Osteochondrosis is a disorder of the musculoskeletal system characterized by thinning of bones and articular cartilage. Most often, patients are diagnosed with spinal osteochondrosis, in which the intervertebral discs in the cervical, lumbar, or thoracic regions are destroyed. Intervertebral cartilage is necessary to cushion movement and reduce load on bone tissue, so the destruction of the intervertebral disc can lead to gradual damage to the vertebrae and deformation of the spine. Osteochondrosis can be a complication of injury, chronic posture errors, or other pathological conditions. Treatment for the disease includes manual therapy, physical therapy, and surgical intervention for severe spinal deformities.
Osteochondrosis is one of the most common diseases of the musculoskeletal system in the elderly. In adolescents and young adults, pathological diagnoses are less frequent. Characteristic symptoms of the disease, which doctors include in the affected joint area, include severe pain and difficulty moving. Without treatment, osteochondrosis can be complicated by spinal cord compression and internal organ dysfunction.
Symptoms of osteochondrosis
The manifestations of the disease depend on the area of destruction of the articular disc. The main symptom is pain or severe pain that worsens with exercise. Because of this, patients often take compulsive postures. Due to cervical osteochondrosis, patients have difficulty looking around and experience severe headaches. If the disease is complicated by compression of the peripheral nerves and spinal cord, symptoms of dyskinesia and visceral dysfunction occur.
Other symptoms and signs:
- Moderate dull pain during the day, aggravated by exercise;
- Spreading pain in the head, shoulders, pelvis, and lower extremities;
- persistent tension in the muscles associated with the affected intervertebral joints;
- performance degradation;
- sleep disorder;
- Postural changes and awkward gait.
If you experience these symptoms, we recommend that you make an appointment with your doctor. Prompt consultation will prevent negative effects on your health.
The disease can develop within a few years. In the early stages of cartilage damage, there are no symptoms, but gradually, persistent pain develops.
Causes of osteochondrosis
Normally, the intervertebral cartilage has a continuous blood supply and receives sufficient amounts of nutrients from the blood to renew cells and maintain its own structure. As tissues age, degenerative changes can occur, characterized by insufficient cell turnover. Abnormal blood flow occurs when an artery is pinched against the backdrop of a permanent curvature or injury to the spine. Furthermore, osteochondrosis may be the result of excessive physical exertion.
Causes:
- Intervertebral cartilage is gradually destroyed due to impaired posture, weightlifting and movement patterns. The reason for the damage to the structure of the intervertebral disc can even be long-term wearing of flat shoes;
- Cranial Vertebral Abnormalities - Violation of the relative position of the cervical vertebrae and skull structures. In this condition, vascular compression and impaired blood supply to tissues often occur.
- Metabolic disorders, accompanied by insufficient formation of hydrophilic cartilage components;
- Inflammation or autoimmune damage to cartilage, in which the body's defense system attacks healthy tissue;
- A herniated disc is a disease characterized by displacement of cartilage and a herniated disc into the spinal canal.
Identifying the etiology of osteochondrosis is important for choosing the right treatment.
Diagnosis of osteochondrosis
When symptoms of osteochondrosis appear, it is necessary to make an appointment with a neurologist. Clinic doctors ask about complaints from patients and review medical histories to identify risk factors for disease. A general examination is then performed to identify external signs of osteochondrosis and rule out symptoms of spinal cord dysfunction. To confirm the diagnosis, a neurologist will perform special tests.
How to diagnose osteochondrosis:
- Spine radiography. The neurologist ordered this study to obtain pictures of the affected part of the spine in two projections. Before surgery, the patient is asked to undress to the waist and stand in front of the machine. The resulting images allow doctors to detect hernias or other lesions and determine the extent of damage to the vertebrae and discs;
- Magnetic resonance imaging is a more informative study that allows neurologists to study layered images of the spine in different projections. During the exam, the patient is asked to remove all metal jewelry and lie down on the tomography table. Diagnosis can take anywhere from 15 minutes to an hour. This is a painless and reliable way to diagnose osteochondrosis. MRI results can immediately rule out other diseases with similar symptoms, such as bone tuberculosis or malignancy. If MRI is contraindicated, myelography is required.
- Examination of the spinal cord subarachnoid space (myelography). Neurologists prescribe this procedure to rule out syringomyelia, oncology, and other pathological conditions of the meninges. The method of obtaining the pictures is no different from conventional X-rays, however, before the study, doctors inject a contrast agent into the subarachnoid space. Before the puncture, the doctor treats the skin with an antiseptic and numbs the tissue. The needle is inserted into the intervertebral space of the lumbar spine.
A safe and reliable diagnostic test in a specialized clinic allows you to quickly start treating osteochondrosis.
Treatment of osteochondrosis
Treat after consultation with a neurologist and orthopaedic surgeon. If the affected cervical segment of the spine is unstable, a Shants collar is applied. A prefabricated orthopedic collar is applied to the neck and reinforced with a bandage. Wearing a collar is necessary to reduce the load on the affected spine and prevent complications. In severe osteochondrosis of the lumbar or thoracic spine, the patient needs rest. Doctors at the clinic also prescribe symptomatic therapy and physical therapy to relieve the patient's condition.
Treatment for osteochondrosis:
- NSAIDs are prescribed for pain relief. A neurologist prescribes nimesulide, celecoxib, or other medications. Long-term use of analgesics should strictly control the amount of analgesics and monitor the status of the liver.
- Traction therapy is a method of stretching the spine to increase the intervertebral space to remove pinching on blood vessels and nerves. Before surgery, massage to relax the muscles. Traction is performed on a special table or in the bathtub. The device is held in the desired position on the patient's body and gently extends the spine. This is a very effective and safe way to treat osteochondrosis.
- Complications of the use of anticonvulsants in the treatment of osteochondrosis. A neurologist prescribes a short-term course of carbamazepine or another drug.
- Use muscle relaxants. These drugs relax the muscles associated with the affected area of the spine and relieve pain;
- Nerve compression with corticosteroids. These drugs relieve inflammatory processes in tissues and include therapeutic massage, special exercises, and warm-ups.
Neurologists choose an individualized treatment plan for osteochondrosis, focusing on the patient's condition. Strict medical control of the course of treatment can give you the best prognosis.
Surgical treatment of osteochondrosis
If the diagnosis shows a hernia or severe compression of the spinal canal, the patient is referred to a neurosurgeon. Physicians assess the severity of the identified pathology and, if necessary, perform surgical intervention.
Surgical treatment options:
- Partial or complete removal of the disc.Surgery is performed under anesthesia. After applying anesthesia, the neurosurgeon treats the surgical area with antiseptic and cuts the skin at predetermined locations. After pushing the muscle layer with a special tool, the doctor removes the affected disc. A spondylectomy is also performed if necessary. Plastic surgery of the spinal segment is performed by the implantation of artificial material. This effective procedure is suitable for treating intervertebral hernias and relieving symptoms of osteochondrosis;
- Spinal stenosis surgery.This intervention removes compression on the nerves and spinal cord. After applying anesthesia, the doctor treats the surgical area with antiseptic and makes a wide skin incision. Pushing back on the muscle layer, the neurosurgeon reaches the intervertebral joint and operates. Interventions involve removal of the vertebral arch or entire joint. Surgery can be performed with minimal risk using X-rays and microsurgical controls.
The most complex surgical procedures are performed in the surgical departments of modern clinics.