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

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

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

If you are experiencing any of 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 back pain at least once in their life. Medical statistics says: 20% complain of lumbar pain constantly, and 1-3% need surgical treatment. The lumbosacral region is the center of gravity of the body, it takes on all the loads that accompany any movement of the human body.

Sometimes these loads exceed the permissible limits, temporary changes and deformation of cartilaginous tissues 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.

There is a beginning of calcification of a certain area of cartilage tissue. This is 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 pain in the lower back.

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.

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

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

The intervertebral disc itself is not provided with a blood supply, so if it is damaged, it cannot recover in the same way that other tissues of the body recover. Therefore, even minor damage to the disk can lead to the so-called. "degenerative cascade", due to which the intervertebral disc begins to collapse.

Despite the relative severity of this disease, it is very common, and current estimates suggest that at least 30% of people aged 30-50 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.

Disease pathogenesis

The spine in the lumbar region and the sacrum is subject to the greatest loads in comparison with its other departments. Therefore, degenerative and dystrophic changes in it develop more often. The incidence is high - up to 30% of the population older than 35 years.

Degenerative-dystrophic changes in the lumbosacral spine are a multifactorial pathology, their development provokes many reasons.
The main links of the process are the same, regardless of the cause:

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

All these factors cause a violation of the proportional ratio of the vertebrae, with subsequent infringement of the spinal roots; the development of inflammation in the area of degenerative changes in the 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 edema.

The pathological process takes a long time, tends to gradual progression and chronic course. The main disease in degenerative changes in the lower back and sacrum is osteochondrosis, which may be accompanied by hernias or protrusions of discs between the vertebrae.

In the case of a predominance of damage to the cartilage of the joints of the vertebrae, spondylosis develops. In order for degenerative changes to pass into an irreversible phase, a lot of time must pass. And this time the disease wins back in a person, due to the fact that the disease does not manifest itself immediately.

Expressed 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" generalizes several diseases.

A type of spinal degeneration

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

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

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

Reasons for the development of the disease

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

But, all this works only when a person follows the posture, has a strong muscular corset. The modern lifestyle is sedentary. And this leads to a weakening of the muscular corset, weight gain.

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

The vertebrae, when the load changes, try to increase their area, grow, thicken intensely, pinching the adjacent nerves.

Causes that provoke pathological changes:

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

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

Inflammation that occurs when proteins in the disc space irritate the nerve roots during the formation of an intervertebral hernia.
Pathological instability of micromotions, 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 low back pain. The combination of both factors is most common in the formation of an intervertebral hernia, which is a complication of the degenerative-dystrophic process in the intervertebral discs.

When a disc herniation occurs, mechanical compression of the neurovascular bundle passing through 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 diseases appear as degenerative-dystrophic lesions develop, but at 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 a long walk and during physical exertion, prolonged sitting in one position, during bending. The pain syndrome is undulating: it arises, then decreases, disappears.

A 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, "screaming" about the presence of pathological changes in the lumbar spine, is a pronounced pain syndrome in the lower back.

The pain sensations are so palpable that the patient is forced to limit his movements, and this significantly reduces the normal standard of living and working capacity. Complaints of pain directly depend on the place where the lesion is localized.

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 disturbed 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 extremity girdle;
convulsions.

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

severe mobility restrictions;
"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 increases from time to time for several days or more. Symptoms may vary depending on the individual case, but the main symptoms in this disease are as follows:

Pain localized in the lower back, which may radiate to the hips and legs;
Prolonged pain in the lower back (lasting more than 6 weeks);
Low back pain is usually described as dull or aching, as opposed to burning pain where it radiates;
The pain is usually aggravated in a sitting position, when the discs are under more pronounced load compared to that which is placed on the spine when the patient is standing, walking or lying down. Prolonged standing can also make the pain worse, as can bending forward and lifting objects;
The pain is exacerbated by certain movements, especially when bending over, turning the torso and lifting weights;
If a herniated disc develops, symptoms may include numbness and tingling in the legs, and difficulty walking;
With a medium or large herniated disc, the nerve root exiting the spinal cord at the affected level can be compressed (foraminal stenosis), which in turn can lead to pain in the legs (sciatica);
Neurological symptoms (eg, weakness in the lower extremities) or pelvic organ dysfunction (various urination and defecation disorders) may result from the development of cauda equina syndrome. With cauda equina syndrome, immediate action is required 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 nerve root compression, other spinal structures can cause pain to radiate to the buttocks and legs. The nerves become more sensitive due to the inflammation triggered 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, pain can be caused by:

