Osteonecrosis is a degenerative-dystrophic disease of the spine and surrounding tissues.Dystrophic processes imply malnutrition, and degenerative processes imply premature aging, changes in the structure and properties of tissues.The degenerative process is irrelevant, i.e. the natural aging process of the body.However, when exposed to various adverse factors, it accelerates, leading to the development of this disease.
The relevance of osteoarthritis of the spine is due to the high frequency of its spread, especially in developed countries, affecting people of working age (30-60 years old) with complete or partial loss of working ability, chronic course of the disease and progression of the disease without adequate treatment and prevention.
Reasons for the development of osteoarthritis
1. Excessive load
The degenerative process in intervertebral discs is considered to be the difference between their strength characteristics and the load applied to them.Increased stress on the spine includes lifting weights, remaining in one position for long periods of time (sitting, standing), sudden movements, jumping from heights, injuries, curvature of the spine, poor posture and excess body weight.
Due to excessive load, injury to spinal structures occurs.Particularly sensitive to overload are the intervertebral discs, which perform the function of shock absorption and, together with the facet joints, provide movement to the spine.
2. Disc malnutrition
The intervertebral disc does not have its own blood vessels and is nourished by diffusion of interstitial fluid from surrounding tissues.The diffusion process is facilitated by the motor activity of the spine and surrounding muscles.
Therefore, prolonged restriction of movements in the spine, sedentary work and physical inactivity are accompanied by a decrease in the nutrition of the intervertebral disc and lead to the development of osteoarthritis.
3. Other factors
Genetic predisposition, metabolic disorders, hormonal changes, somatic diseases.
Under the influence of these factors, blood circulation and metabolism in the spine are disrupted, and the hydration of the intervertebral disc is reduced.In the fibrous annulus of the intervertebral disc, the fibers decompose, small cracks and tears appear, contributing to the movement of the nucleus pulposus and the formation of protrusion or herniation of the disc.
A bulging disc will irritate the sensitive nerve roots of the spinal nerves, causing pain in the back or along the associated nerve fibers.Stress reflexes and spasms of the surrounding muscles develop, accompanied by pain, a feeling of stiffness in the back and limitation of movements.
Emerging changes in surrounding tissues in the form of tension in the back muscles, functional blocks and nerve root irritation contribute to exacerbation of existing disorders of blood microcirculation and metabolic changes, causing the formation of a closed pathological loop of the development of osteoarthritis of the spine.
Types of osteoarthritis
Depending on the location, osteoarthritis of the cervical, thoracic or lumbar spine is distinguished.When all departments are involved, they talk about widespread spinal osteoarthritis.
The lumbar region is most commonly affected, accounting for about half of all osteoarthritis cases.This is because the lower part of the spine is subjected to greater static loads than the other parts.
The second most common location is the cervical region.It accounts for about 1/4 of osteoarthritis cases.This part of the spine often hurts the most because the head is forced into one position - sitting for a long time in front of the computer, working sedentary, doing monotonous manual labor.
The development of cartilage degeneration in the thoracic spine is associated with limited mobility in this segment, which is fixed by the sternum.
Symptoms of degenerative spine disease
Symptoms of osteoarthritis are divided into two main groups:
Local symptomsfor example, pain in the back or in some part of it: pain in the neck, lower back, between the shoulder blades.Local symptoms also include tension, back muscle stiffness, a feeling of heaviness and discomfort.
Long-term symptomsIts appearance is associated with the participation in the process of the nervous or vascular system of the spine, which is responsible for the preservation and blood supply of certain structures of the body.
Cervical spondylosis is characterized by:pain in the neck, occipital, shoulder, and neck areas.The pain may radiate down the arm, shoulder, elbow joint or hand, accompanied by a feeling of numbness in the arm or “crawling” and limited movement in the joints of the upper limbs.
Vertebral artery syndrome is often accompanied by spinal cartilage degeneration in this segment.It appears due to compression or spasm of the vertebral artery, which passes through the transverse processes of the cervical vertebrae and is involved in blood supply to the brain.Vertebral artery syndrome is manifested by splitting headaches, noise in the head, and dizziness.
