Polysegmental osteochondrosis of the spine – what is it
The joy of active movement is associated with spinal health. Problems of the musculoskeletal system reduce the quality of human life. Accurate diagnosis and effective treatment of local and advanced osteochondrosis is available to most patients suffering from pain and discomfort in the back.
Polysegmental osteochondrosis – this diagnosis sounds scary for the patient, but with actual treatment, the prognosis of the disease is favorable. For full participation in the treatment process, it is useful for a person to know about the nature of his illness.
The cervical, thoracic and lumbar spine are divided into 24 functional spinal motion segments (VMS). Each segment includes:
- two vertically adjacent bone fragments – a vertebra;
- connecting intervertebral disc;
- surrounding muscles and ligaments.
Deformation of the bones and cartilage of the segment as a result of osteochondrosis occurs as a result of aging or injury to the spine. Pathological changes begin to manifest themselves at one of the levels.
As the disease develops, other segments are involved in its course – adjacent or located in other parts of the spine. When the examination shows the presence of lesions in several PDS, the doctor makes a diagnosis – polysegmental osteochondrosis.
- Age-related changes in the intervertebral discs lead to drying out of the cartilage tissue. The discs no longer fully play the role of support and shock absorber of movements, their height is reduced, the consistency becomes excessively dense.
- The patient begins to feel discomfort when moving. The joints of adjacent vertebrae cannot cope with the load and do not provide the stability of the upper and lower sections of the spinal motion segment relative to each other.
- The connection between the component parts of the segment weakens, there is a danger of displacement. Excessive mobility within the PDS is the cause of muscle overstrain and spasms. The ligamentous- muscular apparatus becomes incapable of performing fixing functions. The blood vessels are compressed by spasmodic muscles and stop the normal tissue nutrition.
- In other cases, natural movements are blocked, and the spine becomes inactive. The blockade inevitably leads to the spread of pathology to another level, which is forced to take on part of the load and compensate for the impossibility of correct movement. Osteochondrosis becomes polysegmental .
- The general condition of the disc worsens due to disturbances in blood circulation in the surrounding vessels. Lack of nutrition leads to the formation of microcracks in the annulus fibrosus that encloses the disc nucleus. Delaying the required treatment accelerates the deformity and makes it likely that the annulus is ruptured.
In polysegmental osteochondrosis, manifestations of the disease are observed in two or more segments at once. If adjacent areas suffer, then the causes of the pathology are common to them. If lesions are recorded in different parts of the spine – lumbar, thoracic, cervical, then the nature of the disease can be different – from trauma and birth defects to occupational diseases and natural degenerative changes.
In rare cases, total polysegmental osteochondrosis is diagnosed at most levels of the spinal column. The degree of tissue damage can be different, depending on the stage of development of the process in each segment.
Causes of occurrence
Osteochondrosis is recognized as an inevitable evil, a kind of human payment for upright walking and a civilized way of life. Common causes of illness include:
- low mobility and sedentary work;
- disproportionately large body weight;
- regular stress;
- frequent hypothermia of the body;
- extreme physical activity;
- hereditary predisposition;
- features of the anatomy of the spine;
- addictions to smoking, alcohol consumption, overeating.
There are no specific reasons for polysegmental osteochondrosis. This type of disease is affected by common factors that contribute to spinal degeneration. An important role in the development of the disease belongs to the reduction of muscle activity and limitation of the possibility of easy movements.
Pain syndrome interferes with motor activity, creating a vicious circle: a person is afraid of pain, spares the muscles and thereby weakens the muscle corset that can protect the spine from deformations. With the polysegmental form of the disease, the decrease in muscle tone is most significant and harmful.
Symptoms and Signs
When a patient with an acute pain syndrome comes to see a specialist, the doctor with a high probability can assert that the disease develops at several levels, and manifests itself as much as possible in one of them. By the nature of pain, the specialist makes a primary diagnosis, which is clarified with the help of laboratory and hardware studies.
1. The cervical region has 7 segments. The most problematic areas are located at levels close to the thoracic region. The muscular frame of the neck is naturally poorly developed, the disease is observed even in young people.
Symptoms of cervical polysegmental of osteoarthritis are:
- seemingly unreasonable headache and dizziness;
- pain radiating to the arm, shoulder blade or chest;
- loss of elasticity of the neck muscles, which is perceived as hardening or fossilization;
- paralysis of the tongue and upper limbs in advanced conditions.
With the participation of adjacent thoracic segments in the process, the pain captures a large area, makes breathing difficult, and causes a feeling of heaviness in the heart. Cervicothoracic polysegmental osteochondrosis is diagnosed .
2. The thoracic region is separately affected less often than others. The cause of the development of pathology may be a curvature of the spine. A person often cannot associate soreness in the liver, stomach, heart with osteochondrosis. Numbness of the skin in the chest area becomes a confirmatory symptom.
