Who is susceptible to degenerative dystrophic changes in the sacral region? Degenerative-dystrophic changes in the lumbosacral region.

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With a modern sedentary lifestyle, constant sudden movements, injuries, when the spine takes on a large load, temporary changes and deformation of cartilage tissue may occur.

Often, doctors give patients diagnoses such as spondylosis, osteochondrosis, spondyloarthrosis. The degenerative process in the intervertebral discs of the spine develops in 4 stages, and symptoms vary depending on the case.

If you encounter the symptoms listed below, then you need to see a doctor and start treatment.

What are degenerative-dystrophic changes in the lumbosacral spine?

Take any person: everyone has suffered from lower back pain at least once in their life. Medical statistics say: 20% constantly complain of lumbar pain, and 1-3% require surgical treatment. The lumbosacral region is the center of gravity of the body; it takes on all the loads accompanying any movement of the human body.

Sometimes these loads exceed permissible limits, temporary changes and deformation of cartilage tissue occur in the spine. Under the influence of pressure on the damaged area of the spine, salts present in the bloodstream and plasma begin to actively penetrate into its structure.

Calcification of a certain area of cartilage tissue begins. These are degenerative-dystrophic changes in the spine.

Degenerative-dystrophic changes in the lumbosacral spine is a syndrome in which the pathology of the intervertebral disc provokes the appearance of lower back pain.

Although there is a slight genetic predisposition to the occurrence of this disease, the true cause of degenerative changes in the spine appears to be multifactorial in nature.

Degenerative changes can be caused by the natural aging process of the body or have a traumatic nature. However, they are rarely the result of extensive trauma, such as a car accident.

Most often, we will be talking about a slow traumatic process leading to damage to the intervertebral disc, which progresses over time.

The intervertebral disc itself does not have a blood supply, so if it is damaged, it cannot repair itself in the same way as other tissues in the body. Therefore, even minor damage to the disk can lead to the so-called. a “degenerative cascade” due to which the intervertebral disc begins to deteriorate.

Despite the relative severity of the disease, it is very common and current estimates suggest that at least 30% of people aged 30-50 years have some degree of disc space degeneration, although not all experience pain or are diagnosed with it.

In fact, in patients over 60 years of age, some level of intervertebral disc degeneration detected by MRI is the rule rather than the exception.

Pathogenesis of the disease

The spine in the lumbar and sacral areas is subject to the greatest loads in comparison with its other parts. Therefore, degenerative and dystrophic changes in it develop more often. The incidence is high - up to 30% of the population over 35 years of age.

Degenerative-dystrophic changes in the lumbosacral spine are a multifactorial pathology, their development is provoked by many reasons.
The main steps of the process are the same, regardless of the reason:

malnutrition (dystrophy) of the cartilage of the discs between the vertebrae, which leads to their destruction (degeneration);
degeneration of cartilage tissue causes changes in the height of the intervertebral discs,
the appearance of protrusions in them with destruction of the fibrous membrane (hernia) or without (protrusion).

All these factors cause a violation of the proportional relationship of the vertebrae, with subsequent infringement of the spinal roots; development of inflammation in the area of degenerative changes in cartilage - cells of the immune system, due to destruction processes, produce substances that induce the inflammatory process (prostaglandins), which cause pain, increased blood supply (hyperemia) and tissue swelling.

The pathological process takes a long time and tends to gradually progress and become chronic. The main disease with degenerative changes in the lower back and sacrum is osteochondrosis, which can be accompanied by hernias or protrusions of discs between the vertebrae.

In the case of predominant damage to the cartilage of the vertebral joints, spondylosis develops. For degenerative changes to move into an irreversible phase, a lot of time must pass. And this time the disease plays out in a person, due to the fact that the disease does not manifest itself immediately.

Pronounced symptoms show themselves when time is lost, and the degenerative changes themselves have become large-scale and irreversible. The medical term “degenerative-dystrophic changes in the spine” summarizes several diseases.

Type of spinal degeneration

Those few who seek help from a doctor with the firm intention of curing (or at least getting rid of the pain) an illness most often receive the following diagnoses:

Spondylosis. Atypical bone growths form along the edges of the vertebrae. The disease is characterized by marginal bone growths that look like vertical spines on an x-ray. Experts consider this disease to be clinically insignificant. Doctors around the world believe that osteophytes (marginal growths) and thickening of ligaments lead to immobilization (immobilis - motionless) of the problem-prone segment of the spine;
Osteocondritis of the spine. There is a visible thinning of the intervertebral disc, which occurs without inflammation. Simply put, this is a decrease in the height of the disc located between the vertebrae. As a rule, the disease appears as a result of processes of degeneration of vertebral tissues; osteochondrosis is characterized by the absence of inflammatory phenomena. During osteochondrosis, the vertebrae and articular processes come closer together, as a result of which their frequent friction is inevitable - it will inevitably lead in the future to local spondyloarthrosis;
Spondyloarthrosis. This disease is a consequence of osteochondrosis. It is arthrosis of the intervertebral joints. In simple terms, spondyloarthrosis is a type of osteoarthritis.

There are many more similar diseases, the consequences of each of which boil down to disruption of the functioning of the spine, and in some cases even to the loss of a person’s ability to work.

Causes of the disease

The human body is a delicate and calibrated mechanism. It is determined by nature itself that the load on the human spine should be distributed evenly. A healthy spinal column can withstand both jumping and heavy lifting.

But all this works only when a person watches his posture and has a strong muscle corset. Modern lifestyle is sedentary. And this leads to weakening of the muscle corset and weight gain.

Sedentary work contributes to the appearance of degenerative changes in the spine. Due to degenerative changes, intervertebral discs lose moisture, cracks and all kinds of ruptures form in them. This contributes to the appearance of intervertebral hernias.

When the load changes, the vertebrae try to increase their area, grow, and become increasingly thick, pinching the adjacent nerves.

Reasons that provoke pathological changes:

constant or sudden loads;
active sports with heavy loads;
injuries; including generic;
natural aging of the body;
inflammatory diseases of the spine;
poor nutrition.

Degenerative-dystrophic changes in the lumbosacral spine are usually provoked by one or both of the following two reasons:

Inflammation that occurs when proteins in the disc space, when a herniated disc forms, irritate the nerve roots.
Pathological instability of micromotion, when the outer shell of the disc (annulus fibrosus) wears out and cannot effectively withstand the load on the spine, which leads to excessive mobility in the affected spinal segment.

The combination of both factors can lead to persistent lower back pain. The combination of both factors is most common in the formation of intervertebral hernia, which is a complication of the degenerative process in the intervertebral discs.

When a disc herniation occurs, mechanical compression of the neurovascular bundle passing in the spinal canal is also added, as a result of which the pain in the lower back increases significantly and becomes permanent.

Symptoms of the disease appear as degenerative-dystrophic lesions develop, but in the initial stages they pass without pronounced external signs. As the pathological process develops, the patient may feel stiffness and heaviness in the lower back.

