Osteochondropathy of the cervical spine. Symptoms and treatment of different types of osteochondropathy. Osteochondropathy of the cervical spine

Among the diseases most common in children is spinal osteochondropathy. It is not completely clear what kind of pathology this is and what its etiology is. This disease is also called Scheuermann-Mau disease. Its various manifestations are possible in the process of growing up.

With this disease, damage occurs to the vertebral bodies and discs. The pathology is also characterized by a disorder in the endplates of the vertebral bodies and is observed mainly in the thoracic region. Changes are also possible in the lumbar region.

Adolescents from about 11 years of age are susceptible to the disease. Juvenile osteochondropathy often manifests itself during the period of active bone growth in a child, which occurs from 12 to 18 years. Over time, the disease leads to noticeable.

The pathology is characterized by slow progression. Teenagers are susceptible to it, regardless of gender. According to ICD 10, the disease has code M93, designated “Other osteochondropathy.”

Reasons for development

The disease destroys bone tissue. The phenomenon is associated with a failure in its blood supply. Possible reasons for such a violation may be:

The factors that influence the development of this pathology in humans have not yet been clarified. It is also possible that some people may have a genetic predisposition to developing the disease.

Children are also characterized by osteochondropathy of the calcaneus, provoked by metabolic disorders, as well as a disruption in hormonal development. Hereditary factors also have an influence.

Symptoms

Signs of this disease manifest themselves in different ways. Much depends on the person’s age and the severity of the pathology. At an early stage, the disease does not manifest noticeable signs. The child does not seek help due to the absence of symptoms. By the end of the first phase of the disease, a person begins to experience:

frequent fatigue in the back muscles, especially after exercise;
muscle asymmetry in the spine;
mild back pain that disappears after rest.

As the child grows actively, he begins to show more pronounced signs of the disease in the form of:

increasing the intensity of pain in the spinal region;
noticeable deformation of the spine due to the destruction of bone tissue;
difficulty when trying to tilt the head and body forward.

One of the symptoms of pathology in a child is also periodic pain in the place where the spinous processes of the vertebrae are located. They are easily palpable in adolescents with spinal osteochondropathy.

At a late stage in the development of the disease, the child develops a flat back, the chest becomes deformed and becomes funnel-shaped. Neurological disorders are a severe symptom of the disease in the later stages. The patient may also experience deformation of the legs.

Diagnostics

The main method of detecting the disease is x-ray examination. It allows you to install:

rotation of the vertebrae in the sternum and lumbar region;
the presence of their wedge-shaped deformation;
presence .

If a person has neurological disorders, then he is additionally referred to a computed tomography scan of the spine. An MRI may also be indicated.

If necessary, the patient is prescribed electromyography. He may be referred to a cardiologist and pulmonologist if there are suspicions of problems with the heart and lungs.

Treatment

Spinal chondropathy involves the use of conservative methods of therapy. During treatment, patients are also given therapeutic massage. Particular attention is paid to the patient performing a set of special exercises.

Surgery may be used in severe cases. With them, patients undergo spinal osteotomy. One type of operation is vertebral resection.

Drugs

Treatment of osteochondropathy of the thoracic spine includes prescribing the following medications to the patient:

painkillers (“Ketanov”);
vitamin complexes containing calcium;
medications with anti-inflammatory effects (“Nimesil”, “Nise”);
drugs with a vasodilating effect ();
restoring microflora (“Wobenzym”);
medications to strengthen cartilage tissue ().

Lumbar osteochondropathy is treated by taking vitamin B. The therapy is complemented by massage sessions, swimming and physical therapy. Patients are also prescribed physical therapy in the form of exercise therapy.

Exercises

In case of illness, physical therapy is required. It includes a set of exercises that use the back muscles:

Raising the upper body. You need to lie on your back. It is important that the floor is level. A cushion with a thickness of at least 10 cm is placed under the shoulder blades. Hands are placed behind the head, after which the whole body is deflected, the upper body is required to be raised 5 times.
Tilts. Arms straighten above your head. The right hand grasps the left at the wrist. You need to stretch your left arm 10 times. Then the hands are changed, the exercise is repeated 10 times.
Breathing exercises. You need to wrap a long towel around the diaphragm - that's where the lower ribs are located. The towel is taken along the edges. When inhalation is made, it weakens. When exhaling, you need to lightly tighten the towel in the area of the diaphragm. The exercise is repeated 10 times.

Important! In the first three months, exercises should be performed every day. In subsequent months, you can do them once every two days. With irregular exercise, the effectiveness of treatment becomes noticeably lower.

Exercises have been developed for osteochondropathy of the cervical spine. They include:

Shoulder touching ear. During the exercise, the person throws his head back. In this position, you need to touch your left ear with your left shoulder 5 times, and your right ear with your right shoulder.
Head turns. The chin drops to the chest, the shoulders straighten. The head slowly turns to the right and then to the left.
Touching the chin to the jugular fossa. The head is thrown back. In this position, it is necessary, overcoming the resistance of the neck muscles, to touch the chin to the depression in the lower part of the neck.

Exercises are also performed in the treatment of ACP of the lumbosacral spine. To do this, gentle turns of the lower back are made to the left and right sides 10 times every day. The shoulder girdle is also raised as high as possible in a standing position with a straight back.

Prevention

To prevent the development of spinal osteochondropathy it is necessary:

eat right by including foods with vitamin B in your diet (seafood, legumes, nuts);
lead an active lifestyle with frequent stretches for the back and lower back;
correctly carry weights without overloading only one part of the body;
wear comfortable shoes to strengthen the heel bone;
watch your posture;
if you have a predisposition to the disease, take medications that strengthen bone tissue.

The main preventive method is to avoid excessive physical stress on the spine. It is necessary to evenly distribute the load on different parts of the body when carrying heavy loads.

Conclusion

Spinal osteochondropathy is more often observed in adolescents. Children in the age group 11-18 years are at risk. The disease can manifest itself as a result of the influence of hereditary factors.

Therapy involves taking special medications, as well as the patient performing exercises as part of physical therapy. The most common consequences of spinal osteochondropathy in children are severe pain and deformation of the chest, which provokes a malfunction in the functioning of the respiratory and heart organs.

