Spondylosis of the lumbar spine: what is it?

Spondylosis and spondylarthrosis of the lumbar spine: what is it?

Many faced with osteochondrosis of the spine. But if the diagnosis sounds like a spondylosis of the lumbar spine, then what is it? Do I need to heal it? What are the methods of therapy? But first you need to understand the processes occurring in the spine with this disease.

In the course of evolution, a person found the ability to walk on two legs, it was a huge leap in development, freed hands for labor.

All changes are aimed at compensating for the increased vertical load, but it nevertheless makes itself felt.

What is Spinal Disease?

With age, degenerative changes occur in the intervertebral discs, the fibrous membrane loses its elasticity and elasticity, and subsequently the height of the disc decreases.

At the same time, the soft core of the element protrudes, forming a protrusion, the breakthrough of the core content through the fibrous membrane (hernia) is fraught with severe pain and serious complications.

A complex of these conditions is called osteochondrosis of the spine.

Its development is accompanied by two interrelated diseases:

• spondylosis;
• spondylarthrosis.

Also often used the term osteoarthrosis, it combines a group of ailments, in which the pathological process affects the cartilaginous and bone tissue of the joint.

Diseases of the spine are of the same nature as joint dysfunction.

The development of osteoarthritis (among many other signs) leads to a thickening and thickening of the subchondral (near-cartilage) layer of bone and the formation of osteophytes. It is this condition that is called spondylosis.

Simply simplified, the process can be represented as follows: the body records the loss of the intervertebral disc of its properties and for protection The spinal cord tends to maintain the integrity of the spine, triggering the growth of bone tissue at the junction elements.

These build-ups also help increase the area of ​​contact of the vertebra with the cartilaginous disc, resulting in a slight decrease in bone pressure on the damaged cartilage.

The final result of the growth of osteophytes is the complete fusion of the adjacent vertebrae with each other.

So, spondylosis is the process of wear of the structures of the spine, accompanied by ossification of soft tissues, surrounding the vertebrae, and the formation of marginal bony outgrowths (osteophytes) directed along the axis of the spine to meet each other. What is dangerous for spondylosis? In a simple case, this ailment can not manifest itself in any way, but with its development the symptoms intensify, spondyloarthrosis is added.

Patients often confuse these two diseases. With spondylarthrosis, there is degeneration of the small joints surrounding the adjacent vertebrae. Both processes are accompanied by pain syndrome and restriction of the completeness of movement in the spine.

In addition to the vertebrae, spondylosis affects the anterior longitudinal ligament of the spine. It is she, deformed under the influence of growing osteophytes, is the source of pain in the back with the usual vertical position of the body.

In general, spondylosis can be considered as a phenomenon that occurs as a response to a long-term osteochondrosis.

The growth of osteophytes, in addition to back pain, can cause difficulties in walking, and with unfavorable development, disability often develops.

Diagnosis of spondylosis of the lumbar spine

The lumbosacral part takes over the bulk of the load lying on the spinal column, so the most common spondylosis affects this particular department. Symptomatics in this case is similar to the general manifestations of osteochondrosis, but it has its own peculiarities. Thus, the following conditions are noted:

1. Aching in the lower back, thighs, buttocks. Occur in the early stages and intensify with the development of spondylosis. With the tilts and rotational movements of the spine in the lumbar region, the intensity of pain increases significantly. These sensations may disappear if the patient leans forward. At first, the discomfort is aggravated, but with extension, there is a noticeable relief.
2. Morning stiffness, manifested in the fact that the patient needs to warm up before doing the usual movements.
3. Violation of mobility in the lumbar region, affecting posture and gait.

The growth of the bony projections is accompanied by an increase in the muscle tension in the lower back, it provokes spasms in the tissues and causes disruption of the nutrition of the intervertebral discs.

The growth of osteophytes at the initial stage does not lead to a decrease in the distance between the vertebrae, but causes narrowing of the spinal canal, which stimulates the nerve fibers.

Diagnosis of spondylosis involves a primary analysis of the patient's story about the course of the disease (occurrence and progression), examination for the presence of muscle atrophy and check for mobility impairment. After the conversation instrumental researches are appointed:

• Radiography - allows to determine the structure of bone tissue, the geometry of the vertebrae, the presence of osteophytes;
• computed tomography - more accurate diagnosis, determines even small deviations from the norm of bone and cartilaginous tissues;
• magnetic resonance imaging - allows you to detect the pathology of cartilage and soft tissue, see the hernia and determine their size.

