Osteoarthrosis of the spine
Last reviewed: 23.04.2024
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Osteoarthrosis of the spine (osteoarthritis of apophysial joints, spondylarthrosis) and degeneration of intervertebral discs (osteochondrosis) are various diseases.
By definition, osteoarthritis is a disease of synovial joints or diarthrosis, and osteochondrosis is a degenerative lesion of cartilaginous joints or amphiarthrosis. According to the ICD-10 classification, osteochondrosis and osteoarthritis of the spine are referred to different classes of diseases - respectively M42 and M47. However, there is a relationship between osteoarthritis of the joints and osteochondrosis: they can contribute to the emergence of each other and usually coexist in the same zone of the spinal column.
[How does the osteoarthritis of the spine?
Most often, osteoarthritis of the spine affects the cervical (especially C5) and lumbar (especially L3-5) parts of the spinal column.
Osteoarthrosis of the spine is characterized by a "mechanical" character of pain in the lumbar region: pain appears / is amplified by movements, prolonged sitting, standing. She can irradiate into the buttocks and thighs. Increased pain in backbending is more characteristic of osteoarthritis, increased pain when flexing the back - for degeneration of the intervertebral discs.
The osteoarthritis of the spine is all the more complicated by the compression of the nerve roots with osteophytes or with the subluxation of the apophyseal joints, which can be accompanied by sensory and motor impairments. Similar complications can occur when any part of the spine is affected; they are especially pronounced in cervical osteoarthritis. Severe neurologic disorders are observed when the spinal cord is compressed by large osteophytes. When the vertebral arteries are compressed, the blood supply to the brain may be impaired. However, it should be noted that such complications osteoarthritis of the spine is much less common than osteochondrosis.
How is osteoarthritis of the spine recognized?
Morphological and radiological changes in the apophysial joints of the spinal column are similar to those in osteoarthrosis of other localizations. Degeneration of the intervertebral discs is often accompanied by marginal osteophytosis. Probably, the clinical connection between osteoarthritis of apophysial joints and degeneration of intervertebral discs reflects their biomechanical interrelation: any changes in one of these articulations inevitably lead to an abnormal load on the other. The location of osteophytes on the vertebrae probably shows the application of maximum load.
X-ray signs of osteoarthritis of the spine are so often detected at the age of about 40 years that the question is debated: is osteoarthrosis of the spine a natural process in aging? This hypothesis is also supported by the fact that there was no correlation between the degree of radiological changes in the joints of the spine and the severity of the symptomatology - even a significant progression of morphological changes in the apophysial joints of the spinal column with the formation of large osteophytes often does not clinically manifest. This also distinguishes osteoarthritis of the spine from osteochondrosis, which is characterized by a clear relationship between the degree of expression of degenerative changes in the discs and clinical manifestation.