What are the common symptoms of multilevel thoracic spondylosis. How does this condition differ from cervical and lumbar spondylosis. What treatment options are available for patients suffering from multilevel spondylosis. How can physical therapy and minimally invasive surgery help manage this condition.

Understanding Multilevel Spondylosis: A Comprehensive Overview

Spondylosis, derived from the Greek word for vertebrae, is a degenerative condition affecting the spine’s structure and function. When multiple levels of the spine are involved, it’s referred to as multilevel spondylosis. This condition can occur in various regions of the spine, including the cervical (neck), thoracic (mid-back), and lumbar (lower back) areas.

Multilevel spondylosis is a complex condition that can significantly impact a person’s quality of life. Its symptoms and severity can vary widely among patients, depending on the location and extent of spinal degeneration.

What causes multilevel spondylosis?

Several factors contribute to the development of multilevel spondylosis:

• Cumulative wear and tear over time
• Poor lifestyle habits
• Genetic predisposition
• Obesity
• Participation in high-impact sports

These factors can accelerate the natural aging process of the spine, leading to degeneration at multiple levels.

Common Symptoms of Multilevel Spondylosis

The symptoms of multilevel spondylosis can vary significantly from person to person. Some individuals may not experience any noticeable symptoms, while others may suffer from severe pain and discomfort.

What are the most common symptoms of multilevel spondylosis?

The most frequently reported symptoms include:

• Neck pain
• Back pain
• Tingling or numbness in affected areas
• Fatigue
• Stiffness
• Muscle weakness
• Severe pain in advanced cases

The specific symptoms experienced often depend on the location and severity of the spinal degeneration.

Types of Multilevel Spondylosis: Cervical, Thoracic, and Lumbar

Multilevel spondylosis can affect different regions of the spine, each presenting unique challenges and symptoms.

How does cervical spondylosis differ from thoracic and lumbar spondylosis?

Cervical spondylosis affects the neck region and is common in individuals over 50. Thoracic spondylosis, occurring in the mid-back, is less prevalent but can be challenging to diagnose due to its potential similarity to cardiovascular issues. Lumbar spondylosis, affecting the lower back, is the most common type due to the increased stress and weight-bearing responsibilities of this spinal section.

Each type of spondylosis can lead to various complications. For instance, multilevel spondylosis in the lumbar region may cause a disc to slip, potentially pinching the sciatic nerve and resulting in sciatica.

Diagnosis and Evaluation of Multilevel Spondylosis

Proper diagnosis of multilevel spondylosis is crucial for effective treatment. A comprehensive evaluation by a spine specialist typically involves several steps.

What diagnostic tools are used to identify multilevel spondylosis?

Diagnosis often includes:

1. A detailed medical history review
2. Physical examination
3. Imaging studies such as X-rays, MRI, or CT scans
4. Neurological tests to assess nerve function

These diagnostic tools help determine the extent of spinal degeneration and identify any nerve compression or other complications.

Conservative Treatment Options for Multilevel Spondylosis

Initial treatment for multilevel spondylosis often focuses on conservative approaches to manage symptoms and improve quality of life.

How can physical therapy help in managing multilevel spondylosis?

Physical therapy plays a crucial role in managing multilevel spondylosis. It can help by:

• Strengthening the muscles supporting the spine
• Improving flexibility and range of motion
• Teaching proper body mechanics to reduce strain on the spine
• Providing pain relief through various modalities

In addition to physical therapy, pain management techniques such as medication, heat/cold therapy, and lifestyle modifications can be beneficial in managing symptoms.

Advanced Treatment Options: Minimally Invasive Surgery

In cases where conservative treatments fail to provide adequate relief, surgical intervention may be considered.

What minimally invasive surgical options are available for multilevel spondylosis?

Advancements in surgical techniques have led to the development of minimally invasive procedures for treating multilevel spondylosis. These may include:

• Endoscopic procedures
• Laser spinal surgery
• Microdiscectomy
• Laminectomy

These procedures aim to decompress nerves, stabilize the spine, and alleviate pain with minimal tissue disruption and faster recovery times compared to traditional open surgery.

Lifestyle Modifications and Prevention Strategies

While some factors contributing to multilevel spondylosis, such as age and genetics, are beyond our control, certain lifestyle modifications can help prevent or slow the progression of the condition.

