The spine includes the cervical, thoracic, lumbosacral section and consists of 33-34 vertebrae that are located one above the other and connected in one chain.To evenly distribute the load on the spinal column during daily physical activity and when the body is in an upright position, the spine has physiological (normal) curves.Two curves are convex forward in the cervical and lumbar parts (lordosis) and two convex backwards in the thoracic and sacral parts (kyphosis).Between the vertebrae there are intervertebral discs - cartilage, which perform the cushioning function and consist of the nucleus pulposus and the fibrous ring that surrounds it.
Osteochondrosis of the spine is a chronic disease characterized by the development of degenerative-dystrophic changes on the intervertebral discs with subsequent involvement of adjacent vertebrae and surrounding tissues in the process.
Currently, doctors more often use the broader term "dorsopathy" to denote back and neck pain, sometimes replacing the term "osteochondrosis" with it.Dorsopathy includes pain in the neck (cervicalgia), neck and head (cervicocranialgia), neck and shoulder (cervicobrachialgia), chest pain (thoracalgia), lower back pain (lumbodynia), lower back pain radiating to the leg (lumboischialgia).
Causes of osteochondrosis of the spine
To date, there are no accurate data on the causes of degenerative changes in the spine.There are a number of theories that consider different factors: involution, mechanical, immunological, hormonal, dysmetabolic (metabolic), vascular, infectious, functional and hereditary.The most common is the involutive theory, according to which local (local) premature aging of cartilage and bone occurs as a consequence of previous mechanical or inflammatory damage.According to this theory, the development of degenerative changes in the spine is genetically determined, and the appearance of diseases with corresponding clinical manifestations is caused by the influence of various endogenous (internal) and exogenous (external) factors.
The probability of osteochondrosis increases with age, with the presence of excess weight, a sedentary lifestyle and poor physical condition, on the one hand, and heavy physical work and exposure to vibrations, on the other hand.
The load on the spine increases in proportion to the increase in body weight, so overweight people suffer from overload even in conditions of moderate activity;the situation is aggravated by a tendency to physical inactivity due to poor tolerance of physical activity.
Psychoemotional stress, together with a sedentary lifestyle, causes tension in certain muscle groups, changes in muscle tone and movement patterns - posture, gait.The development of scoliosis - lateral curvature of the spine, pathological kyphosis and lordosis (worsening of physiological curves) contributes to the deformation of the intervertebral discs.
Classification of diseases
By localization:
- osteochondrosis of the cervical spine;
- osteochondrosis of the thoracic spine;
- osteochondrosis of the lumbar and sacral spine.
According to the stage of the disease:
- exacerbation (maximum number of clinical manifestations);
- remission (absence of clinical manifestations).
Depending on which formations are pathologically affected, the affected spinal structures differ:
- Reflex syndromes - reflex tension of innervated muscles, or muscle-tonic disorders (muscle spasms), vascular, vegetative, dystrophic - develop when pain receptors are irritated.
- Compression syndromes often develop on the background of protrusion (bulging, protrusion of the intervertebral disc outside the spinal column without violating the integrity of the fibrous ring) or disc herniation due to compression of the nerve root, spinal cord or vessel (according to the syndrome, radiculopathy, neuropathy, myelopathy, radiculoischemic syndrome are distinguished).
Depending on the stage of development of the process, they differ:
- Stage of intradiscal pathological process (chondrosis).During this period, the intradiscal displacement of the nucleus pulposus occurs.The nucleus pulposus penetrates its outer fibers through fissures in the annulus fibrosus.As a result, nerve endings are irritated and pain develops.
- The stage of instability, i.e. the loss of the ability to fix the affected disc, when the upper vertebra is displaced relative to the lower one.During this period, instability syndrome, reflex and even compression syndromes can form.
- The stage of the formation of herniated intervertebral discs due to the violation of the integrity of the fibrous ring, which can compress the adjacent neurovascular formations, including the root of the spinal nerve.
- The stage of fibrosis of the intervertebral discs and the formation of marginal osteochondral growths of the vertebral bodies, which results in the immobility of the vertebrae and a compensatory increase in the area of their support on the defective discs.In some cases, these bony growths, like a herniated disc, can compress adjacent neurovascular formations.
Symptoms of osteochondrosis
Symptoms of osteochondrosis depend on the area of damage to the spine and the degree of changes occurring on it, and damage to the function of internal organs may also occur.
Osteochondrosis of the cervical spine is characterized by pain in the neck, which intensifies during movement, spreads to the hand and is accompanied by numbness of the fingers.
Complaints of headache in the occipital region, dizziness, ringing in the ears, darkening of the eyes or flickering spots before the eyes are possible.
When the thoracic spine is affected, patients may feel pain in the region of the heart, in the interscapular region, long-lasting, painful or pressing, often sharp, piercing, sharp.
They can appear or intensify when breathing deeply, when bending and turning the body, when raising the arms, sneezing, coughing.There may be a feeling of numbness of the skin in the chest, stomach and back.
With osteochondrosis of the lumbosacral region, patients notice stiffness of movement, pain in the lower back, which can radiate to one or both legs, intensifies when bending, turning the body, walking, lifting heavy objects.
Possible vegetative disorders: coldness of the legs at a temperature comfortable for the rest of the body, pallor of the skin of the legs.There is a feeling of numbness, paresthesia (feeling of pricks and needles) in the skin of the legs and buttocks.
Disease diagnosis
Instrumental diagnostics include radiography of the spine to rule out traumatic injuries, congenital structural anomalies, and identify bony growths.The study is also carried out with functional tests - imaging during flexion and extension in the cervical and lumbar regions in order to rule out pathological movement of the vertebrae in relation to others.