But, the main symptom of all degenerative changes in the spine is pain. Pain in the lumbar region occurs during long walking and physical activity, prolonged sitting in one position, and bending. The pain syndrome is wave-like: it arises, then decreases, and disappears.

The progressive degenerative process in the intervertebral discs of the spine can lead to serious and dangerous complications. Degenerative changes develop in stages.

initial stage
The first symptom that “screams” about the presence of pathological changes in the lumbar spine is a pronounced pain syndrome in the lower back.

The pain is so noticeable that the patient is forced to limit his movements, and this significantly reduces the normal standard of living and performance. Complaints of pain directly depend on the location of the lesion.

Second stage
Further progression of degenerative changes is characterized by the presence of:

At the second stage of the disease, radicular syndrome develops - compression of the nerve roots occurs.

Third stage
At the third stage, blood circulation is disrupted due to compression of the radicular vessel, which leads to the development of ischemia. In addition to increasing pain, the third stage is noted:

partial or temporary numbness in the lower extremities;
convulsions.

Fourth stage
Degenerative pathological processes of the spine that have not received proper treatment at the fourth stage of development are fraught with paralysis and paresis. These complications arise due to complete disruption of the blood circulation of the spinal cord.

severe mobility limitations;
“lumbago” that occurs in the lower back;
tingling and goosebumps in the limbs and buttocks.

Most patients with degenerative-dystrophic changes in the lumbosacral spine experience constant but tolerable pain, which intensifies from time to time for several days or more. Symptoms may vary depending on the individual case, but the main symptoms of this disease are as follows:

Pain localized in the lower back, which can radiate to the hips and legs;
Long-lasting pain in the lower back (lasting more than 6 weeks);
Low back pain is usually described as dull or aching, as opposed to a burning pain in the areas to which it radiates;
The pain is usually worse in a sitting position, when the discs are subjected to more pronounced stress compared to what is placed on the spine when the patient stands, walks or lies down. Prolonged standing can also increase pain, as can bending forward and lifting objects;
The pain worsens when performing certain movements, especially when bending, turning the body and lifting heavy objects;
When a disc herniates, symptoms may include numbness and tingling in the legs and difficulty walking;
With a medium or large disc herniation, the nerve root emerging from the spinal cord at the affected level may be compressed (foraminal stenosis), which, in turn, can lead to pain in the legs (sciatica);
Neurological symptoms (for example, weakness in the lower extremities) or dysfunction of the pelvic organs (various urination and defecation disorders) may be a consequence of the development of cauda equina syndrome. Cauda equina syndrome requires immediate action to provide qualified medical care.
In addition to lower back pain, the patient may also experience leg pain, numbness, or tingling. Even in the absence of compression of the nerve root, other vertebral structures can cause pain to radiate to the buttocks and legs. The nerves become more sensitive due to inflammation caused by proteins within the disc space, causing numbness and tingling sensations. Usually in such cases the pain does not go below the knee;

In addition to degenerative changes in the intervertebral discs, the cause of pain can be:

Stenosis (narrowing) of the spinal canal and/or osteoarthritis, as well as other progressive diseases of the spine, the occurrence of which is facilitated by degeneration of the intervertebral discs;
Intervertebral hernia, a consequence of intervertebral disc degeneration.

Diagnostics

X-ray;
CT (computed tomography);
MRI (magnetic resonance imaging).

The first of these methods is the most accessible, but at the same time the least informative. X-rays provide information about the location of the bones and deformities of the spine. It is able to detect the disease in its later stages. CT and MRI are more modern methods.

MRI allows you to see the destruction of the disc space, dehydration of the disc, erosion of the cartilaginous end plate of the vertebral body, the presence of an intervertebral hernia, and a rupture in the annulus fibrosus. But such procedures are usually expensive.

Diagnosis of the presence of degenerative-dystrophic changes in the lumbosacral spine is usually carried out in three steps:

Compiling a history of the patient, including when the pain began, a description of pain and other symptoms, as well as actions, positions and treatments (if treatment was carried out) that relieve or, conversely, increase pain;
A medical examination during which the doctor checks the patient for signs of intervertebral disc degeneration. This examination may include checking the patient's range of motion, muscle strength, looking for painful areas, etc.
MRI scanning, which is used to confirm suspicions of degenerative changes in the spine, as well as to identify other potential causes that led to the appearance of painful symptoms in the patient.

MRI results most likely indicating the presence of degenerative changes as the cause of pain symptoms:

Disk space is destroyed by more than 50%;
Initial signs of disc space degeneration, such as disc dehydration (on MRI such a disc will appear darker because it will contain less water than a healthy disc);
Rupture in the annulus fibrosus;
The presence of protrusion or intervertebral hernia;
There are signs of erosion of the cartilaginous end plate of the vertebral body. The disc does not have its own blood supply system, but, nevertheless, living cells are located inside the disc space. These cells receive nutrition by diffusion through the end plate. Pathological changes in the end plate as a result of degeneration lead to disruption of cell nutrition.

Such changes are best seen on T2-weighted images taken in the sagittal plane. Typically, the end plate appears as a black line on MRI. If this black line is not visible, it indicates endplate erosion.

Treatment of the disease

Degenerative-dystrophic changes in the lumbar spine, alas, are observed in a large number of people, and therefore the question of how to treat these pathologies is very relevant.

After all, if degenerative changes are not treated, they will progress, and the consequences can be very dire, including disability due to impaired motor activity.

There are two methods of treating degenerative-dystrophic changes in the spine - conservative and surgical. The conservative treatment method includes the following actions: Limiting the mobility of the spine (carried out using orthopedic bandages or bed rest is prescribed).

Drug treatment. Drugs are used aimed at combating inflammatory and degradation processes and improving vascular patency. Sedatives and vitamin B complexes are also prescribed.
Novocaine blockades.
Physiotherapy (laser therapy, diadynamic currents, inductothermy, electrophoresis).
Therapeutic methods (flat traction, underwater traction). Traction is considered the most dangerous method of treating degenerative diseases.
Physiotherapy.
Manual therapy.
Acupuncture, acupuncture.

The vast majority of cases of intervertebral disc degeneration do not require surgical intervention and are treated using conservative methods, which include special therapeutic exercises, physiotherapy, and various types of massages.

In addition, spinal traction helps very well with disc degeneration, since it increases the distance between the vertebrae, allows the intervertebral disc to receive the water and nutrients it needs, which contributes to its recovery.

Separately, it is worth highlighting percutaneous nucleotomy. This method is a borderline method between conservative and surgical treatment. This type of treatment involves a puncture biopsy, the purpose of which is to reduce the volume of the affected intervertebral disc.

This type has a large list of contraindications. Surgical intervention is required only in cases of rapidly progressive neurological symptoms of the disease, persistent long-term pain syndrome, and ineffectiveness of conservative treatment.