Osteoarthritis of the thoracic spinemanifested by pain between the shoulder blades and back of the chest, which can spread along the intercostal spaces in the form of intercostal neuralgia, to the front of the chest, simulating a heart attack. In this case, it is necessary to rule out the nature of the pain in the heart.
When affecting the lower thoracic vertebrae, the pain can move to the anterior abdominal wall and down to the abdominal area, simulating internal organ diseases.
For lumbar osteoarthritisThe pain is localized in the lower back, in the buttocks, spreads to the legs and may be accompanied by numbness, tingling, leg muscle twitching, muscle atrophy and dysfunction of the pelvic organs.
Osteonecrosis of the spine is characterized by chronic back pain, which may increase at night, with prolonged sitting or standing, or after physical activity.
Diagnosis of osteoarthritis
Diagnosis of spondylosis is based on the study of the patient's complaints, collection of medical history, clinical, neurological and orthopedic examination of the patient.
If necessary, laboratory or instrumental diagnostic methods are prescribed, such as radiography, spinal magnetic resonance imaging (MRI), computed tomography (CT), Dopplerography of the neck and intracranial vessels, electrocardiogram.Detailed diagnosis is necessary to exclude more serious diseases of the spine, identify complications of osteoarthritis and choose the optimal treatment tactic for osteoarthritis.
Treatment of spondylosis
The Vertebrology Center provides comprehensive treatment for spondylosis.
To treat osteoarthritis, our center uses modern equipment and treatment methods, recruiting qualified specialists: spine specialists, orthopedic traumatologists, neurologists, orthopedists who will help you accurately diagnose spinal diseases and prescribe the necessary treatment procedures.
An individual treatment regimen is selected for each patient, depending on the stage of the disease, clinical manifestations of osteoarthritis, the presence of concomitant diseases and contraindications to treatment.
The center uses the following methods to treat spondylosis:
Treatment of osteoarthritis with medicationaims to reduce the severity of the condition and influence the pathogenesis of the disease.
Back massage, spine adjustmentallows you to normalize the tone and elasticity of the back muscles, improve blood supply, remove pinched nerve roots and restore mobility of moving segments of the spine.
Spinal tractionUsed when cartilage degeneration combined with disc protrusion and intervertebral herniation, when there are symptoms of nerve root compression.Traction is performed under the supervision of the attending physician.
Therapeutic blockade- This is a local injection of medicine into a concentrated pathological area.With its help, you can achieve the maximum concentration of the drug in the desired area to achieve a therapeutic effect.To treat osteoarthritis, paravertebral blockade is mainly used - the introduction of drugs into the tissues surrounding the vertebrae, near the nerve roots between the vertebrae.
Shock wave therapy- a new direction in the treatment of spondylosis and its complications.This method was initially developed in Switzerland to grind stones in internal organs, but later showed high effectiveness in the treatment of diseases of the musculoskeletal system.
At our center, treatment of osteoarthritis is performed using the American Pro-Ajuster shock wave therapy device, specially designed for the diagnosis and treatment of diseases of the spine and surrounding soft tissues.The device allows you to diagnose the state of tissue density and tension, then act on the changed areas.
To treat osteoarthritis, various physiotherapy methods are used, such as: magnetic therapy, laser treatment, ultrasound, muscle stimulation, electrical procedures.
Prevent osteoarthritis
As you know, the best treatment is prevention.To prevent the development of osteonecrosis, issues of prevention of this disease must be addressed at an early age.
Timely examination by a pediatric orthopedist allows timely detection of postural disorders, deviations in physical development and correction of existing changes.From the first years of a child's life, it is necessary to engage in exercise, outdoor sports, games, monitor posture, and avoid overloading the spine.
Key activities that help maintain a healthy spine include:
- Reasonable working and resting regime: avoid sitting for long periods of time, periodically stand up, stretch your back, keep your back straight, pay attention to your posture, sleep on a semi-hard bed;
- Eliminate spinal overload: do not lift heavy objects, especially in a bent position, avoid falls from height, spinal injuries, monitor body weight;
- Systematic exercises for the back;
- Proper nutrition;
- Timely diagnosis and elimination of pain and discomfort in the back.