Depending on the stage of the process of localization of lesions and patient age in
clinical picture of osteochondrosis are several options
disease.
Cervical osteochondrosis as a result of morphological and functional features
characterized clinical manifestation of radicular and
neradikulyarnyh syndromes.
radicular syndromes at the cervical osteochondrosis - a manifestation of
combined lesions are often multiple roots. Damage to the nerve root
may be the type of irritation, compression or conduction abnormalities. When
irritation and compression of the main clinical symptom is pain,
and at the break conductance - radicular paralysis. The pain is accompanied by widespread
irritation (irritation), which leads to a violation
circulation, edema and fibrosis of tissues around the spine, which in turn contributes to
tservikalgy during normal movements of the cervical spine
or voltage neck muscles. Pain syndrome can occur in areas
dermatome when irritated sensitive fibers, miatoma when
process involving motor fibers or sclerotomy (autonomic fibers).
Any damage to the root C 3 pains in half of the neck, changing
taste in my mouth, feeling swollen tongue, difficulty in movement of food.
root irritation with 4 causes pain in the collarbone, shoulder girdle,
atrophy and decreased muscle tone of the posterior neck, which leads to an increase
supraclavicular air bag.
If irritation or compression of the spine with 5 there are pains in the shoulder girdle and
on the outer surface of the shoulder, the deltoid muscle hypotrophy.
At root irritation with 6 pains in the neck and scapula,
irradiating the surface of a broken arm, forearm and thumb
hand, malnutrition biceps.
spine trauma with 7 leads to pain in the neck,
shoulder with radiation to the surface of the broken shoulder, a back surface
forearm and the II and III thumb.
vertebrobasilar syndrome - it is basically functional
neurovascular disorders of vertebral artery in osteochondrosis of the cervical spine
.
bony growths on the articular processes of cervical vertebrae
(unkovertebralnye osteophytes) irritate the sympathetic plexus vertebral
artery, which leads to angiospasm pituitary, hypothalamus, medulla oblongata
and thalamus. Therefore, when the cervical osteochondrosis may occur
changes in the endocrine system and cortical dynamics.
Clinical signs of vertebrobasilar syndrome expressed in
headache in the occipital area or the forehead, vertigo during sharp turn
head, has been a steady blanching and violations of the sensitivity on the face,
not coincide with zones of innervation of the branches of the trigeminal nerve, periodically
pains or tinnitus, vestibular disorders, decreased vision,
changing voice and taste in the mouth. Often these symptoms combined with pain in his hand
or the heart.
Simpatalgichesky syndrome - is characterized by neck-shoulder pain
burning, compressing the nature mostly at night. After a long
finding hands at rest arise in the different nature of the pain, forcing patients
not just wake up and change hand position, but stand up, that would make a rocking motion
hand. Often, the pain spread to the neck and
scapulohumeral-breast area.
syndrome shoulder-scapular periarthritis , arising in cervical osteochondrosis
due to degenerative and inflammatory changes in the capsule
joint, accompanied by intense pain in the shoulder joint.
Abduction and rotation of the shoulder sharply painful, forcing patients to spare hand,
keep it in a state of immobilization, which leads to cicatricial rebirths
periarticular tissues and resulting in the formation of stable contractures or ankylosis
shoulder joint, accompanied by periarticular muscle atrophy and
hyperreflexia.
syndrome shoulder-hand (Steynbrokera syndrome) is simpatokompleksom
reflex neurovascular dystrophy, autonomic limb cervical
osteochondrosis and is manifested by pains in joints and muscles of the affected hand,
edema, cyanosis bassh, hyperesthesia and hyperthermia skin bassh. Restriction
function hand leads to flexion contracture and atrophy of muscles and skin. Later
may occur with diffuse osteoporosis arm bones.
scalenus anticus syndrome - a reflex muscle contraction
in cervical osteochondrosis. Spasm of the anterior scalene muscle leads to compression of
brachial plexus and subclavian artery.
clinic: neck pain with radiation to the ulnar surface of forearm and hand,
blanching, cooling, paresthesias, and sometimes swelling of the bassh.
Pain is getting worse during deep breaths, and shoulder abduction and at an inclination of the head in a healthy
side. Sometimes there is swelling of the supraclavicular fossa. Later joined by
hypotrophy and weakness of muscles of the hand.
to visceral syndromes include cardiovascular and pulmonary
syndromes, as well as vegetative-irritative syndrome with cholecystitis and
cervical osteochondrosis.
