What is thoracic spondylosis. How does it affect the upper back. What are the main symptoms of this condition. Which treatments can help manage thoracic spondylosis effectively.

Understanding Thoracic Spondylosis: A Comprehensive Overview

Thoracic spondylosis is a degenerative condition affecting the upper back region of the spine. It’s a form of osteoarthritis that primarily impacts the thoracic vertebrae and the intervertebral discs between them. As we age, our spinal structures naturally wear down, leading to various changes that can cause discomfort and reduced mobility.

This condition is particularly common in individuals over the age of 70, although it can also develop in younger people, especially those who have experienced previous spinal injuries. Understanding thoracic spondylosis is crucial for proper management and maintaining a good quality of life.

The Anatomy of the Thoracic Spine

The thoracic spine consists of 12 vertebrae (T1-T12) located in the upper and middle back. These vertebrae are connected by facet joints and separated by intervertebral discs, which act as shock absorbers. The thoracic spine is less mobile than the cervical (neck) and lumbar (lower back) regions, but it plays a vital role in protecting the organs in the chest and supporting the rib cage.

Causes and Risk Factors of Thoracic Spondylosis

Thoracic spondylosis develops primarily due to the natural aging process. However, several factors can accelerate its progression or increase the risk of developing this condition:

• Age (most common in individuals over 70)
• Previous spinal injuries
• Genetic predisposition
• Occupations involving repetitive upper back strain
• Poor posture
• Obesity
• Smoking
• Lack of regular exercise

As the body ages, the intervertebral discs begin to lose water content and become less flexible. This dehydration process can lead to disc height reduction and increased stress on the surrounding vertebrae. In response, the body may form bone spurs (osteophytes) around the affected areas, further contributing to the symptoms of thoracic spondylosis.

Recognizing the Symptoms of Thoracic Spondylosis

The symptoms of thoracic spondylosis can vary from person to person, ranging from mild discomfort to severe pain and limited mobility. Common signs and symptoms include:

• Upper back stiffness, especially when turning or reaching for objects
• Pain in the thoracic region, which may worsen with certain movements
• Reduced range of motion in the upper back
• Muscle weakness in the arms or upper back
• Tingling or numbness in the back, arms, or stomach area (if nerves are affected)
• Difficulty performing daily activities due to pain or stiffness
• In severe cases, balance problems or difficulty walking

Do these symptoms always indicate thoracic spondylosis? Not necessarily. Many of these symptoms can be associated with other spinal conditions, which is why a proper diagnosis from a healthcare professional is crucial.

Diagnosing Thoracic Spondylosis: When to Seek Medical Help

If you experience persistent upper back pain, stiffness, or any of the symptoms mentioned above, it’s important to consult a healthcare provider. Early diagnosis and treatment can help manage symptoms effectively and prevent further complications.

Diagnostic Procedures

To diagnose thoracic spondylosis, your doctor may use a combination of the following methods:

1. Physical examination
2. Medical history review
3. X-rays to visualize bone changes and disc height reduction
4. MRI or CT scans for a more detailed view of soft tissues and potential nerve compression
5. Electromyography (EMG) to assess nerve function if neurological symptoms are present

These diagnostic tools help healthcare providers determine the extent of spinal degeneration and develop an appropriate treatment plan.

Effective Treatment Options for Thoracic Spondylosis

Treatment for thoracic spondylosis aims to alleviate pain, improve mobility, and enhance overall quality of life. The approach is typically conservative, focusing on non-invasive methods before considering surgical options.

Conservative Treatments

• Physiotherapy: A cornerstone of thoracic spondylosis management
• Pain management techniques: Including medication and hot/cold therapy
• Exercise and stretching routines
• Postural correction and ergonomic adjustments
• Lifestyle modifications

The Role of Physiotherapy in Managing Thoracic Spondylosis

Physiotherapy plays a crucial role in the treatment of thoracic spondylosis. A skilled physiotherapist can provide a range of interventions to help manage symptoms and improve function:

• Manual therapy techniques to improve spinal mobility
• Specific exercises to strengthen the upper back and improve flexibility
• Postural education and correction
• Pain relief modalities such as TENS or ultrasound
• Massage therapy to relax tense muscles
• Guidance on proper body mechanics for daily activities

How effective is physiotherapy for thoracic spondylosis? Many patients experience significant improvement in their symptoms and overall function with consistent physiotherapy treatment. The key is to start treatment early and maintain a regular exercise routine as prescribed by the physiotherapist.

Lifestyle Modifications and Self-Care Strategies

In addition to professional medical care, there are several self-care strategies that can help manage thoracic spondylosis:

• Maintaining good posture throughout the day
• Using ergonomic furniture and tools
• Practicing stress-reduction techniques like meditation or yoga
• Avoiding activities that exacerbate symptoms
• Applying heat or ice to the affected area as recommended
• Maintaining a healthy weight to reduce stress on the spine
• Quitting smoking, as it can impair blood flow and nutrient supply to spinal tissues

Implementing these lifestyle changes can significantly improve the management of thoracic spondylosis and enhance overall spinal health.

Advanced Treatment Options for Severe Cases

While most cases of thoracic spondylosis respond well to conservative treatments, some severe cases may require more advanced interventions:

• Epidural steroid injections for pain relief
• Nerve block procedures
• Radiofrequency ablation to reduce nerve pain
• In rare cases, surgical intervention may be considered

Are these advanced treatments always necessary? Not typically. The majority of patients find relief through conservative methods. However, for those with persistent, severe symptoms or neurological complications, these options may provide additional relief.

Long-Term Outlook and Prevention Strategies

While thoracic spondylosis is a degenerative condition, its progression can often be slowed with proper management. The long-term outlook varies depending on the severity of the condition and how well it’s managed. Many individuals lead active, fulfilling lives with appropriate treatment and lifestyle modifications.

Prevention Strategies

Although it’s not always possible to prevent thoracic spondylosis, especially as we age, certain strategies can help minimize risk and slow progression:

• Regular exercise to maintain spinal flexibility and strength
• Maintaining proper posture and body mechanics
• Staying at a healthy weight
• Avoiding smoking and excessive alcohol consumption
• Eating a balanced diet rich in calcium and vitamin D for bone health
• Managing stress through relaxation techniques
• Regular check-ups with a healthcare provider to monitor spinal health

By incorporating these prevention strategies into daily life, individuals can take proactive steps to maintain spinal health and potentially reduce the impact of thoracic spondylosis.

Understanding thoracic spondylosis, its causes, symptoms, and treatment options is crucial for effective management. With proper care, most individuals can maintain a good quality of life despite this condition. Remember, early intervention and consistent management are key to achieving the best possible outcomes in thoracic spondylosis.

Thoracic Spondylosis – Upper Back – Conditions – Musculoskeletal – What We Treat

What is thoracic spondylosis?

Thoracic spondylosis is a form of osteoarthritis in the thoracic spine (upper back). Physiotherapy is an effective treatment for thoracic spondylosis.

What can cause thoracic spondylosis?

Thoracic spondylosis is caused by wear and tear of the vertebrae and the shock absorbing discs between each vertebrae bone. As we get older, the discs dry out and extra bone often gathers around the vertebrae (osteophytes) which can irritate some of the structures around the spine. Thoracic spondylosis is more common over the age of seventy or if you have had an injury to the spine when you were younger.

Above: Trigger point massage of the muscles in the upper back by experienced therapist

What are the symptoms of thoracic spondylosis?

You will often experience stiffness in the upper back especially when trying to turn around and reaching for objects. You may also find these movements painful. If a nerve becomes trapped or irritated you may experience neurological symptoms including weakness and pins and needles on your back, stomach area or arms. You may feel weaker in these areas and find it difficult to carry out your normal activities of daily living. Other symptoms may include:

What should I do if I have thoracic spondylosis?

If you think you may have thoracic spondylosis, you should visit a physiotherapist as soon as possible who will help you reduce your symptoms. You may also need to see your GP for some painkillers to help you keep the spine moving.

What shouldn’t I do if I have thoracic spondylosis?

You should not ignore your symptoms if you think your problem may be thoracic spondylosis. The longer you leave it, the more likely your condition will progress and you symptoms will become more debilitating.

Above: Mobilisations of the mid thoracic spine by experienced physiotherapist

Physiotherapy for thoracic spondylosis.