Treatment of diseases of the lumbar region is considered complete and promotes recovery if after treatment the following is observed:

reduction or disappearance of pain;
relieving muscle tension in the lumbar region, pelvis and lower extremities, strengthening muscles;
improvement of blood flow and supply of tissues with nutrients and oxygen, normalization of metabolic processes;
removal or reduction of inflammation;
normalization of lumbar sensitivity;

Non-stress spinal traction is ideal for the treatment of degenerative lesions of the intervertebral discs (spinal osteochondrosis) and its complications - spondylosis, spondyloarthrosis, intervertebral hernias and protrusions. Traction takes place while maintaining all the physiological curves of the spine and is safe, since no force is used during traction.

As the intervertebral distance increases, the nutrition of all intervertebral discs improves, their structure is restored and pain is relieved.
With the help of complex treatment, it is possible to achieve a complete recovery of the patient, and not just pain relief for a limited period.

Complication

Degenerative-dystrophic changes do not occur simultaneously, however, a person is able to feel the symptoms of the disease even at the earliest stages. First of all, nerve damage caused by pinching due to narrowed intervertebral canals makes itself felt. This position causes the nerve endings to swell and reduces their conductivity.

The patient feels this as numbness in the limbs, a feeling of fatigue in the shoulders, neck, and back. Vertebrae change their tissue growth patterns. To reduce the load, the vertebrae expands, which subsequently leads to osteochondrosis and even greater pinched nerves. People suffering from such ailments note increased fatigue, changes in gait, and constant back pain.

And if bacteria and/or fungi are added to these lesions, then arthrosis, arthritis and osteochondropathy cannot be avoided. Subsequently, these ailments transform into herniated intervertebral discs. Also, degenerative changes in muscles lead to scoliosis or even displacement of the vertebrae.

In more severe stages of the disease, ischemia, impaired blood supply, paresis, and paralysis of the limbs are observed.

Prevention

Due to the scale of the spread of degenerative-dystrophic changes in the spine, it is worth paying attention to compliance with preventive recommendations.

These rules will protect you from loss of ability to work in your youth and extend your years of activity into old age:

You should keep your back dry and warm. Humidity and hypothermia are the primary enemies of the spine.
Excessive, sudden physical activity should be avoided. Exercises aimed at developing the back muscles will also protect against degenerative changes in the spine.
When working in a static position, it is necessary to change your body position as often as possible. For office workers, it is recommended to lean back in your chair every half hour. Every hour and a half you need to get up from your chair and make small walks for 5-10 minutes.

Minimum measures to prevent back diseases include:

daily strengthening of the back muscles. This can be done by doing basic physical exercises every day (for example, exercise);
when getting out of bed, “land” on both legs (this will avoid a sharp load on the spine);
Under no circumstances should you keep your back in a curved position (try to keep your back straight even while brushing your teeth);
a serious approach to choosing a mattress. Since ancient times, we have been repeating the truth that sleep is health, because during sleep the muscles of the body relax: if this process is accompanied by an uncomfortable bed that is unable to provide sufficient support to the back, this will lead to the fact that you will wake up with the syndrome "stiff back"

Aging is the main cause of changes in the spine

Degenerative changes are the process of destruction of cartilage and bone tissue of spinal segments. In this case, the elasticity of the intervertebral discs is lost, the bone structure of the vertebrae weakens and changes in the structure of the spinal column occur.

If we consider the degenerative process in the lumbar spine, then it is worth noting that the main cause is age-related changes.

Throughout life, the lumbar region bears the heaviest load, and as a result of natural aging of the body, all processes responsible for maintaining the normal state of cartilage and bone tissue slow down.

That is why, most often, after 30 years of age, people begin to experience unfavorable changes, which in medical practice are called degenerative.

Main causes

Degenerative processes gradually destroy bone and cartilage tissue of all segments of the spine. Therefore, it is very important to identify problems at an early stage of their development. But this is very difficult to do, because the first symptoms appear after certain negative changes.

But what factors provoke degenerative processes?

The most important cause of pathological changes is considered to be an incorrect lifestyle.

This can include poor nutrition, bad habits, lack of physical activity, sedentary lifestyle and many other indicators.

Immobility leads to degenerative changes in the spine

But besides this, there are other irritating factors, which include:

Staying in an incorrect position for a long time impairs blood circulation in the spine, disrupting metabolic processes in tissues. As a result of insufficient nutrition with useful substances, cartilage and bone tissue weakens, any movements lead to microscopic injuries. It is at this moment that degenerative changes in the structure of the spine begin to develop. Large physical loads on the lumbar spine also have a detrimental effect on the normal condition of the spinal segments. Most often, people whose work involves heavy physical labor or professional heavyweight athletes are at risk. Injuries to the lumbar region often cause disruption of metabolic processes in tissues, which subsequently also leads to degenerative changes. Disruption of muscle tissue. The back muscles maintain the correct position of the vertebrae. Therefore, after inflammation or during a spasm, the coordinated work of muscle fibers is disrupted, which as a result negatively affects the condition of the spine. Infectious and endocrine diseases quite often affect segments of the lumbar spine.

There can be many reasons for degenerative changes in the lumbar spine. But the most important thing is to identify them in time and begin treatment.. Therefore, in order to prevent serious pathologies, it is necessary to undergo a full examination by a doctor annually.

Consequences of pathological processes

Osteochondrosis is the scourge of modern man

Any degenerative changes entail many different complications.

The most common of these is considered to be osteochondrosis. It represents a destruction of the anatomical structure of the spine, resulting in serious problems with the musculoskeletal system. Indeed, with this disease, the intervertebral spaces narrow, the vertebrae become displaced, and the compression of the intervertebral discs increases.

At the second or third stage of development of osteochondrosis, patients begin to experience not only back pain, but also other neurological symptoms.

Another degenerative disease is chondrosis, which precedes osteochondrosis. As a result of the development of the disease, microcracks appear in the vertebral bodies and other segments of the spine. Most often, such a degenerative process occurs at an early age or in professional athletes involved in weightlifting. This is due to heavy loads on the lumbar region, which puts enormous pressure on the segments of the spinal column.

Intervertebral hernia is also a disease associated with degenerative processes in the spine. It is these pathological changes that destroy the membrane of the fibrous ring, which, as a result of a strong load on the lumbar region, leads to protrusion of the nucleus pulposus. This tumor compresses the nerve roots extending from the spinal cord and limits a person’s movements. After all, neurological symptoms at the first stage are expressed in pain, and then in disorders of the musculoskeletal system.

Bone growths - osteophytes

Another form of degenerative-dystrophic changes is spondylosis. This is a disease in which bone growths appear on the vertebral bodies. Ossification of the lumbar spine segments occurs slowly. This gradual increase in the size of the bone growths is accompanied by severe pain when turning, bending or other body movements.

Spondyloarthrosis is a process of degenerative-dystrophic changes in the joints of the spine. Affecting cartilage tissue, the disease spreads to adjacent areas of the bone tissue of the vertebrae, forming bone processes on them. They limit the mobility of the lumbar region, and every movement is accompanied by severe pain. Without timely treatment, a person may not only have impaired functioning of the musculoskeletal system, but there is also a possibility of disability.

At the first stage of development, the degenerative-dystrophic process practically does not manifest itself, but its further spread is always accompanied by pain. They can be sharp, dull, aching or pulling, constant or periodic.

