Osteochondrosis of the lumbosacral spine
Last reviewed: 23.04.2024
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One of the most characteristic symptoms of discogenic osteochondrosis of the lumbosacral spine is considered to be the acute development of pain following the influence of some mechanical factor (for example, the concept of gravity, the inclination of the trunk, etc.).
With the compression option, the irrigation of the sinuvertebral nerve causes morbidity in 2 species:
- with persistent compression pain deep, persistent, intensifying with loads on the affected department;
- for immediate compression, sharp, shooting pains occur when the load on the affected PDS begins to act.
Changes in the motor stereotype depend on the speed and intensity of the action of the compression factor: at an acute onset, generalized changes in the motor stereotype develop. The spine acts as a single whole. Movement is possible only in the cervical, hip and ankle joints.
In the dysfiksionnom variant pain occurs during the static-dynamic loads. With palpation, the uniform soreness of all ligamentous-articular structures of the affected PDS is determined. Usually there are regional changes in the motor stereotype. Myofixation almost always has a sanogenic character.
In the disgemic version of the pain, usually aching, fettering, arising after rest and decreasing during movements. They can be accompanied by a feeling of heat, burning, numbness in the affected spine. When palpation is determined severe soreness in the soft tissues of the affected PDS and in a number of located tissues. Changes in the motor stereotype are never poly-regional and generalized.
In an inflammatory variant, patients complain of stiffening pain and a feeling of stiffness arising during the period of sleep and passing after a warm-up. By the evening, patients feel better. Palpation determines the predominant soreness in the region of intervertebral joints in the affected spine.
Usually several PDS is affected. Changes in the motor stereotype also undergo a dynamic during the day: in the morning - generalized and poly-regional, in the day - regional, intraregional, and in the evening can be local. Duration of exacerbation is the largest of all options.
A characteristic feature of osteochondrosis of the lumbosacral spine should be considered biphasic development of osteochondrosis of the lumbosacral spine, which consists in the fact that in the first period of pain localized only in the lumbar region, in the second - also grasping the leg. In this case, the pain in the leg increases, and in the lower back can stop (the transition of lumbalgia into ischialgia) or the intensity of pain remains large in the waist and in the leg (the transition of lumbalgia into lumba-ishialgia).
Thus, there is no doubt that the pain syndrome is nothing more than a syndrome of irritation of the sinuvertebral nerve innervating the posterior longitudinal ligament, the outer fibers of the fibrous ring and the dura mater. Either way, ruptures and strains of both the outer fibers of the fibrous ring and (especially) the posterior longitudinal ligament should be considered the main source of pain.
The protrusion or prolapse of a part of the disc towards the vertebral canal and intervertebral foramen leads to rather complicated and severe disorders of the function of the spine and neural formations.
These disorders are conditionally divided into vertebral and radicular syndromes.
Vertebral syndrome includes disorders of the spine function: a change in its configuration (flatulence of lordosis, kyphosis, scoliosis), restriction of movements in the lumbar spine, contractures of the paravertebral muscles.
The radicular syndrome includes the symptoms of "tension of the nerve trunks", sensitivity and trophism disorders, reflexes and paresis disorders. It is clear that both syndromes are interrelated and interdependent.
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