Cardiovascular Syndrome is caused by irritation of the sympathetic
formations in the pathology of the cervical discs, but can be caused by cardialgia
symptom minor pectoral muscles innervated by roots with 5 -C 7
(pain in the heart, the chest behind the breastbone, in the shoulder girdle, left hand).
arisen vertebral pathological impulses, through its coronary arteries
and heart muscles, causing irritation of sensory nerve endings,
then through the dorsal root enters the gipotalagicheskuyu area involving
hypothalamus in the pathological process by reflex the type of feedbacks.
pulmonary syndrome in osteochondrosis of the cervical and verhnegasdnogo departments
spine is characterized by stagnant and pneumonic manifestations of
the lungs, leading to oxygen starvation and disturbance of acid-base balance
that significantly affects the overall condition of the patient and contributes over
underlying disease.
Vegeto-irritative syndrome with cholecystitis and cervical-thoracic osteochondrosis
shows the reflected pulse from the affected organ, but it is formed
when combined lesions of the gallbladder, and cervical-thoracic osteochondrosis.
pathological impulse, which arose from these two foci, is directed by
phrenic nerve and sympathetic fibers to the cervical spinal cord
and summed up there on the type of dominant. Cholecystitis and osteochondrosis are
close pathological context.
thoracic osteochondrosis is characterized by diverse clinical manifestations,
due to anatomno-physiological peculiarities of this spine.
Despite the fact that the number of discs in the thoracic region twice in the cervical or lumbar
, clinical manifestations of osteoarthritis tend to have significantly less
. This phenomenon can be explained by lower mobility of the thoracic spine
, the small size of the nucleus pulposus and the small thickness
intervertebral disc that rarely leads to the formation of hernias. However
physiological thoracic kyphosis promotes the formation of anterior and posterior osteophytes
.
Osteophytes in spinal-edge and cross-rib joints
contact with the spinal nerves, causing intercostal neuralgia or
lead to irritation of the sympathetic tasnk and the emergence of vegetative
syndromes. Lower cervical and verhnegasdnoy sympathetic nodes are connected at
With 7 - A 1 , then the sympathetic branch goes to the heart,
esophagus, bronchi, spine, carotid arteries and recurrent nerve. From
sympathetic ganglia D 5 - A 10 formed the ventral nerve,
passing the aperture, is woven into the solar plexus.
Autonomic innervation of internal organs
Heart - D 1 - D 6
Esophagus - D 5 - D 9
Cardiac esophagus - D 6 - D 7
Stomach - D 6 - D 9
Small intestine - D 9 - D 10
Colon - D 11 - D 12
liver and gall bladder - D 7 - D 10
Kidney - D 12 - L 1
Genitals - D 12 - L 1
radicular syndromes in breast osteochondrosis occur clinic
intercostal neuralgia. Protassion in the lateral and posterolateral direction or
oseofity occurmorefrequently in the lower senmentah D 10 - D 12 .
Clinic: Pain is the first symptom of the disease, depending on the level
infected disk is either intercostal or abdominal, or groin
localization. It is often accompanied by numbness and paresis of the legs and less frequently -
pelvic disorders (incontinence or urinary retention, rectal dysfunction,
impotence, etc.). Sometimes there are diffuse rahialgicheskie pain,
due to irritation of the sympathetic system of the ligamentous apparatus
spine.
Visceral syndromes arise from the fact that composition of breast
roots include sympathetic fibers and thoracic radiculopathy may
accompanied by pains in the chest and upper abdomen as a result of trophic,
vozomotornyh and secretory disorders. Expressed at the same time pain in the lower divisions
back and lumbar may be associated with lesions of the lumbar and sacral roots
.
to visceral syndrome include cardiovascular, pulmonary and abdominal
.
Kardiospazm (painful spasm of the pyloass and esophagus), which arises as
functional failure during long-term during the transition to organic
disease due to secondary changes in the trophic sphincter muscles.
peptic ulcers and 12 duodenal ulcer is the result of increased
activity of sympathetic and parasympathetic autonomic nervous
system leading to a breach of the secretory function of the stomach and pyloric spasm.
lumbar osteochondrosis
clinical signs are a pain in the lumbosacral area by type
lumbago, lyumboishalgii, sciatica, antalgicheskie posture and autonomic dysfunction
lower extremities and pelvic organs.
Patients with a diagnosis of osteochondrosis, in the presence of
above syndromes are encouraged to provide medical advice manual
physicians and a neurologist for a consultation (treatment).
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