There are a number of physiotherapy treatments that your physiotherapist can offer you to treat thoracic spondylosis. You may receive cryotherapy (ice) or heat to reduce any pain that you have and will be given a series of exercises to improve the range of movement at the thoracic spine. Your home exercise programme will also include specific exercises to strengthen the area which will help minimise your symptoms. Massage and postural advice can be offered to manage your condition.

Other physiotherapy options can include:

Can thoracic spondylosis have any long-term effects?

If you ignore the problem, your symptoms are likely to get worse and cause a lot of pain and stiffness in your upper back. If you do not seek professional help, the thoracic spondylosis could lead to neurological symptoms including weakness and numbness of the upper back and stomach which are more persistent.

Above: Soft tissue massage of the upper thoracic spine

To arrange a physiotherapy appointment call Physio. co.uk on 0330 088 7800 or book online.

Spondylosis Is Osteoarthritis of The Spine

Spondylosis (spinal osteoarthritis) is a degenerative disorder that may cause loss of normal spinal structure and function. Although aging is the primary cause, the location and rate of degeneration is individual. The degenerative process of spondylosis may affect the cervical (neck), thoracic (mid-back), or lumbar (low back) regions of the spine.

How spondylosis can affect the spinal column:

Intervertebral Discs
As people age, certain biochemical changes occur affecting tissue found throughout the body. In the spine, the structure of the intervertebral discs (annulus fibrosus, lamellae, nucleus pulposus) may be compromised. The annulus fibrosus (eg, tire-like) is composed of 60 or more concentric bands of collagen fiber termed lamellae. The nucleus pulposus is a gel-like substance inside the intervertebral disc encased by the annulus fibrosus. Collagen fibers form the nucleus along with water and proteoglycans. The degenerative effects of aging can weaken the annulus fibrosus’ structure, causing the ‘tire tread’ to wear or tear. The water content of the nucleus decreases with age affecting its ability to rebound following compression (eg, shock absorbing quality). The structural alterations from degeneration may decrease disc height and increase the risk for disc herniation.

Photo Source: SpineUniverse.com.

Facet Joints (or Zygapophyseal Joints)
The facet joints are also termed zygapophyseal joints. Each vertebral body has four facet joints that work like hinges. These are the articulating (moving) joints of the spine that enable extension, flexion, and rotation. Like other joints, the bony articulating surfaces are coated with cartilage. Cartilage is a special type of connective tissue that provides a self-lubricating and low-friction gliding surface. Facet joint degeneration causes loss of cartilage and formation of osteophytes (eg, bone spurs). These changes may cause hypertrophy or osteoarthritis, also known as degenerative joint disease.

Bones and Ligaments
Osteophytes (eg, bone spurs) may form adjacent to the end plates, which may compromise blood supply to the vertebra. Further, the end plates may stiffen due to sclerosis; a thickening or hardening of the bone under the end plates. Ligaments are bands of fibrous tissue connecting spinal structures (eg, vertebrae) and protect against the extremes of motion (eg, hyperextension). However, degenerative changes may cause ligaments to lose some of their strength. The ligamentum flavum (a primary spinal ligament) may thicken and buckle posteriorly (behind) toward the dura mater (a spinal cord membrane).

Spondylosis Symptoms and Different Spinal Levels

Cervical (Neck)
The complexity of the cervical (neck) anatomy and its wide range of motion make this spinal segment susceptible to disorders associated with degenerative change. Neck pain from spondylosis is common. The pain may spread into the shoulder or down the arm. When a bone spur (osteophyte) causes nerve root compression, extremity (eg, arm) weakness may result. In rare cases, bone spurs that form at the front of the cervical spine, may cause difficult swallowing (dysphagia).  We have an article that presents a cervical spondylosis case; you should definitely read it if you have spinal osteoarthritis in your neck.

Thoracic (Mid-Back)
Pain associated with degenerative disease is often triggered by forward flexion and hyperextension. In the thoracic spine disc pain may be caused by flexion–facet pain by perextension.

Lumbar (Low Back)
Spondylosis often affects the lumbar spine in people over the age of 40. Pain and morning stiffness are common complaints. Usually multiple levels are involved (eg, more than one vertebrae). The lumbar spine carries most of the body’s weight. Therefore, when degenerative forces compromise its structural integrity, symptoms including pain may accompany activity. Movement stimulates pain fibers in the annulus fibrosus and facet joints. Sitting for prolonged periods of time may cause pain and other symptoms due to pressure on the lumbar vertebrae. Repetitive movements such as lifting and bending (eg, manual labor) may increase pain.

Commentary by Howard S. An, MD

Spondylosis is part of the aging process and the majority of individuals do not have symptoms associated with radiographic changes.

Discography seeks to reproduce the patient’s symptoms to identify the “discogenic source” of pain. In the majority of cases, conservative treatment is successful.

Non-surgical Treatment of Spondylosis (Spinal Osteoarthritis)

Spondylosis is osteoarthritis of the spine. The symptoms may vary from mild and episodic to aggressive and painfully chronic. Spondylosis affects the spine’s joints; the facet joints in the cervical (neck), thoracic (mid back), and/or lumbar (low back) spine. Fortunately, most people with spinal osteoarthritis do not need surgery. Many of the common nonoperative treatments are featured below.
Patients with chronic back pain are urged to seek the advice of a spine specialist. Photo Source: 123RF.com.

• Acupuncture is a popular treatment used to help alleviate back and neck pain. Tiny needles, about the size of a human hair, are inserted into specific points on the body. Each needle may be twirled, electrically stimulated, or warmed to enhance the effect of the treatment. It is believed that acupuncture works (in part) by prompting the body to produce chemicals that help to reduce pain.

• Bed Rest: Severe cases of spondylosis may require bed rest for no more than 1-3 days. Long-term bed rest is avoided as it puts patient at risk for deep vein thrombosis (DVT, blood clots in the legs).

• Brace Use: Temporary bracing (1 week) may help relieve symptoms, but long-term use is discouraged. Braces worn long-term weaken the spinal muscles and can increase pain if not constantly worn. Physical therapy is more beneficial as it strengthens the muscles.

• Chiropractic: Chiropractors believe that a healthy nervous system is synonymous with a healthy body. A subluxation, or the misalignment of a vertebra, may distress the nervous system and lead to a disorder causing back and neck pain. Chiropractors do not prescribe drugs or use surgery. Their practice includes ice/heat, ultrasound, massage, lifestyle modification, and spinal adjustments — also called spinal manipulation.

• Lifestyle Modification: Losing weight and maintaining a healthy weight, eating nutritious foods, regular exercise, and not smoking are important ‘healthy habits’ to help spine function at any age.

• Muscle Relaxants: Muscle relaxant medication helps to alleviate muscle spasm and pain.

• Narcotics: Narcotics (opioids) may be prescribed for short periods of time to reduce acute pain.

• NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) relieve inflammation that often contributes to pain. Many NSAIDs are available over-the-counter (OTC) and others by prescription only. Do not combine OTC medications with prescription drugs without the physician’s permission. Doing so may cause a serious and adverse affect.

• Physical therapy combines passive treatments with therapeutic exercise. Passive treatment modalities include heat/ice, ultrasound and electrical stimulation to alleviate muscle spasm and pain. Therapeutic exercises teach the patient how to increase flexibility and range of motion while building strength. Patients need not be fearful of physical therapy. Even patients experiencing pain and great difficulty moving have found that isometric exercises are beneficial.

• Spinal Injections: There are many types of spinal injections including epidural steroid injections and facet joint injections. These injections combine a local anesthetic and steroid medication to reduce inflamed nerve tissues and thereby often help to reduce pain.

Seldom is Surgery Needed

Very few patients with spondylosis require surgery. When surgery is necessary, seldom is it an emergency. Non-operative therapy is tried first. The physician may determine that combining two or more therapies may benefit the patient to quickly resolve their symptoms. In most cases, non-surgical treatments work.

However, some patients suffer neurologic deficit; such as weakness, incontinence, or develop spinal instability. The cause of severe symptoms often determines the type of surgery needed. For example, it may be necessary to surgically remove bone spurs or disc tissue compressing spinal nerves or causing spinal cord compression. Depending on the extent of the surgery, spinal fusion to stabilize the spine may be necessary. Fortunately, newer minimally invasive spine surgical techniques greatly benefit patients. Minimally invasive spine surgery enables patients to return to normal activities sooner.