How can individuals reduce their risk of developing multilevel spondylosis?

Preventive measures and lifestyle changes include:

• Maintaining a healthy weight to reduce stress on the spine
• Regular exercise to strengthen core and back muscles
• Practicing good posture
• Avoiding smoking, which can accelerate disc degeneration
• Using proper lifting techniques
• Staying hydrated to maintain disc health

These strategies can contribute to overall spine health and may help mitigate the risk of developing or exacerbating multilevel spondylosis.

The Importance of Early Intervention and Specialized Care

Early diagnosis and treatment of multilevel spondylosis can significantly impact the course of the condition and patient outcomes.

Why is it crucial to seek specialized care for multilevel spondylosis?

Consulting with a spine specialist at the onset of symptoms is essential because:

• It allows for accurate diagnosis and differentiation from other conditions
• Early intervention can prevent further spinal degeneration
• Tailored treatment plans can be developed to address individual needs
• Complications such as severe nerve compression can be avoided

Spine specialists have the expertise to navigate the complexities of multilevel spondylosis and provide comprehensive care tailored to each patient’s unique situation.

Multilevel spondylosis is a complex condition that requires a multifaceted approach to diagnosis and treatment. From conservative management strategies to advanced surgical techniques, the field of spine care continues to evolve, offering hope and improved outcomes for those affected by this degenerative condition. By understanding the causes, recognizing the symptoms, and seeking timely, specialized care, individuals with multilevel spondylosis can take proactive steps towards managing their condition and improving their quality of life.

As research in this field progresses, new treatment modalities and preventive strategies may emerge, further enhancing our ability to address the challenges posed by multilevel spondylosis. Patients are encouraged to stay informed about the latest developments and work closely with their healthcare providers to develop comprehensive management plans tailored to their specific needs and circumstances.

The journey of managing multilevel spondylosis may be long, but with the right approach and support, many individuals can find relief and maintain an active, fulfilling lifestyle. Remember, each case is unique, and what works for one person may not be the best solution for another. Therefore, personalized care and ongoing communication with healthcare professionals are key to achieving the best possible outcomes in the face of this challenging spinal condition.

For those living with or at risk of developing multilevel spondylosis, staying proactive about spinal health is crucial. This includes maintaining a healthy lifestyle, being mindful of posture and body mechanics in daily activities, and seeking regular check-ups with spine specialists. By taking these steps, individuals can play an active role in managing their spinal health and potentially slowing the progression of degenerative changes associated with multilevel spondylosis.

As our understanding of spinal health continues to grow, so too does our ability to effectively manage conditions like multilevel spondylosis. From innovative diagnostic techniques to cutting-edge treatments, the field of spine care is constantly evolving to provide better outcomes for patients. This ongoing progress offers hope and improved quality of life for those affected by multilevel spondylosis, emphasizing the importance of staying connected with the latest advancements in spine health and treatment options.

Ultimately, the management of multilevel spondylosis is a collaborative effort between patients and healthcare providers. By working together, developing comprehensive treatment plans, and leveraging the latest medical advancements, individuals with multilevel spondylosis can look forward to improved symptom management and enhanced overall well-being. The key lies in early intervention, personalized care, and a commitment to maintaining spinal health through all stages of life.

Multilevel Spondylosis Treatment NJ | New Jersey Spine Specialists

Derived from the Greek word for vertebrae, spondylosis is a degenerative disease that can lead to the loss of normal spine structure while simultaneously impeding its function. Spondylosis can target any part of the spine. But when multiple levels of the spine begin exhibiting painful symptoms, a patient may suffer from multilevel spondylosis. If you suspect that you’re suffering from multilevel spondylosis, connect with a trusted spine surgeon for a thorough evaluation to prevent further damage.

Common Multilevel Spondylosis Symptoms

Due to the condition’s complex nature, symptoms relating to multilevel spondylosis differ from patient to patient. More specifically, symptoms differ depending on the location and severity of spinal degeneration.

While many patients with this spinal condition don’t always exhibit from any symptoms, the telltale signs of multilevel spondylosis include neck pain and back pain. Other symptoms include a tingling or numb sensation in the affected area, fatigue, stiffness or muscle weakness, and severe pain. Many factors may trigger multilevel spondylosis such as cumulative wear and tear of life, poor lifestyle habits, genetics, obesity, and high impact sports.