Diagnosis and treatment

Degenerative dystrophic changes in the lumbar region lead to the destruction of the anatomical structure of the spine. Therefore, in order to determine the specific location of the lesion, special instrumental diagnostic methods are used in the hospital.

Physical education is the main method of prevention and treatment of degenerative changes in the lumbar region

First of all, radiography is prescribed. It allows you to see on an x-ray all changes in the correct position of the segments, determine the exact location of the disease and the degree of damage.

Also in medical practice, computer or magnetic resonance imaging of the spine is used. These two methods make it possible to more accurately establish degenerative changes in the structure and determine the reasons for their development.

Treatment of degenerative changes always depends on the type of disease. But in any case, it is primarily aimed at stopping its development and eliminating pain in the affected area of the back. For this purpose, painkillers and anti-inflammatory drugs can be prescribed, as well as chondroprotectors for tissue restoration.

Physiotherapeutic treatment often involves back massage. Manual therapy makes it possible to restore the correct position of the vertebrae, and physiotherapeutic procedures such as UHF, electrophoresis and phonophoresis speed up the healing process.

And the most important method of both slowing down and preventing such processes is therapeutic exercises.

Thanks to a specially developed set of exercises, patients not only improve blood circulation and improve metabolic processes, but also maintain the mobility of the spine and the elasticity of all its segments.

Degenerative changes in the lumbar spine are one of the leading social problems: spinal pathology affects not only older people, but also young and middle-aged people, that is, the working population. In addition, the diagnosis of degenerative changes in the spine, in particular displacement of the lumbar vertebrae, is a poorly studied issue in radiology.

Interest in the issue of degenerative changes in the lumbar spine is also not accidental because the displacement of the vertebrae and their instability become the cause of pain and subsequent neurological disorders. And, taking into account the costs of treatment, diagnosis, compensation for disability, disability, we can say that such a spinal disease is the third most expensive disease after oncology and cardiovascular diseases.

This significance of the problem of osteochondrosis (which is a form of degenerative changes in the spine) is due to a number of reasons. One of them is the high prevalence of morbidity: according to WHO data in 2003, up to 87% of the entire working population suffers from spinal osteochondrosis. Incidence rates in Russia are growing, and in most patients the disease is accompanied by damage to the lumbar spine. Lumbar osteochondrosis in the structure of morbidity among the adult population in our country is approximately 50%, while occupying first place (including in terms of time of disability).

What does the health of the spine depend on?

Mobility and health of the spine are possible thanks to the elasticity of the vertebral bodies, intervertebral discs and arches. Under normal static conditions, the function of absorbing vertical pressing forces (for example, the heaviness of the torso, head) is carried out by intervertebral discs. In cases where the articular processes are forced to perform a supporting function that is unusual for them, anterior displacement of the vertebrae and local arthrosis develop in the true joints. With significant and increasing vertical load, neoarthrosis of the articular processes with the bases of the arches develops. Moreover, the entire spine and the muscular-ligamentous apparatus of the entire body resist the applied force, adapting to the external load. It is under the influence of cumulative microtraumas as a result of acute and chronic overloads that degenerative-dystrophic changes develop in the segments of the spine, including the lumbar region.

What to do?

The problem of instability of the spinal motion segment, which arises under the influence of various factors, is far from being resolved. The general principle of treatment for exacerbations of osteochondrosis pain syndrome is the elimination of manifestations of the disease - restrictions in movement and pain itself. This includes eliminating static-dynamic unfavorable loads on the diseased part of the spine, ensuring rest, especially at the very beginning of an exacerbation. Next, you need to take care of strengthening the spinal muscles to ensure the protective function of the spinal segment, that is, special gymnastics and an active lifestyle.

Pathologies of the intervertebral discs can lead to degenerative-dystrophic changes in the lumbosacral spine, which will be accompanied by pain and discomfort. In middle-aged people - from 30 years old - deviations occur in approximately 30% of cases, and at retirement age changes are almost inevitable. However, sometimes the disease can appear in younger people, so at any age it is important to start treatment before complications appear.

Causes of degenerative-dystrophic changes in the lumbosacral region

There are several factors that can contribute to the development of the disease, and they can act together or separately:

The presence of an intervertebral hernia can provoke inflammation. It appears due to irritated nerve roots.
Wear of the annulus fibrosus. The deformation leads to the fact that the spine can no longer cope with the load, especially heavy ones. As a result, pathologically unstable micromovements are formed in the spinal segment.

Most often, degenerative changes in the lumbosacral spine are the result of a disease such as intervertebral hernia.

Symptoms of the disease

A patient interview and external examination may show the following signs:

The pain is of a dull nature, described as aching. At some stages of the disease, it may “give” to the buttocks with subsequent movement to the lower extremities.
Abnormal sensations in the legs, varying in intensity: weakness in the limbs, tingling, numbness.

We previously wrote about the symptoms of radicular lumbar syndrome; we recommend reading the article.

Advice: Degenerative changes take a long time to reach an irreversible form, however, given that a long period of the disease can pass almost unnoticed by a person, you should consult a doctor immediately after the onset of symptoms.

Disorders of urination and defecation, problems with reproductive function.
The need to “disperse” in the morning before fully starting to move. Stiffness may also be felt throughout the day.
Increased temperature in the affected area of the back.
The appearance of redness and swelling in the lower back.
Asymmetry of the buttocks.

A characteristic sign of the first stage of degenerative changes in the lumbar spine is pronounced pain in the lower back, which forces movement to be limited.

Diagnosis of degenerative changes

Only a doctor can make a correct diagnosis. Diagnostics is usually carried out in three stages:

The patient's history is compiled. Information should be collected about the time of onset of pain and its nature, the presence or absence of other signs and concomitant diseases, and attempts to independently cure the disease. Positions and movements are also recognized when the pain subsides and intensifies.
A medical examination is carried out. It involves identifying signs of degenerative changes in the spine.
Registration of the MR picture of degenerative-dystrophic changes in the lumbosacral region using MRI. The study not only confirms the diagnosis, but also identifies possible causes of the disease.

During an external examination, range of motion, muscle strength, causes of pain, etc. are checked.

Important: If the disease is allowed to reach its final stage, blood circulation in the spinal cord will be disrupted, which can contribute to the formation of paralysis or paresis.

Problems detected by MRI

The study may show the following MRI signs of degenerative-dystrophic changes in the lumbar spine:

half or more destroyed disk space;
a rupture observed in the disc lining;
a critical decrease in the amount of water in the disc, reflecting the initial stage of the disease;
destruction of the cartilaginous end plate of the vertebra;
confirmation of the presence of an intervertebral hernia or protusion in the patient.

In contact with

The development of degenerative-dystrophic changes in the lumbosacral region is associated with the complex effect on the cartilaginous intervertebral and bone tissues of the vertebrae of various age-related, metabolic, inflammatory, traumatic, and behavioral factors. Pathology refers to progressive changes - without adequate treatment, not only painful symptoms occur, but also dangerous complications. Therefore, it is important for patients to know whether it is possible to prevent the progression of the pathology, and how to deal with already formed changes.

general characteristics

Quite often, doctors explain the appearance of pain, lumbago in the lower back, numbness and weakness, cramps in the lower extremities, and even malfunctions of the pelvic organs with degenerative changes in the spine. To understand this relationship, let’s try to figure out what it is – dystrophic changes in the lumbar spine.

