What is endplate spondylosis. How does it differ from other types of spinal degeneration. What are the common symptoms and treatment options for endplate spondylosis. How can you manage the condition and improve your quality of life.

What Is Endplate Spondylosis and How Does It Affect the Spine?

Endplate spondylosis is a specific type of spinal degeneration that affects the vertebral endplates, which are the interfaces between the vertebral bodies and the intervertebral discs. This condition is part of the broader category of spondylosis, which encompasses various degenerative changes in the spine.

To understand endplate spondylosis, it’s crucial to first grasp the concept of spondylosis in general:

• Spondylosis is an umbrella term for degenerative conditions of the spine
• It often refers to osteoarthritis of the spine but can include other forms of degeneration
• The term describes both pain and spine degeneration, regardless of the specific cause or location

Endplate spondylosis specifically involves changes to the vertebral endplates, which can lead to various complications and symptoms. These endplates play a crucial role in nutrient exchange between the vertebral bodies and the intervertebral discs, so their degeneration can have significant impacts on spinal health.

The Anatomy of Vertebral Endplates and Their Role in Spinal Health

Vertebral endplates are thin layers of cartilage that separate the vertebral bodies from the intervertebral discs. They serve several important functions:

• Act as a barrier between the vertebral bone and the disc
• Facilitate nutrient exchange between the vertebral body and the disc
• Distribute mechanical loads across the vertebral body
• Prevent the nucleus pulposus of the disc from bulging into the vertebral body

When endplate spondylosis occurs, these functions can be compromised, leading to accelerated disc degeneration and other spinal problems.

How do vertebral endplates contribute to overall spine function?

Vertebral endplates play a crucial role in maintaining the health and function of intervertebral discs. They allow for the diffusion of nutrients from the vertebral body to the disc, which is essential since adult discs lack direct blood supply. This nutrient exchange helps keep the discs hydrated and functioning properly.

Causes and Risk Factors for Endplate Spondylosis

Endplate spondylosis, like other forms of spinal degeneration, can be attributed to various factors:

1. Age-related wear and tear
2. Genetic predisposition
3. Repetitive stress on the spine
4. Poor posture
5. Obesity
6. Smoking
7. Previous spinal injuries or trauma

While aging is a primary factor in the development of endplate spondylosis, it’s important to note that not everyone will experience symptoms as they get older. The presence of multiple risk factors can increase the likelihood of developing this condition.

Can lifestyle changes reduce the risk of endplate spondylosis?

While some risk factors, such as age and genetics, cannot be modified, others can be addressed through lifestyle changes. Maintaining a healthy weight, practicing good posture, avoiding smoking, and engaging in regular, low-impact exercise can all help reduce the risk of developing endplate spondylosis or slow its progression.

Symptoms and Clinical Presentation of Endplate Spondylosis

The symptoms of endplate spondylosis can vary widely from person to person. Some individuals may experience no symptoms at all, while others may have significant pain and functional limitations. Common symptoms include:

• Localized back or neck pain
• Stiffness in the affected area of the spine
• Reduced range of motion
• Radiating pain into the arms or legs (if nerve roots are affected)
• Numbness or tingling in the extremities
• Weakness in the muscles supplied by affected nerves

It’s important to note that the severity of symptoms doesn’t always correlate with the degree of degeneration visible on imaging studies. Some people with significant endplate changes may have minimal symptoms, while others with mild degeneration may experience severe pain.

How does endplate spondylosis differ from other types of spinal degeneration?

Endplate spondylosis specifically involves changes to the vertebral endplates, which can lead to altered nutrient exchange between the vertebral bodies and intervertebral discs. This can accelerate disc degeneration and potentially cause more widespread spinal issues. Other forms of spondylosis may primarily affect different structures, such as facet joints or ligaments.

Diagnostic Approaches for Endplate Spondylosis

Diagnosing endplate spondylosis typically involves a combination of clinical evaluation and imaging studies. The process may include:

1. Medical history and physical examination
2. X-rays to assess bone alignment and detect any obvious degenerative changes
3. Magnetic Resonance Imaging (MRI) to visualize soft tissues, including the intervertebral discs and endplates
4. Computed Tomography (CT) scans for detailed images of bone structures
5. Bone scans to detect areas of increased bone activity
6. Electromyography (EMG) to assess nerve function if neurological symptoms are present

The goal of diagnosis is not only to confirm the presence of endplate spondylosis but also to rule out other potential causes of symptoms and assess the extent of degeneration.

What specific signs do doctors look for when diagnosing endplate spondylosis?

