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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Spondylosis Diagnosis & Treatment – NYC

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Spondylosis is an umbrella term for different forms of age-­related degeneration of the spine.

The bones of the spine are called the vertebrae. Between each pair of vertebrae, there are three joints. There is a joint in the front of the spine that is called an intervertebral disc. There are two joints in the back of the spine, which are called facet joints. These joints are made of cartilage and cushion the bones. Ligaments are around the spinal column and connect the vertebrae together. These help to support the joints and bones.

As people age, their bones, discs, cartilage, and ligaments change. Bone spurs (abnormal overgrowth of bones) may develop, discs may dry and crack, cartilage may wear out, and ligaments may thicken. These age-related degenerative changes are all forms of spondylosis.

Symptoms

Spondylosis does not always cause symptoms. When symptoms do occur, they typically include neck or back pain or stiffness.

Spondylosis can lead to spinal stenosis, which is a narrowing of the spinal canal. As a result, the spinal cord and/or spinal nerve roots can become compressed (pinched). For example, the cervical spinal cord can be affected by compression from spondylosis. This is called cervical spondylotic myelopathy. Symptoms of cervical spondylotic myelopathy include:

• Tingling and numbness in the arms, hands, legs, and/or feet
• Weakness in the muscles of the arms, shoulders, legs, feet, and/or hands
• Coordination problems

Diagnosis

If a patient presents with symptoms associated with spondylosis, the doctor may order an X-ray to help identify any changes in the bones of the spine.

The doctor may also order the following diagnostic procedures:

• Magnetic resonance (MR) scan: provides a detailed image of the spinal cord and surrounding nerves. This diagnostic procedure can help identify if a nerve is being compressed.
• Computed tomography (CT) scan: provides more detailed images of the bones

If there is a concern that spondylosis has begun to compress nerve tissue in the spine, the doctor may order a test to evaluate whether the nerve signals are traveling properly to the muscles.

Risk Factors

Spondylosis is caused by wear and tear on the components of the spine. The major risk factor for developing spondylosis is age. In fact, by age 60 most people will show signs of spondylosis on X-ray.

Treatments

Typically, non-operative measures are effective in treating the symptoms associated with spondylosis. Non-operative measures include pain medications and physical therapy.

However, if spondylosis has resulted in compression of the spinal cord or spinal nerve roots, surgery may be necessary to relieve the pressure.

The type of surgery required varies depending on the cause of the spinal cord compression. The neurosurgeons at the Spine Hospital at the Neurological Institute of New York are skilled at determining the best treatment for each patient and each situation.

Options include:

• Discectomy: to remove a herniated disk
• Laminectomy: to remove bone spurs or remove part of the vertebra called the lamina
• Laminoplasty: to open the space for nerve tissue by changing the position of the lamina
• Spinal fusion: fusing a segment of the spine using a transplanted bone with or without instruments (ex: rods and screws)

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 (in the 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.

ᐈ What is spondylosis? ~【Treatment in Kyiv】

It is a mistake to assume that diseases of the musculoskeletal system concern only the elderly. Indeed, already at an earlier age, a feeling of tension and the appearance of aching pains in the spine may indicate not a short-term problem, but the first symptoms of a disease such as spondylosis. Spondylosis is a chronic degenerative-dystrophic pathology of the spinal column, which is associated with local disorders in the structure of the anterior sections of the intervertebral discs and the anterior longitudinal ligament. The first signs of this pathology can be detected in 20-30 years. And at this moment, it is urgent to seek help. So, in the MEDICOM Clinic in Kyiv on Obolon, you can take a full course of diagnosis, treatment and rehabilitation of spondylosis using the latest technologies under the supervision of experienced doctors.

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Classification of spondylosis

In the medical literature, other terms may be used to refer to spondylosis: “spondylosis deformans”, “spondylopathy”.

Depending on the localization of degenerative changes, cervical, thoracic or lumbar spondylosis is distinguished. To designate the affected areas that are subject to violations, the areas are indicated by the numbering of the vertebrae of a particular section of the spinal column, for example: C4-C5 – 4 and 5 of the cervical vertebra, L1-L2 – 1 and 2 of the lumbar vertebra.

