Osteochondropathy of the cervicothoracic spine. How to treat spinal osteochondropathy. Certain types of osteochondropathy, treatment

Spinal osteochondropathy

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

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.

What is pathology

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 a noticeable curvature of the spine.

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.

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 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

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 (“Actovegin”);
restoring microflora (“Wobenzym”);
medications to strengthen cartilage tissue (Teraflex).

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 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.

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.

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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– a group of cyclical, long-term diseases, which are based on malnutrition of bone tissue with its subsequent aseptic necrosis. Secondary clinical and radiological manifestations of osteochondropathy are associated with resorption and replacement of damaged areas of bone. Osteochondropathies include Legg-Calvé-Perthes disease, Ostgood-Schlatter disease, Köhler disease, Scheuermann-Mau disease, Schinz disease, etc. Diagnosis of osteochondropathy is based on ultrasound, x-ray and tomographic data. Treatment includes immobilization, physiotherapy, vitamin therapy, exercise therapy. Surgical treatment is performed according to indications.

General information

Osteochondropathies develop in patients of childhood and adolescence, more often affecting the bones of the lower extremities, and are characterized by a benign chronic course and a relatively favorable outcome. There is no confirmed data on the prevalence of osteochondropathy in the medical literature.

Classification

Perthes disease

The full name is Legg-Calvé-Perthes disease. Osteochondropathy of the hip joint. Affects the head of the hip bone. It most often develops in boys aged 4-9 years. The occurrence of osteochondropathy may be preceded (not necessarily) by trauma to the hip joint.

In order to ensure restoration of the shape of the head, it is necessary to completely unload the affected joint. Treatment of osteochondropathy is carried out in a hospital with bed rest for 2-3 years. Skeletal traction may be applied. The patient is prescribed physio-vitamin and climate therapy. Of great importance are constant exercises that allow you to maintain range of motion in the joint. If the shape of the femoral head is abnormal, osteoplastic surgery is performed.

Ostgood-Schlatter disease

Osteochondropathy of the tibial tuberosity. The disease develops at the age of 12-15 years, boys are more often affected. Swelling gradually appears in the affected area. Patients complain of pain that worsens when kneeling and walking up stairs. The function of the joint is not impaired or only slightly impaired.

Treatment of osteochondropathy is conservative, carried out on an outpatient basis. The patient is prescribed a limitation of the load on the limb (in case of severe pain, a plaster splint is applied for 6-8 weeks), physiotherapy (electrophoresis with phosphorus and calcium, paraffin baths), and vitamin therapy. Osteochondropathy proceeds favorably and ends with recovery within 1-1.5 years.

Köhler's disease-II

Osteochondropathy of the heads of the II or III metatarsal bones. It most often affects girls and develops at the age of 10-15 years. Köhler's disease begins gradually. Periodic pain occurs in the affected area, lameness develops, which goes away when the pain disappears. Upon examination, slight swelling is revealed, sometimes - hyperemia of the skin on the back of the foot. Subsequently, shortening of the second or third finger develops, accompanied by a sharp limitation of movements. Palpation and axial load are sharply painful.

In comparison with the previous form, this osteochondropathy does not pose a significant threat to subsequent impairment of limb function and the development of disability. Outpatient treatment with maximum unloading of the affected part of the foot is indicated. Patients are given a special plaster boot, vitamins and physical therapy are prescribed.

Köhler's disease-I

Osteochondropathy of the navicular bone of the foot. Develops less frequently than previous forms. It most often affects boys aged 3-7 years. Initially, pain in the foot appears for no apparent reason, and lameness develops. Then the skin on the back of the foot turns red and swells.

Treatment of osteochondropathy is outpatient. The patient is limited in the load on the limb, in case of severe pain, a special plaster boot is applied, and physical therapy is prescribed. After recovery, it is recommended to wear shoes with arch support.

Schinz's disease

Osteochondropathy of the calcaneal tuberosity. Schinz disease develops rarely, usually affecting children aged 7-14 years. Accompanied by the appearance of pain and swelling. Treatment of osteochondropathy is outpatient and includes exercise limitation, calcium electrophoresis and thermal procedures.

Sherman-Mau disease

Osteochondropathy of the vertebral apophyses. Common pathology. Scheuermann-Mau disease occurs in adolescence, most often in boys. Accompanied by kyphosis of the middle and lower thoracic spine (round back). The pain may be mild or completely absent. Sometimes the only reason to visit an orthopedist is a cosmetic defect. Diagnosis of this type of osteochondropathy is carried out using radiography and CT scan of the spine. Additionally, to study the condition of the spinal cord and ligamentous apparatus of the spinal column, an MRI of the spine is performed.