In some cases, scintigraphy (scanning using radioisotopes) can be performed, with oncological diseases it allows to detect metastases in bone tissues.

Causes of spondylosis

The degenerative nature of the disease does not necessarily imply its emergence and development only in old age. Approximately 80% of people over 60 years of age have some signs of spondylosis, but often an ailment occurs and begins to develop in youth.

Pathological proliferation of bone protrusions occurs as a compensatory reaction of the body to violations of the structure of intervertebral discs.

Many patients have an erroneous understanding of the origin of osteophytes, consider their salt deposits.

But this is not salt, but the growth of bone tissue, with their help the body tries to prevent displacement of the vertebrae relative to each other.

In addition to age-related changes, many factors can lead to the onset and development of spondylosis:

• hereditary predisposition;
• overweight;
• inefficient nutrition (with a lack of necessary microelements and vitamins), metabolic disorders;
• bruises, sprains and fractures of the spine;
• curvature of the spine, violation of posture, sedentary lifestyle;
• harmful influence of the environment;
• frequent lifting and carrying of weights, incorrect movements of the trunk, prolonged stay in uncomfortable poses;
• too intense physical activity;
• overload of the spine, associated with flat feet or wearing uncomfortable shoes;
• sudden termination of regular classes (for professional athletes);
• nervous stress;
• smoking;

In recent years, the incidence of spondylosis has increased at a young age, this is due to the prevalence of sedentary work, a long stay at the computer, the development of fast food.

Drug therapy spondylosis lumbar spine

Conservative methods of treatment are aimed at mitigating the manifestations of pain syndrome and preventing further development of pathology. It should be understood that no medication, physical exercises and exercises will restore the mobility of the spine to the level inherent in earlier.

Than to treat a spondylosis? Medicamentous treatment is aimed at removing the concomitant inflammatory process, eliminating muscle spasm and reducing the feeling of pain.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as Diclofenac, Ibuprofen, Naise, Ketonal, etc., are commonly used.

In particular, if the patient has a stomach ulcer, gastritis and similar chronic gastrointestinal diseases, the optimal choice will be a second generation NSAID, the so-called selective means with preferential blocking of COX2 (cyclooxygenase 2). The most famous representatives of this group are Movalis, Arcoxia, Celebrex. Such drugs have contraindications from the cardiovascular system, liver and kidneys. They are usually not prescribed for pregnancy and lactation.

The course of spondylosis has a long duration, therapy should also be long, but the intake of NSAIDs should always be limited. Usually a continuous treatment period for the use of such drugs should not exceed two weeks.

For the suppression of muscle spasms, a group of muscle relaxants are used, such as Midokalm, Fleksen, Sirdalud, and others. Contraindications for these funds are also available.

Justified is the intake of B vitamins, a well-established remedy such as Milgamma.

In all cases of NSAIDs, miorelexants and vitamins, the dosage and course is prescribed by the attending physician.

Physiotherapy and therapeutic gymnastics

Great value in the treatment of spondylosis is given to physiotherapy. It allows to strengthen the muscular corset of the lumbar region of the back, increase the blood supply of this area, reduce the tension of the tissues.

They positively proved themselves: magnetotherapy, electrostimulation, phonophoresis, mud therapy. Many patients are helped by acupuncture and treatment with leeches (hirudotherapy).

These methods contribute to the mobilization of the body's own forces.

An important place in the treatment is physical education. Specially designed exercises are aimed at strengthening the muscles and expanding freedom of movement.

But successful in other diseases, stretching procedures for spondylosis can not be used. One should refrain from manual therapy.

All measures of conservative treatment are aimed at relieving pain, alleviating the condition and preventing complications.

A feature of spondylosis is the probability of a gradual full fusion of the osteophytes of neighboring vertebrae, which will look like a single bone block on an X-ray.

In such cases the pain syndrome decreases, but the limitation in the movements is preserved.

Operative intervention

The operation can relieve osteophytes, but surgical intervention is indicated only in cases of serious complications of spondylosis - "syndrome ponytail which occurs when protrusion of the bony projections into the lumen of the spinal canal leads to compression of the bundle of nerve roots. The syndrome can be manifested by acute pain, leg paralysis, urinary incontinence.