Types of Multilevel Spondylosis

In essence, spondylosis is a general term describing any type of spinal degeneration.
This can be from a variety of problems ranging from bone spurs, degenerative disc, facet joint syndrome, and osteoarthritis. For instance, multilevel spondylosis may cause a disc to slip in your lumbar spine, thereby pinching your sciatic and cause sciatica. Since multilevel spondylosis can affect multiple areas of the spine, each spinal section experiences the condition differently.

• Lumbar Spondylosis: This is the most prevalent diagnosis for multilevel spondylosis because this area of the spine receives the most wear and tear, and subjected to the majority of the body’s weight.
• Cervical Spondylosis: Occurring in the neck area, many folks above the age of 50 tend to experience this condition.
• Thoracic Spondylosis: While less prevalent, doctors sometimes fail to properly diagnose this condition, often confusing it with cardiovascular issues due to patients experiencing pain in and around the chest region.

Treatments for Multilevel Spondylosis

Physical therapy and pain medication are often used to treat spondylosis symptoms. But in severe cases, spinal surgery may be the optimal choice for recovery. Today in appropriately selected patients, minimally invasive surgery, such as endoscopic procedures and possibly even laser spinal surgery, may provide safe and effective alternative therapies for spondylosis and other spinal problems.

Don’t suffer in silence from chronic back pain any longer when relief is a simple phone call away. If you suspect you’re suffering neck or back pain from multilevel spondylosis, contact the experts at New Jersey Spine Specialists for a consultation today! NJSS welcomes patients living in Morristown, NJ and the surrounding areas including Brookside, New Vernon, Madison, and Monroe, NJ. Call us by dialing (908) 608-9619 today! today!

“I am pain free, walking and well on my way to recovery thanks to the help of New Jersey Spine Specialists” —Robert K

Thoracic Spondylosis: Exercises, Symptoms, Causes, Treatment

Overview

As you get older, your vertebrae (spinal bones) tend to wear down. The bony discs and joints can crack.

You don’t have to have an injury, such as a fall, for this to happen. Wear and tear on any bone can cause a stress fracture.

Time can also cause the cartilage, the cushion between your bones, to grow thinner. The ligaments that connect your bones can grow thicker and less flexible.

When these changes develop in the middle of your spine, the condition is known as thoracic spondylosis.

The thoracic portion of your spine refers to the middle of your back. Your spine includes two more sections on the top and bottom of the thoracic region.

The cervical part of the spine is the upper section that includes the neck. The lumbar section is your lower back. Each section can experience spondylosis. Thoracic spondylosis is less common than lumbar or cervical spondylosis.

Spondylosis in any part of your back can also result from a sports injury that causes a small fracture in a vertebra. Children and teens may be especially vulnerable to this problem, because their bones are still developing.

Thoracic spondylosis doesn’t always lead to noticeable symptoms. When it does, you tend to feel stiff or sore or both.

When pain is involved, it’s often because changes in the discs are causing one or more of them to press on nerves that extend from the spinal canal. For example, tissue can form a lump around a stress fracture to help heal the bone. But a lump of tissue can press against spinal nerves, triggering pain or other symptoms.

Spondylosis in any part of your back, including the thoracic section, can cause pain to radiate downward into the legs. Pain can get worse with activity but improve with rest.

Your legs can become tingly or numb. You can also experience muscle weakness in your arms and legs, as well as trouble walking.

Another complication of spondylosis is spondylolisthesis, in which a vertebra slips forward and onto the bone below it and squeezes a nerve. This painful condition is often referred to as a pinched nerve. Check out these exercises to relieve the pain.

Thoracic spondylosis is often an age-related medical condition. With every passing year, your odds of developing some form of spondylosis increase. Even relatively healthy people can experience some disc degeneration.

Because you put less burden on your thoracic spine than the other parts of your back, thoracic spondylosis usually develops because there has been cervical or lumbar spondylosis first. When one part of your back experiences problems, the rest of your spine is at greater risk of trouble.

For older adults, the day-to-day stress on the spine simply adds up over time. The cause of spondylosis may actually be a combination of heavy lifting and an active lifestyle. Osteoporosis, a bone-thinning condition also associated with age, may contribute to stress fractures in the vertebrae.