Osteochondropathy is a disease of the osteochondropathy, consisting of impaired nutrition of bone tissue with the subsequent occurrence of aseptic necrosis. Osteochondropathy translated from Greek means “suffering of bones, cartilage.”

This disease occurs as a result of local circulatory disorders for the following reasons: trauma, heredity, etc. Osteochondropathy is a dangerous disease that cannot be detected in the early stages.

Failure to provide timely assistance from specialists leads to quite serious consequences, since the bone will break not only under external influences, but also under the influence of the weight of one’s own body. This could be muscle cramps or normal muscle strain.

In most cases, osteochondropathy affects those people who lead a pseudo-healthy lifestyle (excluding vital foods from their diet), the percentage of the population that suffers from excess weight, physically developed residents and people who exhaust their bodies with a variety of diets.

Spinal osteochondropathy

Spinal osteochondropathy, according to statistics, occurs most often in children 11-18 years old. It is based on damage to the discs and bodies of the thoracic vertebrae. In addition, damage to the endplates occurs. More susceptible areas of the body are the spine (thoracic region), the lumbar-thoracic region.

Scheuermann-Mau disease has not been fully studied by scientists and doctors. Spinal osteochondropathy proceeds rather sluggishly and unnoticed, and does not have a pronounced pathological process. At the initial level, patients experience increased fatigue in various parts of the spine, periodic pain in the back, which disappears after sleep.

As the child grows, the pain syndrome intensifies, thereby contributing to the formation of a curved spinal column. As a result, the deformation of the spine shifts its apex to the X-thoracic vertebra, and a “flat back” is formed. The changes described above are continuously associated with varus deformation of the legs, as well as with flattening of the human chest.

In severe spinal osteochondropathy, the patient experiences nervous disorders (a type of radicular syndrome). If the disease affects the lumbar spine, the person may not feel pain, and therefore, may not see a doctor. When osteochondropathy manifests itself as a pathology of the cervical vertebrae, every turn of the head causes pain, and without the intervention of a specialist, the person will not even be able to turn his head.

Limited spinal movement may be caused by decreased height of the spinal discs or the development of contracture of the rectus dorsi muscles.

Diagnosis of spinal osteochondropathy

Treatment of osteochondropathy is a long process that is based on X-ray images. On them, the specialist identifies the rotation of the vertebrae, both in the thoracic and lumbar regions, determines the unevenness or jaggedness of the apophyses (anterior, lower and upper edges of the vertebrae). In addition, the doctor determines the level of reduction of intervertebral discs, determines the percentage of flattening of the dorsoventral size of the vertebrae, and checks disc calcification and spondylolisthesis. The severity of this disease is characterized by the degree of deformation of the vertebral bodies. Treatment of osteochondropathy in adults is quite painful.

Osteochondropathy in children

Osteochondropathy in children has 4 stages of development:

Osteochondropathy of the head of the femur (this disease is called Legga-Calvé-Perthes), as well as the heads of the 2nd and 3rd metatarsal bones (this disease is called Aljoan-Keller). This disease can manifest itself as an effect on the phalanges of the fingers or on the sternal end of the clavicle.
Osteochondropathy of the navicular bone of the foot, vertebral bodies or sesamoid bone of the metatarsophalangeal joint.
Tibial tuberosity (referred to as Schlatter's disease), calcaneal tuberosity, or sciatic joint.
Partial osteochondropathy of the elbow, hip and other joints.

After an illness, a person diagnosed with Perthes disease develops arthrosis of the hip joint. And a patient who has suffered from spinal osteochondropathy may develop osteochondrosis.

Osteochondropathy of the foot

Osteochondropathy of the foot is observed mainly in children aged 1-10 years. A larger percentage of diseases occur between 3 and 7 years of age.

Bone necrosis can occur due to various types of trauma or physical overload. The symptom of the disease is pain in the medial part of the foot. Unpleasant sensations occur during walking when body weight is directed towards the affected leg. Sometimes osteochondropathy of the foot is accompanied by local swelling, and irritation or redness may also appear.

Osteochondropathy of the foot is defined as follows: an X-ray examination shows the specialist a flattening of the navicular bone, on which there are many areas of irregular ossification.

Many people believe that the disease develops due to the varied shape of the foot - this is a misconception. The reasons can be different: from physical activity to poor nutrition. They can not be recognized immediately, but within several months after the onset of the disease.

Osteochondropathy of the calcaneus

Osteochondropathy of the calcaneus (otherwise known as Halgund-Schinz disease) most often occurs in children aged 12 to 15 years. Causes: severe physical activity during sports, injuries, hormonal factors (for example, pathology of the function of the endocrine glands), impaired metabolism of vital substances.

In this case, the pain manifests itself in the area of the heel tubercle, it intensifies when walking. During palpation, you can feel swelling and unpleasant painful sensations. Osteochondropathy of the calcaneus can also occur in adults, but in fairly rare cases.

Treatment of osteochondropathy

Treatment of spinal osteochondropathy is aimed at relieving pain, as well as restoring mobility in all areas of the spine. In addition, specialists correct the patient’s posture and prevent osteochondrosis. Subsequently, physical activity is excluded, and in some cases, after an illness, a person wears a corset.
Treatment for osteochondropathy of the foot can vary from simple restrictions (rest, avoidance of physical activity) to the prescription of orthopedic medications and the use of special splints.
Treatment of osteochondropathy of the calcaneus is based on both clinical and radiological data. The diagnosis is made with achillobursitis.

The spine is the support of the entire human skeleton. Thanks to the correct structure, the entire body functions stably, and people can move on two legs. But if the functioning of the spine is disrupted, the consequences can be very dire.

Spinal osteochondropathy is a disease in which destruction of the vertebrae and intervertebral cartilage occurs. Osteochondropathy of the thoracic spine is usually diagnosed; destruction in the lumbar spine is much less common. Cervical osteochondropathy is diagnosed very rarely.

