What is multilevel thoracic spondylosis. How does it differ from cervical and lumbar spondylosis. What are the common symptoms and causes of this condition. What treatment options are available for patients suffering from multilevel thoracic spondylosis.

Understanding Multilevel Thoracic Spondylosis: An Overview

Multilevel thoracic spondylosis is a degenerative condition affecting multiple levels of the spine, particularly in the thoracic (middle) region. This complex spinal disorder can lead to significant discomfort and reduced mobility, impacting a person’s quality of life. To fully grasp the nature of this condition, it’s essential to explore its definition, prevalence, and how it relates to other forms of spondylosis.

Spondylosis, derived from the Greek word for vertebrae, refers to the general wear and tear of the spine that occurs over time. When this degeneration affects multiple levels of the spine, it’s termed multilevel spondylosis. While it can occur in any part of the spine, thoracic spondylosis specifically targets the middle back region.

How prevalent is thoracic spondylosis compared to other types?

Thoracic spondylosis is less common than its cervical (neck) and lumbar (lower back) counterparts. This is primarily due to the thoracic spine’s relative stability and lower range of motion compared to other spinal regions. However, when it does occur, it can be particularly challenging to diagnose and treat due to its location and potential impact on surrounding organs.

The Anatomy of the Spine: Understanding the Thoracic Region

To better comprehend multilevel thoracic spondylosis, it’s crucial to understand the anatomy of the spine, particularly the thoracic region. The human spine is divided into three main sections:

• Cervical spine (neck): 7 vertebrae
• Thoracic spine (upper and middle back): 12 vertebrae
• Lumbar spine (lower back): 5 vertebrae

The thoracic spine, located between the cervical and lumbar regions, plays a vital role in supporting the rib cage and protecting the heart and lungs. Its unique structure and function contribute to both its stability and vulnerability to degenerative changes.

What makes the thoracic spine unique?

The thoracic spine is characterized by its limited mobility compared to the cervical and lumbar regions. This reduced flexibility is due to its connection to the rib cage, which provides stability but also makes it more susceptible to certain types of degeneration. Understanding these anatomical features is essential for recognizing the symptoms and potential complications of multilevel thoracic spondylosis.

Common Symptoms of Multilevel Thoracic Spondylosis

Multilevel thoracic spondylosis can manifest in various ways, and symptoms may differ from patient to patient depending on the severity and exact location of the spinal degeneration. Some individuals may not experience any noticeable symptoms, while others may suffer from debilitating pain and reduced mobility.

What are the most common symptoms of multilevel thoracic spondylosis?

The most frequently reported symptoms include:

• Back pain in the middle of the spine
• Stiffness and reduced flexibility in the thoracic region
• Radiating pain that may extend to the chest or abdomen
• Numbness or tingling sensations in the affected area
• Muscle weakness in the back or chest
• Fatigue due to chronic pain and discomfort

It’s important to note that these symptoms can sometimes be mistaken for other conditions, such as cardiovascular issues, due to their location. This underscores the importance of seeking a proper diagnosis from a qualified spine specialist.

Causes and Risk Factors for Multilevel Thoracic Spondylosis

Multilevel thoracic spondylosis is primarily a result of the natural aging process and wear and tear on the spine. However, several factors can contribute to its development or exacerbate its progression.

What factors contribute to the development of multilevel thoracic spondylosis?

The following are key contributors to this condition:

1. Age: As we grow older, the spinal discs naturally degenerate and lose water content, making them more prone to damage.
2. Genetics: Some individuals may have a genetic predisposition to spinal degeneration.
3. Occupation: Jobs that involve repetitive motions, heavy lifting, or prolonged sitting can increase the risk of spinal wear and tear.
4. Lifestyle factors: Poor posture, smoking, and lack of regular exercise can contribute to spinal degeneration.
5. Obesity: Excess body weight puts additional stress on the spine, accelerating wear and tear.
6. Previous injuries: Trauma to the spine, such as from accidents or sports injuries, can lead to premature degeneration.

Understanding these risk factors can help individuals take proactive steps to maintain spinal health and potentially prevent or slow the progression of multilevel thoracic spondylosis.

Diagnostic Approaches for Multilevel Thoracic Spondylosis

Accurate diagnosis of multilevel thoracic spondylosis is crucial for developing an effective treatment plan. Spine specialists employ a combination of clinical examination and advanced imaging techniques to identify the condition and assess its severity.