The part of a vertebra most commonly associated with spondylosis is a section called the pars interarticularis. The pars joins the two facet joints on the back of a vertebra. Even a very small crack in the pars can cause spondylosis.

For young people with vertebrae that’re still growing and developing, trauma from a football tackle or stress from a gymnastics routine can lead to spondylosis.

Genetics may also play a role. You may come from a family in which vertebral bone is thinner.

When a sore and stiff back start to interfere with your daily functioning or keep you from sleeping or enjoying your usual quality of life, you should see a doctor.

Because the pain and tingling are often felt in the buttocks and legs, it’s not always easy to pinpoint the source of your symptoms. You may be inclined to chalk it up to lower back problems, and not a fracture or other problem with the thoracic part of the spine.

In addition to gathering your medical history and your current symptoms, your doctor will probably order X-rays if spondylosis is suspected. Most adults over age 60 have some sign of spondylosis that will show up in an X-ray. X-rays can reveal the location and size of bone fractures.

MRI scans can provide detailed views of the nerves and soft tissue around the spine. If your doctor suspects a pinched nerve, an MRI can often diagnose the problem.

The goal of treatment is usually to avoid surgery if possible. Symptoms may be controlled by pain-relieving medications and physical therapy.

However, if thoracic spondylosis is pressing on a nerve, surgery may relieve the pressure. Surgical options include:

• discectomy, which removes the injured disc
• laminectomy, which removes bone spurs or the lamina, the arch in the back of a vertebra
• laminoplasty, which changes the position of the lamina to create more room for nerve tissue within your spine
• spinal fusion, which connects parts of your spine with transplanted bone, either with or without rods or screws to help connect two or more bones

A back brace may help keep your spine stable, either after surgery, or instead of surgery while the fracture heals on its own.

Rest may be best for thoracic spondylosis until you start to feel better. However, you don’t want to stay bedridden too long. Lying down or sitting for prolonged periods raise the risk for formation of blood clots in your legs. Light walking and other activity can be helpful, but you should ask your doctor for guidance on when to start and how much is safe.

Your doctor may prescribe anti-inflammatory medications, as well as painkillers if you’ve had surgery. Be sure any medications you take are under the close supervision of your doctor.

Depending on the severity of your condition and whether you underwent surgery, you may have to refrain from heavy lifting and other activities that require bending over or stooping for a few weeks to a few months.

You can begin exercises that stretch and strengthen your back as soon as your doctor gives you the go-ahead. You may benefit most from having physical therapy, in which you’ll learn the proper technique for spine-friendly exercises.

When exercising with thoracic spondylosis, remember to follow the guidance of your doctor or physical therapist and to stop if you experience pain.

Exercise should focus on improving:

• posture
• range of motion
• muscle flexibility
• core strength, since the muscles in your abdomen help keep the spine stable
• spine muscle strength
• weight management
• circulation
• overall fitness

Core-strengthening exercises, which are critical to spine health, can be done at home. The Pelvic Tilt is an easy one:

• Lie on your back and bend your knees. Place your feet flat on the floor.
• Use your abdominal muscles to pull your belly button down toward your spine.
• Hold that position for 10 to 15 seconds.
• Pause and relax for a few seconds.
• Repeat 10 times.
• Do 3 sets of 10 repetitions.

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Another exercise to help strengthen the muscles in your back is called a Bridge:

• Lie on your back and bend your knees. Place your feet flat on the floor.
• Use the muscles in your buttocks and back to lift your hips up while keeping your shoulders flat on the floor.
• Hold that position for 5 seconds.
• Relax and lower your hips.
• Repeat 10 times.
• Do 3 sets of 10 repetitions.

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Swimming is a low-impact exercise that can help boost back and shoulder strength, range of motion, and flexibility. Hydrotherapy is another pool-based treatment that can help relieve pain and loosen tight muscles.

Before starting any form of therapy or any exercise treatment plan, be sure to get the green light from your physician.

Exercising to strengthen your spine and core muscles and maintain your flexibility is important even if you don’t have thoracic spondylosis symptoms. Those exercises may help prevent or at least delay back problems.

If you do have symptoms, don’t ignore them. Have them evaluated by a spine specialist and work out a treatment plan, keeping in mind that surgery should be viewed as a last resort. Ignoring symptoms can lead to long-term neurological problems including pain, numbness, and muscle weakness.