When diagnosing endplate spondylosis, doctors look for several key indicators on imaging studies:

• Irregularities or sclerosis of the vertebral endplates
• Reduced disc height
• Presence of osteophytes (bone spurs) near the endplates
• Changes in the signal intensity of the vertebral bodies adjacent to affected endplates on MRI
• Signs of inflammation or edema in the bone marrow near the endplates

Treatment Options and Management Strategies for Endplate Spondylosis

The treatment of endplate spondylosis is typically focused on managing symptoms and improving function. The approach can vary depending on the severity of symptoms and the extent of degeneration. Treatment options may include:

1. Conservative measures:
   • Physical therapy to improve strength and flexibility
   • Pain management techniques
   • Lifestyle modifications
   • Use of assistive devices
2. Medications:
   • Over-the-counter pain relievers
   • Prescription anti-inflammatory drugs
   • Muscle relaxants
3. Interventional procedures:
   • Epidural steroid injections
   • Facet joint injections
   • Radiofrequency ablation
4. Surgical interventions (in severe cases):
   • Decompression procedures
   • Spinal fusion
   • Disc replacement

The choice of treatment depends on various factors, including the patient’s age, overall health, severity of symptoms, and personal preferences. A multidisciplinary approach involving specialists in pain management, physical therapy, and spine surgery may be beneficial for comprehensive care.

How effective are conservative treatments for managing endplate spondylosis?

Conservative treatments can be highly effective for many patients with endplate spondylosis. Physical therapy, in particular, can help improve spine flexibility, strengthen supporting muscles, and teach proper body mechanics to reduce stress on the affected areas. Pain management techniques, such as heat/cold therapy and gentle stretching, can also provide significant relief. Many patients find that a combination of conservative approaches allows them to manage their symptoms effectively without the need for more invasive interventions.

Living with Endplate Spondylosis: Lifestyle Modifications and Self-Care

Managing endplate spondylosis often requires a combination of medical treatment and lifestyle adjustments. Patients can take several steps to improve their quality of life and potentially slow the progression of the condition:

• Maintain good posture to reduce stress on the spine
• Engage in regular, low-impact exercise to strengthen core muscles and improve flexibility
• Use proper body mechanics when lifting or performing repetitive tasks
• Maintain a healthy weight to reduce stress on the spine
• Quit smoking, as it can accelerate spinal degeneration
• Use ergonomic furniture and equipment to support proper spine alignment
• Practice stress-reduction techniques, as stress can exacerbate pain
• Get adequate sleep to allow for tissue repair and pain reduction

It’s important for individuals with endplate spondylosis to work closely with their healthcare providers to develop a personalized management plan that addresses their specific needs and limitations.

What types of exercises are most beneficial for people with endplate spondylosis?

For individuals with endplate spondylosis, low-impact exercises that focus on strengthening core muscles and improving flexibility are often most beneficial. These may include:

• Swimming or water aerobics
• Gentle yoga or Pilates
• Walking
• Stationary cycling
• Specific exercises prescribed by a physical therapist

It’s crucial to start any new exercise program gradually and under the guidance of a healthcare professional to avoid exacerbating symptoms.

Emerging Research and Future Directions in Endplate Spondylosis Treatment

As our understanding of endplate spondylosis continues to evolve, researchers are exploring new approaches to diagnosis and treatment. Some areas of ongoing research include:

1. Advanced imaging techniques to better visualize endplate changes and assess their impact on disc health
2. Biological therapies aimed at regenerating or repairing damaged endplates
3. Gene therapy approaches to address genetic factors contributing to endplate degeneration
4. Development of new biomaterials for endplate repair or replacement
5. Refinement of minimally invasive surgical techniques for treating endplate-related issues
6. Investigation of the role of gut microbiome in spinal health and degeneration

These research efforts hold promise for improving our ability to diagnose endplate spondylosis earlier and develop more targeted, effective treatments in the future.

How might advances in regenerative medicine impact the treatment of endplate spondylosis?

Regenerative medicine approaches, such as stem cell therapy and growth factor injections, are being studied for their potential to repair or regenerate damaged endplates and intervertebral discs. These therapies aim to stimulate the body’s natural healing processes and potentially reverse some of the degenerative changes associated with endplate spondylosis. While still in the experimental stages, these approaches could offer new options for patients who have not responded well to traditional treatments.

As research in this field progresses, it’s likely that we’ll see more personalized treatment approaches that take into account an individual’s specific genetic, environmental, and lifestyle factors. This could lead to more effective management strategies and improved outcomes for patients with endplate spondylosis.

Spondylosis: What It Actually Means

Spondylosis is a broad term that simply refers to some type of degeneration in the spine.

Spondylosis is an umbrella term used to describe pain from degenerative conditions of the spine. Watch: Spondylosis Video

Most often, the term spondylosis is used to describe osteoarthritis of the spine, but it is also commonly used to describe any manner of spinal degeneration.