Spinal osteochondropathy in children

Scheuermann-Mau disease, or spinal osteochondropathy, is a disease of children and adolescents. The pathology is usually diagnosed in children aged 11 to 18 years. The exact cause of the pathology is still not known, but negative factors that can provoke the disease have been identified:

professional sports;
hard physical labor;
spinal injuries;
hormonal imbalances;
problems with calcium absorption;
congenital malformations of the spine;
circulatory disorders;
hereditary predisposition.

Osteochondropathy develops gradually, depending on the stage of the disease, symptoms increase. First, muscle weakness is observed, the child complains of aching pain in the spine, and upon examination a slight asymmetry is visible.

But over time, the situation worsens, the pain becomes severe and intensifies with palpation. Upon examination, a pronounced deformity of the spine is visible, the back appears flat. Children with osteochondropathy are often diagnosed with valgus feet and chest deformity.

In severe cases of the disease, the pain is very severe, contracture of the back muscles is observed, which disrupts the motor activity of the vertebrae. True, in the thoracic region this is not so noticeable, and if the cervical spine is affected, the patient cannot turn and tilt his head, every movement is accompanied by acute pain.

Treatment of spinal osteochondropathy

First of all, the orthopedist prescribes an x-ray of the diseased area of the spine, which will show the deformation of the vertebrae. Depending on how severely the vertebrae are deformed, the degree of the disease will be determined in the future.

The next step is for the doctor to conduct a differential diagnosis with the following pathologies:

Round youthful back;
Osteomyelitis;
Güntz fibrosis;
Spondyloepiphyseal dysplasia;
Calve's disease.

After confirming the diagnosis, treatment for spinal osteochondropathy is prescribed; it is conservative. First of all, it is necessary to remove the load from the spine in order to stop the destruction of the vertebrae and prevent a pathological fracture. If a child has been involved in professional sports, he will have to stop training. In severe cases, bed rest will be prescribed.

The next step is to relieve the patient of pain; for this he is referred to physical therapy; painkillers and anti-inflammatory drugs, vitamins, and drugs to normalize the functioning of the gastrointestinal tract may also be indicated. The latter are necessary to ensure normal absorption of nutrients. The doctor selects all medications individually.

To strengthen the back muscles and correct posture, the child is referred to physical therapy and massage. If severe deformity is observed, then skeletal traction will be needed, with the help of which the vertebrae will be returned to the physiologically correct position. In especially severe cases, when conservative methods do not help get rid of the deformity, surgical treatment may be indicated.

During and after therapy, the child is recommended to eat proper nutrition, rich in vitamins and calcium. The diet must be balanced; exhaustion or obesity must not be allowed, since in both cases this is fraught with complications. During the treatment period, you need to limit sweets, soda, coffee, smoked and salty foods.

Water procedures have a beneficial effect on the spine, so the child is recommended to visit the pool. Swimming strengthens the back muscles, improves nutrition of the spine and accelerates the recovery of affected bone tissue.

Prognosis for spinal osteochondropathy

Spinal osteochondropathy is a completely curable disease if it can be diagnosed in childhood, when the human body is still actively growing. But it is quite difficult to make a correct and timely diagnosis, since the pathology is very similar to other diseases of the spine and bones.

Lack of treatment for osteochondropathy of the thoracic spine can lead to a pathological fracture and disability. Sometimes, even with timely treatment, osteochondrosis develops at an older age.

To avoid complications, you need to be constantly monitored by an orthopedist. The doctor will be able to promptly identify the pathology and prescribe therapy. To prevent complications, the child is advised not to overload the spine in the future, do gymnastics to strengthen the back muscles, and eat right.

Source: http://sustavof.ru/osteohondropatiya/osteohondropatiya-pozvonochnika.html

How to treat spinal osteochondropathy

What is pathology

The pathology is characterized by slow progression. Teenagers are susceptible to it, regardless of gender. According to ICD 10, the disease has code M93, designated “Other osteochondropathy.”

Reasons for development

The disease destroys bone tissue. The phenomenon is associated with a failure in its blood supply. Possible reasons for such a violation may be:

excessive stress on the spine due to heavy lifting and sports;
hormonal imbalance in the body as you grow older;
existing congenital anomalies of the musculoskeletal system;
improper absorption by the body of calcium and other elements necessary for the formation of bone tissue;
vertebral osteoporosis;
endplate necrosis;
improper development of the spinal muscles;
spinal injuries.

Children are also characterized by osteochondropathy of the calcaneus, provoked by metabolic disorders, as well as a disruption in hormonal development. Hereditary factors also have an influence.

Symptoms

frequent fatigue in the back muscles, especially after exercise;
muscle asymmetry in the spine;
mild back pain that disappears after rest.

As the child grows actively, he begins to show more pronounced signs of the disease in the form of:

increasing the intensity of pain in the spinal region;
noticeable deformation of the spine due to the destruction of bone tissue;
difficulty when trying to tilt the head and body forward.

Diagnostics

The main method of detecting the disease is x-ray examination. It allows you to install:

rotation of the vertebrae in the sternum and lumbar region;
the presence of their wedge-shaped deformation;
presence of Schmorl's hernia.

If a person has neurological disorders, then he is additionally referred to a computed tomography scan of the spine. An MRI may also be indicated.

If necessary, the patient is prescribed electromyography. He may be referred to a cardiologist and pulmonologist if there are suspicions of problems with the heart and lungs.

Treatment

Surgery may be used in severe cases. With them, patients undergo spinal osteotomy. One type of operation is vertebral resection.

Drugs

Treatment of osteochondropathy of the thoracic spine includes prescribing the following medications to the patient:

painkillers (“Ketanov”);
vitamin complexes containing calcium;
medications with anti-inflammatory effects (“Nimesil”, “Nise”);
drugs with a vasodilating effect (“Actovegin”);
restoring microflora (“Wobenzym”);
medications to strengthen cartilage tissue (Teraflex).

Exercises

In case of illness, physical therapy is required. It includes a set of exercises that use the back muscles:

Raising the upper body. You need to lie on your back. It is important that the floor is level. A cushion with a thickness of at least 10 cm is placed under the shoulder blades. Hands are placed behind the head, after which the whole body is deflected, the upper body is required to be raised 5 times.
Tilts. Arms straighten above your head. The right hand grasps the left at the wrist. You need to stretch your left arm 10 times. Then the hands are changed, the exercise is repeated 10 times.
Breathing exercises. You need to wrap yourself in a long towel in the area of the diaphragm - the lower ribs are located there. The towel is taken along the edges. When inhalation is made, it weakens. When exhaling, you need to lightly tighten the towel in the area of the diaphragm. The exercise is repeated 10 times.