By getting a diagnosis and following through with physical therapy and other lifestyle changes, you can enjoy many years with little or no back pain.

Spondylosis – treatment, symptoms, causes, diagnosis

Spondylosis literally means hardening or fixation of the vertebrae as a result of pathological changes in the spine. Spondylosis is caused by degenerative changes in the spine, such as the formation of osteophytes (bone spikes) and degenerative-dystrophic changes in the intervertebral discs. Changes in the spine with spondylosis are referred to as osteoarthritis. For example, the phrase “spondylosis of the lumbar spine” means the presence of degenerative changes such as osteoarthritis in the intervertebral joints and the presence of degenerative changes in the intervertebral discs in the lumbar spine.

Spondylosis can affect all parts of the spine (cervical thoracic lumbar), but the most common is cervical and lumbar spondylosis. Thoracic spondylosis often causes no symptoms. With lumbosacral spondylosis, changes occur not only in the lumbar spine, but also in the sacral region. There are several medical terms that are similar in name to spondylosis and are therefore often confused. These are terms such as:

• spondylitis: inflammation of one or more vertebrae of infectious (including specific origin) or non-infectious origin (in inflammatory diseases such as ankylosing spondylitis). Spondylitis is a completely different disease, because in spondylosis degenerative processes take place, while spondylitis is an inflammatory disease
• spondylolysis: incomplete development and formation of the articular part of the vertebra (pars interarticularis). This defect predisposes to spondylolisthesis due to the development of motor segment instability
• spondylolisthesis: displacement forward or backward of the vertebral body in relation to the underlying vertebra. For example, L4 to L5 anterior spondylolisthesis means that the fourth lumbar vertebrae has moved forward relative to the fifth vertebra. As a result, the geometry of the spine changes.
• spondylosis deformans : results from the growth of osteophytes or bony bridges around a degrading intervertebral disc (this term is practically synonymous with spondylosis).
• stenosis: narrowing of the spinal canal. This is a narrowing of the spinal canal that limits the space needed for the spinal cord and nerves. Pressure on the spinal cord and nerves due to the narrowing of the spinal canal can cause symptoms such as pain, numbness, and tingling.

Causes and risk factors

Spondylosis is an age-related change in the spine. As we age, the bones and ligaments in the spine wear down, resulting in bony growths. In addition, intervertebral discs degenerate, weaken, which can lead to the formation of protrusions or herniated discs. The cause of early spondylosis may be heavy physical exertion of a professional nature. Spondylosis is quite common. The first symptoms may appear between the ages of 20 and 50. More than 80% of people over the age of 40 have radiographic evidence of spondylosis. The rate of development of spondylosis depends on both genetic factors and the presence of injuries or excessive loads on the spine.

Symptoms

Many people who have spondylosis on x-ray have no symptoms. Statistically, lumbar spondylosis , present in 27%-37% of people without any symptoms.

In some people, spondylosis causes back and neck pain due to nerve compression. Nerve compression is caused by herniated discs or osteophytes in the facet joints, which narrow the space where the nerves pass and cause spinal or foraminal stenosis. Even with small disc herniations, when they do not cause root compression, local inflammation and irritation of nerve fibers are possible. In addition, herniated discs can put pressure on the ligaments of the spine and cause pain. With compression, conditions arise for stimulating the growth of blood vessels and nerves, and this leads to a chronic pain syndrome. With pain syndrome, individual parts of the spine try to compensate for pain, and as a result, areas of soreness, muscle spasm, and trigger points appear.

Symptoms of spondylosis include localized pain in the area of ​​the spondylosis, usually in the lower back or neck. If a herniated disc causes nerve compression, the pain may radiate to the limb. For example, large disc herniations in the lumbar spine can compress a nerve and cause pain that starts in the lower back and then travels down one leg and foot. This condition is commonly referred to as sciatica. Back pain due to a herniated disc typically worsens with prolonged standing, sitting, and leaning forward, and often improves with changes in position and walking. Back pain due to arthrosis of the facet joints is usually worsened by walking and standing, and relieved by straightening the torso. Nerve compression can cause numbness and tingling. With severe compression of the nerves, muscle weakness in the limb may appear. If a herniated disc puts pressure on the spinal cord, it can cause damage to the spinal cord (myelopathy). Myelopathy symptoms include numbness, tingling, and muscle weakness. For example, a large herniated disc in the cervical spine can lead to cervical myelopathy, resulting in symptoms such as numbness, tingling, and weakness in the arms and possibly legs. As a rule, patients with spondylosis have already been in contact with doctors, since CT or MRI radiography well visualize changes in the spine characteristic of this disease. The reason for the obligatory visit to the doctor are the following reasons:

