring the process of their restoration during therapy.
Treatment of osteochondrose spine
In an acute period, peace is displayed in the affected engine segment on the vertebra engine.For this purpose, with osteochondrose of cervix, fixation is used using chantz collars, with osteochondrose of the lumbar region - rest in bed.Fixation is also needed for osteochondrose of the cervical region with the instability of the segment gardens.
In drug therapy are not used non-steroid anti -infalmal medications (NSAIDs): DICLOFENAC, NIMESULID, LORNOXICAM, MELOXICAM.With intensive pain syndrome, analgesic, for example, analgesic central action of fluin.Mixy relaxants - Tolperison, Tizanidine is used to mitigate muscle voltages.In some cases, it is advisable to prescribe anticonvulsive drugs - carbamazepines, gabapentin;Antidepressants, among which inclination, are given to the inhibitors of the reverse capture serotonin (cerseraline, paroxetine).
In case of radical syndrome operation, hospital treatment was indicated.It is possible to local introduction of glucocorticoids, treatment against edema, use towels.In the treatment of osteochondrose, physiotherapy, reflexology, massage, widely used physiotherapy exercises.The use of manual therapy requires a clear compliance with the technique of its application and special precautions in the treatment of osteochondrose cervaries.
The spine operations are presented primarily with significant consistency of the spinal cord.It consists of removing the kill of the intervertebral disk and the decompression of the spinal channel.It is possible to perform microdisectomy, laser disk reconstruction, replacing the affected disk with implant, the stabilization of the spinal segment.