Osteochondropathy affects several vertebrae and is accompanied by severe deformation that remains for life. To maintain the normal shape of the vertebrae, the patient must be provided with rest. The patient should remain in bed in a supine position for most of the day (if pain is severe, immobilization is performed using a posterior plaster bed). Patients are prescribed massage of the abdominal and back muscles, therapeutic exercises. With timely, correct treatment, the prognosis is favorable.

Calvet disease

Osteochondropathy of the vertebral body. Calve's disease develops at the age of 4-7 years. The child, for no apparent reason, begins to complain of pain and a feeling of fatigue in the back. Upon examination, local pain and protrusion of the spinous process of the affected vertebra are revealed. Radiographs reveal a significant (up to ¼ of normal) decrease in vertebral height. Usually one vertebra in the thoracic region is affected. Treatment of this osteochondropathy is carried out only in a hospital. Rest, therapeutic exercises, and physiotherapy are indicated. The structure and shape of the vertebra is restored within 2-3 years.

Partial osteochondropathy

They usually develop between the ages of 10 and 25 and are more common in men. About 85% of partial osteochondropathy develops in the knee joint. As a rule, an area of necrosis appears on the convex articular surface. Subsequently, the damaged area can separate from the articular surface and turn into an “articular mouse” (a loose intra-articular body). Diagnosis is made by ultrasound or MRI of the knee joint. In the first stages of the development of osteochondropathy, conservative treatment is carried out: rest, physiotherapy, immobilization, etc. With the formation of an “articular mouse” and frequent joint blockades, surgical removal of the free intra-articular body is indicated.

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.

With osteochondropathy, the vertebrae are deformed and the spine bends backwards

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;

Spinal osteochondropathy is very difficult to diagnose

Signs of osteochondropathy

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

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.

With osteochondropathy, it is important to correct posture and restore vertebral function

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

Special exercises are an important condition for restoring spinal mobility

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.

Source: moyaspina.ru

Spinal osteochondropathy

Spinal osteochondropathy (juvenile kyphosis, aseptic necrosis of the apophyses of the vertebral bodies, Scheuermann-Mau disease)

Spinal osteochondropathy most often occurs in adolescents (aged 11-18 years) and is characterized by damage to the discs and bodies of the thoracic vertebrae (mainly from VII to X), as well as endplates. The disease was described by Scheuermann (1911) and May (1921). The thoracic spine is most often affected; changes in the lumbar-thoracic spine are possible; common forms of spinal lesions are also found.

The etiology of Scheuermann's disease is not fully understood. Of particular importance are increased loads on the spine in people involved in sports and heavy physical labor, traumatic injuries, hormonal disorders (adiposogenital dystrophy, hypogonadism), as well as local microcirculation disorders. There is evidence in the literature about the possible hereditary nature of the disease with a dominant type of inheritance.

Clinical picture of spinal osteochondropathy.

The disease develops slowly, clinical manifestations depend on the age of the child, stage and severity of the pathological process. In the initial period, patients experience increased fatigue of the back muscles and their asymmetry, muscle hypotension, and mild pain in the spine, which are usually diffuse in nature, disappearing after an overnight rest. As the disease progresses, especially during the period of rapid growth of the child, the pain syndrome intensifies, periodic local pain appears in the area of the spinous processes of the vertebrae, and an arched persistent kyphotic curvature of the spinal column is formed. Subsequently, the deformation of the spine below the physiological kyphosis noticeably intensifies, shifting its apex to the X thoracic vertebra, and a “flat back” is formed. Changes in the spine are often combined with varus deformity of the legs, funnel-shaped deformation of the sternum, and flattening of the chest.

In severe cases of the disease, neurological disorders such as radicular syndrome appear, the severity of which depends on the level of compression. So, if with damage to the lumbar spine, patients may not complain, then with pathology of the cervical vertebrae, tilting the head anteriorly is impossible due to the appearance of acute pain in the interscapular area. Limitation of movements in the spine is also due to developing contracture of the rectus dorsi muscles, changes in the configuration of the spine (smoothness of physiological lordosis), and a decrease in the height of the intervertebral discs. A final determination of the degree of vertebral deformation is possible only after the growth of the patient’s spine has stopped.

Diagnosis of spinal osteochondropathy.