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Spondylosis Is a Descriptive Term

As with many other terms to describe spinal problems, spondylosis is more of a descriptive term than it is a clinical diagnosis. Literally it can be translated to mean that one has both pain and spine degeneration, regardless of what is causing the pain or where the degeneration is occurring.

Watch: Video: What Is a Degenerative Disc and the Degenerative Cascade?

For example:

• The patient may have pain from facet joint osteoarthritis, causing pain during times of high activity or after extended inactivity
• There could be spinal stenosis, an abnormal narrowing of the spinal canal, which is creating leg pain when the patient walks
• The pain could be caused by degenerative disc disease, in which a degenerated disc that becomes dehydrated and loses some of its function. The degenerated disc can cause low back pain or neck pain, and possibly leg pain or arm pain.

These examples are only a few of the many possible contributors to a patient’s pain.

See When Back Pain May Be a Medical Emergency

In This Article:

• Spondylosis: What It Actually Means

• Answers to Common Spondylosis Questions

• Spondylosis Video

After arriving at a confirmed clinical diagnosis for the cause of a patient’s pain (rather than just the finding that there is spondylosis, which may or may not be causing the pain), physicians then usually use more specific terms for the diagnosis (such as osteoarthritis, lumbar degenerative disc disease or cervical degenerative disc disease, or lumbar spinal stenosis or cervical spinal stenosis) because those terms more effectively describe what is causing the pain.

Dr. David DeWitt is an orthopedic surgeon practicing at the NeuroSpine Center of Wisconsin, where he specializes in spine surgery. He has more than 15 years of experience evaluating and treating spine diseases and trauma.

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What Is Degenerative Spondylosis? | Discogenic, Lumbar, and Endplate

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WHEN YOUR CONDITION IS DEGENERATIVE DISC DISEASE (SPONDYLOSIS)

Degenerative Disc Disease (DDD), also known as Spondylosis, is a condition that usually occurs due to aging. As the term implies, it is the progressive deterioration of the discs between the vertebral bodies.

Spondylosis (a different term than spondylolisthesis) is typically a degenerative condition of the joints of the spine and is also known as spinal osteoarthritis. The discs, joints, and ligaments of the spine are generally involved.

The discs lose their cushioning effect between the spinal bones, the ligaments become weaker or thicken, and the bones can develop bony growths or spurs. Aging and repetitive stresses to the spine are the primary causes of this degeneration, but they also can be present in younger adults who have had prior trauma.

Not everyone will have symptoms (usually pain) as a result of spondylosis. If severe, spondylosis may cause pressure on nerve roots with subsequent pain or tingle in the arms or legs.

Spondylosis is a degenerative condition of spinal joints and is also known as spinal osteoarthritis. Discs, joints, and ligaments are usually involved. Discs lose their cushioning effect, ligaments become weaker or thicken, and vertebrae can develop bony growths or spurs.

Spondylolisthesis occurs when there is an abnormal alignment of the spine when seen from the side or lateral view. The vertebra above slides forward relative to the one below it. This misalignment may result from several causes, including trauma or degeneration.

There may be abnormal spinal motion associated with this condition. Spondylolisthesis may result in back or neck pain, but extremities can be involved in the spinal cord, or nerve roots are compressed or irritated. Commonly, patients will complain of muscle spasms, thigh and/or buttock pain, and/or tight hamstrings.

There are patients who have spondylolisthesis and do not have symptoms. Spondylolisthesis can be congenital (present at birth) or develop in adolescence or adulthood. The disorder may result from the physical stresses to the spine from physical activity, trauma, and general wear and tear.

In some individuals, the vertebra loses flexibility. Others experience bone spurs or disc bulging that can compress a nerve root, which can cause chronic pain, numbness, and weakness in certain body parts. This condition, however, can occur anywhere along the spinal column, with most cases occurring at the cervical region (degenerative disc disease of the neck) and at the lumbar area (lower back).

Spondylosis occurs with aging, as the shock-absorbing cushions termed intervertebral discs, lose fluid resulting in decreased flexibility of the spine, bulging, thinning, and lesser cushioning ability of the discs. Aside from the normal wear and tear as the individual ages, degenerative disc disease can also occur due to injury as a result of external trauma or repetitive stress on the vertebra.

Other common factors that can contribute to the advancement of disc degeneration include obesity, smoking, and genetic factors.

Symptoms

Not everyone will have symptoms (usually pain) as a result of spondylosis. If severe, spondylosis may cause pressure on nerve roots with subsequent pain or tingle in the arms or legs. The most common clinical manifestation of degenerative disc disease is lower back pain that may or may not radiate to the upper part of the thighs. Some individuals who experience pain from Spondylosis describe morning pain as lower back stiffness or rigidity.

