Osteochondrosis is a degenerative-dystrophic vertebral disease, the basis of which is the damage to the intervertebral disc discs.The development of a degenerative disease of the spine is facilitated by longer microtraumization, excessive static and dynamic stress, hereditary disposition and advanced age.The most common localization of the lesion is the neck and lumbar spine.This is due to their greatest mobility and load.
General concept of osteochondrosis
The intervertebral disc loses its liquid over time and loses its floccon -absorbing function.It becomes less against physical exertion.The fibrous ring, which is located on the periphery of the pane, is gradually thinner and cracks form in it.The pulp core shifts along the periphery in the formed cracks and shapesProtub(Local lead, 1 degree).Due to the intensive physical activity, the lead can increase crampingly and shift into the lumen of the vertebral canal.In this case, talk about the hernia of the hard drive (2 degrees).Sometimes free fragments of the core can form -Sequester.
Pain can be explained in the early stages of the disease by overlapping the fibrous ring and irritation of the rear longitudinal tape.The pain can be localized on site in the back or in the neck as well as in remote areas.With cervical osteochondrosis, the pain in the back of the head, in the blade and in the gap, the shoulder girder and in the hand can be reflected.
The pain is accompanied by the reflex cramp of the segmental muscles.This phenomenon has a protective nature and stabilizes the defined part of the spine.Over time, muscle contraction becomes an independent source of pain.When the hernia changes towards the state hole, it presses neighboring nerve roots.The radicular pain has a shooting, penetrating character that is significantly localized during the innovation of the nerve.It is accompanied by suitable neurological manifestations:
- Acceptance of sensitivity;
- Failure of reflexes;
- Muscle weakness.
The degeneration of the hard drive violates the normal anatomical relationship between the components of the spine: slices, vertebrae, joints and ligaments.The gradual decrease in the height of the intervertebral disc leads to a change in the joint bonds and the formation of subluxation and transfers of the vertebrae.This fact shows the instability of the spine and reduces resistance to injuries, which can lead to a deterioration in osteochondrosis.
Age restores the stability of the spine due to the formation of osteophytes, hypertrophy of joint processes, disc fibrosis, thickening of the joint straps and capsules.The last phase of the pathological process is referred to as spondyloses.Pain subsides during this time.
The main symptoms of a neck osteochondrosis
At the level of the cervix segments, nerve roots and their arteries, the spinal cord and its vessels and spine arteries, compression can be exposed.The compression of the spinal cord is possible due to the rear intervertebral disc or the rear osteophytes.People with a narrow vertebral canal are particularly predisposed.With a hernia, compression signs of cervical osteochondrosis develop pretty quickly, and the symptoms of the cerebrospinal fluvin current block are softer.
It is very difficult to distinguish the compression of the spinal cord with a tumor and hernia clinically.Osteochondrosis of the cervical spine is shown by a spastic paresis of the legs, conduction disorders of sensitivity, pain and weakness in the hands.In some cases, signs of compression are combined with signs of ischemia of the spinal cord substance, which results from the compression of the arteries of the spine and the radicular vessels.
The symptoms of damage to the front horns and the ventral departments can suddenly develop with the participation of the pyramid paths (blood supply to the front spine artery).The front spine syndrome occurs: sluggish paresis of the poor, spastic paresis of the legs, impaired sphincter function.Sometimes symptoms of a rough violation of deep sensitivity arise in the hands.After 2-3 weeks, the signs of a spine stroke begin to withdraw.With regard to the volume of the pathological focus, we can say about the severity of the residual phenomena.
Cervical myelopathy
Myelopathy is chronic ischemization for cervical osteochondrosis.A major role in the development of this syndrome is played by compression of blood vessels.The most characteristic is the defeat of the ventral parts of the side pillars and the front horns.It manifests itself through a spastiocoatrophe parese of the arms, a spastic paresis of the legs, a violation of the deep sensitivity of the legs (classic triad).
In a number of patients, Leragta's symptom occurs: a feeling of passing the electrical discharge along the entire spine with radiation of pain in the hands and legs during the transition.It is possible to develop an amyotrophic sclerosis on pages where there are no bulbar symptoms.