Spondylosis develops gradually. Conventionally, several stages can be distinguished in its course, which are characterized by different severity of symptoms and structural changes in the tissues of the spinal column.

Stage I

The disease is asymptomatic or manifested by moderate pain that occurs only after physical exertion. Pathology is usually detected incidentally during x-rays or CT scans for other diseases. Sometimes the pictures visualize minor changes in the structure of the vertebrae in the form of initial manifestations of growths in the damaged areas of the intervertebral discs.

Stage II

Pathological manifestations become apparent. Patients complain of a feeling of stiffness in the back in the morning. Pain appears after a long stay in a sitting or standing position and their intensity varies throughout the day depending on the magnitude of static loads. Manifestations on x-rays become more pronounced and appear as osteophytes and a slight narrowing of the joint space. At the end of the stage, signs of deformation of bone structures may appear.

Stage III

Pain in the patient appears regardless of the load. Numbness, paresthesia are added to pain and discomfort. Many motor functions are impaired. The images visualize pronounced various lesions of the spine, narrowing of the joint space and compaction of bone structures.

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The etiology of the disease

The main causes of spondylosis are associated with factors that cause inflammation in the tissues of the spinal column. They lead to dystrophic and degenerative disorders. These pathological processes can be triggered by:

• various neck or back injuries;
• curvature of the spine;
• continuous static load;
• obesity;
• hypodynamia;
• spinal column surgeries;
• age-related changes;
• constitutional predisposition;
• excessive physical exertion when performing bending or twisting movements;
• certain communicable and non-communicable diseases;
• osteoporosis.

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Often, several predisposing factors become the cause of spondylosis. The lack of treatment of this pathology of the spine leads to many consequences that significantly worsen the quality of life of the patient and can cause disability.

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Pathogenesis

If you understand the mechanism of development of this disease, it becomes clear what spondylosis is and how to treat it. If a person is injured, often overloads the spine or an infection has entered the body, degenerative-dystrophic deformities may begin to occur in the anterior sections of the intervertebral disc, and its fibrous ring cannot be held under the pressure of the pulpy nucleus. As a result, the ring protrudes and leads to separation of the longitudinal ligament from the place of its fixation to the anterior surface of the vertebral body.

Ligament rupture is accompanied by hematoma. Not far from the zone of detachment of the ligament and hemorrhage, an osteophyte begins to grow. If injuries occur repeatedly, they contribute to the appearance of new bone formations and changes in the structure of the vertebrae. In the future, the lesions continue to have a negative effect on the ligament and cause the appearance of new bone growths.

With a long course of spondylosis, osteophytes form along the edges of the vertebrae, which limit the ability to move. The situation is complicated by the growth of bone formations. Pain intensifies and many neurological pathologies develop.

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Clinical manifestations

Signs of spondylosis may not appear for a long time. Often they are discovered incidentally during an x-ray of the spinal column for other diseases. Pathology develops for a long time (sometimes decades) and its first manifestations are often mistaken for fatigue or other diseases.

The main first symptoms of spondylosis are a feeling of tension and the appearance of aching pains that intensify at the end of the day. The localization of these manifestations depends on the zone of damage to the spine.

During intense physical exertion, sudden movements or hypothermia, the symptoms of the disease increase.

After the age of 30, spondylosis usually occurs with complications and is combined with spondylarthrosis and osteochondrosis. Changes characteristic of this disease can occur in any part of the spine, but more often it is the cervical or lumbar region that is affected.

Cervical spondylosis

This form of spondylosis often develops in patients aged 40-50 who work in a seated position with the body tilted forward (for example, when working at a computer, desk, etc.). The lesion often affects the V and VI cervical vertebrae.

Cervical spondylosis radiates with pain in the neck, temple, shoulder blade, arm. It hurts to throw the head back, migraines occur, it is difficult to move the head. Often tinnitus, the patient begins to hear worse. Darkening is observed in the eyes, so it is difficult to concentrate a clear look on one subject. There are pressure drops.