Diagnosing

Your doctor will first perform a physical exam to observe your posture, range of motion, and physical condition, noting any movement that causes you pain. A neurological exam may also be performed to test your reflexes and muscle strength.

During the neurological exam, your doctor will test your sensation, reflexes, and muscle strength. Very commonly with spondylolisthesis, the neurological exam findings are relatively normal.

As your doctor develops the diagnosis, imaging tests may be performed. The best initial test for diagnosis of spondylolisthesis is an X-ray taken in the standing position, with the spine flexed and then extended. For further confirmation of spondylolisthesis, a CT scan may be ordered.

If the slipped vertebra is suspected to be pressing on nerves, the doctor may order a myelogram or an MRI scan.

Treatments

Treatment varies with the severity of the spondylolisthesis. Most patients require only physical therapy combined with activity modification. If pain is arising from nerve root irritation, an epidural steroid injection may be considered.

For cases with severe pain not responding to therapy, if the slip is severe or there are neurologic changes, the slipping vertebra might be surgically fused to the vertebra below it. It is important to discuss treatment options with your doctor in deciding which treatment, if any, may be best for you.

Non-surgical treatments for spondylosis include epidural injections, chiropractic care, pain management medications, and physical therapy. If the pain continues or there is evidence of a severely compressed nerve, surgery may be considered. Surgery for spondylosis involves two main components: eliminating what is causing pain and then fusing the spine to control movement.

Surgery may also include decompression, which means removing the tissue that is pressing on nerves. Spondylosis and disc degeneration causing functionally disabling pain that fails to improve with conservative treatment may be treated with fusion or disc replacement surgery.

Every case is different. It is therefore very important to discuss treatment options with a spine specialist familiar with all types of spinal surgery in deciding which treatment, if any, may be best for you.

Frequently Asked Questions

Will exercise help?

Like unused rubber that gets brittle as it ages, bones and joints get fragile with immobility. Regular exercise is the key to preventing further damage and complication. However, exercise should be done with caution and to an extent that is comfortable and pain-free.

Exercise #1

• Sit comfortably with both feet on the floor
• Keep your neck straight
• Bring the back of your head up
• Feel the stretch of your neck
• Repeat a few times

Exercise #2

• Sit comfortably with both feet on the floor
• Relax both of your shoulders and arms
• Move your left ear towards your left shoulder as far as you can tolerate without lifting your shoulder
• Return to starting position
• Perform the same exercise on the right side
• Repeat for few times as tolerated

Exercise #3

• Sit comfortably with both feet on the floor
• Relax both of your shoulders and arms
• Keep your neck straight and look straight ahead
• Gently turn your head to the right as far as comfortable (maintain your gaze straight and parallel to the floor)
• Return to starting position
• Perform the same exercise on the right side
• Repeat for few times as tolerated

Exercise #4

• Sit comfortably with both feet on the floor
• Relax both of your shoulders and arms
• Gently move your head down with your chin towards the chest as far as comfortable
• Keep your back and neck aligned
• Return to starting position
• Repeat step 3 for few times as tolerated

Can Epsom Salts help to reduce my pain?

The Magnesium content present in Epsom salt works wonders in healing. It aids in balancing the pH levels in the body. When pH levels are balanced, the stiffness can be minimized. It also helps in lessening the pain of DDD in your neck and shoulders.

To prepare for an Epsom salt treatment, take a couple of tablespoonful of Epsom salt and add water to make a paste. Apply it to your neck and shoulders. Keep it on for approximately 15 minutes, and then wash it off. However, if you have diabetes, cardiac or kidney problems, consult your doctor first prior to using this home management.

Why did I get this?

In most cases, it is just the normal aging process. It can certainly be affected by genetics and if your mother and father have problems with their back it is not unusual that you too will have problems with your back.

Is Degenerative Disc Disease a disease?

No, it really isn’t a disease in the typical sense, meaning that there is not a pill you can take to stop it, and it is not life-threatening. It is more of a wear and tear process.

Will have to live it the rest of my life?

No, most patients usually will respond to an active exercise program, strengthening their core or trunk muscles, learning proper body posture and body mechanics, losing weight if they are overweight, and the use of anti-inflammatories in the vast majority of cases.

How common is Degenerative Disc Disease?

We know that 90% of individuals will experience 1 episode of low back pain and about a third of this 90% will have chronic intermittent back pain. If one exercises and takes care of their spine, the pain-free intervals can actually be quite long and recovery from these episodes will be relatively shortened.  That’s why it is very important to practice good body posture and body mechanics and to do your exercises.

I have young children. Will they get Degenerative Disc Disease?

Unfortunately, we know that genetics does play a role in the conditions that our family gets. While there has been research to determine what genes may be associated with Degenerative Disease, it is not clear-cut at the present time. The most important thing is for all patients to be physically fit, of normal weight, and to practice good body posture and body mechanics.