The operation to remove osteophytes in the simplest case looks like this: the surgeon produces an incision in the projection the affected area of ​​the spine, then with special tools cuts or cuts the bone outgrowths. Thus, the diameter of the spinal canal in the compression zone or the opening through which the suffering nerve passes can be widened. It is possible to completely remove the affected vertebra or replace it with an artificial prosthesis.

Recently, minimally invasive methods of surgical intervention have been increasingly used.

The work is done using a microscope and micro-tools, the cut is 2-4 cm (in contrast to 10 cm in the classical operation).

The traumatization of surrounding tissues is reduced and the healing period is shortened.

Conclusions and recommendations

Spondylosis is a serious disease that occurs with pain syndrome and carries the risk of unpleasant complications.

To prevent its occurrence, it is necessary to avoid a long sitting position, exercise, properly and variously eat, not to allow injuries to the spine.

If the first signs of the disease appear, consult a doctor without delay.

A source: https://osystavax.ru/bolezni/spondilez/poyasnichnogo-otdela-chto-eto-takoe.html

Spondylosis of the lumbar spine

Spondylosis of the lumbar spine -chronic disease of the corresponding part of the vertebral column, at which the formation takes place bony outgrowths at the vertebrae margins and degenerative-dystrophic changes in the structure of intervertebral disks. Osteophytes, bony growths, gradually expanding, limit the mobility of the spine, narrow the vertebral canal, which leads to infringement of the roots of the nerves and the development of painful sensations. Progression of pathology leads to complete immobility of the lumbar region of the spine and can cause disability.

Causes and mechanism of development

The initial stage of development of spondylosis of the lumbar spine can be characterized as a compensatory response of the body to the increasing systemic loads on the spinal column.

The proliferation of bone tissue increases the area of ​​the vertebrae and for some time reduces the load on the intervertebral disc.

The osteophytes compensate for the physical effect on the vertebral column, the bone spines prevent the displacement of the vertebrae.

Over time, uncontrolled proliferation of bone tissue fixes affected by pathological changes in the vertebrae, traumatize the roots of the nerves, lead to a change in the membrane and the substance of the dorsal the brain.

The causes of the emergence and development of spondylosis of the lumbar region, multifaceted and pathology can develop under the influence of several factors.

The main causes of the pathology:

• Traumatic injuries of the bone tissue of the spine, muscles and ligaments in the lumbosacral department,
• Long-term and systemic dynamic loads on the spinal column and single reinforced stress on the background of a sedentary lifestyle.
• Hereditary predisposition associated with the peculiarities of the structure of the ligaments of the spine and its structure,
• Static loads of the spine, systemic stay in a physiologically uncharacteristic human body posture
• The manifestation of complications of infections or tumor formations,
• Increasing the load on the spinal column due to sudden or gradual weight gain,
• Changing the structure and correct loading on the spine as a result of a violation of posture caused by kyphosis, lordosis or scoliosis,
• Age-related changes in the structure of bone and muscle tissue, changes in the quality of ligaments.

Spondylosis of the lumbar region affects, as a rule, 4 and 5 vertebrae, often pathology affects the sacrum.

Mechanism of development of lumbar spondylosis:

• The effect of excessive loads on the spine leads to squeezing the spine and ligament apparatus,
• On the body of the vertebrae, microcracks and micro-traumas are formed,
• A protective mechanism is activated, which changes the structure of the vertebrae and allows some time not to feel the degradation processes,
• An excess of bone tissue forms and osteophytes form,
• Spasm of the musculoskeletal system is a reaction to the appearance of a foreign body and fix the problem joint in a stationary state,
• The proliferation of spine-shaped processes leads to the fusion of the vertebrae with each other,
• The formation of excessive bone tissue on the anterior and lateral surfaces of the vertebrae causes irritation of the anterior ligament of the spine, compression of the vessels and infringement of the roots of the nerves.
• The motor activity in the affected vertebra becomes limited.

The disease in most cases has a long phase of asymptomatic development, which makes itself felt by minor, fast-passing, painful sensations in the lumbar region.

Symptoms

Symptoms of the disease depend on the duration of its course, the general condition of the body and the individual characteristics of the patient.