When probing the cervical region, the tension of the muscles of the neck and shoulders is determined.

Lumbar spondylosis

In most cases, this form of spondylosis develops in those who have to work sitting at a desk or engaged in heavy physical labor. Together with painful and tense sensations, patients may limp. This false intermittent claudication disappears when the torso is tilted forward. Patients may experience a feeling of wadding in the body, numbness or numbness of the legs after a long walk or long standing.

Thoracic spondylosis

This form of spondylosis is rare. The middle or lower vertebrae of this section of the spine are usually affected. The pain may be unilateral or bilateral. At a certain stage of the disease, palpation reveals soreness in certain areas of the back and muscle tension. Compression of the spinal nerves can cause pain to radiate to the sternum or chest.

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Features of the course of the disease during pregnancy

During pregnancy, the symptoms of spondylosis may become more pronounced. This happens because during pregnancy weight increases and the load on the back increases, and the back muscles under the influence of hormones become more relaxed, and the spinal column is under greater stress.

Also, the insidiousness of spondylosis for a pregnant woman lies in the fact that a woman can take the first symptoms of the disease for signs of malaise, natural for this period of life, and frequent pains can disturb the psycho-emotional balance of a woman.

Any manifestations of spondylosis should not be left unattended and are a reason to see a doctor. If possible, for the treatment of this pathology during pregnancy, non-drug methods are selected:

• exercise therapy;
• physiotherapy;
• wearing a brace;
• application of orthopedic pillows and mattresses.

If necessary, the pregnant woman is advised to limit static and other physical activities. To eliminate severe pain, the doctor may prescribe painkillers that are safe for the unborn child.

Features of the disease in children

In childhood and adolescence, spondylosis develops much less frequently. But due to the total passion for computer games and the use of gadgets, the likelihood of its occurrence has been increasing in recent years. Long-term statistical loads significantly increase the risk of developing this pathology, especially among children over 10 years of age and adolescents.

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Complications

The main complication of all forms of spondylosis is chronic pain. The constant presence of pain significantly reduces the quality of life and causes the appearance of psycho-emotional disorders. Prolonged and complicated by osteochondrosis and spondylarthrosis, the course of the disease increases the likelihood of intervertebral hernias.

The nature of other consequences of spondylosis depends on the severity of degenerative lesions and their location.

With cervical spondylosis, the following complications are observed:

• humeroscapular arthritis appears;
• headache and dizziness;
• impaired hearing and vision;
• compressive myelopathy develops;
• scalene muscle syndrome occurs;
• sciatica appears;
• the sensitivity and weakness of the muscles of the arms and legs is disturbed.

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Complications of thoracic spondylosis:

• paresthesia of the lower trunk and legs;
• great weakness in the limbs;
• disorders of the functioning of the intestines and bladder (rare).

Complications of lumbar spondylosis:

• sciatica;
• muscle weakness, paresthesia and numbness of the legs;
• bladder and bowel dysfunctions;
• numbness of the groin and ischial region.

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Diagnostics

If you complain of a feeling of tension and pain in the back, you should consult a vertebrologist. Diagnosis of spondylosis is usually not difficult. After a careful study of complaints, the doctor prescribes an x-ray of the spinal column.

If spinal stenosis is suspected, a CT scan is scheduled. An MRI is performed to detect compression of blood vessels, nerves, discs, or ligaments. In some cases, radioisotope scanning is performed to differentially diagnose spondylosis. Also, a number of laboratory tests are prescribed to exclude an erroneous diagnosis.

Patients who are diagnosed with neurological disorders during the examination are referred for a consultation with a neurologist. Electromyography is performed to assess the condition of the affected nerves.

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Treatment

Most cases of spondylosis are treated conservatively. For therapy, a combination of various techniques is used that improve blood circulation in the affected area, slow down dystrophic and degenerative processes, maintain mobility, eliminate pain and restore the correct relationship between certain structures of the spine. The need for surgical treatment arises only in severe cases.

