Spondylarthrosis

Intervertebral spondylarthrosis (deforming arthrosis) is a chronic pathology that often forms in elderly patients, less frequently in young patients.

The main manifestations of the disease are back pain and limited movement.

Spondylarthrosis of the spine

This pathology is explained by the degenerative and dystrophic damage of the vertebral-rib and articular joints. Separate variants of spondylarthrosis are rare. Usually they occur in combination with osteochondrosis or spondylosis.

What is the risk of spondylarthrosis? If the disease is not treated in time, there may be a significant restriction of movements in the damaged vertebral column, as the marginal osteophytes gradually grow and even grow together. Soreness over time will only increase, interfering with full-fledged life and physical activity. Moreover, acute angles of osteophytes can not only exert pathological pressure, but also damage the artery of the spine, which can provoke even a lethal outcome in the patient.

The consequences of spondylarthrosis are unfavorable, since other possible complications of the disease may be the formation of a hernia, or spondylolisthesis (a pathological displacement of the vertebrae posteriorly or anterior to the next lower vertebra). In this situation, surgery is indispensable: the vertebrae will be fixed with metal spokes. However, even after surgery, physical activity limitations are unavoidable.

Evaluating the aforesaid, it is possible to say with certainty that the treatment of the disease must be carried out necessarily and in a timely manner. Do not expect complications and adverse effects, and in time to contact the doctor.

Causes of spondylarthrosis

Elderly age is the most common period of manifestations of the disease. Changes in cartilaginous tissues that occur with age, favor the development of spondylarthrosis. Over the years, the spine is more difficult to cope with physical stress.

However, spondyloarthrosis often occurs in young people. This can be facilitated by the following factors:

• weakness of muscles and ligaments of the back, pathology of posture, curvature of the spinal column;
• deformation of the foot, its flattening;
• too active way of life, sports that involve excessive spinal congestion;
• frequent and long sitting or standing in an incorrect and uncomfortable position;
• osteochondrosis;
• disturbances in metabolic processes;
• professional, sports or household back injury.

In childhood, the causes of the disease can become birth trauma, congenital defects of the spine (fusion of vertebrae, curvature of the spinal column, spina bifida).

[1], [2], [3]

Symptoms of spondylarthrosis

Manifestations of the deforming form of spinal arthrosis, especially in the early stages of the disease, can rarely be distinct not only in terms of symptoms, but even on the radiograph.

In later stages, the process may manifest as pain in certain areas of the back, a violation of the amplitude of the movements of the trunk. In general, the symptomatology in many respects may depend on the localization of the lesion, therefore, there are usually several types of pathology:

Cervical spondylarthrosis

In cervicoarthrosis (the second pathology name), patients usually complain of soreness in the neck, with irradiation to the shoulder joints, between the shoulder blades, into the nape of the neck, into one of the upper limbs. Bony and cartilaginous growths in the defeat of the cervical spine can contribute to deformation and decrease of the lumen of the spinal canal, as well as the development of radicular phenomena. In addition, osteophytes can be pressed into the wall of the artery of the spine, which triggers a blood flow disorder to the brain. This may be accompanied by dizziness, headache, and cochlear disorders.

[4]

Thoracic spondylarthrosis (dorsartrosis)

It is not detected as often as cervical or lumbar spondylarthrosis. This is due to some difficulties in diagnosis, since on this site the arcuate joints are hidden behind the ribs. In addition, the pathology itself is much less common here, since the thoracic region is initially less mobile than the rest of the spine.

Lumbar spondylarthrosis (lumbararthrosis)

The most common variant of the disease. It is characterized by persistent traumatic pains in the lesion site, with irradiation into the femoral region and buttocks. Soreness becomes more pronounced when turning and tilting the trunk to the back. Most often the pain appears due to prolonged sitting or lying down and is stopped after some motor activity (warm-up, fizzaryadki).

Spondylarthrosis of the lumbosacral spine

The main sign is soreness on the lumbosacral spine. Soreness is aching, irradiation to the femoral and gluteal region is possible, but only to the knee site. Initially, tenderness can appear only in the presence of physical exertion. Over time, the process is increasing, soreness begins to manifest itself both in motion and at rest. The most frequent localization of the pathology of the lumbosacral spine is spondyloarthrosis L5-S1. The disease, detected in a timely manner, lends itself to conservative therapy without the use of surgical intervention.

Degrees of spondylarthrosis

As we said above, the initial spondyloarthrosis usually proceeds asymptomatically. As a rule, the manifestations of spondylosis or osteochondrosis - the degeneration of the fibrous rings of the anterior longitudinal ligament - come to the fore. In this case, the defeat of the small joints of the spine does not yet have sufficiently pronounced symptoms; it is characterized only by the marginal bone growth in the thoracic and lumbar region.