Important! In the first three months, exercises should be performed every day. In subsequent months, you can do them once every two days. With irregular exercise, the effectiveness of treatment becomes noticeably lower.

Exercises have been developed for osteochondropathy of the cervical spine. They include:

Shoulder touching ear. During the exercise, the person throws his head back. In this position, you need to touch your left ear with your left shoulder 5 times, and your right ear with your right shoulder.
Head turns. The chin drops to the chest, the shoulders straighten. The head slowly turns to the right and then to the left.
Touching the chin to the jugular fossa. The head is thrown back. In this position, it is necessary, overcoming the resistance of the neck muscles, to touch the chin to the depression in the lower part of the neck.

Exercises are also performed in the treatment of ACP of the lumbosacral spine. To do this, gentle turns of the lower back are made to the left and right sides 10 times every day. The shoulder girdle is also raised as high as possible in a standing position with a straight back.

Prevention

To prevent the development of spinal osteochondropathy it is necessary:

eat right by including foods with vitamin B in your diet (seafood, legumes, nuts);
lead an active lifestyle with frequent stretches for the back and lower back;
correctly carry weights without overloading only one part of the body;
wear comfortable shoes to strengthen the heel bone;
watch your posture;
if you have a predisposition to the disease, take medications that strengthen bone tissue.

The main preventive method is to avoid excessive physical stress on the spine. It is necessary to evenly distribute the load on different parts of the body when carrying heavy loads.

Conclusion

Spinal osteochondropathy is more often observed in adolescents. Children in the age group 11-18 years are at risk. The disease can manifest itself as a result of the influence of hereditary factors.

Source: https://revmatolog.org/spina/pozvonochnik/osteohondropatiya.html

Timely detection and treatment of spinal osteochondropathy

Favorable conditions for the development of such a pathological condition are created by a damp, cold climate in the patient’s area of residence.

The most common form of the disease affects the vertebrae, discs, and endplates of the thoracic region.

In children with poor development of the musculoskeletal system, due to heavy loads, lack of essential minerals, vitamins, and nutrients, damage to the lumbar region, as well as chondropathy of the knee joint and osteochondropathy of the hip joint, may occur.

Discs of 7–10 vertebrae are usually affected. Spinal osteochondropathy is a rare, difficult to correct condition with an etiology that is not fully understood.

Types of pathological conditions

The disease can manifest itself in children in several different ways.

Children, adolescents, and young men may develop various deformities of a certain part of the spinal column if they engage in strenuous sports, suffer from hypogonadism, adiposogenital dystrophy, and other hormonal disorders. The disease may be a consequence of locally impaired microcirculation. Scientific medical literature mentions cases of the disease due to a hereditary factor of a dominant type.

Any type of osteochondropathy is characterized by slow development, signs of muscle asymmetry, and hypotension. The initial stage of the disease occurs against a background of increased fatigue and minor spinal pain. Even with such symptoms, it is advisable to immediately show the child to a doctor.

How the disease develops

Sometimes the patient complains of pain in the spinous processes.

This means that the spinal column is curved, a persistent kyphotic deformity begins to form, and an abnormal structural arch is formed.

Further curvature leads to a displacement of the apex of the arch to the tenth thoracic vertebra, and “flat back” syndrome appears. Associated pathologies may be:

neurological disorder;
varus deformity of the leg;
sternal funnel deformity;
radicular syndrome;
flattened chest.

Injuries to the lumbar spine can be difficult to recognize, since the child often does not complain of pain with such a complication. But if the cervical vertebra is damaged, sharp pain appears between the shoulder blades when tilting the head forward. Structural changes in the spine and decreased disc height create an obstacle to back movements.

External manifestations may indicate progressive pathology. But it will be possible to accurately determine the degree of its development only when the anatomical period of growth of the spine ends.

Diagnostic methods

The difficulty of determining the presence of the disease forces the use of the main diagnostic method - radiography. But this procedure does not give an unambiguous answer, therefore, with characteristic symptoms, a careful differential diagnosis is necessary. On the resulting x-ray, the doctor may look for signs such as:

multiple Schmorl's hernias;
kyphosis;
vertebrae of reduced height;
spondylolisthesis;
calcification of intervertebral discs.

After analyzing the image, a secondary contact examination of the patient is carried out, palpation of painful areas in order to determine the severity of the disease.

It is determined how far the destructive process has spread, which areas of the musculoskeletal system are affected, how limited the spinal functions are, and how many Schmorl’s hernias the patient has. In this case, the patient is asked to perform certain movements.

Osteochondropathy has many similar symptoms to other pathologies.

Therefore, comparative diagnostics are carried out to exclude congenital fibrosis of Güntz discs, compression fracture of the vertebral body, and Calve's disease.

You should also check for Calve's disease and spondyloepiphyseal dysplasia. In Calve's disease in a young child, only one vertebra is affected, while juvenile kyphosis affects a larger number.

Doctors have to diagnose osteochondropathy over a relatively long period. Based on the obtained X-ray images, structural changes are studied in dynamic development. Fearing harmful radiation, not all parents agree to repeat x-rays. Such an erroneous position can lead to an advanced state of the disease.

Prevention and treatment

Adult patients are prescribed prophylactic use of stoparthrosis, structum, teraflex, alflutop, and other drugs to strengthen cartilage.

A special regime is prescribed that limits active movements, excludes jumping, straining the back when lifting weights, and lying on uncomfortable soft surfaces.

To stop constant pain, conservative therapy is carried out. its task: to restore mobility of the spine and correct posture.

Sessions in the pool can be combined with stretching: the underwater procedure gives a noticeable healing effect and helps relieve severe pain.

Among the medications prescribed for this pathology are prozerin, drugs to improve the condition of blood vessels, B vitamins, systemic enzymes (medicinal forms of phlogenzyme and wobenzyme).