Lifestyle modification

All patients with spondylosis are advised to limit exercise, especially static exercise. But at the same time, it is necessary to maintain sufficient physical activity. The volume of permissible loads is determined individually depending on the severity of the manifestations of the pathology. When working, which is associated with a long stay in a fixed position, you should constantly monitor your posture, periodically change the position of the body and take breaks to perform an individually selected set of exercises.

Patients with cervical spondylosis who have to maintain a forced position for a long time are prescribed to wear an elastic collar. In other cases, the use of corsets may be recommended. The mode and duration of wearing these orthopedic devices are determined by the doctor.

Close attention must be paid to the proper organization of the sleeping area. All patients with spondylosis are advised to use orthopedic pillows and mattresses.

In the daily diet of patients with spondylosis, it is recommended to include more foods that are rich in calcium. Drink at least 1.5–2 liters of purified water daily. To compensate for the lack of vitamins and minerals, mineral water, dried fruit compote, fruit, berry and vegetable juices are recommended.

Drug therapy

Medical treatment of spondylosis is prescribed by a doctor, depending on the severity of the symptoms of the disease. The following drugs may be included in the treatment plan:

• non-steroidal anti-inflammatory drugs;
• vitamin complexes;
• muscle relaxants;
• vasodilators;
• chondroprotectors;
• angioprotectors;
• antidepressants (for prolonged pain).

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Paravertebral and facet joint blocks with local anesthetics and glucocorticoids are used to relieve pain in some patients. As an additional method, injections of hyaluronic acid may be prescribed.

Physiotherapy

For effective treatment of spondylosis, the patient is recommended to regularly perform a set of physical therapy exercises. A set of exercises is compiled by a doctor taking into account the characteristics of the clinical case and is adjusted depending on the progression of the pathology. The results of exercise therapy are significantly improved by periodic massage courses, which can be supplemented with elements of manual therapy.

The effectiveness of drug therapy is significantly improved by various methods of physiotherapy:

• electrophoresis;
• phonophoresis;
• dynamic currents;
• ultrasound;
• reflexology;
• applications of ozocerite and paraffin;
• dry or underwater traction of the spine (with pinched roots), etc. ;
• shock wave therapy.

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The choice of physiotherapy methods is strictly individual. During the period of remission, sanatorium treatment is recommended.

Surgical treatment

Operations for spondylosis are carried out in case of failure of conservative therapy and severe neurological disorders.

Various methods can be used to eliminate the consequences of spondylosis:

• laminectomy;
• foraminotomy;
• microdiscectomy;
• prosthetics of the vertebral disc.

At the appointment with an orthopedist-traumatologist in the hospital of the MEDICOM Clinic in Obolon, the choice of surgical technique is determined by the clinical case. After the operation, the patient undergoes a rehabilitation course. Depending on the method used, recovery after surgery takes from 4 days to 8 weeks.

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Prevention of spondylosis

To prevent the development of spondylosis, you should:

• lead an active lifestyle;
• prevent injury;
• strengthen back muscles;
• monitor posture;
• wear comfortable shoes;
• prevent weight gain;
• sleep on a properly selected orthopedic mattress and pillow;
• treat spinal pathologies and chronic diseases in a timely manner;
• adequately dose physical activity.

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The article is for informational purposes only. Please remember: self-medication can harm your health.

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Sources

• Medscape
• Mayo Clinic

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The author of the article:

Kharlap Igor Vasilyevich

Neurologist, vertebrologist, chiropractor of the highest category, reflexologist of the highest category

Expert in the direction:

Smirnov Yury Anatolyevich

Neurologist, vertebrologist, chiropractor

Which doctor treats spondylosis?

Specialized specialists for the treatment of spondylosis are a vertebrologist and a neurologist. But the services of doctors of other related areas can be used. Our call center operators will help you to find out more details and make an appointment. It is possible to treat spondylosis in Kyiv with the help of the professional staff of the MEDICOM Clinic in the departments in Obolon and Pechersk.