Osteochondrosis of the lumbosacral spine

One of the most characteristic symptoms of discogenic osteochondrosis of the lumbosacral spine is the acute development of pain following the impact of some mechanical factor (for example, the feeling of heaviness, tilt of the body, etc.).

In the compression variant, irritation of the sinuvertebral nerve causes 2 types of pain:

• with persistent compression, the pain is deep, constant, and intensifies with loads on the affected area;
• Direct compression is characterized by sharp, shooting pains that occur at the moment the load begins to act on the affected PDS.

Changes in the motor stereotype depend on the speed and intensity of the compression factor: with an acute onset, generalized changes in the motor stereotype develop. The spine acts as a single whole. Movements are possible only in the cervical region, hip and ankle joints.

In the dysfixation variant, pain occurs during static-dynamic loads. Palpation reveals uniform pain in all ligament-articular structures of the affected PDS. Regional changes in the motor stereotype are usually present. Myofixation is almost always sanogenetic in nature.

In the dyshemic variant, the pain is usually aching, constricting, arising after rest and decreasing with movement. It may be accompanied by a feeling of heat, burning, numbness in the affected part of the spine. Palpation reveals pronounced pain in the soft tissues of the affected PDS and in the adjacent tissues. Changes in the motor stereotype are never polyregional and generalized.

In the inflammatory variant, patients complain of cramping pain and a feeling of stiffness that occurs during sleep and disappears after warming up. By evening, patients feel better. Palpation reveals predominant pain in the area of the intervertebral joints in the affected section of the spine.

Usually several PDS are affected. Changes in the motor stereotype also undergo dynamics during the day: in the morning - generalized and polyregional, in the afternoon - regional, intraregional, and in the evening they can be local. The duration of exacerbation is the longest of all options.

A characteristic feature of osteochondrosis of the lumbosacral spine is the two-phase development of the disease of osteochondrosis of the lumbosacral spine, which consists in the fact that in the first period the pain is localized only in the lumbar region, in the second - it also affects the leg. In this case, the pain in the leg increases, and in the lower back it can subside (transition of lumbago to sciatica) or the intensity of pain remains high in both the lower back and the leg (transition of lumbago to lumbago).

Thus, there is no doubt that the pain syndrome is nothing other than the syndrome of irritation of the sinuvertebral nerve, innervating the posterior longitudinal ligament, the outer fibers of the fibrous ring and the dura mater. One way or another, ruptures and stretches of both the outer fibers of the fibrous ring and (especially) the posterior longitudinal ligament should be considered the main source of pain.

Protrusion or prolapse of a part of the disc towards the spinal canal and intervertebral openings leads to rather complex and severe dysfunctions of the spine and nerve structures.

The indicated disorders are conventionally divided into vertebral and radicular syndromes.

Vertebral syndrome includes disorders of the spine function: changes in its configuration (flattening of the lordosis, kyphosis, scoliosis), limited movement in the lumbar region, contractures of the paravertebral muscles.

The radicular syndrome includes symptoms of "tension of nerve trunks", sensitivity and trophic disorders, reflex disorders and paresis. It is clear that both syndromes are interconnected and interdependent.

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