To eliminate the focus of the inflammatory process and the source of pain, the use of zaldiar, paracetamol or another analgesic is indicated.

Patients are prescribed treatment with Celebrex, Nise, Nimesil, Dexalgin, Airtal, and other drugs from the NSAID group.

If the patient seeks help at the initial stage of the process, the spinal deformity can be stopped. In advanced cases of the disease, the development of severe forms of vertebral osteotomy, and in cases of wedge-shaped resection with fixed kyphosis, surgical intervention is necessary. Practice shows effective results of operations in the majority of patients studied.

Health activities in children's medical institutions

To avoid the development of early osteochondrosis, it is advisable to carry out active physical therapy and orthopedic measures in specialized children's institutions.

These could be private clinics, dispensaries, children's health centers. Repeated physical therapy sessions are required throughout the day.

Their goal is to gradually achieve reclination of kyphosis, if it exists, and to form lordosis, if it does not exist.

The set of exercises is selected individually, depending on the severity of osteochondropathy. If the child does not have radicular syndrome, there are no difficulties with bending the body forward, he does not experience pain, he is allowed to engage in active activities.

It is especially useful to conduct such courses in the fresh air, in country health camps.

The time allocated for recreational activities is evenly distributed between outdoor games, swimming, water procedures, games in the water with balls and other equipment. A contraindication to such activities is radicular syndrome.

Instructors and doctors ensure that the group does not experience physical overload. Effective results are obtained by walking for a long time with a feclinating stick, fixed with the elbows behind the back.

It is recommended that part of the homework (for example, assigned reading or science lessons) be prepared in a lying position. If a child has all the signs of secondary stable radicular syndrome, the intervertebral discs are flattened, unstable, the distance between them is narrowed, it is necessary to wear a corset.

For small patients who have been diagnosed with radicular syndrome, orthopedic hospitals are provided. For sick children, the use of a Glisson loop and a pelvic girdle is indicated. The traction procedure is performed only while constantly wearing a hard leather belt or a weightlifter's belt. Tight fixation of the waist prevents subsidence of the vertebrae and worsening of neuralgic symptoms.

The diet is followed, a diet with carotene and vitamin A is followed, and physiotherapeutic procedures of diathermy, electrophoresis, and ultrasound are performed. Children are given injections of vitamins, massages are performed on their back muscles every day, and they are treated with acupuncture.

The course of treatment in an orthopedic hospital is 3.5 months. During this time, the basic functions of the spine are restored, meningeal and radicular symptoms disappear, and the risk of developing early osteochondrosis is reduced. Therapeutic gymnastics classes continue after discharge from the hospital, at home. It is useful to visit sanatoriums, resorts with warm water treatments, and swim every year.

Source: https://moisustav.ru/bolezni/osteohondroz/osteohondropatiya-pozvonochnika.html

Spinal osteochondropathy

Osteochondropathy is a pathology of bone and cartilage tissue that occurs mainly in young people.

It is believed that the destruction of the vertebrae occurs due to increased physical activity, as well as a lack of nutrients. The disease is quite rare, but difficult to treat.

Boys in adolescence who live in areas with a cold, humid climate are more often susceptible to it.

Features of spinal osteochondropathy

The disease develops in children and adolescents aged 11 to 18 years.

It is difficult to diagnose at an early stage and treat, but with timely treatment it completely resolves along with the cessation of bone growth.

Spinal osteochondropathy develops most often in the thoracic region, but it also occurs in the lumbar region. The disease is the destruction of vertebral bodies or discs. There are several types of it:

Chondropathic kyphosis. The first to describe this disease were two scientists by whose names it is now known. It is called Scheuermann-Mau disease. It causes inflammation of the muscles at the point of attachment to the vertebrae. The vertebrae themselves become deformed and take on a wedge-shaped shape. Because of this, the spine in the thoracic region bends backward - kyphosis develops.
Chondropathy, that is, destruction of the vertebra itself. This type is called Calve's disease. At the same time, the vertebrae expand and decrease in height. The spinous process protrudes strongly, and pain is felt when palpating it.
Inflammation of the vertebral body is called Kümmel's disease. Most often it develops after a previous injury.

Reasons for the development of the disease

Necrosis and destruction of bone tissue most often develops due to disruption of its blood supply. This pathology can be provoked by the following factors:

genetic predisposition;
hormonal imbalance;
severe infectious diseases;
impaired absorption of calcium and some vitamins;
congenital pathologies of the musculoskeletal system;
circulatory disorders;

Signs of osteochondropathy

Diagnosing the disease is very difficult, especially in the initial stages, when there are no obvious symptoms. An X-ray examination or tomography can reveal signs of destruction of bone and cartilage tissue. In order to start treatment on time, parents need to be more attentive to the condition of their children. You should immediately consult a doctor if the following symptoms occur:

at first the child complains of pain, often mild, which goes away after rest;
rapid muscle fatigue, weakness and asymmetry appear;
as the disease progresses, the pain becomes more intense;
due to the destruction of bone tissue, spinal deformity develops;
in the area of the affected vertebrae you can easily feel the protruding spinous process;
many patients with osteochondropathy experience difficulty bending the body or head forward;
in later stages, deformation of the chest is possible.

Treatment of the disease

The most common complication that develops with untimely treatment of the disease is kyphosis, spinal displacement and the so-called flat back. In middle age, this causes osteochondrosis. Due to necrosis of bone tissue, fractures are possible. Therefore, it is very important that treatment is started immediately when complaints of pain appear. Its main goals should be:

pain relief;
correcting posture and restoring the natural curves of the spine;
prevention of osteochondrosis;
restoration of the functions of the vertebrae and discs, body mobility, especially when bending forward.

Treatment of spinal osteochondropathy includes avoiding heavy physical activity, physical therapy, massage, physiotherapeutic methods and taking medications prescribed by a doctor. Sometimes a complete restriction of mobility is indicated - bed rest on a hard bed. For severe pain and deformation of the vertebrae, traction with a load on an inclined plane or under water is used.

Water procedures for osteochondropathy are very useful, especially swimming and medicinal baths. Treatment of the disease also includes a proper diet, which contains many foods rich in vitamins B and A, as well as calcium. In rare cases of advanced disease, surgical treatment is prescribed. It is needed if complications or severe spinal deformity have developed.