X-ray examination of Scheuermann's disease reveals rotation of the vertebrae in the thoracic and lumbar regions, their wedge-shaped deformation, unevenness, waviness and jaggedness of the apophyses (anterior, upper and lower edges of the vertebrae), a decrease in the height of the intervertebral discs, flattening and an increase in the dorsoventral size of the vertebrae at the level of kyphosis with the formation of single or multiple Schmorl's hernias, as well as disc calcification and spondylolisthesis.

The severity of the disease is determined by the prevalence of the pathological process, the degree of deformation of the vertebral bodies, the presence and number of Schmorl's hernias, the severity of pain in the spine, as well as the degree of limitation of spinal function.

Differential diagnosis is carried out with compression fractures of the vertebral bodies, osteomyelitis, Lindemann's fixed round back, congenital fibrosis of the Güntz discs (characteristic of the “box-shaped” shape of the vertebral bodies), spondyloepiphyseal dysplasia, Calve's disease. The latter is diagnosed, as a rule, in young children and is characterized by damage to only one vertebra, while with juvenile kyphosis, up to eight or more vertebrae, most often the thoracic spine, can be involved in the pathological process.

Treatment of Scheuermann's disease is conservative. The goal of therapy is to relieve pain, restore spinal mobility and improve posture, as well as prevent osteochondrosis. Avoid intense physical activity such as jumping and lifting weights. Patients are recommended swimming and physical therapy. For severe pain in the spine, longitudinal traction on an inclined plane, including underwater, is indicated, followed by wearing a corset (belt). Drug treatment includes the use of analgesics (paracetamol, zaldiar), NSAIDs (Aertal, Dexalgin, Nimesil, Nise, Celebrex, etc.), systemic enzyme therapy drugs (Wobenzyme, Phlogenzyme), B vitamins, vascular drugs, proserin.

To prevent osteochondrosis, drugs are prescribed that modify the structure of cartilage tissue (alflutop, arthra, teraflex, structum, stoparthrosis, etc.). Physiotherapy (electrophoresis of novocaine, calcium, magnesium, proserine), acupuncture, massage, therapeutic exercises, and swimming are actively used. With early treatment, it is possible to stop the development of the disease and the formation of spinal deformity. Surgical treatment methods are rarely used and only in cases of severe fixed kyphosis (wedge resection of the vertebrae, spinal osteotomy). The prognosis for this disease is favorable in most cases.

Joint diseases
IN AND. Mazurov

Source: bone-surgery.ru

Spinal osteochondropathy - symptoms, causes, treatment

Spinal osteochondropathy, or Scheuermann-Mau disease, is a disease that is most often diagnosed in adolescents and young adults, between the ages of eleven and eighteen. It is characterized by damage to the thoracic vertebral bodies and discs, as well as the endplates. It is important that in the vast majority of cases, the thoracic spine is affected exclusively. In addition, there are also changes in its lumbar-thoracic region.

Features of the development of the disease

The etiology of this disease has not been fully studied. Most often, its development is influenced by active sports activities, heavy physical labor, injuries, and hormonal disorders.

The disease develops quite slowly. Its clinical manifestations depend on the patient's age. Symptoms of spinal osteochondropathy can be varied. Patients experience muscle hypotonia, asymmetry of the back muscles, and intense pain in the spine. Unfortunately, over time, the described disease only progresses, and this occurs especially actively during the period of rapid growth and puberty of the child. Gradually, deformation of the spine occurs, due to which a flat back is formed, the legs change, and a funnel-shaped deformation of the sternum occurs.

The most severe forms of the disease are accompanied by serious neurological disorders. Some patients note the inability to tilt their head forward, as well as various restrictions on the movements of the spine.

Diagnosis and treatment of the disease

The diagnosis of spinal osteochondropathy is made on the basis of X-ray studies. The severity of the disease can be determined by the prevalence of the pathological process, the presence and number of Schmorl's hernias, as well as by the degree of severe deformation of the vertebrae.

Surgical methods for treating the described disease are extremely rarely used. The operation is performed when fixed kyphosis develops. For most patients with this diagnosis, there is a favorable prognosis.

Treatment of spinal osteochondropathy is carried out mainly conservatively. Drug therapy is aimed at blocking pain, normalizing mobility and posture, as well as preventing osteochondrosis. Physical therapy provides an excellent effect, and a set of exercises is developed exclusively taking into account the individual characteristics of the patient.

If the pain arising in the spine is very strong, then stretching the person on an inclined plane with the subsequent use of a special corset is indicated. Patients are prescribed medications such as Celebrex, Airtal, Nimesil, Dexalgin.