How is multilevel thoracic spondylosis diagnosed?

The diagnostic process typically involves:

• Medical history review: The doctor will inquire about symptoms, lifestyle factors, and any previous injuries or conditions.
• Physical examination: This includes assessing range of motion, muscle strength, and reflexes.
• Imaging studies: X-rays, MRI, and CT scans can provide detailed images of the spine, revealing degenerative changes and potential nerve compression.
• Electromyography (EMG): This test can help determine if nerve roots are being affected by the spinal degeneration.

In some cases, additional tests may be necessary to rule out other conditions with similar symptoms. A thorough diagnostic approach ensures that patients receive the most appropriate treatment for their specific condition.

Treatment Options for Multilevel Thoracic Spondylosis

Management of multilevel thoracic spondylosis typically begins with conservative approaches, progressing to more invasive treatments if necessary. The goal of treatment is to alleviate pain, improve function, and prevent further degeneration.

What are the primary treatment options for multilevel thoracic spondylosis?

Treatment options include:

1. Conservative treatments:
   • Physical therapy to improve strength and flexibility
   • Pain management techniques, including medications and injections
   • Lifestyle modifications, such as weight loss and ergonomic adjustments
2. Minimally invasive procedures:
   • Endoscopic techniques for disc decompression
   • Radiofrequency ablation for nerve pain
3. Surgical interventions:
   • Spinal fusion for severe cases
   • Disc replacement surgery

The choice of treatment depends on the severity of the condition, the patient’s overall health, and their personal preferences. A spine specialist can help determine the most appropriate treatment plan for each individual case.

Exercises and Self-Care for Managing Multilevel Thoracic Spondylosis

While professional medical care is essential for managing multilevel thoracic spondylosis, patients can also take proactive steps to alleviate symptoms and improve their overall spinal health through exercises and self-care practices.

What exercises can help manage multilevel thoracic spondylosis?

Beneficial exercises may include:

• Gentle stretching to improve flexibility and reduce stiffness
• Core strengthening exercises to support the spine
• Low-impact aerobic activities like swimming or walking
• Yoga or Pilates, under the guidance of a qualified instructor

It’s crucial to consult with a healthcare professional or physical therapist before starting any exercise regimen to ensure the exercises are appropriate for your specific condition.

What self-care practices can help manage symptoms?

In addition to exercises, the following self-care practices can be beneficial:

• Maintaining good posture throughout the day
• Using ergonomic furniture and tools to reduce strain on the spine
• Applying heat or cold therapy to alleviate pain and inflammation
• Practicing stress-reduction techniques like meditation or deep breathing exercises
• Getting adequate sleep on a supportive mattress

By incorporating these exercises and self-care practices into their daily routine, patients with multilevel thoracic spondylosis can potentially improve their symptoms and overall quality of life.

The Future of Multilevel Thoracic Spondylosis Treatment

As medical research advances, new treatment options for multilevel thoracic spondylosis continue to emerge. These innovative approaches aim to provide more effective pain relief, improve spinal function, and potentially slow or reverse the degenerative process.

What emerging treatments show promise for multilevel thoracic spondylosis?

Some exciting developments in the field include:

• Stem cell therapy: This regenerative medicine approach aims to repair damaged spinal tissues using the body’s own healing mechanisms.
• Advanced imaging techniques: Improved diagnostic tools can lead to more precise and personalized treatment plans.
• Robotic-assisted surgery: This technology allows for greater precision in spinal procedures, potentially leading to better outcomes and faster recovery times.
• Artificial disc technology: Ongoing improvements in artificial disc design may provide better alternatives to spinal fusion in some cases.
• Gene therapy: Research into genetic factors contributing to spinal degeneration may lead to targeted treatments in the future.

While many of these treatments are still in various stages of research and development, they offer hope for improved management of multilevel thoracic spondylosis in the years to come. Patients should stay informed about these advancements and discuss potential new treatment options with their healthcare providers.

In conclusion, multilevel thoracic spondylosis is a complex condition that requires a comprehensive approach to diagnosis and treatment. By understanding the causes, symptoms, and available treatment options, patients can work with their healthcare providers to develop effective management strategies. As research continues to advance, the future holds promise for even more effective treatments for this challenging spinal condition.

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.