The spine osteochondria is a chronic disease in which degenerative changes occur on the vertebrae and the intervertebral discs between them.Depending on the spine of the spine, they distinguish: the cervical osteochondria, the osteochondria of the thoracic area and the lumbar osteochondria.For the diagnosis of spine osteochondal, it is necessary to carry out radiography in the case of its complications (for example, intervertebral disc herniation) - magnetic resonance imaging of the spine.In the treatment of spine osteochondal, along with drug methods, it is widely used, reflexology, massage, manual therapy, physiotherapy and physiotherapy exercises.
Etiology and pathogenesis
To one degree, the spine osteochondria develops in all people of age and is one of the aging processes of the body.Earlier or later, atrophic changes occur on the intervertebral disc, however, injuries, diseases and various spine overflows contribute to the previous appearance of osteochondry.The most common cervical osteochondria and the lumbar spine osteochondria.
About 10 osteochondal theories have been developed: vascular, hormonal, mechanical, hereditary, infectious allergic and others.But none of them gives a complete explanation of the changes that take place in the spine, but they are complementary to each other.
It is believed that the main point in the appearance of osteochondrication is the steady overload of the vertebral engine consisting of two adjacent vertebrae.Such overload can occur as a result of a stereotype engine - attitude, individual meeting and walking.Poster disorders, sitting in the wrong posture, walking with a heterogeneous spine column cause additional load on the discs, joints and muscles of the spine.The procedure can worsen due to the characteristics of the spine structure and the deficiency of the tissue of its tissues due to hereditary factors.Most of the time, the evils in the structure are found in the cervical area and lead to vascular disorders and the early appearance of cervical spine osteochondic.
The appearance of lumbar osteochondropration is more commonly linked to overloading during the slopes and lifts of severity.A healthy intervertebral disc can withstand significant loads due to the hydrophilic of the coveted nucleus in its center.The core contains a large amount of water and the liquids, as you know, are slightly compressed.The breakdown of a healthy intervertebral disc can occur with compression of over 500 kg, while the disc has changed as a result of osteochondroposis torn with a compression of 200 kg.A 200 kg load faces a lumbar spine of a person weighing 70 kg when holding a load of 15 kilometers in the slope position of the body in front of 200. Such a high pressure is due to the low size of the slurry.With an increase in tilting to 700, the load on the intervertebral discs will be 489 kg.Therefore, often the first clinical manifestations of the lumbar spine osteochondicity appear during or after the lifting of the weights, the performing household work, the will in the garden, etc.
The destruction of the fibrous fibrous ring tissue of the disc, the joints and the joints of the appearance causes the reaction of the immune system and the development of aseptic inflammation by swelling of the joints and their surroundings.Due to the shift of the vertebral bodies, the joints of the joints are stretched and the altered intervertebral disc is not so firmly stabilized by the bodies of adjacent vertebrae.The instability of the part of the spine is formed.Due to instability, it is possible to violate the spinal nerve with the development of a radical syndrome.With cervical spine osteochondria, this is often the case during head turns, with lumbar osteochondria - during body strands.It is possible to form a operating block of the vertebral engine.Due to the reduction of spinal muscles compensation.
The intervertebral disc herniation is formed when the disc shifts back, the rear longitudinal ligament rupture and the ledge of the disc on the spine appears.If at the same time the core of the disc is pressed on the cerebrospinal channel, then such a hernia is called explosive.The severity and duration of the pain with such a hernia is much longer than it does not explode.The disc herniation can cause a radical syndrome or spinal cord compression.
With osteochondria, bone tissue growth occurs with the formation of bones - bone bones in the bodies and vertebrae processes.Osteophytics can also cause spinal cord compression or cause radical syndrome to develop.
Symptoms of spine osteochondic
The main symptom of spine osteochondry is pain.The pain can be acute with high intensity, intensifies with the slightest movement in the affected section and therefore makes the patient take a forced position.Thus, with the cervical spine, the patient holds his head in the less painful posture and cannot convert it, with the osteochondria of the thoracic area, the pain increases even with deep breathing and with the osteochondria of the area.This pain syndrome is characteristic of the spine compression of the spine.
In about 80% of cases, there is a dull pain and moderate intensity.In such cases, after examination, the doctor must differentiate the manifestations of the spine of the spine from the back muscle myositis.The stupid pain in the osteochondria is due to excessive muscle intensity, holding the affected vertebral engine, inflammatory changes or significant extent of the intervertebral disc.In patients with such pain, there is a forced position, but the restriction of movements and physical activity is revealed.Patients with cervical spine osteochondicism avoid sharp turns and inclinations with their heads, with lumbar osteochondria - sitting slowly and raise, avoid body slope.
Complications of spine osteochondry
The complications of osteochondry are associated with the intervertebral disc herniation.These include the compression of the spinal cord, which is characterized by numbness, the inability of certain muscle groups of the extremities (depending on the compression level), leading to the appearance of production, muscle atrophy, the change of reflex tendon, urination and abstraction.The intervertebral hernia can cause compression of the artery that supplies the spinal cord with the formation of ischemic areas (spinal cord infarction) with the death of nerve cells.This is manifested by the appearance of a neurological deficit (reduced movements, sensitivity, food disorders) that correspond to the level and prevalence of ischemia.
Diagnosis of spine osteochondry
The diagnosis of spine osteochondryosis is performed by a neurologist or a vertebrae.At the initial stage, spine x -ray is performed in 2 projections.If necessary, they can shoot a separate part of the spine and turn to additional views.For the diagnosis of intervertebral gardens, it is used to evaluate spinal cord status and detects osteochondricular complications, magnetic resonance imaging and resonance tomography (spine MRI).An important role is played by magnetic resonance imaging in the differential diagnosis of osteochondrication and other spine diseases: tuberculosis spondylitis, osteomyelitis, tumors, ankylosing vertebral breasts, rheumatism, infectious lesions.Sometimes in cases of complicated cervical spine osteochondicism, it is necessary to exclude symphony.In some cases, if magnetic resonance imaging is impossible, myelography occurs.
A targeted study of the affected intervertebral disc is possible using discography.Electrophysiological studies are used to determine the degree and detection of damage to the nerve pathways, to monitor the rehabilitation process during treatment.
Treatment of spine osteochondal
In the acute period, peace is presented in the part of the spine.To this end, with the cervical spine osteochondria, stabilization is used using a Chantz collar, with lumbar osteochondria - bed rest.Stabilization is also essential for cervical osteochondria with spine instability.
Osteochondal medicinal therapy are used, non -essential anti -inflammatory drugs (NSAIDS): Diclofenac, nimesulide, lornoxicam, meloxicome.With severe pain syndrome, analgesics show, for example, an analgesic central activity of fluorine.To relieve muscle voltage, muscle relaxing - tiraerenidine are used.In some cases, it is recommended to prescribe anticonvulsant drugs - carbamazepine, gabapentine.Antidepressants, including preference to inhibitors of serotonin reverse conception (cerseralin, paroxetine).
In the case of radical syndrome, hospital treatment is indicated.The local introduction of glucocorticoids, the treatment of edema, the use of attraction is likely.In the treatment of osteochondry, physiotherapy, reflexology, massage, physiotherapy exercises are widely used.The use of manual therapy requires a clear adherence to its technique and special attention to the treatment of cervical spine osteochondry.
Spine functions are mainly indicated by significant compression of the spinal cord.It consists of removal of the intervertebral disc hernia and spine decompression.It is possible to perform a microdicochectomy, laser reconstruction of the disc, replacement of the affected disc with implant, stabilization of the spine section.