What medications are prescribed?

Spinal osteochondropathy is characterized by pain and tissue destruction. Therefore, medications are used that relieve the patient of these symptoms:

painkillers - Paracetamol, Ketanov, Ibuprofen;
anti-inflammatory – “Nimesil”, “Aertal”, “Dexalgin”
vasodilators, for example, Actovegin;
multivitamins with calcium;
means for restoring intestinal microflora, which are needed to better absorb microelements from food, for example, Wobenzym.

Physical activity for osteochondropathy

The main treatment for the disease is physical therapy. Heavy physical activity should be avoided, especially heavy lifting and jumping. In the absence of severe pain, special exercises are performed with a gradual increase in their number and number of repetitions. It is advisable to exercise 2-3 times a day.

A useful exercise for all patients is to sit or walk using a special reclining stick located at the level of the thoracic spine. You need to grab it from behind with your elbows. Other exercises are developed individually, taking into account the characteristics of the course of the disease.

Pain in children most often occurs after exertion or prolonged sitting at a table. Therefore, it is recommended to do some homework in a lying position, and to sit using a chair with a high back curved forward. You need to sleep on a hard bed, placing a wooden board under the mattress.

Often, after an illness, people develop osteochondrosis. To prevent the destruction of spinal bone tissue, it is very important to form a muscular corset in children, as well as protect them from strong physical exertion. Proper nutrition and normalization of metabolism are also very important for the prevention of osteochondropathy.

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Source: https://joint.propto.ru/article/osteohondropatiya-pozvonochnika

Osteochondropathy of the cervical and thoracic spine in children and adults: ICD-10 code, signs of apophyseal deformation, symptoms, treatment

Spinal osteochondropathy is also called Scheuermann-Mau disease. It affects the middle and lower thoracic region. Due to the progression of the disease, the so-called “round back” appears in adults.

Classification of the disease according to ICD-10

This disease received ICD code M42. The pathology has a long course and can develop over years. Clinical manifestations depend to a large extent on the age of the patient.

The disease usually affects male patients aged 10-25 years. Moreover, the greatest progression of the disease occurs during periods of rapid growth.

As the pathology develops, a deformity of the spine develops, which outwardly looks like a round back.

Also in the process there is a change and deformation of the thoracic or cervical spine. The sternum takes on a funnel-shaped shape. In especially severe cases, severe neurological impairment may occur, including the inability to tilt the head forward or limited mobility of the spine.

The main reasons put forward are factors such as:

Genetic predisposition;
Professional fees;
Frequent injuries;
Osteoporosis;
Fast and strong growth of bone tissue;
Hormonal imbalance.

Considering these factors, doctors still cannot choose the most effective method that allows one to completely restore the normal anatomical curve in the thoracic region using non-surgical methods.

Symptoms of spinal osteochondropathy

As mentioned earlier, the main age for the development of the disease is 10-25 years. The condition manifests itself in such manifestations as:

Back asymmetry;
Muscular hypotonia;
Intense back pain;
Funnel-shaped thoracic region.

In some cases, pain may be absent for some time, but a cosmetic defect in the form of poor posture is still visible to the naked eye.

Children may also complain of some back fatigue and be moody. Due to the characteristics of the disease, there is a negative impact on a number of organ systems, which can affect the physical and mental development of the child.

Age-related changes in the spine with osteochondropathy

Diagnostics and tests

To diagnose this disease, consult with an orthopedist, traumatologist or surgeon. In this case, it is usually prescribed:

X-ray of the thoracic spine;

If we are talking about disturbances in the functioning of internal organs, then doctors can supplement the examination with other methods.

MRI image of a thinned vertebral apophysis

Treatment

The treatment is generally comprehensive, but the greater focus is not on medications, but on external influences, that is, physical activity, physiotherapy and other methods.

Medication

If we talk about drug treatment, the list of drugs that can really help cope with the disease is quite short. Mainly used:

Painkillers and muscle relaxants: Dexalgin, Aertal, Sirdalud, Baclofen, Tizanidine and others;
NSAIDs: Diclofenac, Nurofen, Nimesil and so on;
Blockades (a mixture of drugs is used, one of which is either lidocaine or novocaine);
Vitamin preparations and dietary supplements: Sustanorm, Artra, Glucosamine, Chondroitin and so on.

That is, the main goal of such treatment is to eliminate pain, as well as prevent the progression of the disease.

Phys. loads

The disease is considered quite severe. Considering that the risk group includes those who are often injured or play professional sports, there are certain restrictions on playing sports.

In particular, patients are allowed to engage in only exercise therapy and swimming. But even despite the safety of the impact, training should be carried out with an experienced instructor who can correctly select each type of movement.

Such patients do not go to physical education classes, as they require a special approach due to the severity of the disease. It is important to consider that exercise therapy will be effective in the early stages. As you get used to it, it can also be supplemented with cycling or walking.

If we talk about complications, then the most acute periods of progression occur during the period of rapid human growth, that is, at 9-10 years, as well as at 12-15. And it was at this time that internal systems and the ODA itself were actively being formed. As a result of such deformation, the following appear:

Disturbances in the work and structure of the internal systems of the body (especially in the affected department):

Diseases of the heart and blood vessels;
Diseases of the central nervous system;
Gastrointestinal diseases;
Diseases of the respiratory system and so on.
Developmental delay in children;
Disability of the patient.

It is not uncommon for patients with Scheuermann-Mau disease to end their lives with a stroke, heart attack, pulmonary embolism and other similar terrible diagnoses.

The prognosis is generally disappointing, since the disease can only be slowed down, but cannot be completely cured. As a rule, it stops developing by the age of 25, when the body is already formed. Sooner or later, the patient has to make a decision about spinal surgery.

Features of the development of spinal osteochondropathy:

Source: http://gidmed.com/ortopediya-i-travmatologiya/sustavu-kosti/osteohondropatii/pozvonkov.html

Basics of formation, causes, symptoms of osteochondropathy kyphosis

Osteochondropathic kyphosis (Scheuermann-Mau disease, dorsal juvenile kyphosis, juvenile apophysitis) is the formation of a pathological concavity posteriorly in the thoracic spine. It is most often observed in adolescence (12-17 years).