Initial signs of spondylarthrosis appear only when the bony marginal growths become large, the articular processes are lengthened, the contour of the joints changes, and the articular surfaces increase. As a result, articular cracks narrow, and often the ratio of articular axes changes, which can not but affect the functions of the affected department or the entire spine as a whole.

Spondyloarthrosis in its current passes several degrees:

• 1 degree - loss of elasticity of the intervertebral disc, joints, ligaments, a decrease in the amplitude of mobility of the spinal column;
• 2 degrees - increasing the load on the discs, the loss of the ability of fibrous rings to full-fledged performance of their functions;
• 3 degrees - X-ray confirmation of bone growths, dystrophic changes in ligaments;
• 4 degrees - the presence of bone growths of impressive size, limiting the mobility of the spine, squeezing the nerve endings and vascular walls.

The mechanism of formation of pathology can be called the processes of dystrophy in the tissues of cartilage, the spread of changes in the structure of the fibrous ring, the degeneration of ligaments that hold the vertebrae, and the growth of osteophytes.

[5]

Varieties of spondylarthrosis

Depending on the course and stage of the process, spondyloarthrosis is divided into several variants. We will consider general information about each of them.

Deforming spondylarthrosis

The term "deforming" can be applied to virtually any type of spondyloarthrosis, because this disease occurs against the background of deformation (changes in size, configuration and shape) of the vertebrae and posterior part of the spinal canal due to the formation of bone outgrowths and displacement of intervertebral discs. The deformation is irreversible and is detected radiographically.

[6], [7]

Degenerative spondylarthrosis

It is also a complex concept, since spondyloarthrosis itself is a degenerative-dystrophic disease. With this pathology of degeneration, arch and spinal-rib joints, as well as fibrous rings of the intervertebral discs, respond. Rings lose elasticity, flatten, shift. This gives an appropriate clinical picture of the disease.

[8], [9]

Uncovertebral spondylarthrosis

Such a term is called arthrosis of the arcuate joints, which develops in the interval between the spinous processes on the posterolateral surface of 1-2 vertebrae of the cervical region. Its main symptoms are neuritis (humerus, cervical), hypertension, imbalance of body balance and weakness of neurological reflexes.

Spondyloarthritis of the arch of arched joints

This is one of the manifestations of spondylarthrosis, the degenerative-dystrophic processes of which can affect the arcuate joints and vertebral-rib joints. An isolated variant of spondyloarthrosis of the articular joints is observed extremely rarely, as a rule, there is a combined defeat of the peri-vertebral joints.

Ankylosing spondylarthrosis

It is better known as Bekhterev's disease. More often affects men, and at a young age (20-30 years). In addition to the joints of the spine, it also affects the joints of the hands and feet: the spine becomes tight and deformed. Progression of this disease is steady, chronic. The condition worsens over time, so the disease requires compulsory treatment, and sometimes operational.

[10], [11]

Polysegmental spondylarthrosis

Serious pathology, in which several parts of the spine are affected simultaneously: lumbar, sacral, thoracic and cervical. Treatment of such a disease is time-consuming and long, and manifestations of the disease are many-symptomatic. There is a combined clinic of lesions of several departments of the spinal column.

Dysplastic spondylarthrosis

The term "dysplastic" is used when they want to emphasize the nature of pathology. Dysplastic spondylarthrosis is accompanied by a violation of the structure of the joints, a change in their shape, size, structure. Dysplasia is not a diagnosis, it is just a manifestation of another disease, in this case, spondyloarthrosis.

[12]

Diagnosis of spondylarthrosis

The disease is diagnosed on the basis of clinical picture, as well as radiographic and tomographic indices.

X-ray examination of the deforming pathology of the arcuate joints presents certain difficulties, because on x-rays taken in the anteroposterior projection, the joints settle on other osteogenesis (articular ribs, transverse processes, etc.). This is especially noticeable on the thoracic and cervical spine. To solve this problem, in addition to standard radiographic shots, atypical patient arrangements (use of oblique, three-quarter projections) are used, as well as computed tomography - layered visualization of the picture.

In the presence of inflammatory processes in the lesion focus, the method of radioisotope scanning is used. This technique is the recording of radioactive radiation of the patient's body after a radioactive drug is injected into the body (often intravenously). As a rule, pay attention to the uniformity of the distribution of matter throughout the body, which helps in detecting inflammation and determines the exact location of the focus.

Also, additional studies, such as ultrasound of vessels, or consultations of other specialists, may be prescribed.