3. The lumbar region, which has 5, less often 6 vertebrae, is recognized as the most problematic area of the spine. Backache and burning sensation are concentrated at levels close to the sacrum, and can affect the upper part of the sacral region.
The symptoms of lumbar polysegmental osteochondrosis include:
- painful lumbago with recoil in the leg;
- heaviness and burning sensation in the lower back;
- a sharp increase in pain when moving;
- inability to relax even in a supine position;
- disorders of the intestines, bladder and urethra, genitals;
- weakness of the muscles of the legs and loss of sensitivity of the skin of the limbs.
4. Suspicion of lumbosacral polysegmental osteochondrosis appears at the doctor in those cases when, with the other symptoms listed, the patient complains of numbness of the toes, uncertainty when walking, inability to straighten up, severe pain with the slightest movement.
This type of disease is widespread and affects several levels, since neighboring areas take on an extra load from the affected segments. Lack of treatment leads to a rapid, often irreversible loss of performance, sometimes to paralysis of the limbs.
A separate type of polysegmental osteochondrosis is represented by lesions of different parts of the spine. The combination of symptoms aggravates the severity of the disease. Soreness, restriction of movement in the lower back and neck indicate the presence of problems that develop independently of each other in both parts.
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The diagnosis is made by a physician based on a complete examination of the patient. At the reception of the patient, a neurologist examines, checks reflexes, prescribes primary blood and urine tests, and, if necessary, X-ray. A decisive role is played by high-tech procedures – computed and magnetic resonance imaging (CT and MRI).
MRI is indispensable for determining specific levels affected by osteochondrosis. A complete and detailed picture of the state of the spine gives the doctor information about the stages of the pathology. Data is especially important when deciding on the surgical treatment of a patient.
With cervical osteochondrosis, CT is more often prescribed . The procedure allows you to get an idea of the degree of damage to bone fragments that are characteristic of this part of the spine. An experienced doctor decides what type of research will be as informative as possible.
Spinal degeneration in the early stages is not painful. A person asks for help when his condition reaches a certain severity. This complicates the treatment, but does not exclude its successful outcome.
- To relieve pain, anti – inflammatory drugs (NSAIDs) are prescribed – externally, orally, intravenously, intramuscularly. The method, volume and duration of administration is determined by the doctor.
- Neurovitamin complexes accelerate the removal of the inflammatory process.
- The psycho-emotional sphere needs correction with sedatives and magnesium preparations, which improve sleep and relieve stress.
- Muscle spasms are overcome with the help of muscle relaxants.
- After relief of painful manifestations, treatment continues with the help of drugs that improve tissue blood supply and metabolic processes.
- When the patient’s condition stabilizes, it is possible to prescribe physiotherapy, rehabilitation courses of exercise therapy.
The above scheme is classic in most cases of osteochondrosis, including the polysegmental type. Manual therapy, intensive massage, spinal stretching are rarely used, since the multilevel nature of the pathology is fraught with an unpredictable response to such treatment.
Possible concomitant complications of the disease
Complications of osteochondrosis are manifested by muscle dystrophy, circulatory disorders, pinched nerves. Dangerous consequences of the development of the disease are protrusion and herniated discs.
Due to the increase in pressure on the intervertebral disc, its gelatinous nucleus protrudes beyond its natural boundaries. If the fibrous ring restrains the pressure and does not rupture, then protrusion forms .
If a rupture occurs, then a hernia is formed, with a strong protrusion outward or into the lumen of the spinal column. There comes an infringement of the endings of the spinal nerves, the pain syndrome is extremely aggravated.
protrusion of the disc
Polysegmental osteochondrosis of the lumbar region can have complications in the form of several protrusions . The patient is sometimes unaware of the problem until suddenly severe pain appears. In 80% of cases, the lower back and the area adjacent to the sacrum are affected.
Even a slight protrusion of the nucleus pulposus of the disc compresses the spinal nerves and blood vessels. If there are several such protrusions, then degenerative changes are growing rapidly. The pain radiates to the legs, the front and back of the thighs grow numb. Due to tissue nutritional disorders, an uneven reduction in the volume of the calf muscles occurs.
Protrusions are rarely operated on, although the complication is treated with the participation of a neurosurgeon.
Long-term conservative therapy usually leads to relief. The protrusions of the disc are reduced in volume and take a position at which the compression of the nerves and blood vessels stops.
In order to prevent exacerbation, the patient should be observed by a specialist and timely prophylaxis. Shown are sanatorium treatment and physiotherapy.
Osteochondrosis, which forms at several levels of the spine, occurs in most people over the age of 40. Moderate, regular physical activity helps to slow down aging and stay active at any age. A long life without back pain is a goal worth the effort.