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

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 most uninformative. X-rays provide information about the location of the bones and the deformity of the spine. He is able to determine the disease in the 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, a rupture in the fibrous ring. But such procedures are usually expensive.

Diagnosis of the presence of degenerative-dystrophic changes in the lumbosacral spine, as a rule, is carried out in three steps:

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

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

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

These changes are best seen on T2-weighted images taken in the sagittal plane. Usually, the end plate appears as a black line on MRI. If this black line is not visible, this indicates an erosion of the end plate.

Treatment of the disease

Unfortunately, degenerative-dystrophic changes in the lumbar spine 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 the most deplorable, up to disability due to impaired motor activity.

There are two methods of treatment of degenerative-dystrophic changes in the spine - conservative and surgical. A conservative method of treatment includes the following actions: Restriction of the mobility of the spine (carried out with the help of orthopedic bandages or prescribed bed rest).

Medical treatment. Drugs are used to combat inflammatory and degradation processes, improve vascular patency. Sedative drugs and vitamin complexes of group B are also prescribed.
Novocaine blockade.
Physiotherapy (laser therapy, diadynamic currents, inductothermy, electrophoresis).
Therapeutic methods (traction on the plane, underwater traction). Traction is considered the most dangerous method of treating degenerative-dystrophic diseases.
Physiotherapy.
Manual therapy.
Acupuncture, acupuncture.

The prevailing 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 with degeneration of the discs, as 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 a rapidly progressive course of 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 its implementation there is:

reduction or disappearance of pain syndrome;
relieving tension in the muscles of the lumbar, 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 the sensitivity of the lumbar;

Load-free traction of the spine is ideal for the treatment of degenerative lesions of the intervertebral discs (osteochondrosis of the spine) and its complications - spondylosis, spondylarthrosis, intervertebral hernias and protrusions. Traction takes place with the preservation of all physiological curves of the spine and is safe, since no force is applied during traction.

With an increase in the intervertebral distance, there is an improvement in the nutrition of all intervertebral discs, the restoration of their structure and the removal of pain.
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-dystophic changes do not occur at once, however, a person is able to feel the symptoms of the disease even at the earliest stages. First of all, nerve damage caused by infringement due to narrowed intervertebral canals makes themselves felt. This position causes the nerve endings to swell, reduces their conductivity.

The patient feels this as numbness of the limbs, a feeling of fatigue in the shoulders, neck, and back. The vertebrae change the pattern of tissue growth. To reduce the load, the vertebra expands, which subsequently leads to osteochondrosis and even more 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 are transformed into herniated 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

In connection with the scale of the spread of degenerative-dystrophic changes in the spine, it is worth taking care to follow preventive recommendations.

These rules will protect against disability in youth and extend the years of activity until old age:

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

The minimum measures for the prevention of back diseases include:

daily strengthening of the back muscles. This can be done by doing elementary physical exercises every day (for example, exercises);
getting out of bed, "land" on both legs (this will avoid a sharp load on the spine);
under no circumstances keep your back in an arched position (try to keep your back straight even while brushing your teeth);
serious approach to choosing a mattress. Since ancient times, we have been repeating the truth that sleep is health, since 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 "hard back".

Aging is the main cause of spinal changes

Degenerative changes are a process of destruction of the cartilage and bone tissue of the segments of the spine. At the same time, 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 here that the main cause is age-related changes.

Throughout life, the lumbar region bears the greatest load, and as a result of the 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 in people after 30 years of age, adverse changes begin to occur, which in medical practice are called degenerative.

The main causes of occurrence

Degenerative processes gradually destroy the 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 are provocateurs of degenerative processes?

The most important cause of pathological changes is an unhealthy lifestyle.

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

Immobility leads to degenerative changes in the spine

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

Prolonged stay in the wrong position impairs blood circulation in the spine, disrupting metabolic processes in the 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 adversely affect the normal condition of the spinal segments. Most often, people whose work is associated with hard physical labor or professional heavyweight athletes fall into the risk group. Injuries of the lumbar spine often cause disturbances in metabolic processes in tissues, which also leads to degenerative changes in the future. Violation of the work 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 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 start treatment.. Therefore, in order to prevent serious pathologies, it is necessary to undergo a complete examination by a doctor every year.

Consequences of pathological processes

Osteochondrosis - the scourge of modern man

Any degenerative changes entail many different complications.

The most common of these is the disease of osteochondrosis. It is a destruction of the anatomical structure of the spine, resulting in serious problems with the musculoskeletal system. Indeed, with such a disease, the intervertebral spaces narrow, the vertebrae shift, and the compression of the intervertebral discs increases.

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

Another disease of a degenerative nature is chondrosis, which precedes osteochondrosis. As a result of the development of the disease, microcracks appear in the bodies of the vertebrae 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 shell of the fibrous ring, which, as a result of a strong load on the lumbar region, leads to a protrusion of the nucleus pulposus. Such a neoplasm compresses the nerve roots extending from the spinal cord, and limits the movement of a person. 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 bodies of the vertebrae. Ossification of segments of the lumbar spine occurs slowly. Such a gradual increase in the size of the bone growths is accompanied by severe pain when turning, tilting or other body movements.

Spondylarthrosis is a process of degenerative-dystrophic changes in the joints of the spine. Affecting the cartilaginous tissue, the disease spreads to neighboring areas of the bone tissue of the vertebrae, forming bone processes on them. They limit the mobility of the lumbar, and every movement is accompanied by a sharp pain. Without timely treatment, a person can not only disrupt the work of the musculoskeletal system, but there is a possibility of a disability group.

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 and 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 the x-ray all the changes in the correct position of the segments, determine the exact location of the disease and the degree of damage.

Also in medical practice, computed 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 causes of 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, painkillers and anti-inflammatory drugs can be prescribed, as well as for tissue repair - chondroprotectors.

Physiotherapy treatment often consists of a back massage. Manual therapy makes it possible to restore the correct position of the vertebrae, and physiotherapy 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 designed set of exercises, patients not only improve blood circulation, 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: not only the elderly, but also young and middle-aged people, that is, the able-bodied population, suffer from spinal pathology. In addition, the diagnosis of degenerative changes in the spine, in particular, displacements of the lumbar vertebrae, is a poorly studied issue in radiology.

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

Such 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-age population suffer from osteochondrosis of the spine. Morbidity rates in Russia are growing, while in most patients the disease is accompanied by a lesion of the lumbar spine. Lumbar osteochondrosis in the structure of the incidence of the adult population in our country is approximately 50%, while occupying the first place (including the time of disability).

What determines the health of the spine?

Mobility and health of the spine are possible due to the elasticity of the apparatus of the vertebral bodies, intervertebral discs and arches. Under normal static conditions, the function of absorbing vertical pressure forces (for example, the heaviness of the torso, head) is carried out by the intervertebral discs. In those cases when the articular processes are forced to perform a support function unusual for them, anterior displacements of the vertebrae and local arthrosis develop in the true joints. With a significant and increasing vertical load, neoarthrosis of the articular processes with the bases of the arches develops. Moreover, the entire spine and the musculo-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 and in the lumbar region as well.

What to do?

The problem of instability of the spinal motion segment, which occurs under the influence of various factors, is far from being resolved. The general principle of therapy for exacerbations of pain syndrome of osteochondrosis is the elimination of manifestations of the disease - restrictions in movement and pain itself. This includes the exclusion of static-dynamic unfavorable loads on the diseased spine, ensuring rest, especially at the very beginning of an exacerbation. Next, you need to take care of strengthening the muscles of the spine 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 the appearance of 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 about 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, while 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. Deformation leads to the fact that the spine ceases to cope with the load, especially heavy. As a result, pathologically unstable micromotions are formed in the spinal segment.

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

Symptoms of the disease

Questioning the patient and external examination may show the following signs:

Pain of a dull nature, described as aching. At some stages of the disease, it can "give" to the buttocks, followed by movement to the lower extremities.
Abnormal sensations in the legs of varying intensity: weakness in the limbs, tingling, numbness.

Earlier we wrote about the symptoms of lumbar radicular syndrome, we advise you to read the article.

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

Violation of urination and defecation, problems with reproductive function.
The need to “disperse” in the morning before fully starting to move. Stiffness can also be felt throughout the day.
An increase in temperature in the affected area of the back.
The appearance of redness and swelling on 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 you to limit movement.

Diagnosis of degenerative changes

Only a doctor can make a correct diagnosis. Diagnosis is carried out, as a rule, in three stages:

A patient history is being compiled. Information should be collected about the time of onset of pain and their nature, the presence or absence of other signs and concomitant diseases, attempts to cure the disease on their own. Positions and movements are also recognized when the pain syndrome subsides and intensifies.
A medical examination is being carried out. It involves determining the signs of degenerative changes in the spine.
Making an MRI 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, the amplitude of movements, muscle strength, causes of pain, etc. are checked.

Important: If you start the disease to the last stage, the blood circulation of the spinal cord will be disturbed, which can contribute to the formation of paralysis or paresis.

Problems detected by MRI

The study can show the following MR signs of degenerative-dystrophic changes in the lumbar:

half and more destroyed disk space;
rupture observed in the disc shell;
a critical decrease in the amount of water in the disk, reflecting the initial stage of the disease;
destruction of the cartilaginous end plate of the vertebra;
confirmation of the patient's intervertebral hernia or protrusion.

In contact with

The development of degenerative and dystrophic changes in the lumbosacral region is associated with a 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, but dangerous complications join. Therefore, it is important for patients to know whether the progress of pathology can be prevented, and how to deal with already formed changes.

general characteristics

Quite often, doctors explain the appearance of pain, backache, 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 body, are separated by layers of fibrous cartilage - intervertebral discs. Movement and flexibility depend on the state of the vertebral processes that form the joints, which are lined with cartilage.

Under the influence of various factors, the intervertebral and articular cartilages lose their functionality: they dry out, crack, lose their 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 departments. Degenerative processes also affect the joints of the hands and feet.

But if, with the defeat of the joints of the limbs, we are talking about diseases of arthritis, arthrosis, bursitis, then with the destruction of the vertebral cartilage, it develops:

osteochondrosis - a decrease in the height of the discs with coracoid growth of the vertebrae and the formation of vertebral hernias, protrusions;
spondylosis in the form of marginal bone growths covering the disc;
spondylarthrosis - destruction of the intervertebral joints.

The mechanism of development of such diseases is directly related to dystrophic changes in the discs, cartilage of the joints, which are dehydrated, dry out and thicken, which leads to subsidence of the fibrous ring, proliferation of bone tissues.

Video

Video - changes in the lumbosacral region

Causes of the disease and risk group

The state 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:

Cartilaginous tissue malnutrition. It is associated with the aging of the body, insufficient intake of nutrients from food, metabolic disorders against the background of hormonal disruptions and endocrine diseases.
Excessive load on the spine. Risk factors - playing sports, stress on the lower back associated with professional and labor activities, overweight.
Lack of physical activity. A passive lifestyle, a long stay in an immobilized state due to other diseases, being in weightlessness lead to dehydration of cartilage tissues and their destruction.
Spinal injuries, including birth. For a young or growing organism, traumatic conditions become an impetus for the development of tissue dystrophy.
Inflammatory diseases of an autoimmune, infectious, etc. nature.