Conclusion

Patients with chronic back pain are urged to seek the advice of a spine specialist. The all-important first step to relieve back and neck pain is to obtain a proper diagnosis. Back pain can be caused by many problems including spinal stenosis, fibromyalgia, spondylolisthesis, osteoporosis, compression fractures, and bone tumors. The in-depth and specialized training spine physicians receive equips them to treat a variety of disorders causing back and neck pain.

Spondylosis – The Spine Hospital at The Neurological Institute of New York

Summary

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

Causes and 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.

Tests and 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.

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)

Preparing for Your Appointment

Drs. Christopher E. Mandigo and Patrick C. Reid are experts in treating spondylosis. They can also offer you a second opinion.

Degenerative Spinal Spondylosis Treatment Central Texas

Spondylosis, sometimes called cervical, lumbar or thoracic spondylosis, usually refers to age-related wear and tear on the bones in the spinal column (vertebrae). This includes shrinkage of the disks, the development of osteoarthritis and the growth of bone spurs. Spondylosis is common, and affects more than 85 percent of men and women who are over the age of 60.

Wellness & Prevention

Spondylosis is related to normal changes in the body that come with age and cannot be prevented. However, the better you take care of your body and bone health in your younger years, the less likely it is that you will experience significant spine degeneration:

• Eat a diet that gives your bones enough calcium and Vitamin D
• Exercise regularly to keep bones and muscles strong
• Practice good posture
• Visit your doctor if you notice ongoing neck pain or stiffness that doesn’t go away

Diagnosis

The term “spondylosis” is used more often as a description rather than a diagnosis. It can refer to any spine condition that causes both pain and degeneration. Many other spine conditions can lead to spondylosis, including spinal stenosis and degenerative disc disease. A more specific diagnosis is important for the best treatment.

Although spondylosis progresses with age, the symptoms often do not cause any problems beyond stiffness or pain in the back or neck. More severe spondylosis may compress the spinal cord, which can lead to more serious symptoms:

• Numbness or tingling in the limbs
• Feelings of weakness in your arms, hands, legs or feet
• Problems walking with muscle coordination
• Loss of bladder or bowel control

There are several tests that may be performed to check for spondylosis:

• Range of motion tests that show limited ability to move the neck.
• During a cervical compression test, the person flexes his or her head downward, and extra pressure is applied. Neck or shoulder pain on the side the head is turned toward is considered a positive sign of spondylosis.
• Medical history to determine the presence of Lhermitte’s sign. This symptom is a sensation like an electric shock that’s felt when flexing the neck.

In some cases, imaging scans like MRIs or CT scans can be helpful. However, these test results are only considered in combination with a physical evaluation and medical history.

Treatments

Since spondylosis symptoms are typically mild, most treatments are conservative:

• Lifestyle changes such as losing weight if overweight, getting regular exercise and eating a healthful diet can all help improve overall health. This can reduce symptoms of spondylosis.
• Medication, including over-the-counter drugs like aspirin or ibuprofen, can be taken as needed for minor discomfort. In some cases, doctors may prescribe a muscle relaxant or other medication.
• Physical therapy can show people different ways of moving that won’t make symptoms worse. Physical therapy can also help improve range of motion and flexibility.
• Spinal injections combine a local anesthetic (painkiller) with steroid medication to reduce inflammation.
• Some people report success with alternative treatments like acupuncture, yoga, trigger point therapy and massage to relieve discomfort and stiffness.

For more serious cases, more advanced treatments may be needed:

• A supportive brace may be worn for short periods, although this is not usually seen as a long-term solution.
• Bed rest may be tried for a few days until symptoms pass.
• Surgery can be an option for those who have more serious issues arising from spondylosis that don’t respond to other treatments. Some types of surgery can alleviate spinal cord compression, while spinal fusion surgery can help stabilize the spine.

Aftercare

Because spondylosis is progressive, ongoing care is needed. Continued changes to lifestyle and prioritizing back care are important for optimum health. Recovery after surgery for spondylosis, especially fusion surgery, can take several months or more.

With the right approach, back pain due to spondylosis can be better managed. Although there is no way to stop the aging process, taking steps to take care of spine health can minimize some effects of aging on the back and neck.

A Case of Thoracic Spondylosis Deformans and Multilevel Instrumented Spinal Fusion in an 84-Year-Old Male

Spondylosis deformans is a type of spinal claw osteophytosis which can be found on the anterolateral vertebral bodies of any region, and which consists of protrusions of intervertebral disc tissue covered by a bony shell. We report here a case of thoracic spondylosis deformans and multilevel instrumented fusion found during routine dissection of a cadaver. Theories of the etiology of this condition are reviewed in general, and with respect to this specific case and the potential interaction of the presenting comorbidities. The clinical implications of these osteophytes, including musculoskeletal and visceral sequelae, are also discussed.

1.

Introduction

Spondylosis deformans (SD) is a type of spinal osteophytosis of uncertain etiology which contains elements of both an osteophyte and an intervertebral disk (IVD) herniation. These nodules arise from Sharpey’s fibers at the rim of the anterolateral vertebral endplates and grow towards the adjacent vertebral body [1]. This bony migration ultimately forms a bridge between vertebral bodies that covers an IVD tissue bulge and can thereby result in the fusion of the involved segments [2–4]. The bony protrusions of SD can be considered a type of claw osteophyte according to Nathan’s classification system [5, 6] and have not been extensively studied in humans, and then almost exclusively in the lumbar spine [7, 8]. The usage of the term “spondylosis deformans” is more common in the veterinary than the human literature, but a wide variation in the nomenclature used for the condition in both human and animal studies has created some confusion. For example, Morgan and Biery [4] noted more than 10 different terms used in the literature to refer to SD. Regardless of the terminology used, awareness of the diverse patient presentations that can be seen with this type of spinal osteophytosis is essential for clinicians treating patients with either musculoskeletal or visceral complaints.

2. Case Presentation

Approval to conduct this research was received from the body donor program that provided our study subject, and exemption from human subjects review was obtained from the Thomas Jefferson University Office of Human Research. This report concerns observations made during a routine dissection of an 84-year-old male during a gross anatomy laboratory course. The cause of death was congestive heart failure and respiratory failure, with no other past medical history available. After removal of the anterior chest wall, the subject’s bronchi, pulmonary vessels, and inferior vena cava were transected. The lungs were then removed and the heart reflected superiorly, revealing large osteophytes on the thoracic spine. These were noted to arise from the anterolateral vertebral bodies of T6 to T11 and to bridge the intervening IVDs (Figure 1).

The anterior longitudinal ligament was partially degraded where it contacted the osteophytes between T6 and T9 (Figure 1(b)). Although the esophagus remained oriented in the midline, its deep surface was noted to be in contact with osteophytes at T6-T7 and T8-T9. No compression of the sympathetic trunk by the osteophytes was found. At the conclusion of the anatomy lab course, the spine was disarticulated from the cadaver at the sacroiliac and atlantoaxial joint; at which time, hardware from an extensive thoracolumbar posterior fusion was noted. In order to expose the spine and hardware completely, residual soft tissue was removed by sharp dissection and successive immersion and rinsing using a bleach solution. This exposed the pedicle screws and rods spanning from T9 to L3 bilaterally, overlapping the thoracic osteophytes by two segments (Figure 2). A seam over the middle of the intervening IVD, a hallmark of SD, [8] showed clearly where the bony contributions from the involved vertebral bodies intersected (Figure 3). A wedge cut into one of the osteophytes was then made and IVD tissue was noted within the bone tissue surrounding the osteophyte (Figure 3).

3. Discussion

The pathology seen in the spine of our subject is complex and includes disk herniation, osteophytosis, multilevel instability, and both organic and surgical spinal fusion. Interactions among these conditions are very likely, but the lack of available medical history makes the sequence of onset of the various conditions unknown.

Although research on SD is very common in the veterinary literature [3, 4], human studies are few, and the specific etiology is unknown. Spondylosis deformans ultimately results in a type of organic spinal fusion, and thus it has been theorized that the unique osteophytes characteristic of SD form in order to correct an underlying spinal instability [4].