Common symptomatology of spondylosis of the lumbar spine:

• Painful sensations in the lumbar region - the irritating effect of osteophytes on the anterior longitudinal ligament of the spine, compression of the roots of the spinal nerves cause the manifestation of pain. Painful manifestations are localized in the lumbar region, with spondylosis affected by the sacrum, extend to the coccyx zone. Possible painful manifestations in the groin and lower extremities. Aching, constant pain increases with intense motor and physical activity. When the disc herniation develops, the character of pain changes, it becomes sharp, shoots, extends to the gluteal region and the back of the thigh. Long walking, prolonged exposure on the legs also increase painful symptoms.Reduced pain manifestations when in the embryo position, this arrangement of the body reduces the burden on the vertebral column and osteophytes less irritate the anterior ligament of the spine.
• Disturbance of sensitivity - compression of sensitive fibers of the posterior roots and compression of the nerve, in which motor and sensitive fibers lead to partial or total loss of sensitivity on the skin of the lower extremities, in the lumbar region, the area buttocks. The second variant of manifestation of a symptom may be the appearance of tingling, numbness, or cold. Compression of the femoral nerve is manifested by loss of sensitivity of the genital organs.
• Stiffness of the lumbar zone, impaired motor activity - the onset of muscle spasm is compensatory reaction of the organism to the growth of osteophytes with the aim to reduce the mobility of this department the spine.With a long course of the disease there is a fusion of the vertebrae, which not only limits motor activity in the lumbar zone, but can cause the impossibility of independent movement.
• Intermittent claudication, gait disturbance - a sharp narrowing of blood vessels reduces the flow of blood into the muscle tissue of the lower extremities and worsens metabolic processes. The result is the formation of lactic acid, which irritates the nerve endings and causes pain. During walking, there is a sharp tension of the gastrocnemius muscle and there is weakness. The attack of pain is weakened when the torso stops and tilts forward, this pose reduces the tension of the anterior ligament of the spine.

The initial stage of pathology is marked by an asymptomatic course. As the disease progresses, the symptomatology may correspond to the age-related changes typical of older people.

Diagnostics

The diagnosis of spondylosis of the lumbar spine often becomes untimely.

This is due to both the asymptomatic course of the disease in the early stages, and to the similarity of the symptoms of manifestations of other pathologies.

Rheumatoid arthritis, minor trauma of the lumbar spine, or significant physical exertion accompanied by a similar spondylosis symptomatology.

Diagnosis of spondylosis of the lumbar spine is conducted by a windblogger, neurologist or traumatologist.

The basic measures of diagnostics:

• An anamnesis, in which attention is paid to possible injuries or pathologies associated with the spine,
• Carrying out a complete physical and neurological examination allows to determine the degree of mobility of the lumbar zone, to test the condition of the muscular and nervous tissue. Particular attention is paid to checking the reflexes, the level of sensitivity, the definition of motor activity.
• X-ray images allow us to see osteophytes and the degree of their growth,
• MRI provides an opportunity to visualize the damage to soft tissues and ligaments, the condition of the spinal cord.
• Computer tomography determines the degree of narrowing of the intervertebral canal.
• Electromyography can be prescribed additionally to clarify the degree of reaction and conduction of pulses by nervous and muscular tissues.

Lumbar spondylosis is manifested by a discrepancy between the clinical picture and X-ray findings.

With poorly expressed pathology, acute clinical manifestations are possible in the pictures and vice versa, a prolonged development of the disease, impressive osteophytes rarely disturb the patient with attacks of acute pain and intermittent lameness.

Treatment

Treatment for lumbar spondylosis is prescribed by a windblogger or traumatologist, in the presence of neurologic symptoms, a neurologist or neurosurgeon deals with treatment.

There are conservative treatment of spondylosis and surgical intervention.

Conservative treatment should take into account the age and individual characteristics of the patient, have a comprehensive impact.

The main tasks of conservative treatment:

• Reduction of pain syndrome or its complete docking,
• Restoration of blood circulation and metabolism of the tissues of the spine, intervertebral disc, muscle tissue and ligaments,
• Restoration of the function of the musculoskeletal apparatus and its strengthening,
• Improve the state of cartilage and connective tissue,
• Restoration of mobility of the spinal column.

Conservative treatment includes the following forms and activities:

• Medications,
• Physiotherapeutic procedures,
• Massage,
• Exercise therapy.