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.

Spinal osteochondropathy is characterized by disorders of the vertebrae and discs of the thoracic region, as well as the end plates. Such violations lead to unpleasant back pain.

This disease manifests itself primarily in adolescents and children aged 10 to 18 years.

The thoracic region is most often affected, but thoracolumbar lesions also occur, and in rare cases, osteochondropathy manifests itself in the cervical spine.

The disease is quite difficult to treat, but if it is not advanced to stages with complications, the prognosis is positive.

Development of the disease

When blood circulation in the body is impaired, bone tissues die and are destroyed, which leads to the development of the disease. The causes of this pathology are the following factors:

physical activity that puts pressure on the spine;
predisposition at the genetic level;
lack of calcium in the body;
hormonal disbalance;
infectious lesion;

The development of the disease occurs quite slowly. Active progression of the disease in children begins during puberty.

Asymmetry of the shoulder girdle appears due to the curvature of the spine, the chest is deformed, the pain intensifies and is localized in certain places.

In severe cases of the disease, manifestations of neurological disorders are possible.

If the lumbar or lumbosacral spine is affected, a person may not notice pain, but if the cervical area is affected, then when the head is lowered forward, the pain becomes unbearable.

How is diagnostics performed?

In order to promptly detect the disease and undergo treatment, parents need to pay attention to the health of their child after the following signs appear:

At first, back pain appears, which can be eliminated after a short rest.
Muscle fatigue occurs more quickly, and there is a frequent feeling of weakness.
The pain gets worse over time.
The death of cartilage and bone fibers leads to curvature of the spine and asymmetry of the back muscles.
The spinous processes protrude near the damaged vertebral bodies.
Feeling of discomfort when tilting the head and body.
At advanced stages, the shape of the chest changes.

If your child complains of the symptoms described above, there is no need to delay. Detection of the disease in the early stages significantly speeds up and facilitates treatment, and prevents the development of complications that may lead to the need for surgical intervention.

Treatment process

If you do not go to the doctor in a timely manner, in most cases a complication develops, causing displacement of the spinal discs and the formation of a flat back. In the future this leads to .

Due to bone necrosis, the risk increases. Therefore, the earlier health procedures are started, the lower the risk of serious health problems. The main objectives of the health improvement course:

get rid of pain;
restoration of correct posture;
preventive procedures to prevent the development of osteochondrosis;
improving mobility, eliminating discomfort after tilting the head or body.

The treatment process for spinal osteochondropathy involves avoiding heavy physical work. The patient is prescribed a visit and taking certain medications.

In case of complications, strict bed rest (the bed should be hard) and complete lack of physical activity are prescribed.

If the patient’s pain becomes more intense each time, then the method of stretching on inclined surfaces or under water with a load is used.

Visiting swimming pools promotes recovery. The patient is also prescribed a special diet, which contains a lot of calcium and (groups A, B).

In case of acute complications and severe back deformation, surgical intervention is required.

Use of medications

Tissue necrosis and pain are the main characteristics of osteochondropathy of the apophyses of the vertebral bodies. Based on this, doctors prescribe the following series of drugs:

painkillers,
anti-inflammatory,
vitamin complexes with calcium,
drugs for dilation of blood vessels,
means that promote better absorption of beneficial microelements from food.

Physical exercise

The basis of the treatment course is placed on proper physical activity. If there is no severe pain, you can perform a number of special exercises 3 times a day.

A set of exercises for spinal osteochondropathy is prescribed by a specialist depending on the degree of development of the disease and location.

A common exercise that will be useful at different stages is walking or sitting using a long stick located at the level of the shoulder blades. The stick is covered by the elbow bends.

In this position, the spine straightens and mobility gradually improves. Other types of exercises are developed individually for the patient.

Pain in the thoracic spine occurs due to sitting for a long time at a table in one position. Therefore, it is recommended to select a set of exercises for the lying position.

Chairs should have a high and hard back. A hard bed is required, you can put a wooden board under the mattress.

Full recovery of the body is achieved no earlier than 4 months after discharge.

During this time, it is necessary to continue to perform the prescribed set of exercises, attend water treatments, follow a diet and minimize the impact of heavy loads on the back.

Denial of responsibility

The information in the articles is for general information purposes only and should not be used for self-diagnosis of health problems or for therapeutic purposes. This article is not a substitute for medical advice from a doctor (neurologist, therapist). Please consult your doctor first to know the exact cause of your health problem.

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