Physical stress, including obesity, is considered the primary cause of osteophyte formation [6, 9]. Biomechanical factors stimulate periosteal cells in the bone-cartilage interface to initiate the process of osteophyte formation, with evidence of a strong role for TGF beta and bone morphogenic protein in their formation [6]. Osteophyte incidence increases with age and may be associated with dietary and genetic factors [6], and spinal osteophytes arise in all regions of the spine, with the highest incidence in the lower thoracic region [5]. They can be subdivided into either traction subtypes, which curve away from the IVD or claw subtypes, which curve towards the IVD [6, 7]. Thoracic spine osteophytes are more frequently located on the right side, as seen with our subject, possibly due to interruption of spur formation on the left side caused by aortic pulsations [2].

Fissures in the annulus, a common age-related change in human and canine spines, have been noted to be a precursor to both SD and IVD herniation [4]. Anterior disk bulges have been associated with osteophyte formation, but the order of IVD disease versus osteophyte formation has not been well established [4, 10]. Anterior IVD herniation is less common than posterior herniation, likely due to human lifestyles involving repeated flexion, and also to morphological factors such as the thinner wall found in the posterior annulus [2]. As with anterior osteophytes, anterior disk herniations have been known to impinge upon visceral structures [11] and to cause visceral pain due to compression injuries of the sympathetic trunk [12].

Other common spinal lesions involving both the vertebral bodies and the IVDs can be differentiated from SD by considering the specific lesion location and anatomical features involved. For example, diffuse idiopathic skeletal hyperostosis (DISH) results in a fusion of spinal segments that is similar to the fusion seen with SD; however, DISH always involves ligament ossification [13]. In the spine, DISH creates a bridge over an intervening IVD and commonly impacts the anterior longitudinal ligament, which was largely spared in our subject. A Schmorl’s node is another condition involving both the vertebral body and the IVD, but in this case, the IVD actually protrudes through the center of the cartilaginous endplate and into the cancellous bone at the center of the vertebral body [14].

The multilevel instrumented fusion seen in the present subject suggests that adjacent segment disease (ASD) was present in addition to the other pathologies previously discussed. Adjacent segment disease refers to pathological changes that arise in the mobile segments next to a spinal fusion. Spinal fusion surgeries are performed in cases of traumatic instability, or when decompression surgery at multiple levels creates this instability. The pathological manifestations of ASD can include degeneration, listhesis, instability, herniation, and osteophyte formation [15–17]. The etiologies of ASD involve complex biomechanical processes and can be categorized as leading to either increased degeneration or to increased motion in the neighboring segments. Older patients and those with multijoint involvement, 2 characteristics shared by our subject, are most at risk for ASD [15, 16, 18].

4. Conclusion

Our subject represents an unusual case of thoracic SD coupled with multilevel instrumented spinal fusion. The presence of SD in the thoracic spine is inherently contradictory because thoracic disk bulges are rare and represent fewer than 3% of all disk herniations [19], while thoracic osteophytes are quite common. The SD osteophytes seen in our subject may have developed, in part, secondary to ASD. Yet we have not found evidence in the literature that ASD can specifically cause the osteophytes characteristic of SD. Spondylosis deformans is itself a type of nonsurgical spinal fusion, and one study using a canine model showed that the organic fusion of SD can itself cause a type of ASD [20]. Regardless of the timing of onset of the conditions seen in the present case, awareness of thoracic SD and its potential complications is lacking among clinicians. This is important because while thoracic SD may be asymptomatic, it has the potential to cause dysphagia, respiratory issues, and compression of the sympathetic trunk or the aorta [6, 9, 21, 22]. There is a greater awareness among clinicians of the potential for cervical osteophytes to cause visceral symptoms, but imaging studies and diagnostic work-ups may miss thoracic involvement in, for example, dysphagia [22]. Particularly, when visceral symptoms occur in patients also experiencing back pain, clinicians should consider the possibility of the interaction of these two conditions. Awareness of the potential relationship between these bony deformities and visceral symptoms can prevent unnecessary testing and lead to appropriate referral for imaging, diagnostic work-up, and treatment.

Conflicts of Interest

The authors have no declared financial, personal, consultant, institutional, or other relationships constituting a conflict of interest related to this research.

Spondylosis: Causes, Symptoms & Treatment

This condition is a degeneration of the spine that can affect the spine at any level, resulting in pain and discomfort that can grow worse over time.

What You Need To Know About Spondylosis

What is Spondylosis?

Spondylosis is a painful degenerative spine disorder. The condition is caused by the spinal discs and joints changing from a lifetime of wear and tear on the spine. These changes can make simple movements difficult on your back, causing extreme discomfort.

As you age, your body changes in response to shifts in your life. For example, your hair may go gray, or you may lose your hair all together. These are natural parts of the aging process. Likewise, degenerative conditions such as spondylosis are a reaction to the aging process. During spondylosis, the spinal discs deteriorate as a result of aging. This deterioration affects their cushioning ability, and creates a more rigid position for the spine. However, as the spine becomes more rigid, simple activities become more difficult.

Over 85% of people who are 60 or older have spondylosis, and it is the most common type of progressive condition that affects the neck. If left untreated, symptoms from spondylosis compound and significantly affect the quality of your life.

Book your appointment now to talk with our experts at the Resurgens Spine Center.

What Causes Spondylosis?

There are 24 bones that make up your vertebrae. These bones provide spine support for your body and protect the nerves that lead to your spine. Between each of these bones, you have facet joints that connect the vertebrae. Between each of these joints are discs that absorb bone impact. Together, these components allow your spine to function and give you movement.

The degeneration process usually begins with the discs. As the body gets older, the spinal discs begin to dry out, lose their elasticity and collapse. The thinning of the discs places stress on the facet joints and the ligaments that hold the vertebrae together. These structures weaken, allowing the vertebrae to become overly mobile.

As you age, these discs change consistency and lose some of their utility. The vertebrae may begin to shift out of proper alignment and rub against each other. As these discs dissolve away, the discs begin to rub together. Friction from deteriorated discs causes bone growths — called bone spurs — to appear on the spine. As resistance grows, back movement is more compromised, and friction increases. The vertebral shifting and the excess bone growth can reduce the space through which the nerve roots travel, and the nerve roots or the spinal cord can become painfully compressed.

There are many factors that can contribute to spondylosis, including:

Getting a proper diagnosis for spondylosis requires a proper consultation from a spine physician.

Spondylosis Symptoms

Spondylosis can affect the cervical, thoracic, and lumbar portions of the spine. Each condition variation produces different symptoms.

• Cervical Spondylosis Degeneration in the cervical spine may cause neck, shoulder and arm pain. It may also result in loss of fine motor skills, weakness, numbness and tingling in the arms and legs.
• Thoracic Spondylosis Degeneration in the thoracic spine may cause pain in the chest and upper abdomen. It may also result in weakness, numbness and tingling in the legs.
• Lumbar Spondylosis Degeneration in the lumbar spine may cause pain in the back, buttocks, or legs, with possible numbness, and muscle weakness that may be worsened by activities such as lifting, bending, twisting, or sitting.

One symptom that is common across all these conditions is pain induced by sudden movements, such as sneezing, coughing, or moving unexpectedly.

How Spondylosis Is Diagnosed

Diagnosing spondylosis involves a physical examination and diagnostic screening.

During your physical examination, your doctor will ask you questions about your condition. They will test your reflexes and monitor your reactions. Your doctor may need to aggravate your condition to assess your response. This portion of the exam may cause you some brief discomfort but will help your doctor narrow down causes for your pain.

Your doctor will use imaging technology to determine if you have spondylosis. The use of x-rays, MRIs, and nerve conduction and EMG machines will help confirm their diagnosis and understand the extent of your condition.

Spondylosis Treatment

Depending on the severity of your condition, there are many options for treatment. Your doctor will recommend the best treatment option for your situation.

For milder cases, your doctor may recommend using over-the-counter pain relievers such as Advil, Aleve, Tylenol, or their store brand counterparts. These drugs can help relieve your pain and inflammation. However, some people may need prescription medication to alleviate their symptoms. These can include extra strength anti-inflammatory drugs, corticosteroids, muscle relaxants, anti-seizure medications, antidepressants, and more and robust painkillers. Be careful with all medication, as it can become habit-forming.

Physical therapy with a trained expert can also help guide your recovery. Increasing the strength of key areas in your muscles and shoulders can help alleviate your discomfort.

If conservative options do not help alleviate your pain, you may need surgical options to create more room for your spinal nerves. Your doctor will not recommend surgery unless other options have failed to produce optimal results for your healing.