The most common cause of dystrophy is still called age. On the MR picture, degenerative and 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. A degenerative dystrophic change develops in the lumbar spine for quite a long time. Therefore, characteristic signs in 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 be manifested by aching pain, heaviness in the lower back after exertion or a long stay in a static position.
With the progress of the pathology, a violation of the mobility of the spine joins. In addition to aching and dull pain symptoms of a periodic nature, “lumbago” can be observed radiating to the buttocks, legs, and to the sacrum. 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 pains with a concentration at the site of the pathology and the spread of soreness along the damaged nerve. When the blood vessels are squeezed, soft tissue ischemia develops. There are malfunctions in the work of internal organs, primarily the bladder, genital organs, and rectum.
Symptoms and signs of degenerative-dystrophic changes in the lumbar region of the advanced 4th stage are manifested by the addition of complications in the form of paresis, 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 that allow not only to identify changes, but also to exclude the presence of diseases similar in symptoms.

The examination begins with the study of the anamnesis, external examination, palpation, and motor neurological tests.

But such methods are not enough to assess the picture of dystrophic changes in the lumbosacral spine. It is possible to confirm a preliminary diagnosis only after instrumental examinations:

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

Computer images show ruptures (hernias) and protrusions (protrusions) of the fibrous ring.

Treatment

For diseases associated with pathological changes in the spine, the alternation of periods of exacerbations with temporary remissions against the background of the progress of dystrophy is characteristic. Therefore, for each period and stage, its own tactics for the treatment of degenerative dystrophic changes are chosen:

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

Preparations

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.

Pain relief may include:

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 with non-intense pain, the use of external agents is allowed: ointments, gels, patches.
Analgesics: Dexamezaton, Analgin, Spazgan are administered drip for quick relief of pain.
Steroid preparations of Betamethasone, Triamcinolone, Prednisolone in short courses in the form of injections.

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

Additionally, the following may apply:

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

Physiotherapy

Exercise therapy is an excellent way to restore mobility of the spine and strengthen the muscular corset. Adequate physical activity helps to 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 with exacerbation and the presence of hernias.

The complex should be developed individually and include exercises for:

traction of the spine;
strengthening the muscle corset from both the back and the press.

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

Water aerobics, swimming, traction on the crossbar, 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, spinal cord is affected, nerves are blocked, massage, especially manual, is strictly prohibited.

It is impossible to massage the back during the acute period of the disease. The blood flow under the influence of massage will provoke increased swelling, inflammation and pain.

Diet

There is no special diet for patients with in 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.

To a greater extent, diet is important for overweight people, since obesity is one of the risk factors for the development of dystrophic changes.

Prevention

It is rather difficult to avoid age-related dystrophic processes, but it is possible to prolong an active life, despite age.

This will help simple preventive measures.

Degenerative-dystrophic changes in the lumbosacral region - a set of pathologies in the intervertebral disc or, alternatively, in the lumbar vertebrae. Mostly, such a disease can be recognized by 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 such a diagnosis, and this number is growing, not intending to slow down the pace of development, which cannot please.

The body of any person is an extremely delicate and well-oiled system. And it is not surprising that changes in the activity of at least one of its components inevitably entail disruptions in the work of all other parts of the body. In recent years, the incidence of diseases of the musculoskeletal system has greatly increased among the population. As a result, 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, its organs and tissues are not so rare 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 powerful pains.

Without such changes in the spine, none of his known diseases is possible. Any osteochondrosis, spondylarthrosis, herniated disc and the like are exactly the results of degenerative dystrophic pathologies of the intervertebral disc that have not been cured in time, which can be detected by making the necessary examination by a specialist. However, an examination is not so necessary, when the most common symptoms of pathology that can be detected during the first examination can indicate the disease.

Despite the fact that a person may not have a very great propensity for this pathology, transmitted to him by inheritance, in reality its root lies in the totality of many genes. Degenerative processes are also possible due to the aging process or due to any injury. And yet, this is not often the result of extensive injuries like the same car accident. In most cases, they occur due to a slow traumatic process, from which the intervertebral disc is damaged. 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". That 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 has reached the fourth or sixth decade, has such a problem, at least to the smallest extent. This means that almost every elderly patient has such a diagnosis or pain, if not both.

Why the disease begins

In more than half of the cases, the occurrence of such a problem has at least one of the following reasons:

inflammatory processes that begin due to the fact that the nerve roots are irritated by a protein located in the disk space during the appearance of a hernia;
microscopic damage that occurs if the fibrous ring wears out, completely losing any ability to bear the load. The consequence is an excess of mobility in the diseased 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 anymore.

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

the harmful effects of large loads on the spine, due to which the lumbar segments become less elastic. Because of this circumstance, people who constantly expose themselves to heavy physical exertion are most at risk of catching one or another disease of the lower back, especially if this is required at work;
a long stay in a sitting position, and with an incorrect posture, which also leads to impaired blood supply. And this affects both the lumbar region and the rest of the body. This entails a metabolic disorder in the bones and muscles. Violation of metabolism spoils the structure of tissues. And because of all this, microtrauma can easily appear in the spine from any movement. On this occasion, 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 injury. 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 a person, but only carry out supporting therapeutic procedures for him to prevent the aggravation of the disease.

What can happen due to this pathology

One has only to start dystrophic changes in the spine, and serious complications are not excluded in the lumbar region:

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

In order to avoid such problems, one should choose in time and correctly what and how to cure the pathology. So you can 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 incessant pain, which, however, can be tolerated. But sometimes they get stronger for a long time. For the most part, each patient has their own symptoms of the disease, but there are several of its common signs:

back pain, with possible pain in the hips and legs;
pain in the lumbar region lasting over one and a half months;
in the lower back pain is dull / aching, and in the hips and legs - burning;
when the patient sits, the pain becomes worse. Standing, walking or lying down, he feels the pain less. Standing too long, bending forward, or lifting something heavy causes the patient to experience more "bright" pain;
if a person has become the owner of a disc herniation, his legs may go numb, their tingling is not excluded. In addition, he may have trouble walking;
if the hernia turned out to be medium in size, it is possible that the nerve root that comes out of the spinal cord at the affected level will be compressed (foraminal stenosis), and this will already provoke pain in the legs ();

symptoms of neuralgia, like weakened legs, as well as various problems in the functioning of the organs in the pelvic area (difficulties with 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 become more responsive to stimuli. It is from this that the legs become numb and tingling is felt. And in most cases, such sensations are localized in the knee or above.

If you want to learn more about how to treat, as well as consider symptoms, diagnosis and alternative treatments, 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 pathology of the spine that worsens over time, caused by deterioration of the discs. However, this does not mean that such diseases cannot be combined;
herniation 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 more and more severe:

stage№1 . The disease rarely manifests itself in any way. Unless after physical work you can feel a dull pain, but in most cases it is taken for normal fatigue;
stage№2 . It is possible to accurately distinguish symptoms from normal phenomena. From time to time in the back "shoots". 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, the metabolism in the lower back is disturbed, since the blood vessels are damaged. There is ischemia, convulsions, numbness of the legs. Pain becomes stronger;
stage№4 . Due to the deformation of the spinal cord, the legs may be paralyzed. This pathology has exacerbations - the time of the greatest severity of symptoms. If the dystrophy becomes chronic, the symptoms subside to a state of tolerable discomfort.

Diagnostics

It is very important that the disease be diagnosed before the first complications appear. For this purpose, diagnostics are done 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 necessarily prescribes additional examinations to make the diagnosis more accurate.

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

X-ray is the most accessible, but at the same time it is the least useful. This technique allows diagnosing pathology when it has already moved to one of the rather late stages. Much better than MRI and CT. With the help of these methods, it is possible to more reliably find out both where the focus of the disease is and how much it has developed.

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

What can an MRI show for disc dystrophy:

destruction of the disk, if they exceed half of it;
disc dehydration. MRI shows this tissue as darker;
the presence of hernias, as well as protrusions;
erosion of the cartilage plate, which allows the disc to receive nutrients.

Sometimes electroneuromyography is needed, which allows you to recognize where and how the nerve is damaged. Of course, doctors take blood tests. They need this to detect infections and endocrine pathologies.