To prevent friction and provide shock absorption, the vertebrae, which protect the spinal cord from external influences and provide support and movement of the torso, are separated by layers of fibrous cartilage - intervertebral discs. Movement and flexibility depend on the condition of the vertebral processes that form the joints, which are lined with cartilage tissue.

Under the influence of various factors, intervertebral and articular cartilage lose their functionality: they dry out, crack, lose elasticity, which entails a number of physiological changes

Doctors do not consider DDSD to be a disease of the lumbar spine of a degenerative dystrophic nature. Usually cartilage is destroyed simultaneously in other parts. Degenerative processes also affect the joints of the arms and legs.

But if, when the joints of the limbs are affected, we are talking about diseases such as arthritis, arthrosis, bursitis, then when the vertebral cartilage is destroyed, the following develops:

osteochondrosis – decreased disc height with beak-like growth of the vertebrae and the formation of vertebral hernias and protrusions;
spondylosis in the form of marginal bone growths covering the disc;
spondyloarthrosis – destruction of intervertebral joints.

The mechanism of development of such diseases is directly related to degenerative changes in the discs and joint cartilage, which become dehydrated, dry out and harden, which leads to subsidence of the fibrous ring and the proliferation of bone tissue.

Video

Video - changes in the lumbosacral region

Causes of the disease and risk group

The condition of cartilage tissue is affected by various factors, so it is almost impossible to single out a single cause of dystrophic changes.

Among the most common are:

Impaired nutrition of cartilage tissue. Associated with the aging of the body, insufficient supply of nutrients from food, metabolic disorders due to hormonal imbalances and endocrine diseases.
Excessive load on the spine. Risk factors are sports, stress on the lower back associated with professional and work activities, excess weight.
Lack of physical activity. A passive lifestyle, a long stay in an immobilized state due to other diseases, and being in weightlessness lead to dehydration of cartilage tissue and its destruction.
Spinal injuries, including birth injuries. For a young or growing organism, traumatic conditions become an impetus for the development of tissue degeneration.
Inflammatory diseases of an autoimmune, infectious, etc. nature.

The most common cause of dystrophy is still age. On the MRI picture, degenerative-dystrophic changes in the lumbosacral spine of varying degrees are observed in 80% of elderly people.

Symptoms and signs

The clinical picture of the pathology directly depends on the degree of destruction. Degenerative dystrophic changes develop in the lumbar spine over a fairly long period of time. Therefore, characteristic signs at the initial stages of the development of pathology may be completely absent.

Cartilaginous degeneration in the initial stages of degenerative changes in the lumbosacral spine can manifest itself as aching pain, heaviness in the lower back after exercise or prolonged stay in a static position.
As the pathology progresses, the mobility of the spine becomes impaired. In addition to aching and dull painful symptoms of a periodic nature, “lumbago” may be observed, radiating to the buttocks, legs, and sacrum area. Patients are concerned about numbness of the skin, goosebumps, cramps of the lower extremities. The development of scoliosis is observed.
At the third stage, it joins, manifested by sharp, piercing pain with concentration at the site of pathology and spread of pain along the damaged nerve. When blood vessels are compressed, soft tissue ischemia develops. There are malfunctions in the functioning of internal organs, primarily the bladder, genitals, and rectum.
Symptoms and signs of degenerative-dystrophic changes in the lumbar region at advanced stage 4 are manifested by the addition of complications in the form of paresis and paralysis of the lower extremities. The mobility of the spine itself is practically absent, the pain becomes chronic.

Diagnostic methods

Doctors use various direct and differential diagnostic methods, which allow not only to identify changes, but also to exclude the presence of diseases with similar symptoms.

The examination begins with a history, external examination, palpation, and motor neurological tests.

But to assess the picture of dystrophic changes in the lumbosacral spine, such methods are not enough. A preliminary diagnosis can be confirmed only after instrumental examinations:

An x-ray will show subsidence of the discs, the presence of bone growths, and displacement of the vertebrae.
CT reveals the pathological picture in more detail in a 3-dimensional image and allows one to diagnose the presence of hernias and protrusions using indirect signs.
To study the condition of soft tissues, damaged nerves and blood vessels, doctors prescribe MRI. This method is considered the most informative and safe. A significant disadvantage is the cost of such a survey.

Computer images show tears (hernias) and protrusions (protrusions) of the annulus fibrosus.

Treatment

Diseases associated with pathological changes in the spine are characterized by alternating periods of exacerbations with temporary remissions against the background of the progress of dystrophy. Therefore, for each period and stage, its own tactics for treating degenerative changes are selected:

At the initial non-acute stages and during the period of remission, preventive and behavioral treatment methods predominate.
During periods of exacerbations, conservative medication and physiotherapeutic methods come to the fore.
In advanced stages, when changes affect the nerves and spinal cord, are accompanied by loss of mobility and other complications, they resort to surgery.

Drugs

Medicines for dystrophic changes in the lumbar spine of degenerative origin are selected individually, taking into account the stage, intensity of pain, and the presence of complications.

To eliminate pain, the following may be prescribed:

Non-steroidal drugs that not only relieve pain, but also relieve inflammation in the form of Diclofenac, Movalis, Meloxicam, Ortofen, Ketanov, Ibuprofen. Most often, infusions of nonsteroidal drugs are prescribed, which accelerates the analgesic effect. During the recovery period and for mild pain, the use of external agents is allowed: ointments, gels, patches.
Analgesics: Dexamesaton, Analgin, Spazgan are administered by drip to quickly relieve pain.
Steroid drugs Betamethasone, Triamcinolone, Prednisolone in short courses in the form of injections.

In case of radicular syndrome, a paravertebral or epidural blockade is performed with the introduction of anesthetics: Lidocaine, Novacaine or combinations of drugs.

Additionally the following can be used:

muscle relaxants;
B vitamins;
chondroprotectors;
means for restoring nerve conduction;
vasodilators.

Physiotherapy

Exercise therapy is an excellent way to restore spinal mobility and strengthen the muscle corset. Adequate physical activity helps stop the progress of changes and even relieve pain during the recovery period.

But you need to be careful when choosing exercises. Intense loads, jumping, twisting are prohibited, especially in cases of exacerbation and the presence of hernias.

The complex should be developed individually and include exercises on:

spinal traction;
strengthening the muscle corset both from the back and the abs.

For back diseases, other exercise therapy exercises can aggravate the condition or lead to complications.

Water aerobics, swimming, stretching on a horizontal bar, and on an inclined board are considered safe and effective for such patients.

Massage

Some patients see salvation in massage, without thinking that the mechanical effect on the vertebrae harms even a healthy spine. Only massaging soft tissues and exclusively by a professional massage therapist will give a positive effect in the initial stages of the pathology.