There are many minimally-invasive or traditional surgery options available to treat spondylosis. Your doctor will choose the best option for your condition.

Book an appointment now to talk to the physicians today.

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90,000 Treatment of spondylosis of the thoracic spine in Moscow at the Dikul clinic: prices, appointment

Spondylosis is a degenerative process that affects the anatomical structures of the spine. This is a condition that usually develops with age, when bones gradually wear out from prolonged use, leading to the formation of bone spurs (osteophytes). Spondylosis is a general term used to describe a general deterioration in the condition of the spine.

X-ray studies show signs of spondylosis in more than 80% of people over 40 years of age.It is believed that most cases are associated with a genetic predisposition and the presence of previous trauma.

Spondylosis in the thoracic spine develops much less frequently than in the lumbar or cervical spine, which is associated with the anatomical rigidity of this region of the spine. Nevertheless, timely diagnosis and treatment of spondylosis of the thoracic spine is necessary, which avoids neurological complications.

What is thoracic spondylosis?

The main definition of thoracic spondylosis is that it is a condition that can narrow the spinal canal in the upper and middle spine, resulting in compression of the spinal cord and nerve roots.In the long term, this compression can damage these structures, causing symptoms such as weakness and numbness in the upper limbs, impaired walking, and even pain that radiates to the arms.

Back pain is one of the most common types of pain that affects people as they age. These painful manifestations often appear due to the natural deterioration of the condition of the bones of the spine as a result of age-related wear and tear of the musculoskeletal system.

The thoracic vertebrae are located in the middle of the spine, and the range of motion in this part of the spinal column is much less than in the cervical and lumbar regions.

Degeneration of the thoracic spine is not as common as in the neck or lower back. Age-related risk factors are the main cause of degeneration. The vertebral column consists of several bone segments separated by cartilage pads (discs) that soften the impact of the vertebrae against each other and reduce the overall load on the spine.These gel-like cartilage pads are called discs, and over time, natural involutional changes in the body lead to dehydration of the disc cartilage and loss of functionality, leading to back pain. There is also a risk of disc protrusion or herniation as spondylosis progressively progresses.

Reducing the thickness of the protective cartilage also allows the vertebrae to come closer to each other, which leads to progressive damage to the structures of the spine.

Spondylosis of the thoracic spine can also lead to a condition called spinal stenosis, in which narrowing of the spinal canal occurs, which leads to compression of nerve structures with the development of pain and other neurological symptoms. The development of bony spines (osteophytes) can put pressure on the spinal nerve roots, which also leads to pain.

Causes and symptoms of thoracic spondylosis

Causes of spondylosis of the thoracic spine

Age is the main cause of thoracic spondylosis.Most cases of thoracic spondylosis develop in people over 45 years of age. Due to the natural involutionary aging process, the discs in the spine begin to wear out and lose their strength and function. This can lead to rupture of the annulus fibrosus and the formation of herniated discs or protrusions. These degraded discs do not perform their cushioning functions, which leads to excessive stress on joints, muscles, ligaments and back pain.

Symptoms

Since the functionally the thoracic spine is not as loaded as the cervical and lumbar spine, thoracic spondylosis develops as an effect of degeneration of the spine in other spine.Some of the common symptoms of thoracic spondylosis:

• Pain in the upper back, especially in the morning when getting up
• Stiffness in the middle or upper back
• Numbness and tingling in the upper and lower extremities
• Muscle weakness
• Discoordination
• Problems with walking

Diagnosis of thoracic spondylosis

Specialists who are engaged in the diagnosis and treatment of spondylosis of the thoracic spine are neurologists, neurosurgeons, orthopedists, physiotherapists, exercise therapy doctors.

Thoracic spondylosis can be diagnosed by physical examination and medical imaging techniques:

• The doctor will take a medical history and medical history, as well as a detailed physical examination of the spine and neurological tests.
• Imaging tests such as x-rays, computed tomography or MRI of the thoracic spine may be ordered to confirm the diagnosis to determine the degree of degeneration of the thoracic spine

Treatment of spondylosis of the thoracic spine

Conservative treatment

Symptoms of spondylosis of the thoracic spine can range from mild and episodic discomfort to intense and chronic pain syndrome.Spondylosis affects the facet joints in the spine, significantly impairing mobility in the motor segments. Fortunately, most people with thoracic spondylosis do not need surgery. The following conservative treatments are most common

• Acupuncture is a popular treatment used to relieve back and neck pain. Tiny needles, the size of a human hair, are inserted at specific points on the body. Each needle can be twisted, electrically stimulated, or heated to enhance the effect of the treatment.Acupuncture is believed to work (in part) by stimulating the body to release certain chemicals that help relieve pain.

• Bed rest : In severe cases of spondylosis, bed rest may be required (no more than 1-3 days). Long-term bed rest should be avoided as the risk of deep vein thrombosis increases.

Use of braces : Temporary fixation (1 week) may help relieve symptoms, but long-term brace use is not recommended.Corsets that are worn for a long time weaken the muscles in the back and can increase pain if not worn constantly. Physical therapy (exercise therapy) is more beneficial because it strengthens the muscles.

• Chiropractors : Chiropractors believe that a healthy nervous system is synonymous with a healthy body. Subluxation or misalignment of the vertebrae can lead to nervous system breakdown and the development of back and neck pain. Spinal manipulations, which the chiropractor performs with his hands, can eliminate subluxations and increase the mobility of the motor segments.

• Lifestyle modifications : Losing and maintaining a healthy weight, eating healthy, nutritious foods, exercising regularly, and avoiding smoking are important “healthy habits” to help your spine function at all ages.

Medicines

• Muscle Relaxants: Muscle relaxants help relieve muscle spasms and pain.
• Narcotics (opioids) may be prescribed for short periods of time to relieve acute pain.
• NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) relieve inflammation, which often contributes to the development of pain.

It is not recommended to take NSAIDs on your own, especially for a long time, as this can lead to serious side effects and adverse effects on the body.

• Physical Therapy – Combines passive treatment with exercise therapy. Passive treatments include heat / ice, ultrasound, and electrical stimulation to relieve muscle spasm and pain.Therapeutic exercises allow the patient to increase flexibility and range of motion while building muscle strength.

Patients should not be afraid of physical therapy. Even patients experiencing pain and walking problems have found that isometric exercises have some effectiveness.

• Spinal injections : There are many types of spinal injections, including epidural steroids and facet joint injections. These injections use a combination of local anesthetics and steroid drugs to reduce inflammation in the nerve tissues and thus often help relieve pain.

• Hydrotherapy : By using the emollient effect of water, hydrotherapy can treat a variety of bone and joint pains. It differs from swimming in that it involves exercises that the patient does in warm water, usually between 35-37 degrees.

• Taping : This is a technique used for injury prevention or rehabilitation. Exercise therapy specialists are specially trained in how to effectively apply the tape to the skin in order to maintain the stability of certain muscles or bones.Benefits of using this treatment include:

• Injury Prevention
• Ability to get back to sports or work faster
• Protection of damaged soft tissues such as ligaments, tendons or fascia
• Improved mobility
• Pain relief
• Reduced risk of re-damage
• Improvement of joint stability
• Reduction of edema

• Postural Realignment : If symptoms are the result of years of poor posture, the realignment of the vertebral bones, combined with postural exercise, can help reduce back pain.This often includes assessing the current posture, helping to identify any tight or weak muscles that may be causing back pain. The doctor then gives advice on how to make changes in posture – sitting, standing and manipulating objects properly. There is also a selection of exercises to stretch and strengthen the muscles of the back, which helps to improve posture.

• Soft Tissue Exposure : Includes assessment and treatment of any soft tissue injury that causes pain and dysfunction.Soft tissues include ligaments, tendons, muscles, and fascia. Soft tissue treatments include myofascial release, massage, heat therapy, stretching, and electrotherapy.

Benefits of soft tissue treatment include:

• Faster recovery from injury
• Reduced risk of re-damage
• Increase functionality
• Accelerated healing process
• Increased mobility
• Increase in muscle strength
• Reduction of edema
• Increase in the length of soft tissues
• Increased range of motion
• Pain relief

Surgical treatment

Very few patients with spondylosis of the thoracic spine require surgery, as conservative therapies usually reduce symptoms.

