Spinal Osteochondrosis
Description of the Disease
Spinal osteochondrosis is a degenerative disease of the intervertebral discs. Over time, degeneration may progress to involve the vertebral bodies, facet joints, and spinal ligaments. The condition may develop as a result of trauma, including joint injuries and fractures, repeated microtrauma, congenital abnormalities that cause spinal instability, rheumatoid and other autoimmune diseases, or impaired blood supply to the intervertebral discs.
Risk factors for spinal osteochondrosis include older age, female sex, obesity, and certain conditions such as Paget’s disease, gout, and hemochromatosis.
Symptoms
Cervical osteochondrosis is characterized by persistent neck pain that worsens with head movement. A cracking or grinding sensation may occur when turning the head. Because of pain, patients often hold the head in a fixed position, resulting in restricted movement, muscle tension, and neck stiffness. Pain may radiate into the shoulder, arm, and fourth or fifth fingers. Reduced blood flow associated with cervical spine disorders may also cause dizziness, headache, and nausea. In some cases, the pain may resemble angina.
Thoracic osteochondrosis commonly causes pain between the shoulder blades, particularly after sleep or prolonged work. The pain may mimic pain originating from the stomach, heart, or gallbladder. Numbness of the skin may also occur.
Lumbar osteochondrosis causes pain in the lower back that may radiate to the buttocks and the back of the legs. The pain often improves when lying down or bending the legs. Patients may walk with a stooped posture, take short steps, limp on the affected side, or have difficulty sitting. As the condition progresses, stiffness of the lumbar spine may develop.
Generalized osteochondrosis involves all regions of the spine and is most commonly associated with rheumatic diseases.
Diagnosis
Diagnosis is based on the patient’s medical history, symptoms, neurological examination, and imaging studies. During the neurological examination, the straight leg raise (Lasègue) test is performed to assess possible nerve root irritation or compression. Muscle strength, sensory function, and patellar and Achilles tendon reflexes are also evaluated.
Imaging studies include plain X-rays in anteroposterior and lateral projections, with additional oblique or flexion-extension views when spinal instability is suspected. Computed tomography (CT), magnetic resonance imaging (MRI), angiography, and myelography may provide more detailed information when clinically indicated.
Treatment
Treatment may be conservative or surgical, depending on the severity of the disease and the patient’s response to therapy. During acute exacerbations, reducing spinal load is recommended. Treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, manual therapy, physiotherapy, acupuncture, and nerve blocks.
During remission, rehabilitation focuses on massage, therapeutic exercises, ultrasound therapy, local anesthetic treatments, B-group vitamins, and spa or rehabilitation therapy.
Surgical treatment is considered when conservative therapy fails or when the condition significantly impairs daily functioning or work capacity. Surgical procedures may include removal of the damaged intervertebral disc and repair or stabilization of the affected spinal segment.
Prevention
Preventive measures include maintaining a healthy body weight, sleeping on a firm mattress, regular swimming and exercise, strengthening the back muscles, and periodic therapeutic massage.
Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology