Spinal degeneration: effective prevention and treatment methods

Chondrolysis is a disease of the spine, characterized by degenerative-dystrophic damage to the intervertebral discs, vertebral bodies and ligaments.

Osteonecrosis of the spine has a chronic, progressive course.The disease does not manifest for a long time and symptoms only appear when complications arise.

According to statistics from the World Health Organization, 40-80% of the world's population suffers from osteoarthritis.

Among patients, people over 30 years old predominate.However, recently there has been a trend toward rejuvenation of osteoarthritis.Osteoarthritis ranks first among spinal diseases in terms of patient disability.

Brief anatomy of the spine

The spine performs the main functions - spinal canal, support and movement, and connects the head, shoulders and pelvic girdle.

The structural unit of the spine is the vertebrae.

The 24 vertebrae are connected together by intervertebral discs, which are the body's shock absorbers.

The spine is divided into five parts: cervical, thoracic, lumbar, sacrum, and coccyx.

The normal shape of the spine is S-shaped.

This configuration of the organ helps to evenly distribute the weight and load of the body.

Structural and functional elements of the spine

Vertebrae are a bony structure consisting of a body, arch, and processes.

The main load falls on the vertebral body, so this is its heaviest part.

Important!Adjacent vertebral arches form the spinal canal - which contains the spinal cord, blood vessels, spinal nerve roots and fatty tissue.

LigamentThe spine is represented by the posterior longitudinal ligament, which connects the vertebrae along the posterior surface, and the yellow ligament, the main purpose of which is to connect the vertebral arches.

Vertebral process.The vertebra has 7 processes extending from the arch: spinous processes, two transverse processes, two upper processes and two lower articular processes.The ligaments and muscles of the spine are attached to the spinous processes.Other processes form the intervertebral joints of the spine.

Intervertebral discis a disc-shaped disc consisting of a cartilage plate, annulus fibrosus, and nucleus pulposus.Intervertebral discs connect adjacent vertebrae, providing flexibility and stability to the spine.

intervertebral jointsformed by the activity of two adjacent vertebrae.The main function of the intervertebral joints is to move the vertebrae relative to each other and provide flexibility to the spine.

Intervertebral foramenlocated on both sides of the spine and formed by the articular processes, bodies and pedicles of adjacent vertebrae.Spinal nerve roots exit through the intervertebral foramen and enter blood vessels.

Spinal cord- This is part of the central nervous system consisting of nerve fibers.The spinal cord has three membranes - soft, arachnoid and hard.The spinal dura mater consists of two sheets that connect and form a dural sac, filled with cerebrospinal fluid - cerebrospinal fluid.

Spinal nerve roots- This is the substance that transmits nerve impulses from the spinal cord to internal organs and vice versa.Each spinal nerve root has autonomic, sensory and nerve fibers within its structure.

Paraspinal muscles- these are the muscles of the spine that support the spine and create tilt and rotation of the body.

The functional unit of the spine isspinal motion segment, consists of two adjacent vertebrae, an intervertebral disc, ligaments and muscles.

Pathogenesis (development mechanism) of spondylosis

During development, osteonecrosis passesfour stages:

1. First stage.Pathological changes do not extend beyond the boundaries of the intervertebral disc.The nucleus pulposus dries out, leading to a decrease in the height of the disc.The fiber ring cannot withstand the load - it cracks and tears.
2. Second stage.As the height of the intervertebral discs decreases, the spinal ligaments and muscles sag, leading to instability of the spinal motion segment.The vertebrae can slide and move relative to each other.In this case, spondylolisthesis is formed.
3. Third stage.The disease is progressing.Protrusion of the intervertebral discs and osteoarthritis of the joints between the vertebrae, as well as malunions, occur.
4. Fourth stage.At this stage, adaptive reactions are triggered in the form of bone growth of the vertebral body (osteoporosis).Therefore, the body tries to limit the excessive mobility of the vertebrae.Bone spurs have sharp edges that damage spinal nerve roots.Fibrous ankylosis of the intervertebral discs and joints is formed, the spine is immobilized.The period of stiffness is characterized by the disappearance of pain.

What leads to osteoarthritis?

