Intervertebral osteochondrosis
| Classification according to ICD-10 | |
|---|---|
| M42.1- | Osteochondrosis of the spine in adults |
| ICD-10 online (WHO version 2019) | |
The osteochondrosis or osteochondritis (inter) vertebral ( "vertebra" = vertebra ) is a degenerative disease of the spine . Affected are the bones ("osteo") of the vertebral bodies and the cartilage ("chondro") of the intervertebral discs . Extracts ( spondylophytes ) form on the vertebrae. The intervertebral discs change their elasticity and shape. The associated decrease in height of the intervertebral spaces leads to wear of the vertebral arch joints ( spondylarthrosis ).
causes
Spinal wear and tear occurs regularly in people with age. It is caused by the static load when walking upright and by the high life expectancy. Obesity and other inappropriate loads accelerate the occurrence of osteochondrosis.
Signs
roentgen
The change in shape of the vertebral bodies in the sense of the spondylophytes and the reduction in the intervertebral space due to loss of height of the intervertebral discs are clearly visible in the conventional X-ray image . The wear on the vertebral arch joints is also clearly evident here.
Magnetic resonance imaging (MRI)
Early stages of osteochondrosis, namely an increased blood flow to the bone marrow near the cover plates of the vertebral bodies, can be made visible in the MRI . The transformation of this tissue that occurs later, the "fatty degeneration", is also evident here. The change in shape of the intervertebral disc itself can also be mapped, while in the X-ray image it only becomes clear indirectly through the reduction in height of the intervertebral space.
Clinical signs
Osteochondrosis often remains clinically silent, that is, it does not cause any symptoms. The changes in shape of the vertebral bodies and the intervertebral disc can lead to a narrowing of the spinal canal ( spinal stenosis ) or where the nerves exit the spine (neuroforamina). This then leads to pain in the supply area of the affected nerve, for example in the sense of sciatica . The reduction in height of the intervertebral disc also irritates the structure of the vertebral joints, which also causes pain.
therapy
The osteochondrosis of the spine cannot be reversed.
Conservative
In the case of acute symptoms, treatment is first given symptomatically . This is where physical therapy (e.g. step bed positioning, warmth, massages, stretching treatment, electrical stimulation) is used. Medicines such as painkillers ( analgesics ), anti-inflammatory drugs ( anti-inflammatory drugs ) and muscle-relaxing drugs ( muscle relaxants ) can be used to support this. Aids such as stabilizing bodices are only indicated in exceptional cases .
In terms of prophylaxis, it makes more sense to actively stabilize the affected region by training the muscles. This can be achieved through consistent physiotherapy, but also through appropriate sport.
Most sensible and a prerequisite for the lasting effect of all therapeutic efforts is to refrain from overloading the spine. In many cases this means primarily weight reduction .
Operational
When osteochondrosis serious nerve irritation causes, it may be necessary to create the beleaguered nerve surgically place - either by removing protrusions or incidents of disc tissue, either by removal of bony spondylophyte. In individual cases, it can make sense to widen the narrowed intervertebral space again with a spacer.
literature
- Wolfgang Noack: The intervertebral disc , practical orthopedics; Vol. 24 , Georg Thieme Verlag, Stuttgart / New York, 1994, ISBN 3-13-129201-6
- Carl Joachim Wirth: Orthopedic Practice , Georg Thieme Verlag, Stuttgart / New York, 2001, ISBN 3-13-125683-4
- Joachim Brossmann, Christian Czerny, Jürgen Freyschmidt: Limits of the normal and the beginnings of the pathological in the radiology of the child and adult skeleton , 13th edition. Georg Thieme Verlag, Stuttgart / New York, 2001, ISBN 3-13-362214-5