When degenerative changes in the lumbosacral spine are accompanied by the formation of an intervertebral hernia, protrusion, the spinal cord is affected, and nerves are blocked, massage, especially manual massage, is strictly prohibited.

You should not massage your back during the acute period of the disease. Blood flow under the influence of massage will provoke increased swelling, inflammation and pain.

Diet

There is no special diet for patients with the list of therapeutic diets. Doctors recommend that patients adhere to a balanced diet that can provide the body with all the necessary nutrients, vitamins and minerals, which in turn will contribute to the proper nutrition of cartilage tissue.

Diet is more important for people with excess body weight, since obesity is one of the risk factors for the development of dystrophic changes.

Prevention

Age-related degenerative processes are quite difficult to avoid, but it is possible to prolong active life, despite age.

Simple preventive measures will help with this.

Degenerative-dystrophic changes in the lumbosacral region are a set of pathologies in the intervertebral disc or, alternatively, in the lumbar vertebrae. This disease can mainly be recognized by lower back pain.

In most cases, able-bodied people suffer from such problems, and gender does not play a role here. Statistics say the following: there are now an extremely large number of people with this diagnosis, and this number is growing, with no intention of slowing down the pace of development, which is not encouraging.

The body of any person is an extremely delicate and well-functioning system. And it is not surprising that changes in the activity of at least one of its components inevitably entail disruptions in the functioning of all other parts of the body. In recent years, cases of diseases of the musculoskeletal system have increased greatly among the population. Because of this, people's ability to meet their needs has decreased.

The spine is a component of the human skeleton. This organ plays a certain number of vital functions:

support;
participation in the movement;
giving the body flexibility;
distribution of nerve fibers throughout the body.

Due to the high complexity of the structure of the body, it is not so rare for its organs and tissues to age earlier than the time allotted by nature. Degenerative dystrophic changes begin to appear in the spine, which necessarily cause osteochondrosis, coupled with extremely severe pain.

Without such changes in the spine, none of its known diseases is possible. Any osteochondrosis, spondyloarthrosis, intervertebral disc herniation and the like are precisely the results of untreated degenerative dystrophic pathologies of the intervertebral disc, which can be detected by doing the necessary examination by a specialist. However, an examination is not so necessary when the disease can be indicated by the most common symptoms of pathology, which can be detected during the first examination.

Despite the fact that a person may not have a very strong tendency towards this pathology, inherited to him, in reality its root lies in the combination of many genes. Degenerative processes are also possible due to the aging process or due to any injury. And yet, extensive injuries like the same car accident do not often lead to this. In most cases, they occur due to a slow traumatic process that damages the intervertebral disc. Moreover, this damage gradually becomes more pronounced, which leads to the disease.

The intervertebral disc does not receive blood, and therefore, in case of damage, it will not be able to “patch” them in the same way as other organs and tissues. For this reason, any, even the slightest, damage to this tissue can lead to the most serious consequences, starting the so-called “degenerative cascade.” This inevitably leads to the destruction of the intervertebral disc. And this severe pathology has a very high “popularity”. According to modern statistics, almost a third of the world's population who have reached the age of four to six decades has this problem, at least to the smallest extent. This means that almost every elderly patient has such a diagnosis or pain, if not both.

Why does the disease begin?

In more than half of the cases, this problem occurs for at least one of the following reasons:

inflammatory processes that begin due to the fact that the nerve roots are irritated by the protein located in the disc space during the appearance of a hernia;
microscopic damage that occurs if the annulus fibrosus wears out, completely losing any ability to bear load. The consequence is excess mobility in the affected area.

Most often, the combination of these two factors occurs when an intervertebral hernia begins to develop, which is a complication of the pathological process in the intervertebral discs. When it appears, the neurovascular bundle passing through the spinal canal is compressed by mechanical action. Because of this factor, lower back pain becomes much stronger and does not stop.

In general, degenerative-dystrophic pathologies most often cannot arise without an incorrect lifestyle. This is characterized by a lack of moderate exercise, an unbalanced diet, as well as insufficient sleep and, of course, bad habits such as addiction to tobacco and alcohol consumption. Other reasons why dystrophy of the lumbar spine may begin:

the harmful effects of heavy loads on the spine, due to which the segments of the lumbar region become less elastic. Because of this circumstance, the greatest danger of contracting one or another lower back disease is faced by people who constantly expose themselves to heavy physical activity, especially if it is required for work;
staying in a sitting position for a long time, and with incorrect posture, which also leads to impaired blood supply. And this affects both the lumbar region and the rest of the body. This entails metabolic disorders in bones and muscles. Metabolic disorders spoil the structure of tissues. And because of all this, microtraumas can easily appear in the spine from any movement. In this regard, pathology may begin to develop;
infectious pathologies, as well as diseases associated with the endocrine system. Because of them, harmful processes in the lower back can also easily begin;
certain mechanical injuries of the spine. They cause injuries to bones and muscles;
back muscle damage. This, of course, also has a detrimental effect on the spine in general, and on its lumbar region in particular;
Often the cause of the pathology can be described with just one simple word: “old age.” Then the disease can hardly be cured. In this case, they do not try to cure the person, but only provide supportive therapeutic procedures to prevent the disease from worsening.

What can happen due to this pathology

Once you start degenerative changes in the spine, severe complications in the lumbar region cannot be ruled out:

hernias;
osteochondropathy;
numbness and partial paralysis of the lower extremities;
complete paralysis of the legs;
difficulty going to the toilet;
decrease/loss of libido.

To avoid such problems, you should promptly and wisely choose what and how to cure the pathology. This way you can most effectively keep the intervertebral discs intact.

How to recognize the disease

More than half of the patients who have degenerative-dystrophic pathologies in the lower back complain of ongoing pain, which, however, can be tolerated. But sometimes they become stronger for a long time. For the most part, each patient has his own symptoms of the disease, but there are several common signs:

the back hurts, and pain in the hips and legs is possible;
pain in the lumbar region lasting over one and a half months;
in the lower back the pain is dull/aching, and in the hips and legs it is burning;
when the patient sits, the pain becomes stronger. Standing, walking or lying down, he feels less pain. Standing for too long, bending forward or lifting something heavy, the patient feels a more “bright” pain;
If a person has a herniated disc, his legs may go numb and their legs may tingle. In addition, he may have trouble walking;
if the hernia turns out to be medium in size, it is possible that the nerve root that exits the spinal cord at the affected level will be compressed (foraminal stenosis), and this will already provoke pain in the legs ();

symptoms of neuralgia, such as weakened legs, as well as various problems in the functioning of organs in the pelvic area (difficulty going to the toilet) can quite eloquently “hint” at the appearance of cauda equina syndrome. Then you need to urgently consult a doctor;
inflammation caused by proteins trapped in the disc causes the nerves to react more sharply to stimuli. This is what makes your legs go numb and tingling. Moreover, in most cases, such sensations are localized in the knee or higher.

If you want to learn in more detail how to treat, and also consider symptoms, diagnosis and alternative treatment methods, you can read an article about this on our portal.

Lower back pain can easily appear not only due to pathological processes in the discs, but also from the following:

narrowing (stenosis) of the spinal canal, osteoarthritis, any other spinal pathology that worsens over time, caused by deterioration of the discs. However, this does not mean that such diseases cannot be combined;
hernia caused by disc pathology.

Moreover, with the development of the disease, as well as the transition from one stage to another caused by it, its symptoms become increasingly stronger:

stage№1 . The disease rarely manifests itself in any way. Perhaps after physical work you may feel a dull pain, but in most cases it is mistaken for normal fatigue;
stage№2 . You can clearly distinguish symptoms from normal phenomena. From time to time there is a “shoot” in the back. It's also hard to bend sometimes. The reason lies in the nerve endings: they are compressed, and therefore the pelvic area “tingles”;
stage№3 . Spicy. At this time, metabolism in the lower back is disrupted because the blood vessels are damaged. Ischemia, cramps, and numbness of the legs appear. The pain becomes stronger;
stage№4 . Due to deformation of the spinal cord, the legs may become paralyzed. This pathology has exacerbations - the time of greatest severity of symptoms. If dystrophy becomes chronic, the symptoms weaken to a state of tolerable discomfort.

Diagnostics

It is very important that the disease is diagnosed before the first complications appear. For this purpose, diagnostics are made using a variety of methods so that they capture many types of stimuli. However, the patient must first be examined by a neurologist. After the examination, the specialist will definitely prescribe additional examinations to make the diagnosis more accurate.

In most cases, the following methods are used: x-rays, computed tomography (CT), and MRI.

X-rays are the most accessible, but at the same time they are the least useful. This technique allows you to diagnose pathology when it has already reached one of the fairly late stages. MRI and CT are much more useful. Using these methods, it is possible to more reliably determine both where the focus of the disease is and how far it has developed.

Moreover, it is best to rely on MRI for information about the presence/absence of changes.

What an MRI can show for disc degeneration:

destruction of the disk if it exceeds half of it;
disc dehydration. On MRI, such tissue is shown darker;
the presence of hernias, as well as protrusions;
erosion of the cartilage plate that allows the disc to receive nutrients.

Sometimes electroneuromyography is necessary to determine where and how the nerve is damaged. Of course, doctors take blood tests. They need this to identify infections and endocrine pathologies.

If you want to find out in more detail and also consider when a magnetic resonance examination is indicated, you can read an article about this on our portal.

How to treat

First of all, conservative therapy procedures are carried out. Among them are the use of painkillers, warming ointments, therapeutic exercises, massage, and physiotherapy. If there is no benefit from these treatment methods, surgery is performed.

Medicines

First of all, the pain should be relieved so that the patient can walk normally. For this purpose, the doctor prescribes the necessary painkillers (for example, Ketanov and Ketonal), as well as anti-inflammatory drugs (Movalis and Diclofenac).

Next, to relax the lower back muscles, muscle relaxants (Mydocalm and Sirdalud) are used. These drugs are not used constantly, but with periodic breaks, since otherwise they make the muscular system less strong.

Chondroprotectors are also used in treatment. With their help, you can quickly restore cartilage and joints.

But with all the miraculousness of the complex of drugs, it is necessary to remember that they can easily cause an unpleasant “side effect”, disrupting the functioning of the gastrointestinal tract.

Exercise therapy

Of course, therapeutic exercises should be done both during treatment and rehabilitation. Properly selected and planned exercises are very useful for any symptoms of degenerative-dystrophic pathologies in the lower back. When selecting and planning exercises, it is necessary to look at the causes, severity and main signs of the disease.

If the pathology is acute, of course, it is recommended to abstain from exercise therapy. First, it is necessary to use other methods to alleviate pain: NSAIDs, a state of complete rest, local cooling, blockades.

If the symptoms are severe, static gymnastics with low amplitude will be very useful. But it should be done extremely carefully, and haste can only do harm. During the rehabilitation period, it is much better to use dynamic exercises.

As the patient’s condition improves, you can make it more complicated and also begin to use weighting agents in it.

Massage and physiological procedures

Doctors still cannot come to a consensus about the advisability and safety of massage for dystrophic changes in the lumbar spine. Even for a spine that is not affected by disease, it is harmful when it is mechanically affected. If you really can’t do without a massage, such a procedure should only be carried out by a real professional. And only while the pathology is at the first stage of development.

During the acute period, the back is not massaged. This is because due to this action, blood rushes to it, and after this the sore spot begins to become more inflamed and swollen.

In case of remission, that is, a temporary absence of inflammation and acute pain, physiological procedures can be used. Thanks to electrophoresis, acupuncture, and magnetic therapy, the patient can quickly recover from the disease. And with the help of manual therapy, the vertebrae can be placed where they are supposed to be by nature.

Surgery

Surgical intervention is carried out in case of revealed uselessness of massage, therapeutic exercises, as well as taking medications, and further progression of the disease. This method is also used for the diagnosis of intervertebral hernia. During surgery, the doctor installs devices in the patient’s body to support the diseased area of the spine. This allows you to reduce pressure on the ridge to avoid further development of the disease.