If you want to know in more detail, as well as consider when magnetic resonance imaging 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, physiotherapy. In the absence of benefit from these methods of treatment, an operation is performed.

Medications

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

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

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

But with all the miraculousness of the complex of drugs, it must be remembered 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 refrain from exercise therapy. Before it is necessary to use other methods to alleviate pain: NSAIDs, a state of complete rest, local cooling, blockade.

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

As the patient's condition improves, it is possible to complicate, and also begin to use weighting agents in it.

Massage and physiotherapy

Doctors still cannot come to a consensus about the appropriateness and safety of massage for dystrophic changes in the lumbar spine. Even for a spine that is not affected by a disease, it is harmful when it is mechanically affected. If there is absolutely no way without a massage, only a true professional should carry out such a procedure. And only while the pathology is at the first stage of development.

In the acute period, the back is not massaged. This is because, due to such an action, blood rushes to it, and after that, the sore spot begins to become more inflamed and swell.

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

Surgery

Surgical intervention is carried out in case of revealed futility of massage, therapeutic exercises, as well as medication, and further progression of the disease. This method is also used in the diagnosis of "intervertebral hernia". During the operation, the doctor installs devices in the patient's body to support the diseased part of the spine. This allows you to reduce pressure on the spine to avoid further development of the disease.

Table. Types of spinal surgery

View	Description
discectomy	During this operation, 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 on the back in the lumbar region; Microdiscectomy is performed through a much smaller incision. The surgeon inserts a thin tube with a camera on one end to view and remove the damaged disc. Thanks to this method, pain sensations are significantly reduced, and the functions of the spine and lower extremities are fully restored.
Laminectomy	Laminectomy is an operation in which space is created in the spinal canal by removing the lamina, the back of a vertebra. Also known as decompression surgery, laminectomy enlarges the space to relieve pressure on the spinal cord or nerve endings. This pressure is most often caused by growths in bone or cartilage, which can occur in people with arthritis. Laminectomy is usually only used when conservative treatments such as medications or physical therapy have failed to alleviate symptoms and get rid of the cause of the pain. Laminectomy may also be recommended if symptoms are very severe or worsen rapidly. Surgeons usually perform the operation using general anesthesia, so the patient does not feel any discomfort during the procedure. Doctors monitor his heart rate, blood pressure and blood oxygen saturation during the procedure using instruments attached to his chest.
Vertebroplasty and kyphoplasty	Vertebroplasty and kyphoplasty are procedures used to treat painful vertebral compression fractures, most commonly the result of osteoporosis. In vertebroplasty, bone cement is injected into vertebrae that are cracked or broken. The cement hardens, repairs fractures, and supports the spine. Kyphoplasty is similar to vertebroplasty but uses special deflated balloons to create spaces in the vertebrae that are then filled with bone cement. Kyphoplasty can correct spinal deformity and restore lost flexibility. Vertebroplasty and kyphoplasty can increase the patient's functional ability 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 are almost unable to move can get out of bed, and this can help reduce the risk of developing other diseases. Generally, vertebroplasty and kyphoplasty are safe and effective procedures. No incision is required - there will be only a small puncture of the skin that does not need to be sewn up.
Spinal fusion (arthrodesis of the vertebrae)	Spinal fusion is an operation to permanently connect two or more vertebrae in the spine, eliminating movement between them. Spinal fusion involves techniques designed to mimic the normal healing process of broken bones. During the operation, the surgeon places bone or additional material in the space between two spinal vertebrae. Metal plates, screws, and rods can be used to hold the vertebrae together so they can fuse into one solid block. Since spinal fusion surgery immobilizes parts of the spine, it changes the way it "works". This puts additional stress and strain on the vertebrae above and below the fusion and can increase the rate at which these areas of the spine begin to deteriorate. Surgery is done to improve stability, correct a deformity, or reduce pain. A doctor may recommend spinal fusion to treat the following problems: vertebral fracture. Not all damaged vertebrae require such an operation. But if a broken vertebra makes the spinal column unstable, surgery is vital; spinal deformities. Spinal arthrodesis 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 "pops" forward relative to the lower one. If the condition causes severe back pain or nerve compression, as well as pain in the legs, spinal fusion is needed; herniated disc. Such an operation can be used to stabilize the spine after the removal of a damaged disc.
Nucleoplasty	Nucleoplasty is a treatment for people who suffer from long-term and severe back pain due to a herniated disc that cannot be relieved with conventional 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 pressure within 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 introduction of the "needle" is controlled by fluoroscopy. Discomfort can 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 nerve compression. 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 lead to the desired results. A special needle is inserted into the natural opening of the sacrum under local anesthesia, observing the process thanks to an x-ray. In the case of a narrow spinal canal, a balloon catheter is inserted to widen the canal and get a clear view of the free space. The duration of the procedure is from 20 to 60 minutes. The patient is under local anesthesia throughout the operation.

