Degenerative changes of the spine - treatment and social problem
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 6
Abstract
Current opinion of origin and natural course of degenerative spine changes is presented. Complications of degenerative spine disease influence clinical picture with dominant pain and symptoms of nervous system's damage. Development of degenerative changes in the disc and facet joints can lead to weakness and destabilisation of the spinal intersegmental connection system. In consequence the vertebral spine column is more sensitive to overloading and microtrauma, becoming a source of pain called mechanical. Musculoskeletal or pseudoradicular. The pain is generated by stimulation of the articuloligamento-muscular nociceptors following trauma and inflammation. Degeneration of the intervertebral disc may cause hernias and damage of nerve roots or spinal cord, with radicular neuralgia or specific neuropathic pain in some patients. The pain in the lumbar spinal hernias is due to compression and inflammation. In the late stage the proliferative degeneration process with advanced osteophytosis and new bone formation shaping even invertebral bridges may be positive because of vertebral column restabilisation. Although in some patients it can lead to the stenosis of spinal canal and intervertebral foramens, disturbing the arterio-venous microcirculation in the spinal cord and/or nerve roots. Then it can cause myelopathy in spinal canal stenosis or neurogenic (radicular) intermittent claudication generated by compression and ischemia, especially in elderly patients. The clinician should consider those mentioned above mechanisms of clinical symptoms and existence and degree of neurological complications in therapeutic approach. The new trends of nonstandard treatment and protection from disability are described according to recent investigations.
Authors and Affiliations
Tadeusz Styczyński
Keywords
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