Osteochondropathy of the vertebral bodies is characterized by a violation of the transformation of the cartilaginous structure of the spine into bone, which leads to their wedge-shaped deformation. As a result, with juvenile kyphosis, specific signs of pathology are formed on the radiograph:

Anatomically, the spinal column has 2 kyphosis - in the thoracic and sacral regions. They represent a posterior convexity of the spine with an angle of no more than 40 degrees. If the curvature exceeds 40 degrees, pathological kyphosis occurs.

Pathology, depending on the causes, is classified into:

Congenital;
Acquired.

Congenital kyphosis is caused by the presence of a wedge-shaped hemivertebra, fusion of the bodies of some of them with each other, and structural anomalies.

Acquired osteochondropathy kyphosis occurs when there are osteochondropathy in the body:

Scheuermann-Mau diseases;
Rickets;
Tuberculous spondylitis (inflammation of the vertebra);
Calvet's disease;
Neurofibromatosis;
Bekhterev's diseases.

Most often, the pathology develops in young men with Scheerman-Mau disease. On radiographic examination, it is characterized by wedge-shaped deformation of the bodies of the 7th to 10th thoracic vertebrae with the formation of Schmorl's hernias at several levels simultaneously.

With rickets, a small amount of vitamin D is observed in the child’s body. It is necessary for the inclusion of calcium in bone tissue. Weak bone structure is accompanied by a decrease in vertebrae in size.

Tuberculosis of the spinal column leads to various deformities. Against the background of the disease, the formation of a pathological concavity posteriorly in the thoracic region cannot be ruled out.

Legg-Calvé-Perthes disease is characterized by a violation of the transformation of cartilage tissue into bone (osteochondropathy) in the area of small bones of the hands and vertebral bodies.

Neurofibromatosis is accompanied by impaired innervation of skeletal muscles. With the disease, the muscular corset of the back is weakened, so it cannot support the spine in the correct physiological position.

Ankylosing spondylitis is characterized by the deposition of calcium salts in the ligaments of the spine (ossification), which leads to limited mobility. Under such conditions, not only kyphosis increases, but also lumbar lordosis becomes more pronounced.

X-ray of osteochondropathy kyphosis

Pathogenetic basis of the formation of osteochondropathy

Juvenile apophysitis is observed against the background of dystrophic changes in the intervertebral discs with impaired ossification of their marginal plates. In this case, a free space appears in the spongy substance of the vertebral body, into which part of the intervertebral disc penetrates over time (a Schmorl's hernia is formed).

During osteochondropathy there are 3 stages:

Osteoporosis.
Fragmentation.
Repair.

Osteoporosis is a weakening of the bone structure due to low calcium content or loss of calcium. Fragmentation is the division of the bone structure into several ossified fragments, which are separated from each other by strips of cartilaginous tissue. During the physiological process of ossification (deposition of calcium salts), the bone area (growth zone) must be completely covered.

Reparation - over time, the cartilage strips are closed with calcium salts, but this process is individual. It largely depends on the quality of nutrition, a person’s lifestyle and the nature of his diet.

Osteochondropathic kyphosis is accompanied by damage mainly to the anterior sections of Th7-Th10 with wedge-shaped deformation of the vertebrae.

Clinical symptoms

In the initial stages, the disease is asymptomatic. Parents of children with pathology usually consult a doctor if there is a pronounced degree of pathological thoracic kyphosis. In this condition, children usually already have the following symptoms:

rapid fatigue and muscle weakness;
pain in the back when bending over;
increased heart rate due to compression of the nerve roots in the thoracic spine.

These symptoms are not specific to the disease, so the diagnosis is made on the basis of an X-ray examination of the thoracic spine. The pathology image shows the following changes:

Wedge-shaped thoracic vertebrae - the anterior sections are lower than the posterior ones;
The joint areas have uneven and wavy contours;
The height of the intervertebral fissures varies at several levels.

Typically, with osteochondropathy kyphosis, several segments are simultaneously involved in the process (5-8). The degree of curvature can be different, which depends on the duration of existence and the severity of the pathology. For example, if osteochondropathy has formed by the age of 20, it is not accompanied by pronounced deformities of the spinal column, but persists throughout life.

The course of juvenile dorsal kyphosis is characterized by 3 main stages:

Initial – the period of an “immature” vertebra, when its body mostly consists of cartilaginous tissue;
At its height, there is fusion of several ossification points with each other;
Residual effects - during the almost complete ossification of the bone structures of the spine.

The clinical picture and external manifestations of the pathology will significantly depend on the stage at which the pathology arose and the magnitude of the concavity. The underlying cause of osteochondropathy has a certain influence on the severity of the symptoms of the disease.

Juvenile kyphosis due to Scheuermann-Mau disease is fixed, and therefore does not disappear when the person bends or changes his posture. With rickets, the curvature is not noticeable when the person is in a horizontal position.

Tuberculous spondylitis leads to moderate or severe pain in the spine, but the general condition of the child is satisfactory. With Leg-Calvé-Perthes disease, one vertebra is usually “flattened”, which does not cause compression of the nerve roots.

In conclusion: osteochondropathy kyphosis is treated mainly with therapeutic exercises and physiotherapy. Only in cases of severe curvature with pain is surgical correction of the axis of the spinal column prescribed.

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Spinal osteochondropathy in children

professional sports;
hard physical labor;
spinal injuries;
hormonal imbalances;
problems with calcium absorption;
congenital malformations of the spine;
circulatory disorders;
hereditary predisposition.

Treatment of spinal osteochondropathy

The next step is for the doctor to conduct a differential diagnosis with the following pathologies:

Round youthful back;
Osteomyelitis;
Güntz fibrosis;
Spondyloepiphyseal dysplasia;
Calve's disease.

Prognosis for spinal osteochondropathy

Lack of treatment for osteochondropathy of the thoracic spine can lead to a pathological fracture and disability. Sometimes, even with timely treatment, osteochondrosis develops at an older age.

