Osteochondropathy of the spine

This form of the disease is more common in adolescents 11-18 years of age. Pathology of bone and cartilage tissue occurs due to increased physical exertion and nutritional deficiencies. Spinal osteochondropathy most often affects the thoracic region, less often the lumbar spine. 

[1], [2]

Causes of the spinal osteochondropathy

Aseptic necrosis develops due to circulatory disorders, but other factors can also trigger it:

• High load on the spine, microtrauma.
• Congenital pathologies of the musculoskeletal system.
• Violation of the absorption of calcium and vitamins.
• Infectious and inflammatory diseases.
• Hereditary predisposition

[3], [4], [5],

Symptoms of the spinal osteochondropathy

Kummel-Verney disease or traumatic spondylitis is the name of aseptic necrosis of the vertebral bodies. Most often, this pathology is diagnosed in men of young age. Degenerative processes affect the thoracic vertebrae, less often the lumbar region. The basis of the disease is aseptic necrosis of the spongy substance of the vertebrae. Necrosis develops from trauma, past infectious or inflammatory diseases, circulatory disorders.

Symptoms depend on the stage of the degenerative-dystrophic process:

1. Stage of acute injury - the disease develops due to heavy physical exertion or back injury. There are sharp pains from which loss of consciousness is possible. Pain persists for 10-12 days.
2. The stage of the light interval - this stage lasts from 4-6 months to several years. The patient does not complain of pain or any discomfort.
3. Relapse - after a certain period of time in the affected area again, pain, but less intensity. In the place of damage to the spine is determined by its deformation. There is also a protrusion of the spinous process, pain during palpation, disruption of the muscular system.

The diagnostic process consists of analyzing the results of instrumental and differential studies with clinical manifestations of pathology. For the diagnosis using radiography, CT, MRI. Differentiation is carried out with tumor lesions of the spine, post-typhoid spondylitis, destructive tuberculous spondylitis.

The treatment is aimed at relieving the spine. To do this, use physiotherapy, wearing a special corset, therapeutic exercises and massage to strengthen the muscular system of the back. To reduce pain, stimulate the growth of healthy bone tissue and the general strengthening of the body, drug therapy is carried out.

Osteochondropathy of the cervical spine

One type of Scheuermann-Mau disease is aseptic necrosis of the cervical spine. Osteochondropathy of this localization is very rare. The main group of patients consists of adolescents 11-18 years old. Pathology is characterized by lesions of the discs and vertebral bodies, the switching plates.

The degenerative-dystrophic process develops due to circulatory disorders of the cervical region. This occurs in traumatic injuries, hormonal disorders, impaired local microcirculation, due to heavy physical exertion. Also in medical practice there are cases of hereditary susceptibility to this problem.

The disease develops slowly. At the initial stage, increased muscle fatigue, non-intensive pain, which disappears after a full night's rest. But as the disease progresses, especially during the active growth of the patient, the discomfort increases, it becomes difficult to turn and tilt the head. A degenerative change in the cervical spine is also possible. Treatment depends on the stage of necrosis and its complications. With timely treatment for medical care, pathology has a positive prognosis.

Osteochondropathy of the thoracic spine

Juvenile kyphosis or Scheuermann Mau disease is an aseptic necrosis of the thoracic spine. This pathology appears in the period of active growth of the skeleton due to insufficient strength of the muscular frame supporting the spine.

The disease causes a feeling of fatigue and severe pain in the thoracic region. As it progresses, the affected area deforms. Patients complain of sharp pains when trying to straighten their backs. In some cases, on the background of the disease develops subfebrile.

For diagnosis, an x-ray is performed that defines wedge-shaped deformations with jagged edges of the vertebral bodies. CT scans and MRI may also be prescribed. The treatment is conservative. Shown bed rest on a hard bed, physiotherapy, massages. Effectively wearing a special corset that supports the back muscles. Of the drugs prescribed chondroprotectors, painkillers, multivitamin complexes, drugs to stimulate blood circulation and bone growth.

Osteochondropathy of the lumbar spine

The degenerative-necrotic diseases include Calvet's disease, that is, osteochondropathy of the vertebral body. Most often it is localized in the lumbar spine.

Causes and risk factors for disease:

• Hereditary predisposition
• Increased exercise.
• Local disruption of the blood supply to the bone tissue of the lumbar vertebrae.

Necrotic processes occurring in the body of the vertebrae violate its bone structure. This leads to compaction of the vertebrae and thickening of the intervertebral discs adjacent to them. Pathology is manifested by pulling pains in the lumbar region, extending all over the back and radiating to the lower limbs. An increase in total body temperature, edema of the affected tissues and pain during their palpation are possible.

Diagnosis consists of a set of instrumental methods. Special attention is paid to differentiation. Aseptic necrosis is compared with ankylosing spondylitis, spinal tuberculosis, inflammatory pathologies, abnormalities in the development of the spine.

Treatment begins with conservative methods. Patients prescribed discharge mode for the spine, massage, physiotherapy, exercise therapy. In severe cases, that is, with progressive deformation of the vertebrae, surgery is performed. It is aimed at fixing the spine and eliminating degenerative changes.

Forms

There are several types of degenerative-dystrophic diseases:

1. Chondropathic kyphosis is a Scheuermann-Mau disease in which there is inflammation of the muscles at the attachment point to the vertebrae. Vertebrae deform, acquiring a wedge-shaped form, kyphosis develops.
2. Calvet disease is chondropathy, destruction of the vertebra. Affected bone tissue expands and decreases in height. When probing the spinous process there are sharp pains.
3. Kummel disease is an inflammation of the vertebral body. As a rule, occurs after trauma.

[6], [7]

Diagnostics of the spinal osteochondropathy

The disease is difficult to diagnose, as in the early stages it does not cause vivid clinical signs. During radiography or tomography, the destruction of bone and cartilage tissue can be detected. As the pathology progresses, fast fatigability of the back muscles, their asymmetry and weakness, and spinal deformity appear.

[8]

Treatment of the spinal osteochondropathy

Treatment begins with relief of acute pain, restoration of blood supply to the affected tissues and their nutrition. To correct the posture and restore the natural position of the spine, physiotherapy, wearing a special corset, exercise therapy are shown. Particular attention is paid to the prevention of osteochondrosis.