Table. Types of spine surgeries

View	Description
Discectomy	During this surgery, the surgeon removes part of the damaged disc to relieve pressure on the nerve endings. It can perform the operation in several ways: open discectomy is performed with a large incision in the back in the lumbar region; A microdiscectomy is performed through a much smaller incision. The surgeon inserts a thin tube with a camera at one end to view and remove the damaged disc. Thanks to this method, pain is significantly reduced, and the functions of the spine and lower extremities are completely restored.
Laminectomy	Laminectomy is an operation in which space is created in the spinal canal by removing the lamina - the back of the vertebra. Also known as decompression surgery, laminectomy increases space to relieve pressure on the spinal cord or nerve endings. This pressure is most often caused by bone or cartilage growths that can occur in people with arthritis. Laminectomy is usually used only when conservative treatments, such as medications or physical therapy, have failed to relieve symptoms and address the cause of the pain. A laminectomy may also be recommended if symptoms are very severe or get worse. Surgeons usually perform the operation using general anesthesia, so the patient does not feel discomfort during the procedure. Doctors monitor his heart rate, blood pressure and blood oxygen saturation during the procedure using devices attached to his chest.
Vertebroplasty and kyphoplasty	Vertebroplasty and kyphoplasty are procedures used to treat painful vertebral compression fractures, which most often result from osteoporosis. In vertebroplasty, bone cement is injected into vertebrae that have cracked or broken. The cement hardens, repairs fractures and supports the spine. Kyphoplasty is similar to vertebroplasty, but it uses special deflated balloons to create spaces in the vertebrae, which are then filled with bone cement. Kyphoplasty can correct spinal deformities and restore lost flexibility. Vertebroplasty and kyphoplasty can increase a patient's functional abilities and allow a return to activity levels without any physical therapy or rehabilitation. These procedures are usually successful in relieving pain caused by a fracture due to vertebral compression; many patients experience significant relief almost immediately or within a few days. After vertebroplasty, about 75 percent of patients regain lost mobility and become more active, which helps fight osteoporosis. After the procedure, patients who were barely able to move can get out of bed, and this may help reduce the risk of developing other diseases. Generally, vertebroplasty and kyphoplasty are safe and effective procedures. No incision is required - there will only be a small puncture of the skin that does not need to be stitched.
Spondylodesis (vertebral arthrodesis)	Spinal fusion is a surgery to permanently connect two or more vertebrae in the spine by eliminating movement between them. Vertebral arthrodesis involves techniques designed to mimic the normal healing process of broken bones. During surgery, the surgeon places bone or additional material into the space between two vertebrae. Metal plates, screws, and rods may be used to hold the vertebrae together so they can fuse into one solid block. Because vertebral fusion surgery immobilizes parts of the spine, it changes the way it “works.” This places additional stress and strain on the vertebrae above and below the fused portion and can increase the rate at which these areas of the spine begin to deteriorate. Surgery is performed to improve stability, correct deformity, or reduce pain. Your doctor may recommend spinal fusion to treat the following problems: vertebral fracture. Not all damaged vertebrae require such surgery. But if a broken vertebra makes the spinal column unstable, surgery is vital; spinal deformities. Spinal fusion can help correct spinal deformities such as scoliosis or kyphosis; spinal instability. The spine can become unstable if there is abnormal or excessive movement between two vertebrae. This is a common symptom of severe arthritis; spondylolisthesis. With this disorder, one vertebra “jumps” forward relative to the lower one. If the condition causes severe back pain or nerve compression, as well as leg pain, spinal fusion is necessary; intervertebral disc herniation. This surgery can be used to stabilize the spine after a damaged disc has been removed.
Nucleoplasty	Nucleoplasty is a treatment method for people who suffer from long-term and severe back pain due to a herniated disc that cannot be relieved with traditional treatment methods. Nucleoplasty is a minimally invasive procedure. Performed on an outpatient basis; This procedure uses a “needle” that emits radio waves to get rid of the bulge by dissolving excess tissue. This reduces the pressure inside the disc and the nerves responsible for causing pain. The procedure usually takes less than one hour. The operation is performed under local anesthesia, and the person can inform the doctor about his condition. The insertion of the “needle” is controlled using fluoroscopy. Discomfort may be experienced for another seven days while the damaged area heals, after which the patient can again live a full life.
Epiduroscopy	It is an excellent procedure for patients with persistent or intermittent back pain after spinal cord surgery or due to compression of nerve endings. The source of pain is most often epidural fibrosis in the spinal canal, which irritates the spinal root or causes narrowing of the epidural space. This method is effective in patients for whom conventional therapy does not produce the desired results. A special needle is inserted into the natural opening of the sacrum under local anesthesia, observing the process using X-rays. In the case of a narrow spinal canal, a balloon catheter is inserted, which will expand it and get a clear picture of the free space. The duration of the procedure is from 20 to 60 minutes. The patient is under local anesthesia throughout the operation.

Possibility of complications

By starting this pathology, you can allow a hernia to appear. This term refers to the displacement of a deformed disc. This can rarely be cured without surgery. Also, with advanced dystrophic processes, the sciatic nerve may become inflamed and disruption of the functioning of the genitourinary system may begin. Moreover, there are usually problems with going to the toilet “for minor needs.”

Prevention

You can prevent such pathologies in the spine by following simple rules. First of all, greater physical activity is required. You should start your morning with exercise. Moreover, it is worth choosing exactly the kind of exercises that would help make your back muscles stronger. Those who are forced to sit for long periods of time while working should sometimes pause to stretch their muscles.

Also, to maintain the health of the spine, it is useful to know how to choose a mattress: it should be firm, but in moderation. It is best to also use orthopedic pillows. It is important that the width of such a pillow is suitable for the distance of the shoulders. If you are obese, you should lose weight: it puts extra strain on the spine.

Bottom line

Regular back pain is a reason to consult a doctor. Alas, any organism is not eternal, and with aging, the spine suffers first. If a person begins to feel the first signs of the disease, he should immediately be examined by a doctor. Many serious illnesses first signal themselves with completely minor discomfort, but if you miss the moment, you can forget about normal life for a long time. Degenerative-dystrophic pathologies cannot always be cured, but it is quite possible to stop their development and maintain health.

Video - What are degenerative-dystrophic changes in the lumbosacral region?

Destructive changes in the spine in the lumbar region are a serious pathology affecting the structure of the intervertebral discs; ligamentous apparatus; articular, cartilage and other tissues. Diseases in this area usually follow the patient throughout his life and are fraught with loss of ability to work or disability.

General information

Such processes consist of three components:

Osteochondrosis (visible thinning of the disc that occurs without an inflammatory process);
Spondylosis (characterized by the presence of atypical bone growths along the edges of the vertebra);
Spondyloarthrosis (arthrosis of the intervertebral joints).

Most often, two parts of the spine are subject to degenerative-dystrophic changes:

Cervical (as the thinnest and most mobile);
Lumbar (as the area exposed to the greatest stress).

Clinical picture

More than 80% of the population are forced to experience degenerative-dystrophic changes in the lumbar spine, and only half of them receive quality medical care. Previously, it was believed that these processes are characteristic only of older people, as a result of the natural aging of the body. However, recently the disease has become younger.

initial stage

The first symptom of harmful changes in the lumbar region is pronounced pain in the lower back. The discomfort is so noticeable that the patient is forced to significantly limit his movements, which interferes with normal functioning and performance.

The patient's complaints directly depend on the location of the lesion. A careful study of the symptoms contributes to the correct diagnosis of unhealthy lumbar vertebrae.

Second stage of the disease

Further development of degenerative-dystrophic changes in the lumbar spine is characterized by:

Serious limitations in mobility;
“Shots” in the lower girdle of the limbs;
The presence of tingling or “pins and needles” in the legs or buttocks.

This is how radicular syndrome manifests itself, in which compression of the nerve processes occurs.

Third stage

It is characterized by impaired blood circulation, which is caused by compression of the radicular vessel, as a result of which its ischemia develops. This stage is marked, in addition to increasing pain, by the appearance of:

Partial or temporary numbness in the lower extremities;
Cramps.

Fourth stage

Processes that have not received adequate therapy up to this stage of development are fraught with paresis and paralysis, the occurrence of which is due to a complete disruption of the blood circulation of the spinal cord.

Timely diagnosis

To avoid serious consequences, see a doctor and have a full examination of the spine using an X-ray machine, computed tomography or MRI.

Treatment of such destructive processes occurring in the area of the lumbosacral vertebrae is most often conservative in nature and represents a set of simple measures: taking medications, therapeutic exercises and physiotherapeutic procedures. Surgical intervention is indicated starting from the third stage of disease development.

The consequences of the development of such processes have a detrimental effect on the patient’s quality of life. In addition, it is precisely as a result of such changes that the highest percentage of disability occurs. While the initial stages of dysfunction are fairly amenable to conservative treatment. Therefore, the slightest signs of the onset of the disease cannot be left without attention, quality therapy and medical supervision.