The likelihood of complications

By running this pathology, you can prevent the appearance of a hernia. This term hides the displacement of a deformed disc. This rarely can be cured without surgery. Also, with neglected dystrophic processes, the sciatic nerve can become inflamed and disruption of the functioning of the genitourinary system begins. Moreover, there are usually problems in order to go to the toilet "for small needs."

Prevention

You can prevent such pathologies in the spine by following simple rules. First of all, a lot of physical activity is needed. Morning should start with charging. And it is worth choosing exactly such exercises that would help make the back muscles stronger. Those who have to sit for long periods of time during their work should occasionally take breaks to stretch their muscles.

Also, to maintain the health of the spine, it is useful to be able to choose a mattress: it should be firm, but in moderation. It is best to use orthopedic pillows as well. It is important that the width of such a pillow is suitable for the distance of the shoulders. In case of obesity, you should lose weight: it once again loads the spine.

Outcome

Regular back pain is a reason to see 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, you should immediately be examined by a doctor. Many serious illnesses at first signal themselves with absolutely insignificant discomfort, but if you miss the moment, you can forget about normal life for a long time. It is not always possible to cure degenerative-dystrophic pathologies, but it is quite possible to stop their development and maintain a state of 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; ligament apparatus; articular, cartilaginous and other tissues. Diseases of this sphere usually haunt the patient all his life and are fraught with disability 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);
Spondylarthrosis (arthrosis of the intervertebral joints).

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

Neck (as the most thin and mobile);
Lumbar (as the area subjected 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 high-quality medical care. Previously, it was believed that these processes are typical only for the elderly, as a result of the natural aging of the body. However, in recent years, the disease is getting younger.

initial stage

The first symptom of the presence of detrimental changes in the lumbar region is pronounced pain in the lower back. Unpleasant sensations are so palpable that the patient is forced to significantly limit his movements, which interferes with normal life and performance.

Complaints of the patient directly depend on the localization of the lesion. A careful study of the symptoms contributes to the correct diagnosis of unhealthy lumbar vertebrae.

The second stage of the disease

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

Severe mobility restrictions;
"Shots" in the lower extremity belt;
The presence of tingling or "goosebumps" in the legs or buttocks.

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

Third stage

It is distinguished 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 the increasing pain syndrome, by the appearance of:

Partial or temporary numbness in the lower limbs;
Seizures.

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 violation of the circulation of the spinal cord.

Timely diagnosis

Seeing a doctor and a complete examination of the spine using an X-ray machine, computed tomography or MRI will help to avoid serious consequences.

Treatment of such destructive processes taking place in the region of the lumbosacral vertebrae is most often conservative in nature and is a combination of simple measures: medication, therapeutic exercises and physiotherapy procedures. Surgical intervention is indicated, starting from the third stage of the development of diseases.

The consequences of the development of such processes adversely affect the quality of life of the patient. In addition, it is precisely because of such changes that the greatest percentage of disability occurs. While the initial stages of dysfunction are tolerably amenable to conservative treatment. Therefore, the slightest signs of an onset of the disease cannot be ignored, high-quality therapy and medical supervision.