In literal translation from Latin dorsopathy means back disease( dorsum - back, patia - disease).In fact, dorsopathy is not an independent disease, but a pathological condition that is characteristic of osteochondrosis, spinal injuries and specific vertebral lesions in syphilis, tuberculosis, and tumors. With dorsopathies, not only bone and cartilaginous tissue of vertebrae and intervertebral discs undergo pathological changes, but also adjacent muscles, nerves, ligamentous apparatus, blood vessels.
Dorsopathy can occur in the following anatomical areas:
- In the cervical spine of
- In the thoracic spine of
- In the lumbosacral spine of
- Combined variant with lesions of several
departments Of all the above options, dorsopathy of the lumbosacral spine is most common. It is the lumbar vertebrae that are most vulnerable in the functional plan. The loin bears the maximum mechanical load, it accounts for the majority of the body weight. In this anatomical zone there is a large muscular mass, from the sacral plexus originates the largest nerve - ischial.
Intervertebral discs are compressed by massive bodies of the lumbar vertebrae and are shifted to the side or back. Initially, the integrity of the outer fibrous membrane of the disc is not impaired( protrusion of the disc).Later it bursts, and the gelatinous substance flows outward( disc hernia).At the same time, the roots of the spinal nerves are squeezed and inflamed, the work of the internal organs is disrupted.
Dorsopathy of the cervical spine is also a common phenomenon, although the neck is not affected as often as the lumbosacral department. Nevertheless, this pathology has its own peculiarities. The neck does not experience such a mechanical load as a loin. But in the neck are carried out large in terms of the volume and complexity of the movement - turning, rotating, tilting toward the head. Especially vulnerable is the articulation of the 1st( atlant) and 2nd( axis) cervical vertebrae. These vertebrae have a different anatomical structure, the articulation between these vertebrae assumes the maximum load when making movements. In addition, the cervical spine passes the vertebral artery. Therefore, the dorsopathy of this department is accompanied not only by damage to the peripheral nerves, but also by a violation of the central nervous system, the brain.
Dorsopathy of the thoracic spine is less common, although this species is most often observed in young patients. Displacements of disks are observed here infrequently, since the lumbar region is enclosed in the costal framework. The curvature of the spine, pain in the spine, pain on the skin, dyspnoea and palpitation come to the fore.
Depending on the structural damage and functional disorders, the dorsopathy of the spine is divided into three main groups:
- Deforming osteopaths - this includes all kinds of curvature of the spine( kyphosis, lordosis, scoliosis), and displacement of the vertebrae relative to each other without disc hernias and protrusions.
- Spondylopathies - inflammatory, degenerative-dystrophic or mechanical damage of the vertebrae in traumas, osteomyelitis, tumors, tuberculosis
- Dissociated dorsopathies - pathologywhich leads to the degeneration of the fibro-cartilaginous tissue of the intervertebral discs with subsequent dislocation of the disc in the form of protrusion or disc hernia
The causes or etiological factors of dorsopathy are diverse. This is any disease or adverse external effect, which leads to the above pathological changes. The etiological factors of dorsopathies are:
- Overweight, sedentary lifestyle
- Inadequate nutrition resulting in dystrophy of intervertebral discs
- Weak immunity, frequent colds
- Adverse conditions at work and at home - carrying heavy loads, vibration
- Constant stay in uncomfortable position in schoolchildren, students, officeemployees
- Injury of the spine
- Severe concomitant diseases of the nervous, cardiovascular, digestive system
- Specific pathology - tuberculosis,syphilis, oncology
Symptoms of dorsopathy are as diverse as their etiological factors. The pain syndrome comes to the fore. Pain occurs due to inflammation and compression of the nerve roots, but not only. Along with the radicular pain of the patient with dorsopathia, muscle pain is caused by the pathological tension of the muscles. There are various unpleasant sensations on the skin in the form of burning, crawling, crawling, numbness. In addition, dorsopathy is characterized by a limited mobility of not only the spine, but also limbs. Very often, a decrease in the volume of movements is accompanied by a decrease in sensitivity.
In the case of dorsopathia of the neck, in addition to the symptoms described above, signs of cerebral circulation disorders with dizziness, gait unsteadiness, fatigue, sleep disturbance, fluctuations in blood pressure figures are noted. But these symptoms do not arise immediately, but gradually. Dorsopathy is characterized by staging. This is the cunning of this pathology, which takes place in several stages. As an example, consider dorsopathy of the lumbar spine.
Initially, dystrophic processes with a metabolic disorder in the intervertebral disk occur at the tissue level. The defeat of the cartilage tissue at this stage is not felt by the patient and is not clinically detected.
In the future, the bone tissue of the vertebrae is involved in the pathological process. They shift relative to each other and press on the intervertebral disc. The disc also shifts and squeezes the sensitive nerve roots. There is pain.
As a result of further displacement and compression of intervertebral disks, due to sudden movements or lifting of the heaviness, the fibrous membrane of the disc is destroyed. Lumbar lordosis( anterior displacement) is further intensified, and with it pain increases.
In the final period, a persistent muscular tension is formed, a change in posture due to displaced vertebral bodies. Intervertebral spaces are filled with a fibrous tissue with subsequent deposition of mineral salts in it.
Diagnosis of dorsopathy in most cases is not difficult. To recognize the nature of the pathology, the neuropathologist can on the basis of patient complaints and neurological tests. In order to clarify the diagnosis, an X-ray examination of the spine is performed.
For more accurate diagnosis, ultrasound, computer or magnetic resonance imaging is performed. If necessary, the attending physician can resort to the help of colleagues - surgeon, traumatologist, therapist, gynecologist.
Treatment of dorsopathies should be comprehensive. Along with medicines, massage, medical gymnastics, physiotherapy procedures are used. If dorsopathy is caused by a lesion of intervertebral discs or a curvature of the spine, a good result is given by manual therapy. It, like a massage with physiotherapy exercises, can not be used in cases where dorsopathy is caused by tuberculosis, a tumor, and some concomitant diseases of the internal organs.
Among medications most often used painkillers, injections and ointments. Along with them apply anti-inflammatory drugs - non-steroidal and steroid( hormones).Restore affected cartilage can be a long-term use of chondroitin sulfate in tablets and ointments. As already indicated, in most cases dorsopathies develop against a background of low immunity. In this regard, patients take vitamins and drugs that stimulate the immune system.
In the case of dorsopathies, treatment with folk remedies may be effective. A mixture of natural substances is used as local flavors, compresses and lotions. These substances can be used in their original form or in the form of infusions, decoctions. It is important to remember that popular treatment in no way excludes the generally accepted, but only supplements it.
- Diagnostic tests
- Therapeutic tactics
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