An important role in confirming myalopathy is played by MRI and CT, which result in the compression of the shell bag with osteophytes and a thickened yellow bundle.
Signs of radicular compression
Since the underlying windows wear out faster, spondylarthrosis develops in the corresponding segments.Osteophytes limit the band ship holes and press the roots (more frequently compressing the hernia of the disc in epidural space on the lumbar level).When moving the growth of growth, the spine is violated, which leads to the formation of edema, which further narrowed the bandwriter hole.Develop reactive inflammatory reactions.
Clinical manifestations:
- C3 -Koreshok (under 2 cervical vertebrae occurs quite rarely) - pain in the corresponding half of the neck, a feeling of swelling of the tongue, a feeling of a coma in the throat;
- C4 -Koreshok -pain in the suitable shoulder current, collarbone, atrophy of the trapezoidal muscle, a decrease in the sound of the neck muscles (irritation of 3 and 4 cervical roots increases the sound of the diaphragm, which leads to a shift in the liver and the occurrence of angina -papard pain);
- C5 -Decor - Pain in the neck and the outer surface of the shoulder, hypotrophy of the delta muscle;
- C6 -KORESHOK (one of the most common localizations) pain in the neck, sound, shoulder shoulder, the radial surface of the forearm spreads on 1 finger, parepezesia in the hands, the weakness of the bicep of the two muscles;
- C7-Koreshok pain spreads to 2-3 fingers, accompanied by paraesthesia, weakness of the three-member muscle;
- C8 -Koreshok - The pain extends to the elbow surface of the forearm to the 5th finger, accompanied by paraesthesia.
Neck -reflex syndromes
The vertebral syndrome manifests itself through acute sore throat (bastards, cervix), less frequent chronic or subacute pain.The main sources of pain syndrome are a fiber ring, the rear longitudinal tape, joint capsule and tense muscles.Krivosheya is not as exhausted as the curvature of the spine at lumbar height.
The pain is painful and shine on the back of the head.Intensify when driving or a longer stay in one position.In the case of palpation, the pain of the misconception and capsules of the joints is determined on the painful side (along the rear surface of the neck of 3 to 4 cm laterally as spicy processes).The participation in the process not only the back, but also the front muscles of the spine (front stairs, etc.) is characteristic.
Front stairs syndrome
The stair muscle tension very often occurs with cervical osteochondrosis.The muscle is determined on the side of the muscle from the chest in the form of a brod bug -layer muscle in the form of stressful sizes, dense and increased size compared to the healthy side.Due to the tension, the compression of the supravich vessels occurs, which is accompanied by pain and swelling in the hand, affects the sensitivity and motor activity (along the elbow nerve).The pain increases in a horizontal position.
Small breast muscle syndrome
The development mechanism is similar to the previous one.The compression of the vascular default beam occurs between the muscle and the shoulder bone (or the coraving process) under conditions of increased abduction of the hand.It is accompanied by pain in the chest, shoulder blade, hand.
The existing characteristics are often regarded as pain in the heart with VSD (there are no acute attacks, the effect of taking nitroglycerin or sedatives is not, increased symptoms while moving and palpation of pain points).
The rear sympathetic syndrome
Unknown vasomotor diseases that occur due to the irritation of the likeable plexus of vertebral artery are characteristic.The branches of the plexus are in the tissues of the brain and skull.It manifests itself clinically through dizziness, ringing in the ears, spectacular disorders, anxiety.
The compression of the vertebral arteries with osteophytes, which emerge from the joints of the spine in combination with the atherosclerotic damage to these vessels, is an important pathogenetic factor for the development of the inadequacy of the arteries of the brain and spinal cord.
Diploma
In most cases, pain is associated with cervical osteochondrosis in the hands and in the throat.In some patients, the pain is caused by the hernia of the intervertebral disc on others - osteophytes and osteoarthritis of the back joints.Each of these options can lead to local or reflected pain, radicular syndrome and myelopathy.When examining patients with pain in the neck, it is necessary to rule out such pathologies:
- Tumors of the spine;
- Epidural abscess;
- Spondylitis;
- Subarachnoid bleeding;
- Meningitis;
- Hall abscess;
- Stratification of carotidaries;
- Fracture of the cervical vertebrae.