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Juvenile osteochondrosis of the spine
Last reviewed: 23.04.2024
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Juvenile osteochondrosis of the spine is indicated in ICD-10 by code M42.0. Other names are: osteochondropathy of apophyses of vertebral bodies, aseptic necrosis of apophyses of vertebral bodies, Sheyermann-Mau disease, osteochondropathic kyphosis, juvenile kyphosis. The disease is more common in young men during the growth of the organism, at the age of 11-18.
[Causes of juvenile osteochondrosis of the spine
The reasons for the development of the dorsal juvenile kyphosis are not fully understood. At present, there are many theories of this disease. The Danish orthopedic surgeon Sheyermann, whose name was the disease, believed that the cause of deformity of the spine was avascular necrosis of the terminal plates of several vertebral bodies.
Other researchers believe that the deformation of the spine is due to a violation of the processes of ossification of the cartilaginous matrix in the closure plates of several vertebral bodies. Perhaps in the genesis of the disease, a certain role and disturbances in the structure of the muscle tissue play a role. All researchers recognize the importance of hereditary predisposition to the disease.
Symptoms of juvenile osteochondrosis of the spine
During the juvenile osteochondrosis of the spine, three stages are distinguished, depending on the age and activity of the spine growth. The initial stage is manifested in the period of immature vertebra, the stage of swelling - during the synostosis of apophyses and the stage of residual phenomena - during the period of apophysis ossification. The severity of the lesion depends on: the angle of the kyphosis of the thoracic spine (45 ° and more), the number of affected vertebrae, the degree of their deformation and the severity of the pain syndrome. The disease is often combined with endocrine disorders.
Patients complain of deformity of the spine, rapid fatigue, weakness of the back muscles, pain in the left side. Clinical examination reveals augmentation of the thoracic kyphosis, the vertex of which is displaced caudally, the shape of the kyphosis is arcuate, smooth. In the lumbar region, the lordosis increases in depth. Mobility of the spine is significantly limited.
X-ray examination is carried out in two standard projections with the radiation centering on the top of the kyphotic deformation.
On the radiographs are determined: wedge deformation of vertebral bodies, fragmentation of apophyses, changes in end plates (sinuosity, intermittence, serration). Intervertebral discs at the level of kyphosis are modified in the form of impressions of a rounded shape in the region of the terminal bone plates of the superior and underlying vertebrae (cartilaginous Schmorl's nodules). The points of ossification of the apophyses of the vertebrae are ruffled, often enlarged in size. Almost always there are lateral deviations of the axis of the spine in the lumbar region, but the arc of scoliosis does not exceed 10-15 °.
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Treatment of juvenile osteochondrosis of the spine
The most effective long-term and systematic treatment, therapeutic gymnastics, not provoking pain syndrome, swimming, massage and unloading of the spine. In addition, it is recommended to wear a corset with a pelot on the top of the deformation in the area of the affected vertebrae in the position of re-spinal column.
Another component of conservative treatment is complex medication and physiofunctional therapy for normalization of blood circulation and muscle tone, elimination of pain syndrome and stimulation of osteoregeneration. With early treatment, it is possible to stop the development of the disease, the formation of deformity. The prognosis for this disease is favorable.