Leaders in Advanced Spine Procedures

To find out whether you would benefit from artificial disc surgery, make an appointment to visit Texas Back Institute in the Dallas, TX, area for an evaluation. We always reserve surgery as a last resort, so we’ll seek to relieve pain first through conservative treatments such as physical therapy and pain management. If severe pain persists and it is determined that you would benefit from surgery, we can help you determine whether artificial disc replacement is right for you.

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Deforming spondylosis – treatment, symptoms, causes, diagnosis

The term deforming spondylosis has Latin roots (spondyl means the spine, and osis – disorders) and the term reflects the presence of problems in the spine. Currently, this term refers to degenerative changes in the joints of the spine (osteoarthritis or osteoarthritis) and, like osteochondrosis, spondylosis is an involutionary process in the spine. As the body ages, the structures of the spine wear out, especially the joints, ligaments, and intervertebral discs.

However, the aging of the organism is a purely individual process. Just as some people start going gray earlier, the development of spondylosis also appears earlier in some people. In fact, some people may not experience pain at all. It all depends on how part of the spine has undergone degeneration, and how these changes affect the spinal cord or spinal roots.

Deforming spondylosis can develop in all parts of the spine (cervical thoracic and lumbar) and, depending on the localization of degenerative changes in spondylosis, there will be corresponding symptoms. Spondylosis ( spondylosis deformans ) is often referred to as osteoarthritis or osteoarthritis of the spine.

Deforming spondylosis is a degenerative process that goes in parallel with osteochondrosis and degenerative changes occur in the following structures of the spine.

Intervertebral discs . As people age, certain biochemical changes occur that affect tissues throughout the body. There are also changes in the structure of the intervertebral discs (in the annulus fibrosus, in the nucleus pulposus). The annulus fibrosus consists of 60 or more concentric bands of collagen fibers. The nucleus pulposus is a jelly-like substance inside the intervertebral disc, surrounded by the annulus fibrosus. The core consists of water, collagen fibers and proteoglycans. Degenerative involutional changes can weaken these structures, causing the annulus to wear out or tear. The water content in the core decreases with age, which affects the depreciation properties of the intervertebral disc. The result of structural changes in disc degeneration may be a decrease in the height of the intervertebral disc and an increased risk of disc herniation.

Facet joints (or zygapophyseal joints) . Each vertebral body has four facet joints that work like hinges. This allows the spine to flex, extend, and rotate. Like other joints, facet joints are covered with cartilage. Cartilage is a special type of connective tissue that is provided with lubrication and a good sliding surface. With degenerative changes in the facet joints, cartilage tissue disappears and osteophytes form. These changes can lead to joint hypertrophy (osteoarthritis, osteoarthritis).

Bones and ligaments . Osteophytes can form near the end of the vertebral plates, which can lead to impaired blood supply to the vertebra. In addition, the end plates may thicken due to sclerotic phenomena; thickening or thickening of the bones under the end plates. Ligaments are bands of fibrous tissue that connect the vertebrae and they protect the spine from excessive movement such as hyperextension. Degenerative changes cause the ligaments to lose their strength. Changes to, for example, the yellow ligament can lead to hardening and thickening of the ligament, which in turn can lead to an effect on the dura mater.

Symptoms in spondylosis of various parts

Spondylosis of the cervical region. The complex anatomical structure of the cervical spine and the wide range of motion make this spine very prone to degenerative disorders. Pain in the neck with spondylosis in this department is common. The pain may radiate to the shoulder or down the arm. When osteophytes cause compression of the nerve roots that innervate the limbs, in addition to pain, weakness in the upper limbs may also appear. In rare cases, bone spurs (osteophytes) that form in the front of the cervical spine can lead to difficulty swallowing (dysphagia).

When spondylosis is localized in the thoracic spine, pain due to degenerative changes (spondylosis) often appears with forward flexion and hyperextension. Flexion causes faceted pain.

Lumbar spondylosis is common in people over 40 years of age. The most common complaints are back pain and morning stiffness. Changes, as a rule, take place in several motor segments. The lumbar spine bears most of the weight of the body. Therefore, when degenerative changes compromise structural integrity, symptoms, including pain, may accompany any physical activity. Movement stimulates pain fibers in the annulus and joints. Sitting for long periods of time can lead to pain and other symptoms due to pressure on the lumbar vertebrae. Repetitive movements such as lifting weights and bending over can increase pain.

Symptoms of spondylosis can range from mild to severe and become chronic or even crippling. These may include:

• Cervical region
  
  • Pain that comes and goes
  • Pain that radiates to the shoulders, arms, hands, fingers
  • Morning stiffness in the neck or shoulder or limited range of motion upon waking
  • Neck or shoulder soreness or numbness
  • Weakness or tingling in the neck, shoulders, arms, hands, fingers
  • Headache in the occipital region
  • Unbalance
  • Difficulty swallowing
• Thoracic spine
  
  • Upper and middle back pain
  • Pain occurs when bending and straightening the trunk
  • Morning stiffness in the back after waking up
• Lumbar Spine
  
  • Pain that comes and goes
  • Morning stiffness in lower back after getting out of bed
  • Pain that improves with rest or after exercise
  • Pain in the lower back or numbness
  • Ischialgia (moderate to severe pain in the legs)
  • Weakness, numbness or tingling in the lower back, legs or feet
  • Walking disorder
  • Impaired bowel or bladder function (these symptoms are rare, but possible with compression of the cauda equina).

Causes of spondylosis deformans

Body aging is the main cause of spondylosis. The body is subjected to daily stress for many years, and over time, changes occur in various structures of the spine. Before symptoms such as pain and stiffness appear, degeneration of the spinal structures occurs. Spondylosis is a cascade process: one anatomical change leads to another, resulting in changes in the structure of the spine. These changes together cause spondylosis and the corresponding symptoms.

As a rule, degenerative changes begin in the intervertebral discs first. For this reason, patients with spondylosis often also have osteochondrosis. The consequences of these degenerative changes in the spine are closely related.

Changes begin in the discs, but eventually the aging process also affects other parts of the motor segments of the spine. Over time, the collagen that makes up the annulus begins to change. In addition, the water content in the disk is reduced. These changes reduce the cushioning functions of the disk and the ability to absorb load vectors. With degeneration, the disc becomes thinner and denser, which already leads to changes in the joints, which take part of the load of the disc on themselves, providing stabilization of the spine. When the disc becomes thinner, the cartilage of the joints begins to wear out faster, the mobility of the spine increases, and conditions arise for irritation of the nerve roots located nearby. This hypermobility, in turn, causes a compensatory reaction of the body in the form of excessive growth of bone tissue in the area of ​​the joints (osteophytes). Osteophytes with sufficient magnification can have a compressive effect on the roots of the spinal cord and cause a corresponding clinical picture. Osteophytes can also cause spinal stenosis. As a rule, the cause of stenosis of the spinal canal is not osteochondrosis, but spondylosis.

In the development of spondylosis, to a certain extent, genetic determinism plays a role. Also, bad habits, such as smoking, have a certain influence.

Diagnosis

It is not always easy to determine that spondylosis is the cause of back pain because spondylosis can develop gradually as a result of body aging, and pain can also be due to another degenerative condition such as osteochondrosis. First of all, a neurologist is interested in answers to the following questions:

• Beginning of pain manifestations
• Activities that preceded the onset of pain
• What measures were taken to relieve pain
• Presence of irradiation of pain
• Pain aggravating or pain relieving factors

The neurologist will also perform a physical examination and examine the patient’s neurological status (posture, range of motion in the spine, presence of muscle spasm). In addition, the neurologist should also examine the joints (hip joints, sacroiliac joints), as the joints can also be a source of back pain. During a neurological examination, a neurologist will check tendon reflexes, muscle strength, and the presence of sensory disturbances.

Verification of the diagnosis also requires instrumental methods, such as radiography, MRI or CT, which allow visualization of changes in the spine. Radiography well reflects changes in bone tissues and allows you to visualize the presence of bone growths (osteophytes). But for a more accurate diagnosis, methods such as CT or MRI are preferable, which also visualize soft tissues (ligaments, discs, nerves). In some cases, it is possible to use scintigraphy, especially if it is necessary to differentiate oncological processes or infectious (inflammatory) foci.

In the presence of damage to the nerve fibers, the doctor may prescribe ENMG, which allows you to determine the degree of conduction disturbance along the nerve fiber and determine both the degree of damage and the level of damage. Based on the totality of clinical data and the results of instrumental methods, the examination by a neurologist can make a clinical diagnosis of spondylosis and determine the necessary treatment tactics.

Treatment

In most cases, the course of spondylosis is quite slow and requires almost no treatment. With the active course of spondylosis, treatment is required, which can be both conservative and, in some cases, surgical. Most often, spondylosis requires conservative treatment. Various therapies are used to treat spondylosis.

Acupuncture . This treatment method can reduce back and neck pain. Needles that are inserted at specific points can also be stimulated both mechanically and electrically. In addition, acupuncture increases the production of its own painkillers (endorphins).

Bed rest. In severe cases, severe pain may require bed rest for no more than 1-3 days. Prolonged bed rest increases the risk of developing complications such as deep vein thrombosis and back muscle wasting.

