Vertebral syndrome

Vertebral syndrome is a symptomatic complex of pathological conditions caused by diseases of the spinal column. It can be formed by a variety of pathological conditions, but general is the presence of pain by the type of lumbargia or radiculgia, changes in mobility, spine configuration, posture and gait, there may be changes caused by damage to the spinal cord, spinal nerves and their roots.

The configuration is determined by three basic curvatures. Of these, kyphosis and lordosis can be functional and pathological.

Kyphosis - curvature of the spine in the sagittal plane by convexity posteriorly. Kyphosis is congenital if there is an inborn wedge-shaped vertebra or a semi-vertebra.

But more often kyphosis is formed in osteochondropathy spondylitis and spondyloarthrosis, after surgery, especially extended laminectomy, trauma, after a specific infection, with senile involutions and degenerations of the vertebrae.

Clinically vertebral syndrome is marked by a characteristic arcuate or angular spinal curvature convex posterior. Localization depends on the characteristics of the main process, mainly in the thoracic region (upper, middle, lower divisions). All of the spine can be affected, for example, with Bekhterev's disease, an arcuate deformation is formed from the neck to the tailbone. The degree of expression varies: from the "point" hump, determined by the distance of one spinous process, to the "giant", with an acute angle of curvature of the spine. With a pronounced form, the vertebral syndrome is combined with deformation of the chest and a decrease in the height of the trunk. It is often combined with scoliosis (kyphoscoliosis).

There are non-fixed, mobile kyphosis, i.e. Corrected, which develops with osteochondropathy, rickets, spondylitis, some diseases of the spinal cord; and fixed kyphosis, mainly in degenerative processes, Bekhterev's disease, etc. By rapidity of development, the rapidly progressing, slowly progressing and not progressing kyphosis is distinguished.

Lordosis - curvature of the spine with a bulge forward. As an independent vertebral syndrome lordosis practically does not occur, but often compensatory, lordosis, due to the increase or decrease in physiological lordosis. This is due to the fact that the spine, pelvis and lower limbs are a single support system, any violation in one of these links leads to changes in the entire system to provide a vertical axis of the body. In adolescents, lordosis is mobile, but by the age of 20-25 it becomes fixed, causing the development of painful pathological conditions (osteochondrosis, spondylarthrosis and arthritis) giving lumbargia. Instrumental research: radiography in two projections and roentgenography in standing position, maximum flexion and extension.

Scoliosis - curvature of the spine in the frontal plane. Vertebral syndrome is a manifestation of many diseases of the back. Pathogenesis distinguishes: discogenic, arising, with disk dysplasia and its displacement; gravitational, formed during contracture of the muscles of the back, changes in the position of the pelvis and hip joints; Myopathic, developing with the inadequacy of the muscles of the trunk, for example, with poliomyelitis, myasthenia, etc.

The level of curvature distinguishes the upper, thoracic, thoracolumbar, lumbar, combined, when there is a curvature in the two divisions. In the shape of curvature, there are C-shaped and S-shaped scoliosis. By the size of the curvature, four degrees are distinguished: I - from 5 to 10 degrees; II - 11-30 degrees; III - 31-60 degrees; IV - 61-90 degrees.

Vertebral syndrome itself is seen by eye, the degree is specified by scoliosis with a plumb line strengthened on the spinous process of the 7th cervical vertebra. Instrumental research - X-ray, according to roentgenograms also conduct scoliosis. It is important to identify early scoliosis and refer the patient to a specialist vertebrologist.

Lumbalia - vertebral syndrome in the lumbar region, which occurs when sharp or careless movements in it. The movements of the patient become cautious, as at any moment the lumbago comes, especially when you get up - the position of "Lazarus rising from the coffin" - with the support, listening to the sensations. Lumbalia is the main symptom of the pathology of the lumbar region, is more often caused by osteochondrosis, spondylosis, spondylitis and spondyloarthrosis, often combined with radiculitis and sciatica.

Spina bifida is a defect in the development of the spine, characterized by the non-healing of the bodies or arches of the vertebrae and incomplete closure of the spinal canal. Vertebral syndrome is more often observed in the form of a hidden cleft (without hernial, bulging of the brain), or there may be a spinal hernia, which is detected with the birth of a child. It can be localized in any department, but in most cases it is located in the lumbar region.

The latent cleft is often asymptomatic. Skin over the cleft zone may not be altered, but hypertrichosis with excessive hair growth on unchanged or pigmented skin is more common.

Vertebral syndrome can be observed in the form of radiculitis, paresthesia of the lower limbs, bedwetting, mandatory urges to urinate, sexual dysfunctions, lowering of perineal and cremaster reflexes. This vertebral syndrome is combined with deformities of the feet in the form of clubfoot and flat feet.

The diagnosis is confirmed by radiographic.

Shmorlja hernia - hernial-like protrusion of the pulpous nucleus of the intervertebral disc.

The rupture of the plate of hyaline cartilage with subsequent protrusion can occur in curvatures, vertebral fractures, bruises, intervertebral disc rupture, as well as in degenerative diseases.

This vertebral syndrome can be formed even in adolescence, but is more common after 25-30 years.

The protrusion can occur in the spongy substance of vertebral bodies, but more often bulge into the vertebral canal, with the development of myelopathy and radiculitis. Hernias of Schmorl localize mainly in the lower cervical and lower lumbar regions, very rarely, but can be in the thoracic region. There is no specific symptomatology of the disease, except that the pain is more pronounced than with osteochondrosis, accompanied by lumbago in the arm or leg, more extensive in prevalence, in verifying the motor function of the spine, circular movements in it are usually not violated, but with a pronounced discoid, the flexion and extensor movements can cause jams. The diagnosis is based on radiographic examination or magnetic resonance imaging.