Drugs for spondylosis of the lumbar spine and their effect on the body:

• Non-steroidal anti-inflammatory drugs and combined analgesics Ketorolac, Arthrotek, Plivalgin exert an analgesic effect and normalize vascular tone.
• Vasoactive drug forms nicotinic and ascorbic acid improve blood flow through the expansion of blood vessels, participate in regenerative-oxidative reactions at the cellular level. Vitamin C stimulates the restoration of components of the intervertebral disc.
• Miorelaxants relieve spasm of the lumbar muscles and pain syndrome.
• Medicines that promote tissue repair, aloe extract, Kontraktube improve tissue regeneration and eliminate the formation of blood clots.
• Vitamin-mineral complexes VITABS arthro, Flexinovo strengthen connective tissue and promote the resumption of mobility of joints, stimulate the synthesis of collagen fibers.

Selection, the scheme of application, compatibility of preparations and a dosage is appointed or nominated by the attending physician.

Massage is an important and effective method of treatment and is contraindicated only in the acute form of spondylosis and other disorders.High temperature, tuberculosis, and the presence of a tumor are contraindications to this method of treatment.

Physiotherapeutic procedures in the treatment of spondylosis of the lumbar spine:

• Electrophoresis - course appointments allow to stop painful manifestations, promote the restoration of metabolism, remove inflammatory processes.
• Vacuum therapy - helps to accelerate the withdrawal of toxins, improve blood supply, increase the functionality of the ligament apparatus.
• Electromyostimulation improves muscular nutrition, relieves painful manifestations.
• Mud applications and baths - a general soothing effect, the removal of spasms, improve the outflow of lymph.
• Warming up - restore and accelerate the metabolism in the affected area.

Therapeutic physical training is one of the important and effective directions in the treatment of pathology. The implementation of special exercises makes it possible to reduce the rate of development of the disease, improve the flexibility of the spine, restore the muscles and ligaments.

Surgical intervention is appointed in the absence of positive dynamics of conservative treatment, during the operation osteophytes are removed, the integrity of the vertebral tissue is restored.

A source: http://www.knigamedika.ru/kost/dorsopatii/spondilez-poyasnichnogo-otdela-pozvonochnika.html

Lumbar Spondylosis

Lumbar Spondylosis- Involutional dystrophic process in the lumbar vertebrae.

It is accompanied by a dystrophy of fibrous rings of intervertebral disks, and also gradual ossification anterior longitudinal ligament and the appearance of bone proliferation along the lateral and anterior surfaces the spine. It usually develops as a result of natural aging, less often occurs in young people with gross violations of posture. Often it is asymptomatic. Pain, discomfort and movement limitation are also possible. Diagnosis is made according to radiography, MRI and CT. The treatment is conservative.

Lumbar spondylosis is a degenerative-dystrophic process in the lumbar spine.

At the heart of the process is the dystrophy of the lateral or anterior sections of the fibrous rings of the intervertebral discs and the formation of bone outgrowths along the lateral and anterior surfaces of the vertebral bodies. Is manifested stiffness, pain or discomfort.

27-37% of patients are not accompanied by clinical symptoms. It is observed in both men and women. The incidence rate increases dramatically with age.

Currently, specialists consider spondylosis, spondylarthrosis and osteochondrosis as equal manifestations of the aging processes of the spine.

Many patients have a combination of these diseases, with the pain often resulting from spondylarthrosis or osteochondrosis, and isolated spondylosis can be asymptomatic.

Treatment of lumbar spondylosis is performed by orthopedists, traumatologists and vertebrologists.

Causes of lumbar spondylosis

Modern specialists in orthopedics and traumatology tend to consider lumbar spondylosis, as a pathology that occurs the influence of many factors, the main of which are natural age changes in intervertebral discs, bones and ligaments the spine. Along with this, a certain role is played by the inactive way of life of modern man.

The lumbar spine and surrounding muscles, deprived of normal physiological loads, are gradually weakening. Against this background, one-off physical exertion with occasional attempts to "lead a healthy lifestyle" is often cause microtrauma of ligaments of the spine and provoke an increased replacement of damaged bone ligament cloth.

The factors that provoke the development of spondylosis are also metabolic disorders and spinal congestion, including excessive weight (obesity), heavy physical labor, inadequate nutrition and the presence of chronic diseases: atherosclerosis, diabetes mellitus, etc.

Some authors note a constitutional predisposition. In addition, lumbar spondylosis can occur at various times after trauma and infectious diseases, or become a consequence of gross violations of posture - kyphosis, scoliosis and kyphoscoliosis.