However, some patients may have persistent neurological deficits; symptoms such as weakness, walking problems, or the development of spinal instability. The type of surgery is determined by the cause of persistent neurological symptoms. For example, it may be necessary to surgically remove bone spines (osteophytes) or portions of a disc that compress spinal nerve roots or cause compression of the spinal cord. Depending on the extent of the surgery, a spinal fusion may be required to stabilize the spine.

Fortunately, modern minimally invasive surgical methods for the treatment of the spine significantly reduce the risks of surgery, accelerate the recovery of spinal functions, and allow patients to return to normal activities earlier than with traditional surgery.

90,000 Spondylosis deformans – treatment, symptoms, causes, diagnosis

The term spondylosis deformans has Latin roots (spondyl means the spine, and osis means disorders) and the term reflects the presence of problems in the spine.Currently, this term denotes 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 joints, ligaments, intervertebral discs.

Nevertheless, the aging of the organism is a purely individual process. In the same way that some people start to go gray earlier, also the development of spondylosis 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 degenerated and how these changes affect the spinal cord or spinal roots.

Spondylosis deformans 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.

Spondylosis deformans is a degenerative process that goes along with osteochondrosis and degenerative changes occur in the following structures of the spine.

Intervertebral discs . With age, people undergo certain biochemical changes that affect the tissues of the entire body. Changes also occur 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 fiber.The nucleus pulposus is a jelly-like substance within the intervertebral disc, surrounded by a fibrous ring. The nucleus is composed of water, collagen fibers, and proteoglycans. Degenerative involutional changes can weaken these structures, causing the annulus fibrosus to wear out or break. The water content in the nucleus decreases with age, which affects the cushioning properties of the intervertebral disc. Structural changes with disc degeneration can result in a decrease in the height of the intervertebral disc and an increase in the risk of disc herniation.

Facet joints (or zygapophyseal joints) . Each vertebral body has four facet joints that act as hinges. This allows the spine to bend, unbend, and rotate. Like other joints, the facet joints are covered with cartilage. Cartilage is a special kind of connective tissue that is provided with lubrication and a good sliding surface. With degenerative changes in the facet joints, the disappearance of cartilage tissue and the formation of osteophytes occur.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 a violation of the blood supply to the vertebra. In addition, the end plates can become compacted due to sclerotic phenomena; thickening or hardening 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 lead to the fact that the ligaments lose their strength. Changes, for example, the yellow ligament can lead to thickening and thickening of the ligament, which in turn can lead to effects on the dura mater.

Symptoms in spondylosis of various departments

Cervical spondylosis. The complex anatomical structure of the cervical spine and the wide range of motion make this spine highly susceptible to degenerative disorders.Neck pain with spondylosis in this section 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 cause difficulty swallowing (dysphagia).

When spondylosis is localized in the thoracic spine, pain caused by degenerative changes (spondylosis) often appears when the trunk is flexed forward and hyperextension.Flexion causes faceted pain.

Spondylosis of the lumbar spine is common in people over 40 years of age. The most common complaints are lower back pain and morning stiffness. Changes usually take place in several motor segments. The lumbar spine is responsible for most of the body’s weight. Therefore, when degenerative changes compromise structural integrity, symptoms, including pain, can accompany any physical activity.The movement stimulates painful fibers in the annulus fibrosus and joints. Sitting for extended periods of time can lead to pain and other symptoms due to pressure on the lumbar vertebrae. Repetitive movements such as lifting weights and tilting the torso can increase pain.

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

• Cervical
  
  • Pain that comes and goes
  • Pain that spreads to the shoulders, arms, hands, fingers
  • Morning stiffness in neck or shoulder or limited range of motion upon waking
  • Neck or shoulder soreness or numbness
  • Weakness or tingling in the neck, shoulders, arms, hand, fingers
  • Headache in the occipital region
  • Imbalance
  • Difficulty swallowing
• Thoracic spine
  
  • Pain in the upper and middle back
  • Pain occurs when flexing and straightening the trunk
  • Morning back stiffness upon waking
• Lumbar spine
  
  • Pain that comes and goes
  • Morning stiffness in the lower back after getting out of bed
  • Pain that ameliorates with rest or after exercise
  • Low back pain or numbness
  • Sciatica (moderate to intense leg pain)
  • Weakness, numbness or tingling in the lower back, legs or feet
  • Walking Disorder
  • Dysfunction of the intestines or bladder (these symptoms occur quite rarely, but are possible with compression of the cauda equina).

Causes of deforming spondylosis

Aging is the main cause of spondylosis. The body is subjected to daily stress for many years and changes in various structures of the spine occur over time. Before symptoms such as pain and stiffness appear, degeneration of the structures of the spine occurs. Spondylosis is a cascade process: some anatomical changes lead to others, which leads to changes in the structure of the spine.These changes in the aggregate cause spondylosis and the corresponding symptoms.

As a rule, degenerative changes start first in the intervertebral discs. 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 ultimately the aging process affects other components of the motor segments of the spine.Over time, the collagen that makes up the annulus fibrosus begins to change. In addition, the water content of the disc is reduced. These changes reduce the damping function of the disc 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 some of the load on the disc, stabilizing the spine. With thinning of the disc, 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 exert 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 spinal stenosis is not osteochondrosis, but spondylosis.

Genetic determinism plays a role in the development of spondylosis to a certain extent.Also, bad habits, such as smoking, have a certain effect.

Diagnostics

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

• Onset of pain symptoms
• Activity prior to onset of pain
• What activities were carried out to relieve pain
• Presence of pain irradiation
• Factors that increase pain or reduce pain

A neurologist will also conduct 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 joints can also be a source of back pain. During a neurological examination, a neurologist will check tendon reflexes, muscle strength, and sensitivity disorders.

To verify the diagnosis, instrumental methods are also required, such as radiography, MRI or CT, which allow visualizing changes in the spine. Radiography well reflects changes in bone tissue and allows visualizing 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 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 neurologist can make a clinical diagnosis of spondylosis and determine the necessary treatment tactics.

Treatment

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

Acupuncture . This treatment can reduce back and neck pain. The needles, which are inserted at specific points, can also be stimulated both mechanically and using electrical impulses. In addition, acupuncture increases the production of your own pain relievers (endorphins).

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

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

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

Drug treatment .Spondylosis medications are mainly used to relieve pain. These are drugs such as NSAIDs, and muscle relaxants can be used if there are signs of muscle spasm. Tranquilizers can also be used to relax muscle spasms, which can also improve sleep. Opioids are used in the treatment of pain syndrome only sporadically, with severe pain manifestations. Any drug treatment should be carried out only as directed 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 area of ​​the spinal roots. Typically, the steroid is given 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.

Injections into the facet joints are also used in the treatment of spondylosis and improve the mobility of the facet joints, reduce painful manifestations caused by arthrosis of the facet joints.

LFC . This treatment is one of the most effective treatments for spondylosis. Dosed physical activity allows you to restore a 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 syndrome.

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

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

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

Surgical treatments

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

90,000 Symptoms and treatment of spondylosis of the lumbar spine

The term spondylosis in medicine is a degenerative process in the spine, leading to the formation of bone growths along the edges of the vertebral bodies. You can literally see the processes occurring in the vertebral body on an X-ray.The X-ray image shows distinct contours of the vertebrae and pronounced bone formations of various shapes – osteophytes. Osteophytes are the hallmark of spondylosis . If the growth of osteophytes is not interrupted, the process ends with the fusion of two vertebrae together. Depending on the location of , spondylosis is called the corresponding anatomical structures of the spine: spondylosis of the cervical spine, spondylosis of the thoracic spine, spondylosis of the lumbar spine . Spondylosis of the cervical spine occurs more often in people of intellectual work – this is due to a long, monotonous, sitting position due to which the cervical spine experiences prolonged stress. Spondylosis of the lumbar spine is diagnosed mainly in people of physical labor. In most cases, at the initial stage , spondylosis is asymptomatic and reveals itself only during examination on suspicion of other diseases: osteochondrosis, disc protrusion, herniated disc of the spine, etc. The prevalence of spondylosis in the population is not uniform. Predominantly spondylosis affects people over middle age. Possible clinical manifestations of spondylosis among young people, as a rule, this is facilitated by pathologically curved posture. An important place in the prevention and treatment of spondylosis of the spine is occupied by therapeutic exercises, therapeutic massage, the development of a culture of movement and compliance with safety measures when working with weights.