Back bone necrosisis a multifactorial disease, it is not possible to point to a specific cause.

The basis of osteonecrosis is a violation of the scope of circulation and metabolism in the tissues of the spine, which can arise due to improper distribution of loads on the spine.

Factors that contribute to the development of osteonecrosis include:

• improperly formed posture in childhood (scoliosis, kyphosis, kyphoscoliosis, stooping);
• weakness of the back muscles (incompetent spinal muscle corset);
• staying in one position for a long time (working in front of a computer, office work, manual work);
• lifting weights incorrectly;
• physical inactivity and sedentary lifestyle;
• metabolic diseases, especially calcium, phosphorus, calcium, vitamin, magnesium, zinc deficiency;
• Genetic predisposition to osteoarthritis;
• infectious diseases;
• frequent hypothermia of the body;
• chronic stress;
• hormonal imbalance;
• weightlifting;
• spinal injury;
• overweight and obesity.

Symptoms of osteoarthritis

Chronic osteonecrosis can present with a variety of symptoms.It all depends on the stage of the disease, the degree of spinal damage and the presence of complications.

Clinically, the disease manifests when the degenerative-dystrophic process has spread to the posterior part of the annulus fibrosus and the posterior longitudinal ligament, the spinal nerve roots are irritated, compressed and the transmission of nerve impulses through them is interrupted.

At the same time, compression of the spinal cord and blood vessels occurs, manifested by reflex and compression syndrome.

Important!Pain syndrome in cartilage degeneration occurs because the spinal nerve roots in the intervertebral foramen are compressed by bone spurs, muscle spasms and vertebrae are displaced.

Osteonecrosis with its symptoms often resembles acute coronary syndrome, pleurisy, acute pancreatitis, abdominal and renal pain, acute appendicitis and adnexitis.

Therefore, it is important to perform a thorough differential diagnosis to rule out life-threatening conditions.

Most popularSymptoms of osteoarthritis:

• pain in the neck, lower back, thoracic spine, which can be aching, sharp, or in the form of low back pain.The pain spreads to the head, upper and lower limbs, shoulder blades, heart and stomach.Pain syndrome increases after physical activity, sneezing, laughing, coughing or staying in one position for a long time;
• sensory disordersdifferent parts of the body at the level of innervation of the pinched nerve;
• contractionneck, back, upper and lower limb muscles;
• like a migraine headache;
• painin the joints of the limbs;
• increased fatiguefrom physical and mental labor;
• dizziness and loss of consciousnesswith a strong turn of the head (vertebral artery syndrome);
• visual impairment(eye floaters or blobs);
• hearing loss, tinnitus;
• pain in the heart;
• painfulalong the intercostal spaces;
• decreased blood supplyupper and lower limbs, manifested by a feeling of cold skin;
• paraesthesia- Crawling, tingling and burning sensation in the spine;
• dry skin;
• sweating disorders;
• urinary disorders(dysuria, enuresis);
• decreased sexual desire, impotence.

Early diagnosis of osteonecrosis will facilitate treatment.

Methods of diagnosing osteoarthritis

A neurosurgeon diagnosed osteonecrosis.If necessary, the patient can be referred to a cardiologist, gastroenterologist, orthopedist, surgeon and others for consultation.

During the interview, it is necessary to accurately determine the nature of the complaints, when they arose and what the patient associates with them.Remember to check the patient's medical history, occupation, and whether any relatives have osteoarthritis.

Laboratory tests in this case are not informative.By conducting a biochemical blood test, you can pay attention to the levels of calcium, phosphorus and other trace elements.

The main place in the diagnosis of osteoarthritis is taken by instrumental methods, such as spine radiography, computed tomography and magnetic resonance imaging.

X-ray examination of the spine is the simplest, most accessible, and most informative method for diagnosing osteonecrosis.

Mandatory radiography is performed in direct and transverse projection of the desired part of the spine.Osteoporosis is characterized by: reduced height of the intervertebral disc, presence of bone spurs, osteoporosis and spinal deformity.

Myelogram- This is an X-ray examination of the spine with the introduction of contrast material into the spinal canal.This method is dangerous due to an allergic reaction to the contrast agent.