• No effect of prescribed treatment
• Presence of evidence of acute nerve dysfunction (eg, weakness in one or more limbs)
• Bladder or bowel dysfunction, accompanied by acute back or neck pain, indicates severe nerve dysfunction and requires hospitalization
• Numbness in the groin or ischial area may indicate serious dysfunction of the nerve structures and also requires immediate hospitalization.

Diagnosis

Spondylosis is diagnosed using radiological methods such as plain radiography, MRI or CT. Radiography allows visualization of osteophytes, thickening of the joints and a decrease in the distance between the vertebrae. A CT scan of the spine is able to visualize the spine in more detail and can diagnose narrowing of the spinal canal (stenosis) if present. An MRI study is the most informative and allows you to visualize soft tissues (disks, ligaments, nerves) and diagnose the presence of compression of nerve structures, which often allows you to find out the true cause of pain in spondylosis.
If nerve damage is suspected, ENMG may be prescribed to determine the degree of nerve fiber damage and conduction disturbance. Sometimes, to clarify the diagnosis, a radioisotope scan may be prescribed, based on varying degrees of absorption of radioactive material by tissues with different metabolisms (for example, with inflammation or tumors, more radioisotope will accumulate abnormally in the bone tissue).

Treatment

There is currently no treatment that can reverse spondylosis because it is a degenerative process. Treatment of spondylosis is to treat symptoms such as pain in the lower back or neck and is similar to that in the treatment of degenerative disc disease.

Medical treatment. There are no medications that reliably stop the degenerative process in the spine. In pain syndrome, as a rule, drugs of the NSAID group and muscle relaxants are widely used. Non-steroidal anti-inflammatory drugs can be very effective in relieving back and neck pain associated with spondylosis (ibuprofen, movalis, naproxen). Muscle relaxants such as cyclobenzaprine (Flexeril) and tizanidine (Zanaflex) have been shown to significantly reduce muscle spasm associated with spondylosis. For severe pain, analgesics such as tramatodol or drugs of the narcotic group can be used.
Antidepressants may be used for chronic pain. Medicines called tricyclic antidepressants, including amitriptyline (Elavil) and doxepin (Sinevkan), have been used for many years in low doses to treat chronic back pain. Recently, an antidepressant such as duloxetine (Cymbalta) has been used, and its effectiveness in chronic back pain has been reliably proven. A good effect is the use of ointments containing capsaicin.

Physiotherapy helps reduce pain, improve microcirculation in the tissues of the spine.

LFK . A carefully selected program of exercises both with weights (on simulators) and in the form of gymnastics (qigong or yoga) can also reduce both pain manifestations and improve the functionality of the spine.

Manual Therapy Gentle manual therapy techniques achieve mobilization of the motor segments and reduce pain. However, some patients should not be subjected to manual manipulation, especially when spondylosis is combined with a disease such as ankylosing spondylitis.

Acupuncture reduces pain and improves conduction along nerve fibers.

Minimally invasive procedures, such as injecting steroids into the epidural space or into joints or injecting into trigger points, can also reduce pain.

Surgical treatment

Recommended for patients with severe neurological symptoms and no effect of conservative treatment. Usually, surgical methods of treatment are used in the presence of severe spinal stenosis, in the cauda equina syndrome, or in the presence of severe compression of the root by a disc herniation (osteophyte).

Prognosis

Spondylosis is a degenerative process, and there are currently no treatments that can reliably stop degenerative pathological processes. But with systematic monitoring and treatment, it is possible to achieve stabilization of pain manifestations and preserve the functionality of the spine.

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 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 exercise
  • Pain in the lower back or numbness
  • Sciatica (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 it is spondylosis that is the cause of back pain because spondylosis can develop gradually as a result of aging of the body, 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 prior to the onset of pain
• What activities were done 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.