Many people associate the word "osteonecrosis" with old age. There are opinions that this is a disease of her grandparents, including the disease "back pain", "back pain". However, there is only part of the truth in this illusion: indeed, osteonecrosis isdegenerative(i. e. due to local metabolic disorder)changes inspine, inevitably appears in all elderly. However, osteonecrosis today is found in 9 out of 10 people over 45, and the first symptoms of the disease can begin as early as 25 years old.
This disease is even known as"disease of civilization", as the main cause of osteonecrosis disease is due to improper "exploitation" of the spine. The fact is that a modern person forces him to be under excessive load, and paradoxically, not when he runs or lifts weights, but when he sits without getting up from his chair for many hours. This load is calledstaticand is very complicated. Because a person thinks he is resting while he is sitting. But in fact, the sitting spine works with increased stress.
How the spine works
To understand what osteonecrosis is, you need to understand what the human spine is. We all know that the spine is composed of vertebrae, connected by discs. In total, a person typically has 33-34 vertebrae: 7 of which make up the cervical region, 12 - thoracic region, 5 (or 6 in a small proportion) - lumbar, 5 more vertebrae, developedTogether, the coccyx forms the ultimate and, ultimately, the coccyx region consists of five (or four - depending on individual characteristics) vertebrae. In fact, the vertebrae are bones and they are immobile, but so that they can move freely, giving mobility to our entire body and also preventing them from collapsing by impact and ghosts. Close, there is a gelatinous layer between each vertebra (the so-calledThenucleus of the spinal cord) is surrounded by sturdy laminated plates (annulus fibrosus). Collectively, this is called adisk.In addition, the structure of the spine also contains many ligaments, blood vessels, and nerves. This is a very complex organ, which largely determines the work of almost all body systems, as it protects the spinal cord and affects its work.
The vertebrae and disc are constantly being renewed throughout a person's life. This is because they have an adequate supply of blood and are always well-nourished. However, if for some reason, nutrition into the spine begins to flow in insufficient quantities, the marrow nucleus loses its properties, the disc becomes flat and less elastic, cracks appear withinthe cushions, and the vertebrae themselves begin to move in different directions and come together. All of this leads to some dangerous deviations - mostlyInflammation of both the spine itself and surrounding tissues and compression of the spinal cord and spinal nerves.
It is interesting to note that the concept of "spinal necrosis" mainly exists in the post-Soviet space. In foreign literature, the changes that occur in the spine are called"hernia", "myalgia", "disc injury", "back disease". So if you've heard something similar about yourself, then you've got osteoarthritis of the spine. Fordisc herniation, it is considered one of the stages of osteonecrosis.
The disease does not have an acute course and develops gradually: first the disc narrows, degeneration changes, then appearsprotrusions - the pulp seems to be squeezedand mixed with a fiber bag, but not broken. When ring ruptures, they refer to disc herniation.In the final, most severe stage of degenerative osteoporosis,the discs are completely worn out, the vertebrae begin to rub together and also collapse, pathological foci appear andbone-forming cells. In the final stage, the spine becomes "petrified", ie the loss of mobility, which can lead to disability.
Causes of spinal disease
For what reason do all the abovedegenerative changes occur?As mentioned, the main cause is due tohaving an abnormal load on the spine:for example, when a person has to sit a lot in uncomfortable positions, "hunching over”, The neck and chest areas are stretched and not getting needed. nutrition. Additionally,bone necrosis can develop due to incorrect posture.However,sports, especially strength sports, a violation of exercise techniquescan also lead tospinal degenerative changes.
Another common cause is anyback injury. The development of osteonecrosis can also be influenced bygenetic predisposition, hormonal disturbances, overweight, unhealthy diet, inadequate drinking and, as a result, loss. water, smoking and alcohol abuse.
Women often experience the first symptoms of osteoporosis during pregnancy, then, when young mothers have to breastfeed in uncomfortable positions and are frequently held in their arms, the conditionThe spine becomes exacerbated.
Symptoms of bone necrosis
Symptoms of osteonecrosis vary widely and depend on the exact part of the problem. Pain is the main manifestation of this pathology, however, it is not untilbreaks the ringthat it is mild, can be dull, dramatic, and the patient may not notice it.The pain is usually more severe in the morning or after exertion, spreading to the arms, legs, neck, ribs, and chest (in this case, osteonecrosis can be easily confused with heart diseasecoronary circuit).
Additionally,may appear numbness and tingling in the limbs.
Withbone necrosis disease of the cervical spine, headache can appear, sometimes very severe, dizziness, nausea, wheezing in the ears. The development of a hernia, leading to compression of nerve ends, can lead to disruption of the work of internal organs involved in the affected nerve. For example, with a hernia in the lumbar spine, problems with urination may appear, the effect disappears, chest tightness - indigestion, cervix - problems with blood supply to the brain.
Diagnosis of bone necrosis
Only a doctor can distinguish osteonecrosis from other diseases of the internal organs and determine the source of the pain. Today, the most reliable method to diagnose spinal diseases is magnetic resonance imaging.
X-rays are also reliable, but less informative. On X-ray imaging, you can see changes in the disc, but you cannot see a hernia and evaluate the condition of the spinal cord and how much compression it has caused by displaced vertebrae. In addition, MRI allows you to differentiate osteonecrosis from other dangerous diseases, including melanoma and Bechterew's disease.
Is bone necrosis cure possible?
Unfortunately, it is not possible to cure osteonecrosis, but it may alleviate the patient's condition andprevents further destruction of the disc, however, tocompletely changed the way of life - exercising physical therapy, swimming, taking regular courses of massage or manual therapy, starting to eat properly, and quit bad habits. Sports, massage, proper nutrition and weight loss can have a much greater and lasting therapeutic effect than medicine.
Doctors are still debating the effectiveness of chondroprotectors - drugs that restore cartilage tissue and, supposedly, fortify the fibrosis, their effectiveness has yet to be fully proven, but because of themThey are certainly not harmful so they can be used to treat osteonecrosis.
For severe pain, your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants (muscle relaxants), and pain relievers.
Used in the treatment of osteonecrosis andvitamins, since their deficiency causes further destruction of the disc: Example:vitamin BIt helps to improve protein metabolism between tissues and since then protein is the main building material in the body, then normalization of protein metabolism contributes to the repair of nerve and cartilage tissues. Vitamin A improves blood circulation. However, taking vitamins, like any other medicine, should be careful, as they can cause serious side effects and should be taken only after consulting a doctor and under supervision. doctor's watch.
Surgical treatment for osteonecrosis is also possible, but as a rule it applies whensignificantly narrows the spinal canal and overpresses the nerve and spinal cordlive from a hernia. In this case, the situation was so difficult that the patient could not walk, his internal organs began to fail or was in danger of having a stroke. Usually, such serious consequences are due to necrosis of the spine of the neck and lumbar spine, degenerative changes in the thoracic spine, even in the presence of a hernia, almost never needing surgical treatment.
Today,methods known as surgical resectionare being actively incorporated into medical practice, as physicians manage to preserve the indispensable structure of the vertebra. by partially removing the marrow nucleus withendoscopy. The device is inserted into the position of spinal injury through small incisions in the skin, avoiding large blood loss. Since the entire disc is not removed during surgery, the biomechanics of the spine are generally not disturbed, and this helps shorten the recovery time. Usually, patients get up within a day after surgery. However, any spinal surgery has potential complications and subsequent relapses, so experienced specialists will try to delay surgical treatment to the end. And here everything is up to the patient himself: if they follow all the recommendations of their doctors and healthcare, then even with a hernia, they will be able to do it without surgery. technique.