[13], [14], [15], [16]

Treatment of spondylarthrosis

The methods of treatment of spondylarthrosis are mainly conservative. They are aimed at arresting painful symptoms and increasing the mobility of the affected area of the spine. To reduce pain, non-steroidal anti-inflammatory drugs are usually prescribed. There are quite a lot of them, however, the most popular are diclofenac, ketonal, xephoxam, ketorol, etc. Of the new generation drugs, there are tsellebex, nayz, movalis.

In the remission phase, the use of a massage, sparing gymnastic exercises, exercises in the pool is shown. All this favors the strengthening of the muscular corset of the spinal column and allows to preserve the motor functions of the spine.

In case of violation of muscle tone and the presence of severe soreness, it is recommended to conduct isometric (static) exercises.

In elderly patients (or in other cases when active measures to strengthen muscles are contraindicated) physiotherapy methods are often used. For relief of pain, in addition to drug therapy, magnetotherapy, ionogalvanization procedures with anesthetics (lidocaine or novocaine), sinusoidal modulated currents are used. The use of phonophoresis with hydrocortisone is also popular: this procedure perfectly removes puffiness and inflammation.

Since the main etiological factor in the formation of spondylarthrosis is the damage to the structure of the intervertebral discs, the method of structural-modifying therapy has recently become widespread. This technique involves the use of glucosamine sulfate and chondroitin sulfate - these are substances that can slow down the processes of degeneration of cartilage tissues. Such a method can be used already at the initial stages of the development of the disease.

Treatment of cervical spondylarthrosis, as well as other parts of the spine, does not appear at present without the use of chondroprotectors. These are drugs that help repair damaged articular cartilage. Such agents can be used orally, in the form of injections or ointments.

One of the representatives of chondroprotective ointments is chondroxide, an external preparation that improves the exchange of calcium and phosphorus in cartilage tissue, which inhibits the degenerative process, which contributes to the restoration of the cartilaginous surface of the joint. The drug also has analgesic and anti-inflammatory effects.

Chondroxide is also used as a medicinal component of phonophoresis, which accelerates the elimination of pain and symptoms of stiffness of the spine.

Recently, the use of the medical plaster Nanoplast forte has been popular. It is an analgesic anti-inflammatory drug that improves blood flow in the lesion. It is used in both acute and latent stages of the process. The patch is glued to the affected area of the back, you can overnight. Usually, the patch is not removed within 12 hours: an acute process is usually stopped when using a patch for 4-5 days.

In severe cases, surgical methods of treatment are possible. These include:

• A minimally invasive method is the destruction of nerve endings by radiofrequency beams. This procedure does not remove the main problem, but it significantly alleviates the pain syndrome;
• method of hemilaminectomy - operative excision of a site of the vertebral arch, which compresses the nerve endings.

Treatment of spondylarthrosis with alternative means

Alternative treatment is the use of various ointments, compresses, decoctions and baths from medicinal plants. Such funds can bring real benefits if they are combined with the methods of traditional medicine: the use of medicines, manual therapy, physiotherapy, etc.

Treatment of spondylarthrosis at home involves the use of the following methods and means:

• therapeutic bath. It is recommended to take the bath at a water temperature of up to 40 ° C. 150 g of sea salt or rock salt are used per 50 liters of water;
• decoction. A mixture of parsley and celery leaves (200 g) boil 8 minutes in 0.5 liters of water. In the resulting broth add the lemon juice and honey to taste, drink in small sips during the day;
• medical infusion. A mixture of equal parts of juniper, flaxseed, peppermint, cones of hops, oregano, calendula, fill it in a thermos and pour boiling water overnight. Drink three times a day for half an hour before a meal;
• medicinal tinctures. Effective tinctures of fruits of chestnut and pine nuts. Tinctures make on vodka and stand up to 40 days. Take a teaspoon before meals three times a day;
• medical compress. Take 100 g of calendula for 0.5 liters of vodka or alcohol lotion, insist in a dark place for 14 days. Used as compresses or grindings;
• medical ointment. The same parts of coriander, mint, birch buds and dandelion roots boil for 5 minutes, insist and filter (6 tablespoons of collection per cup of boiling water). The broth is mixed with 100 g of fat of nutria, or vegetable or butter. Lubricate the affected place at night;
• curative heat. Apply pouches to the affected area with hot sand, heated salt or freshly cooked chicken eggs;
• fir oil. Finished oil, sold in a pharmacy. Used as a massage ointment, or for oral administration (100 ml of milk with a teaspoon of oil).