Traction therapy . In most cases, spinal traction is rarely needed or used to relieve symptoms associated with spondylosis.

Manual therapy . Manipulations of a chiropractor using various techniques can increase the mobility of motor segments and remove muscle blocks.

Medical treatment . Drugs for the treatment of spondylosis are mainly used to relieve pain. These are drugs such as NSAIDs. In addition, muscle relaxants can be used if there are signs of muscle spasm. Tranquilizers can also be used to relax muscle spasm, which can also improve sleep. Opioids are used in the treatment of pain only occasionally, with severe pain manifestations. Any drug treatment should be carried out only as prescribed by the attending physician, since almost all drugs have a number of side effects and have certain contraindications.

Epidural steroid injections are sometimes used for pain syndromes and can relieve pain, especially when there is swelling and inflammation in the spinal roots. Typically, the steroid is administered in combination with a local anesthetic. The effect of such injections is usually limited to 2-3 days, but this allows you to remove the pathological process and connect other methods of treatment.

Facet joint injections are also used in the treatment of spondylosis and improve the mobility of the facet joints, reduce pain associated with arthrosis of the facet joints.

LFC . This treatment method is one of the most effective treatments for spondylosis. Dosed physical activity allows you to restore the normal muscle corset, reduce pain, increase the stability of the spine, improve the condition of the ligamentous apparatus and stop the progression of degenerative processes in the spine. As a rule, exercise therapy is prescribed after the relief of acute pain.

Physiotherapy . Modern methods of physiotherapy (for example, HILT therapy, SWT therapy, electrical stimulation, cryotherapy) can not only reduce pain manifestations, but also influence the development of degenerative processes in the spine to a certain extent.

Corsetting . The use of corsets in spondylosis is possible for a short period of time, since prolonged use of the corset can lead to atrophy of the back muscles.

Lifestyle change. Losing weight and maintaining a healthy lifestyle with a balanced diet, regular exercise, and smoking cessation can help treat spondylosis at any age.

Surgery

Only a small percentage of spondylosis cases require surgery. Surgical methods of treatment are mainly necessary in the presence of persistent, resistant to conservative treatment of neurological symptoms (weakness in the limbs, dysfunction of the bladder, intestines, or other manifestations of compression effects on the spinal cord and roots). Surgical treatment consists in decompression of the nerve structures (for example, removal of osteophytes that have a compressive effect on the nerve structures). Depending on the extent of the operation, spinal fusion may be performed to stabilize the vertebrae. Currently, minimally invasive methods of surgical treatment are widely used, which allows you to quickly restore the function of the spine and normalize the quality of life.

Discospondylitis (spondylitis) in dogs – symptoms, treatment

What is discospondylitis in dogs?

Discospondylitis is a disease that affects the intervertebral disc, and in particular its internal contents – the nucleus, which subsequently leads to neurological symptoms. In addition to the nucleus pulposus, the endplates of the vertebrae and vertebral bodies are involved in this process, which leads to dysfunction of the spine, to various deformities and neurological disorders.

Discospondylitis is a very common disease in veterinary practice, but it is quite difficult to diagnose at the initial stage of the disease. This is not a genetic pathology, and it occurs in all types of dogs and even cats. There are a number of dogs that suffer from a breed predisposition to immunosuppression. These are such breeds as Rottweiler, Bernese Mountain Dog, Basset Hound, Great Dane, Boxer. These breeds are most likely to develop discospondylitis.

This condition is more common in males than females.

Symptoms of discospondylitis in dogs

Clinical signs of discospondylitis develop in different ways, but the disease usually occurs in young animals. According to the course of the disease, it can be divided into two groups:

• acute course;
• chronic course.

In both cases, discospondylitis is accompanied by symptoms such as pain. The pain syndrome can be local or radiating, weak, moderate or very strong. Also often clinical signs are manifested in movement disorders in the limbs of the dog: outpatient proprioceptive paresis and proprioceptive ataxia are observed. Paraplegia or tetraplegia are extremely rare in clinical practice.

The neurological deficits in discospondylitis will be consistent with the location of the compression problem, and will have corresponding neurological deficits.

The pathophysiology of discospondylitis is not fully understood. According to the latest information, it is believed that the mechanism of colonization in the intervertebral disc of bacteria brought with the blood flow from the body is directly related to slow blood flow in the vascular loop of the subchondral part of the vertebra. Neighboring intervertebral discs may be involved in this process: bacteria or other infectious principles penetrate there with blood flow through the venous sinuses.

As a result of infection, the intervertebral disc undergoes destructive changes and formation of granulation tissue, which, in turn, can lead to compression of the spinal cord or nerve roots. Also, in the affected segment, the development of instability is possible, and subsequently – dislocations or fractures of the vertebrae.