Spinal osteochondropathy is a pathological condition of bone and cartilage tissue. In official medicine, a number of other names for the disease are accepted. This pathology is often called Scheuermann-Mau disease, aseptic necrosis of the apophyses of the vertebral bodies, and juvenile kyphosis. The main category of patients with such problems are adolescent or young boys, 11–18 years old. Hereditary manifestations of the disease occur in younger children. Favorable conditions for the development of such a pathological condition are created by a damp, cold climate in the patient’s area of residence.

The most common form of the disease affects the vertebrae, discs, and endplates of the thoracic region. In children with poor development of the musculoskeletal system, due to heavy loads, lack of essential minerals, vitamins, and nutrients, damage to the lumbar region, as well as chondropathy of the knee joint and osteochondropathy of the hip joint, may occur. Discs of 7–10 vertebrae are usually affected. Spinal osteochondropathy is a rare, difficult to correct condition with an etiology that is not fully understood.

Types of pathological conditions

The disease can manifest itself in children in several different ways.

Any type of osteochondropathy is characterized by slow development, signs of muscle asymmetry, and hypotension. The initial stage of the disease occurs against a background of increased fatigue and minor spinal pain. Even with such symptoms, it is advisable to immediately show the child to a doctor.

What function do they have? ?
Device .
Symptoms and treatment of inflammation of the jaw joint.

How the disease develops

The early stage with diffuse pain that goes away after sleep is replaced by a more acute and painful period. The active growth of a child with progressive osteochondropathy is accompanied by increased pain. Sometimes the patient complains of pain in the spinous processes. This means that the spinal column is curved, a persistent kyphotic deformity begins to form, and an abnormal structural arch is formed.

Further curvature leads to a displacement of the apex of the arch to the tenth thoracic vertebra, and “flat back” syndrome appears. Associated pathologies may be:

neurological disorder;
varus deformity of the leg;
sternal funnel deformity;
radicular syndrome;
flattened chest.

External manifestations may indicate progressive pathology. But it will be possible to accurately determine the degree of its development only when the anatomical period of growth of the spine ends.

Diagnostic methods

multiple Schmorl's hernias;
kyphosis;
vertebrae of reduced height;
spondylolisthesis;
calcification of intervertebral discs.

After analyzing the image, a secondary contact examination of the patient is carried out, palpation of painful areas in order to determine the severity of the disease. It is determined how far the destructive process has spread, which areas of the musculoskeletal system are affected, how limited the spinal functions are, and how many Schmorl’s hernias the patient has. In this case, the patient is asked to perform certain movements.

Osteochondropathy has many similar symptoms to other pathologies. Therefore, comparative diagnostics are carried out to exclude congenital fibrosis of Güntz discs, compression fracture of the vertebral body, and Calve's disease. You should also check for Calve's disease and spondyloepiphyseal dysplasia. In Calve's disease in a young child, only one vertebra is affected, while juvenile kyphosis affects a larger number.

Doctors have to diagnose osteochondropathy over a relatively long period. Based on the obtained X-ray images, structural changes are studied in dynamic development. Fearing harmful radiation, not all parents agree to repeat x-rays. Such an erroneous position can lead to an advanced state of the disease.

Prevention and treatment

Preventive measures against this unpleasant pathology must be taken from early childhood. Swimming classes and active movements without strong physical exertion, which develop coordination of game movements, are useful. Adult patients are prescribed prophylactic use of stoparthrosis, structum, teraflex, alflutop, and other drugs to strengthen cartilage. A special regime is prescribed that limits active movements, excludes jumping, straining the back when lifting weights, and lying on uncomfortable soft surfaces.

To stop constant pain, conservative therapy is carried out. Its main task is to restore the mobility of the spine and correct posture. The patient is recommended to wear a special corset, traction of the spinal column is performed with a special inclined apparatus, and physical therapy classes and swimming are prescribed. Sessions in the pool can be combined with stretching: the underwater procedure gives a noticeable healing effect and helps relieve severe pain.

Among the medications prescribed for this pathology are prozerin, drugs to improve the condition of blood vessels, B vitamins, systemic enzymes (medicinal forms of phlogenzyme and wobenzyme). To eliminate the focus of the inflammatory process and the source of pain, the use of zaldiar, paracetamol or another analgesic is indicated. Patients are prescribed treatment with Celebrex, Nise, Nimesil, Dexalgin, Airtal, and other drugs from the NSAID group.

If the patient seeks help at the initial stage of the process, the spinal deformity can be stopped. In advanced cases of the disease, the development of severe forms of vertebral osteotomy, and in cases of wedge-shaped resection with fixed kyphosis, surgical intervention is necessary. Practice shows effective results of operations in the majority of patients studied.

Health activities in children's medical institutions

To avoid the development of early osteochondrosis, it is advisable to carry out active physical therapy and orthopedic measures in specialized children's institutions. These could be private clinics, dispensaries, children's health centers. Repeated physical therapy sessions are required throughout the day. Their goal is to gradually achieve reclination of kyphosis, if it exists, and to form lordosis, if it does not exist.

It is especially useful to conduct such courses in the fresh air, in country health camps. The time allocated for recreational activities is evenly distributed between outdoor games, swimming, water procedures, games in the water with balls and other equipment. A contraindication to such activities is radicular syndrome. Instructors and doctors ensure that the group does not experience physical overload. Effective results are obtained by walking for a long time with a feclinating stick, fixed with the elbows behind the back.

Special beds are provided for children to sleep in the afternoon and at night. They have a hard, even bed (wooden shield) covered with an orthopedic mattress. For sitting at the dining and study table, chairs with high straight backs and an ergonomic forward bend in the thoracolumbar vertebral area are used. It is recommended that part of the homework (for example, assigned reading or science lessons) be prepared in a lying position. If a child has all the signs of secondary stable radicular syndrome, the intervertebral discs are flattened, unstable, the distance between them is narrowed, it is necessary to wear a corset.

The course of treatment in an orthopedic hospital is 3.5 months. During this time, the main ones are restored, the membrane and radicular symptoms disappear, and the risk of developing early osteochondrosis decreases. Therapeutic gymnastics classes continue after discharge from the hospital, at home. It is useful to visit sanatoriums, resorts with warm water treatments, and swim every year.