Massage with spondyloarthrosis can be easy and sparing during an exacerbation, using anti-inflammatory external drugs (diklak-gel, ointment diclofenac, diclofit, viprosal). In the relief of symptoms, you can use massage with honey:

• honey massage. For massage use warmed up to 40 С natural honey which put on a skin, strongly press a palm and sharply tear a palm from a surface of a skin. In this way, we kind of squeeze honey into the skin and immediately remove it. After the session, honey should be washed off with decoction of herbs: mint, melissa, oregano, marigold. The procedures should be performed every other day for 14-20 days.

Therapeutic exercise in spondylarthrosis

To achieve the effect of therapeutic procedures for spondylarthrosis can be achieved with an integrated approach, using, among other things, therapeutic physical education. It favors the reduction of pain, stabilizes the muscle tone, facilitates the mobility of the back.

Start the exercises with spondyloarthrosis with a warm-up, gradually performing more complex exercises.

Specificity of doing exercises during the exacerbation of the disease is to perform exercises during periods between bouts of pain, alternating with other therapeutic measures.

The starting position is usually chosen, proceeding from the features of the course of the disease in each specific case. The most acceptable position is lying on your back, side or stomach. Do not overload the affected part of the spine, the movements should not be sharp and rapid. If pain occurs during exercise, the activity should be discontinued.

Gymnastics with spondylarthrosis:

• lie on your back, hands behind your head. We bend the legs in the knees, hands in the elbows, close them together and return to the starting position.
• lie on his back, bending his right leg in the knee. Trying to bend over, raising the pelvic area and leaning on the head and foot, we return to the original position.
• we are on our knees, leaning on our elbows. Breathing in, rounding our back and lowering our head. Exhaling, we return to the original position.
• lie on your back, hands behind your head. We pull the knees bent at the knees to the stomach, we clasp our knees with our hands and press our heads to them, we come back.

During the training you should try to breathe deeply, exercise to perform measuredly and slowly.

Also, a good effect is given by the exercise on fixing the correct posture: we take a stick (about 1 m long) and wind it behind the back horizontally, keeping the inner surfaces of the elbow joints. Thus, you should move several times a day for 25-30 minutes.

Nutrition for spondylarthrosis

The diet for spondylarthrosis should be divided, eating - every 3 hours.

Exclude or restrict in use:

• grapes (also wine or juice);
• strong meat broth, fatty meat, lard;
• beans (beans, peas);
• sorrel;
• refined products;
• spices, salt, sugar.

It is recommended to consume vegetables (salads, grilled vegetables, stews), fruits (salads, juices, baked apples and pears), lean meat, dark bread, berries (especially sea-buckthorn), greens, dairy products.

If you have excess weight, you need to limit the caloric content of the diet and completely eliminate the intake of simple carbohydrates: sugar, sweets, cookies, cakes, and cakes. Along with this, it would be nice to increase physical activity, walk more, move, exercise.

Once in 7-10 days you can arrange a day of unloading on curd, milk, kefir, vegetables or apples.

In general, food should be dairy-vegetable with restriction of animal proteins (meat, fish, eggs), fatty foods and table salt.

By the way, joint diseases in vegetarians happen much less often than in adherents of traditional nutrition. Especially it concerns laktovegetarians.

It is also important to drink enough fluids: it should be pure water or herbal tea, but, by no means Coca-Cola or energy drinks.

Prophylaxis and prognosis of spondylarthrosis

The prognosis of spondylarthrosis is relatively favorable. Timely treatment to the doctor and treatment of pathology helps to prevent the development of serious consequences.

At the heart of the preventive measures of the disease is the reduction of the load on the vertebral column. What to do:

• follow the normal body weight;
• Do not allow excessive strain on the spine, lifting heavy objects;
• beware of trauma to the spine;
• follow the posture, both during walking and in a sitting position;
• sleep should be on a semi-rigid mattress, the pillow should be small (exclude soft feather beds and large high pillows);
• to show physical activity, to be engaged in swimming;
• eat and drink enough clean water.

With a long sitting position, try to change the position every 10-15 minutes, and every half an hour should be possible to stand and warm up, walk around the room, distract.

Disability with spondylarthrosis is not excluded. If the disease is started, there are certain neurological symptoms, as well as signs of physical and motor activity limitations that interfere with the patient's full vital activity, an expert decision can be made with the definition of the appropriate disability group.

The spine is a very important part of the body. This is the protection and support of the spinal cord, which performs the vital functions of the body. It is the framework for the passage of a multitude of nerves and vessels. Spondylarthrosis of the spine is a pathology that makes its changes in the vertebral structure. To prevent this, it is necessary to monitor the health of the back, protect it and prevent overload.