The height of the discs with lumbar spondylosis for a long time remains unchanged, the ratio of various elements of the spine is not disturbed, Therefore, in the absence of spondylarthrosis (arthrosis of small intervertebral joints) and osteochondrosis, the disease often occurs is asymptomatic.

In later stages or in the combination of spondylosis with other degenerative-dystrophic processes, compression of the nerves is possible, which can be manifested by pain, a violation of sensitivity and movements.

Uncomplicated spondylosis is asymptomatic or manifests local pain in the affected area. Pains are unstable, intensified with intense physical exertion and unfavorable weather conditions.

It is also possible rapid fatigue and reduced mobility of the lumbar spine.

For pain in the intervertebral hernia is characterized by an increase in tilt, forward, prolonged sitting or standing.

If the pain syndrome is caused by osteoarthritis (arthrosis of the facet joints), the pain usually increases with standing and walking and decreases or disappears when the trunk is straightened.

When compressing the nerve roots, tingling and numbness in the lower extremities may occur, and sometimes muscle weakness is observed.

If the nerve is sharply contracted, acute back pain may occur in combination with impaired bowel function or bladder, severe muscle weakness in one or both extremities, numbness of the sciatic zone or inguinal region.

Diagnosis of lumbar spondylosis

The diagnosis is confirmed using the data obtained by radiography of the spine. Based on the radiographs, one can judge the prevalence and severity of pathological changes.

The presence of lumbar spondylosis is indicated by osteophytes located along the edges of the bodies of one or more vertebrae.

In appearance, the bony growths may resemble beak-shaped projections, small tapering or massive "staples" that connect the bodies of adjacent vertebrae.

Possible as a mild manifestation of manifestations with gross pathological changes on radiographs, so and bright clinical symptoms with moderate to mild radiology spondylosis.

The radiological picture changes slowly, smoothly, over the years. At a considerable prescription of the disease in the pictures, extensive outgrowths of osteophytes can be detected with the formation of fixation blocks between two or more vertebrae.

In some cases, radioisotope scanning is used in the differential diagnosis process. If suspicion of spinal stenosis in addition to radiography is prescribed CT of the spine.

If necessary, visualize soft tissue formations (nerves, ligaments, discs) and identify the compression of the nervous structures of the patient sent to the MRI of the spine. Patients with neurologic disorders are examined by a neurologist.

Electromyography is used to assess the functional state of the involved nerves.

Treatment of lumbar spondylosis is performed by orthopedists or vertebrologists. In the presence of neurological symptoms, patients usually go into the care of neuropathologists or neurosurgeons.

Patients are advised to follow a rational motor regimen, do not overcool and do not overload the spine. With pain syndrome and muscle spasms, muscle relaxants and drugs from the NSAID group are prescribed.

NSAIDs include naproxen, meloxicam, ibuprofen, among the muscle relaxants - tizanidine, cyclobenzaprine and other agents. With intense pain in some cases, use tramadol and other narcotic analgesics.

An important part of the treatment of lumbar spondylosis is therapeutic gymnastics, conducted during the period of remission. It allows strengthening of the invertebral muscles and, thereby, reducing the burden on the spine.

In addition, as a result of regular exercise, exercise therapy reduces pain and improves the functionality of the spine.

Physiotherapeutic procedures are actively used, including diathermy, electrophoresis with iodine and calcium, paraffin and ozocerite applications. Ultrasound is used in the early stages.

To activate metabolic processes in the tissues of patients sent to massage, to improve nerve conduction - acupuncture. In the absence of contraindications, sometimes prescribe manual therapy.

With persistent pain, steroid drugs are injected into the epidural space or trigger points.

Patients are given directions for sanatorium treatment (radon and hydrosulphonic therapeutic baths, mud cure, etc.).

Surgery for lumbar spondylosis is very rare. Indications for surgical intervention are pronounced neurologic disorders with ineffective conservative therapy.

The operation is performed in a planned manner, after a comprehensive examination, in the conditions of the vertebrologic or neurosurgical department.

During the surgical procedure, the doctor removes osteophytes, performs transpedicular fixation, interbody spinal fusion, etc., if necessary.

The prognosis for lumbar spondylosis is relatively favorable. In the absence of other involutive processes in the lumbar spine, the disease often occurs without severe pain and neurological disorders.

Systematic observation and regular adequate treatment allows to stabilize the patient's condition and to preserve the functionality of the spine for a long time, however, full recovery is impossible, because modern medicine does not know medicines or non-medicinal techniques that can "reverse" the degenerative changes in the spine.