Symptoms characteristic of spondylosis

Back pain with spondylosis does not have a pronounced acute or shooting character. Back pain may be completely absent. More often, patients complain of a feeling of stiffness in the back, a feeling of fatigue in the neck, lower back, aching pains that disappear when kneading the affected area. There is also a meteorological dependence of the area affected by spondylosis. For these reasons, spondylosis can be detected only after a thorough neurological examination using methods of radiation diagnostics: radiography, magnetic resonance imaging.

Why does spondylosis occur?

There is no consensus on the causes of spondylosis among specialists: surgeons, orthopedists, neurologists. But the main thing can still be highlighted. The onset of spondylosis is largely promoted by a sedentary lifestyle, or, as we often hear now, physical inactivity. One-time physical activity against the background of physical inactivity (mainly seasonal trips to the country, as well as seasonal trips to fitness centers and sports clubs) lead to microtraumas of the ligamentous apparatus of the spine, which entails a reaction of replacing injured ligaments with bone tissue and the development of spondylosis

In whom and how can spondylosis be detected?

The majority of the able-bodied male population employed both in physical work and in the field of knowledge workers is considered to be at risk for the manifestation of symptoms of spondylosis.Of course, spondylosis also occurs in women with the same distribution of symptoms by type of work activity, but nevertheless, the ratio of the number of patients with spondylosis to the total mass of healthy people is clearly not on the side of men. Early diagnosis of the disease allows timely initiation of treatment for spondylosis of the entire spine, as well as of the lumbar spine, and to protect oneself from the transition of spondylosis; to a chronic form, as well as not wait for the moment when only radical methods of surgery will be effective treatment.To diagnose spondylosis, you just need to take an X-ray of the spine. In case of detection of osteophytes, the main signs of spondylosis, we recommend that you undergo an additional examination on a magnetic resonance imaging (MRI) scanner, which will allow you to see what X-ray diagnostics cannot show. MRI clearly demonstrates the condition of the spinal ligaments and the condition of the intervertebral disc. Since in spondylosis the ligaments are at the first line of contact with osteophytes, monitoring their condition will avoid such a dangerous complication of spondylosis as a herniated disc of the spine.

Spondylosis treatment

We use time-tested natural methods of restoring the body for various pathologies of the spine. In the treatment of spondylosis of the spine, the use of hirudotherapy (treatment with leeches), homeopathic preparations from Hell (Germany), safe apparatus traction of the spine, a rich arsenal of techniques for gentle manual effects on the spine and, of course, therapeutic gymnastics have proven themselves well.

Before touching on the topic of treatment, it is necessary to point out that treatment does not mean the elimination of the symptoms of back pain and the external manifestations of the disease, namely, therapeutic measures that contribute to the elimination of the causes leading to the pathology of the spine and back pain of a chronic or acute nature.Pharmacological / drug help for back pain justifies itself only at the initial stage of the acute course of the disease, when all drugs are good for the speedy relief of an acute pain attack in the lumbar or any other area of ​​the back and ridding a person of fear. After all, fear is a sufficient irritant of the central nervous system, multiplying the perception of pain. In cases of acute back pain, the use of drugs is 100% justified. Since such conditions are rare in spondylosis, the use of anesthetic and anti-inflammatory drugs of artificial origin in this disease is considered undesirable.Any chemical product / medicine has a harsh effect on the general physicochemical balance of the body, to which your attention is drawn in the annotation to medicines in the sections: contraindications / complications. Do not test your body for strength. He needs your help, not shock therapy, “deafening” the nervous system with or without reason. Refrain from unreasonable use of drugs of a chemical nature in the treatment. Never self-medicate, be sure to visit a specialized specialist in person.The consequences of inappropriate drug use can be severe or irreversible.

You can make an appointment with the head physician of our clinic’s vertebro-neurologist by calling 8 (903) 722-62-21, 8 (499) 610-02-10 or by leaving a request on our website.

Three reasons to make an appointment with the head physician vertebroneurologist

1. It’s fast

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90,000 Spondylosis of the thoracic spine treatment in the clinic Omega Kiev

Spondylosis of the thoracic spine is a chronic disease that is manifested by deformation of the vertebral bodies of the thoracic spine.This deformation occurs as a result of irreversible pathological proliferation of bone tissue. With spondylosis, osteophytes form on the vertebrae – spines and protrusions, which also cause a narrowing of the spinal canal. Sometimes osteophytes can lead to fusion of adjacent vertebrae, due to their large size.

This ailment usually affects the elderly. The joints and ligaments of the intervertebral discs wear out with age and undergo various changes.

Especially if a person throughout his life put a heavy load on the thoracic spine or did not follow the safety rules during physical exertion.Thoracic spondylosis, unlike cervical and vertebral spondylosis, does not have pronounced symptoms for a long time, and therefore it is very difficult to diagnose in a timely manner.

Therefore, at the slightest discomfort in the thoracic spine, you should be examined by a vertebrologist. In the clinic “Omega-Kiev” qualified specialists of the highest category will help you avoid complications that can cause an illness.

Symptoms and manifestations of thoracic spondylosis

The clinical picture of a disease of the thoracic spine is pronounced: usually patients complain of prolonged aching dull one-sided pain in the middle spine.Painful sensations can spread to the chest area, namely in the case when the anterior roots of the spinal nerves are involved in the process. Typical manifestations of the disease are:

• pain in the chest region;
• pain that worsens when walking or standing for a long time;
• pulling nature of the pain syndrome;
• change in gait and gradual change in the position of the trunk;
• shallow breathing caused by fear of increased pain;
• pseudo-angina pectoris.

Special attention should be paid to the long-term asymptomatic development of this type of spondylosis. The disease may also not make itself felt with a large area of ​​distribution of osteophytes (growths of bone tissue).

Causes of spondylosis of the thoracic spine

Unfortunately, according to various estimates, the disease can be found in about 80-90% of elderly people.Despite this, due to the peculiarities of the lifestyle, professional activity, spondylosis of this spine also occurs after 30 years. It should be noted that far from all patients the disease manifests itself clinically.

Basically, mental workers suffer from degenerative-dystrophic changes in the spine. Spending a lot of time in an uncomfortable position, sitting at the table, they regularly give their spine static loads.

So, the risk factors for the disease are:

90,032 90,033 age;

Stages of development of thoracic spondylosis

In case of spondylosis of the thoracic region, the allocation of certain stages of the disease is to some extent conditional and characterizes the duration of the development of the disease, as well as the pain experienced by the patient. Also, in general, it should be noted that thoracic spondylosis is a rather rare form of this disease. Doctors designate three main stages of this ailment of the spine:

• The onset of a pathological condition is accompanied by pain in the lower and upper vertebral spine.Pain sensations are most often asymmetrical, one-sided. At this stage, due to external unfavorable factors, the body tries to adapt to permanent pressure on the vertebrae and erasure of intervertebral discs. The rudiments of osteophytes are formed – bone growths on the spine.
• While the first stage passes without disturbing the usual way of life (pain is mild), in the second stage, palpation along the anterior chest and spine makes it possible to detect spondylosis.Pressing is accompanied by characteristic pains, disturbances occur in the region of the anterior branches of the spinal nerves.
• At the third stage, the fusion of the vertebrae may occur due to an increase in the space of the bone growth. Such changes in the thoracic spine are irreversible. They lead to a significant decrease in the quality of life, since a patient with spondylosis has great difficulty walking, sitting in one place, even breathing.

Spondyloarthrosis and spondylosis, treatment with modern methods

About the disease

This ailment has several names, so if you come across the terms spondylosis , spondyloarthrosis and facet arthropathy – know that we are talking about one diagnosis.Spondyloarthrosis is a disease that occurs as a result of the destruction of the joints of the spine, as a result of which growths are formed, which are called osteophytes.

Spondyloarthrosis is the next stage of osteochondrosis, this is exactly what the doctors came to. Most often, the elderly suffer from this ailment, in the younger generation it occurs mainly due to injuries. Spondylosis usually develops in cervical , thoracic or lumbar .

Reasons

Spondyloarthrosis develops at a high rate, it is caused either by frequent trauma in the past or by a genetic predisposition. The main reasons for the onset of spondylosis include metabolic disorders, as well as age and changes in the body that it carries. Spondyloarthrosis is diagnosed in people who work in a seated position for a long time, because not every person has the correct posture when working in a static position.
This disease, as a rule, is not independent and arises as a result of other already existing diseases, these include osteochondrosis, scoliosis, displacement of the vertebrae, and a previous infection, trauma or obesity can also be the cause.