As mentioned above, the cause of discospondylitis is an infectious onset. The infection itself can be carried to the disc in the blood stream from the bladder, skin, etc. The same happens with open injuries, surgical operations, immunosuppressive conditions, endocrine disorders (diabetes mellitus). Of the specific infectious agents, the cause of discospondylitis is B. Canis, Aspergillus, Actinomyces. From non-specific -St.Aureus, St.Intermedius, Streptococcus, E.Coli and others.

In some cases, the infectious onset is extremely difficult or even impossible to determine.

Discospondylitis due to a bacterial infection is characterized by an acute course, general hyperthermia, lethargy and other disturbances in the general condition of the dog and may be complicated by subdural abscesses if the veterinary specialist is not contacted in time.

Diagnosis of discospondylitis in dogs

Discospondylitis is a common disease in veterinary practice, but it is quite difficult to diagnose at the initial stage of the disease. Often, veterinarians confuse it with spondylosis when diagnosing, although it has its own distinctive features in the clinical picture and diagnosis. Diagnosis of discospondylitis should include, in addition to a general and neurological examination, special research methods, such as X-ray, MRI and CT.

In addition to spondylosis, differential diagnosis should take into account oncological diseases of the spine – tumors of the vertebral bodies. A distinctive feature of neoplasms of the vertebrae is the intactness of the boundaries of the disc and lesions within one vertebra.

Fig. 1. Discospondylitis in a dog on CT scan.

In x-ray examination, the characteristic signs of discospondylitis will be narrowing of the intervertebral spaces, demineralization and erosion of the subchondral plates, uneven endplates, growth of bone tissue with the formation of spondylophytes, up to fusion of the vertebrae. There may be an expansion of the intervertebral space and erosion of the vertebral bodies.

Fig. 2. Discospondylitis in a Th9-L4 dog.

Computed tomography – a more detailed study of the bone tissue, the signs will be the same as in x-ray diagnostics.

Magnetic resonance imaging for discospondylitis allows you to see the disease at an early stage of development. With MRI, it is possible to determine the involvement of the spinal cord in the process of inflammation, to see compression problems and, accordingly, to assess the pathological process in more detail. Characteristic signs on MRI in the T-1 mode are a decrease in the MR signal from the disc and the part of the vertebral body adjacent to the disc. In the T-2 mode, an increase in the mr signal from these structures.

In the study of discospondylitis, it is necessary to determine the root cause of this pathology, therefore, dogs must be examined for brucellosis (ELISA – diagnostics), bacteriological cultures are made during CT-assisted biopsy of the intervertebral disc.

In case of pain syndrome and the presence of discospondylitis according to X-ray diagnostics, MRI diagnostics is mandatory.

Treatment of discospondylitis in dogs

Discospondylitis is a therapeutic pathology with neurological disorders and early treatment is usually therapeutic.

Therapeutic treatment includes the administration of specific antibiotics, eg for brucellosis.

In the event of discospondylosis of unclear etiology, broad-spectrum antibiotics – fluoroquinolones, cephalosporins, penicillin antibiotics – are prescribed for at least 6 weeks. In some cases, antibiotics are used for up to six months.

The course of the disease is monitored by MRI and special examinations.

In combination with antibiotics, painkillers and anti-inflammatory drugs (gabapentin, previcox, trocoxil, meloxicam and others) are used. The term for taking the drugs is determined by the attending veterinarian.

If fungal infections are present, systemic antifungal drugs such as ketaconazole or fluconazole are given. The term for taking the drugs is also set by the veterinarian.

Glucocorticosteroids are not used in the treatment of this disease.

Surgical treatment of discospondylitis is applicable to relieve compression of the spinal cord and nerve roots using various techniques: dorsal laminectomy, hemilaminectomy, corpectomy, as well as in the presence of localized spinal abscesses, growths of granulation tissue. Sometimes, with the development of spinal instability, various stabilizing structures are used (transpedicular fixation, etc.).

The prognosis for discospondylitis in a dog

The prognosis with timely treatment and with a mild degree of neurological deficit is favorable. In advanced cases of discospondylitis with the development of inflammation of the nervous tissue, prolonged compressions and the presence of a fungal infection from cautious to unfavorable.

Clinical case of discospondylitis in dogs

The owners of the French bulldog Ulyana complained of squealing when the dog moved, they also began to observe weakness in the hind legs. During a neurological examination by a neurologist Maslova E.S. a neurological deficit of the pelvic limbs of the second degree was found. After examinations, the doctor made a preliminary diagnosis – a disease of the intervertebral disc in the lumbar spine. To confirm the diagnosis, Uliana was sent for a CT scan. According to the results, the extrusion of the disc of the 4th-5th lumbar vertebra was found in the dog with a visible overlap of up to 40% of the canal section.