Myelography allows us to study the internal structure of the spinal canal.This method is very valuable in diagnosing Schmorl hernia (intervertebral hernia).

Magnetic and nuclear tomography– these are modern diagnostic methods that help visualize each layer of soft tissue and bone of the spine.

These methods are expensive and should be used in severe cases, especially for differential diagnosis of osteoarthritis and diseases with similar symptoms.

Because osteoarthritis is often disguised as diseases of the heart, lungs, pleura, stomach, intestines, kidneys, and liver, differential diagnosis is necessary.

For this purpose, the patient may be prescribed an electrocardiogram, ultrasound of the heart and internal organs, blood troponin test, vascular ultrasound, chest X-ray, electroencephalogram and other methods.

Methods of treating osteoarthritis

Treatment of osteochondrosis is possibleconservation and surgery.

Important!First of all, comprehensive conservative methods are used, and surgical treatment is used only in extreme cases.

Let's see how osteoarthritis can be treated properly.KconservativeTreatment methods for osteoarthritis can include:

• drug treatment;
• physical therapy;
• physical therapy methods;
• manual therapy;
• massage;
• acupuncture.

Drug treatmentOsteonecrosis is aimed at relieving pain, relaxing muscles, reducing swelling of nerves and muscles, improving blood flow and conduction of nerve impulses.For this purpose, the following groups of drugs are used:

• non-steroidal anti-inflammatory drugs;
• chondroprotector, which includes components of cartilage tissue.These drugs protect vertebral cartilage and intervertebral discs from the negative effects of various factors;
• diureticshelps remove excess fluid from the body and reduces swelling of spinal nerve roots and paraspinal muscles;
• muscle relaxantsrelax cramped muscles;
• medicine, improves metabolism and microcirculation in the tissues of the spine (vitamins B1, B6, B12, C, A and E);
• Calcium supplements;
• Hormonal drugs, prescribed when nonsteroidal anti-inflammatory drugs are ineffective.

Therapeutic exercises– these are quantitative physical activities that can be performed both at home and at work for the treatment and prevention of osteoarthritis.

There are many sets of exercises for osteoarthritis.The appointment of exercise therapy and supervision of its implementation is carried out by a qualified specialist - a physiotherapist.

Thanks to properly selected exercise therapy, you can reduce pain, improve mobility and blood supply to the spine, stopping the progression of the disease.

Physical therapy treatmentOsteoarthritis is performed in special physiotherapy departments of hospitals, sanatoriums and clinics by physiotherapists.

Physiotherapy methods include: electrophoresis, magnetic therapy, laser therapy, mud therapy, bath therapy, ultraviolet light exposure to the affected part of the spine, vibration therapy and others.

Manual therapy– this is a quantitative manual impact on the spine aimed at restoring mobility, eliminating displacement of the vertebrae and discs.

Manual therapy should only be performed by a qualified chiropractor.

Massage and self-massagefor osteoarthritis, it is performed to relieve muscle spasms, improve microcirculation in paravertebral tissues and increase spinal mobility.

Acupunctureis a treatment for cartilage degeneration in which thin needles are injected into active sites.

Under the influence of needles in the body, endogenous levels of opiates and cortisol increase, which have anti-inflammatory and analgesic effects.

Prevent osteoarthritis

To maintain your health and keep your spine flexible until old age, follow some principles to prevent osteoarthritis:

• watch your posture– always keep your back straight, do not hunch over;
• selectcorrect postureto sleep;
• Sit right at the table(relaxed shoulders, straight back, furniture suitable for your height);
• for long periods of time in one position (working in an office, in front of a computer, doing crafts), try every 1-1.5 hoursexercise a little, give yourself a back massage or just get up and walk around;
• Precise load distributionon the spine when lifting and carrying various weights;
• wear orthopedic shoes;
• healthy sleepon a flat, medium-firm mattress.It is better to buy an orthopedic mattress and pillow.

Degeneration of the spineis a chronic progressive disease that, unfortunately, cannot be cured.The effectiveness of treatment directly depends on its timeliness.

Do not self-medicate so as not to make your condition worse.At the first signs of osteoarthritis, contact a neurologist.