In the presence of concomitant osteochondrosis and spondylarthrosis, the probability of intervertebral hernia formation increases, strengthening the pain syndrome and the appearance of neurological symptoms that adversely affect the ability to work and quality life.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/lumbar-spondylosis

Bone lengthening or spondylosis of the lumbar spine: how to treat degenerative processes

Spondylosis of the lumbar region is a degenerative change, against which the fibrous ring breaks down, but the intervertebral disc retains its integrity. In severe spondylosis, osteophytes appear in the zone of several vertebral structures, often other parts of the spine are affected.

Degenerative processes develop not only in old age. Spondylosis is increasingly diagnosed in young people. Causes, features of the disease, symptoms, treatment methods are described in the article.

Spondylosis: what is it?

Chronic pathology affects different parts of the spine, but occurs more often in the lumbar region due to high loads on this area. On X-ray images, the doctor reveals bony growths.

Osteophytes are not saline deposits, but enlarged vertebral tissues. Formations appear in response to a weakening of the ligamentous apparatus and muscles, a decrease in the damping properties of the intervertebral disc.

With the help of additional bone outgrowths the spine becomes stronger, which allows it to withstand habitual loads, but at the same time there is stiffness of muscles and vertebrae, limiting the mobility of the affected site.

During treatment, physicians put forward not painkillers and NSAIDs, but physiotherapy procedures, therapeutic massage sessions and special exercises. Daily work on restoring the functions and health of the spinal column, discs, muscles, ligamentous apparatus reduces the risk of serious complications.

Spondylosis of the lumbar department code on the ICD - 10 - M47.

Causes of the disease

Excessive physical activity, disturbance of metabolic processes - causes of growth of osteophytes, development of deforming spondylosis.

The risk group is men aged 30 to 40 years and elderly patients.

After 50 years, there are natural degenerative changes in the vertebral structures, at a young age the loin often suffers from excessive physical exertion.

Many doctors believe that spondylosis is a complication in severe forms of osteochondrosis.

The more active and extensive the process of destruction of intervertebral discs, the higher the risk of involvement in the pathological process of soft tissues and surrounding structures.

The result is negative: the appearance of bone growths, muscle spasms, limitation of mobility of the problem department.

The provoking factors:

• malnutrition, high percentage of carbohydrate and fatty foods;
• weak muscles and ligaments during hypodynamia;
• stay in an uncomfortable, harmful for the spine, posture throughout the day;
• lifting and moving too heavy loads according to the type of activity;
• changes in the discs and vertebrae with aging;
• diabetes, gout, atherosclerosis, diseases of infectious and inflammatory nature;
• too intense training in the gym;
• spinal injury;
• genetic predisposition to orthopedic pathologies.

On a note!A high degree of obesity is another negative factor that causes degenerative and dystrophic processes in vertebral structures. Excessive pressure on the discs, constant overloads increase the risk of damage to hard and soft tissues. It is no accident that in the treatment of diseases of the musculoskeletal system, doctors strongly recommend that patients lose weight to the optimal values, according to sex and age.

First signs and symptoms

The first sign of spondylosis - pain sensations of different strength, lumbago in the lower back. In most cases, discomfort occurs with physical activity, sudden movements and lifting of goods.

Soreness increases throughout the day, then unpleasant sensations become weaker, after the loads arise again. Often, pain is given to the buttock or leg along the jammed sciatic nerve.

To ease the condition, the patient takes the embryo posture or leans forward. At this position, bone growths less press on nerves, vessels, soft tissues. Some patients complain of increased discomfort when weather changes.

Aching pains bother with long standing in the "standing" or "sitting" position. Intermittent claudication increases with the progression of the disease.

With compression of the nerve roots, cerebral complications appear: pain in the legs, reduction or complete loss of sensitivity of the lower extremities, muscle weakness.

The disease has several stages.

The initial stage is accompanied by a weak pain syndrome, in the second and third stages of lumbar spondylosis, signs develop Myelopathy: tingling in the legs, the gluteal region partially loses sensitivity, it is difficult to completely unbend the knee with the affected side. Against the background of middle and severe spondylosis, lumbosacral radiculitis develops, ossification increases with progression of degenerative changes.