It is also worth noting that women suffer from spondylosis much less frequently than men. Spondyloarthrosis cannot be completely cured, but pain can be blocked and the destruction process stopped.

Symptoms

At the first stages, this ailment is almost asymptomatic and without any pain.At the moment when a person begins to feel a certain stiffness in movements, we can say that spondylosis has acquired a chronic character. It also happens that a disease is detected by chance on an x-ray, and the patient does not feel any inconvenience.

The arising painful sensations during spondylosis gradually intensify and already interfere with the patient’s sleep or disturb even in a motionless state. It also happens that the pain intensifies during weather changes.

Spondyloarthrosis of the lumbar spine is manifested by the following symptoms: a feeling of heaviness, pain when bending over, stretching, and pain that bothers while sitting.

Spondylosis of the cervical spine , in turn, manifests itself in stiffness in the neck, difficulty and soreness when turning, as well as pain in the back of the head, radiating to the shoulder. As a result, sleep disturbance occurs.

Spondyloarthrosis of the thoracic region is less common than the first two variants of the disease. Of the main symptoms, one can single out a violation of the work of internal organs: the heart, lungs, gastrointestinal tract.

Treatment

First of all, when diagnosing a disease, measures are taken to prevent inflammation and pain.Treatment of spondyloarthrosis, like many diseases of the spine, should be comprehensive and include:

• Chondroprotector, which restores the cartilaginous base
• Taking anti-inflammatory and analgesic medications and massage (strictly according to the doctor’s prescription, taking into account all the features and only during remission)
• Kinesitherapy, manual therapy;
• Physiotherapy, reflexology, laser therapy;

Surgery is a last resort for the treatment of spondylosis.As a result, people who have undergone this disease should monitor their posture: correctly distribute weight when walking, do not lift weights.

At the Institute of Physical Rehabilitation you can get expert advice from experienced doctors. If the diagnosis is confirmed on the basis of our clinic, it will be possible to undergo a course of treatment and rehabilitation.

90,000 Spinal diseases: lumbar spondylosis

With age, as well as due to various external factors, osteoporosis develops in the spinal column.It is characterized by thinning of the intervertebral discs. At the same time, the vertebrae themselves become lower. Unfortunately, the disks are not self-recoverable. Due to a person’s upright posture, cartilage tissue cannot fully feed. This leads to unnecessary stress on the spinal column. There is a gradual but permanent destruction of the hyaline cartilage. In places where the cartilage disappears, connective tissue grows.

The result is that the spine can no longer resist even minor loads.There is a loss of amortization of the intervertebral discs and the inability to perform the functions assigned to them.

According to the orthopedic surgeon , spondylosis is a healed osteochondrosis. It is a chronic disease of the spine, the essence of which is the deformity of the vertebrae, which is a consequence of the increase in bone tissue. Degeneration processes are observed in the spinal canal, which is expressed in the appearance of growths.

Pathogenetic morphological changes are caused by the deposition of calcium salts on the ligaments.Outwardly, this is manifested by the appearance of bone growths (osteophytes). There is a pinching of the nerves located in the spinal canal, which is clinically manifested by pain. Its localization mainly affects the region of the IV and V lumbar vertebrae. As a result of the appearance of osteophytes in the spine, mobility disappears.

This process is usually typical for older people. Unfortunately, there is a tendency for the disease to occur in younger people as well. This does not happen often, but still such a possibility exists.As a result, we can conclude that a person can get sick at any age, which doctors have to observe in their clinical practice.

Spondylosis develops for various reasons:

• There is a curvature in the spinal column due to improper posture or injury.
• Protracted development of the pathological process associated with osteochondrosis.
• Lifting and carrying excessive loads, which clearly does not correlate with the physical development and constitution of a person.
• Low mobility, leading to atrophy of the musculo-ligamentous apparatus of the back.
• Disruption of metabolic processes in the body, leading to the weakness of the cartilage tissue.
• Age-related changes in tissues.
• Dynamic loads constantly acting on the lumbar region.

Neurological symptoms are present in clinical manifestations:

1. Feeling of numbness in the lower extremities.
2. A patient complains of stiffness in the lumbar region.
3. Discomfort in the thighs and buttocks.
4. With prolonged movement, sensitivity in the lower back and legs is lost.

When bending forward, the pain loses its intensity somewhat. This is understandable, since the processes in this position put less pressure on the nerve endings. The back relaxes due to the disappearance of the spasm.

MRI or radiography provide essential assistance in diagnosis. The disease has the ability to progress.Therefore, you cannot run it. As soon as the first symptoms appear, you should consult a doctor. If the disease is not started on time, then it will certainly turn into a chronic form. The result will be the fusion of the vertebrae. As a result, the spinal column in this place will lose its mobility. A hernia will join, radiculitis will appear.

There is still no specific treatment for spondylosis. Only symptomatic therapy is carried out. First of all, the activities are aimed at relieving pain.For this, NSAIDs and muscle relaxants are prescribed. Non-steroidal anti-inflammatory drugs relieve pain. The appointment of muscle relaxants is carried out to relieve spasms.

If the pain is severe enough, then non-narcotic analgesics are prescribed. With chronic pain, the state of the nervous system suffers. In order to eliminate these manifestations, antidepressants are prescribed.

Sessions of manual therapy, hirudotherapy, cryotherapy can give a certain effect. Massages and acupuncture sessions will be of some benefit.A positive effect occurs after physiotherapy, electrophoresis, ultrasound.

When a patient contacts an orthopedist, an individual treatment plan will be drawn up.

Medical gymnastics is an obligatory step in the treatment of spondylosis. It is necessary to consolidate the treatment. Physical therapy helps to strengthen the muscles of the back, and this, in turn, is the prevention of the development of spondylosis.

If the measures are ineffective, surgical treatment is sometimes indicated.

Preventive measures to prevent the development of degenerative changes consist in proper back care and the implementation of medical recommendations.

Make an appointment for a consultation, you can ask the orthopedist-traumatologist at the clinic by phone +7 (978) 088 86 97 or make an appointment on the website.

90,000 Spondylosis. Spinal spondylosis treatment

• Quickly relieve back pain, often after the first session
• We return the correct position of the vertebrae without surgery
• We effectively treat vertebral dislocations

Spondylosis is a degenerative-dystrophic process in the spine, as a result of which bone growths (osteophytes) form on the vertebrae.

The reasons

Currently, scientists identify the following factors leading to the development of spondylosis:

• sedentary lifestyle (physical inactivity)
• rare forced loads against the background of a sedentary lifestyle (periodic trips to the country, seasonal fitness classes)
• consequences of injuries
• congenital malformations, connective tissue insufficiency
• excessive physical activity

In connection with the above reasons, there are zones of microtrauma of the spinal ligaments, which are subsequently replaced by bone tissue.

Symptoms

Spondylosis is characterized by the following symptoms:

• pain syndrome is not pronounced, there is no acute or shooting character. Pain, aching, dull, passing over time.
• Feeling of stiffness and fatigue in the back, neck, lower back.
• meteorological dependence (dependence on weather conditions).

Spondylosis does not have vivid and specific symptoms, therefore, it can be detected only after a thorough examination by a doctor using additional diagnostic methods.

Diagnostics

Radiography is the gold standard for diagnosing spondylosis. On the roentgenogram, bone growths are clearly visible – osteophytes, the shape of which can be different.

Complications

If you do not consult a doctor in time, do not interrupt or slow down the growth of osteophytes, then the disease may end with the fusion of two vertebrae together.

Classification

Depending on the area where spondylosis has developed, it is called the corresponding anatomical structures: cervical, thoracic, or lumbar spine.

Spondylosis treatment

The Bone Clinic uses the most modern physiotherapeutic methods for treating spondylosis: a computerized traction system, massage, and many other methods. The most important thing is to prevent further progression of the process.

Prevention

• Remedial gymnastics, massage
• avoid prolonged position of the body (sitting or standing)
• Fostering a culture of movement and adherence to safety when working with weights

If you are diagnosed with spondylosis, you need to undergo maintenance therapy courses 1-2 times a year.

The treatment program for this disease in the “Bone Clinic” may include:

View all methods
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