Diagnosis for acute pain

Already at the first admission the doctor may suspect spondylosis: palpation of the vertebrae, in the area of ​​which the bony growths appeared, causes pain.

Other signs of a pathology: with an inclination forward, discomfort decreases, intermittent claudication develops.

If the doctor asks the patient to bend back, turn the body left-right, then the stiffness, reduced mobility of the lumbar region is clearly visible.

When diagnosing spondylosis, the specialist directs the patient to the examination with the help of modern equipment:

• conduct X-ray of the lumbar region;
• a good result with accurate mapping of the state of soft tissues, bone structures is provided by tomography: computer and magnetic resonance imaging.

Effective methods of treatment

Spondylosis in the lumbar region is a chronic disease, the patient should be attuned to a long course of therapy.

To reduce the pain syndrome, restore the mobility of the affected area, doctors focus not on medicines, but on massage, therapeutic gymnastics, physiotherapy.

Without surgery, osteophytes can not be eliminated, but with persistent treatment, daily exercise of exercise therapy, an integrated approach to really stop the progression of spondylosis.

Spine diseases are treated by a vertebrologist. If the specialist does not take in a small village, then the therapy is performed by an orthopedic trauma specialist or a neurologist with the participation of a physiotherapist.

Important!Folk treatment, uncontrolled taking of tablets, applying gels and ointments without prescribing a doctor interferes with treatment, lubricates the picture of the deforming spondylosis. Warming of the painful zone, a massage performed by an amateur, "vertebrae reduction" by a manual therapist without special training can lead to severe neurologic disorders, displacement of vertebrae, disability.

Tasks of treatment:

• to stop the destruction of the vertebrae and the growth of osteophytes;
• normalize the functionality of intervertebral discs;
• Relieve the patient of soreness in the lumbar region or minimize discomfort;
• reduce the pressure of bone structures on elastic cartilaginous pads;
• normalize nutrition and blood supply to affected tissues.

Medications

With many diseases of the spine and articular tissues, NSAIDs are prescribed - non-steroid formulations with an anti-inflammatory, pronounced analgesic effect.

In spondylosis of the spine of the lumbar zone, this category of drugs is less often used: in most cases degenerative changes develop, bone growths appear, but the inflammatory process develops infrequently and in weak form.

The main types of medicines:

• Analgesics, for example, Dexalgin or Renalgin. Long-term use can provoke a disruption in metabolic processes with prolonged penetration of synthetic components into the blood and lymph;
• chondroprotectors. The additional supply of cartilaginous tissue maintains the elasticity of the discs to preserve the damping function. Inflammatory process with spondylosis occurs infrequently, in most cases enough multi-component chondroprotectors with glucosamine, hyaluronic acid, vitamins and chondroitin. Effective names: Structum, Formula-C, Arthron complex, Tri-active, Chondroitin-gel, Chondroxide, Don, Hondrolon;
• compositions for improving nervous regulation. Milgamma, B vitamins (injections are most effective);
• drugs that activate blood supply to the affected area. Ascorutin, Trental.

Alternative therapies

Useful procedures:

• shock wave therapy;
• mud treatment;
• acupuncture;
• orthopedic corset to reduce the burden on the spine;
• use of medicinal leeches (hirudotherapy);
• underwater or spinal traction;
• therapeutic gymnastics to strengthen the muscles of the back, legs, increase the flexibility of the spine;
• electrophoresis with calcium preparations;
• paraffin and ozocerite applications;
• mineral and pearl baths;
• manual therapy (strictly according to the prescription of the doctor, it is obligatory to conduct treatment by an experienced doctor);
• massage of the affected area, back, lower limbs;
• gymnastics qigong, yoga, aqua aerobics;
• therapeutic swimming.

Surgical intervention

With severe compression of the spinal canal, active jamming of blood vessels and nerve processes, an operation is required to remove the largest osteophytes that irritate sensitive tissues.

Returning the usual diameter of the vertebral canal, eliminating the pinch of blood vessels and nerves reduces the pain syndrome, normalizes the nutrition of tissues, slows the progression of pathology.

Spondylosis is a degenerative disease with pain syndrome and impaired mobility of the spine. If you see on the pictures of marginal bone growths on the vertebrae to prevent rupture and displacement of the disc, it is urgent to begin treatment.

- a complex of analgesic exercises for the lumbar spine and prevention of spondylosis:

A source: http://vse-o-spine.com/bolezni/spondilez/poyasnichnyj.html