Synonyms in a broader sense
- Wear-related spinal column disease
- Spinal column wear
- Spinal degeneration,
- Degeneration of the spine
- Wear and tear of the spinal column
- Lumbar spine syndrome
- Cervical spine syndrome,
Definition
Degenerative (wear-related) spinal diseases (back problems) include several clinical pictures that can occur in isolation or together and whose common characteristic is age-related. The lumbar spine is most frequently affected. The degenerative spinal diseases (back problems) are essentially
- Spinal canal stenosis (narrowing of the spinal canal)
- Spondylarthrosis (arthrosis of the small vertebral joints = facet syndrome)
- SpondylosisOsteochondrosis (wear and tear of the intervertebral discs and vertebral bodies)
- Degenerative Spondylolisthesis (Pseudospondylolisthesis = vertebral body slippage)
Anatomy
The spinal column consists of the vertebrae, the intervertebral discs (= intervertebral discs) and associated ligaments, whose task is to connect and stabilize the spinal structures. The human spine is made up of 33 – 34 vertebral bodies, which are differentiated according to their different areas of responsibility. Accordingly, a distinction is made between seven cervical vertebrae of the so-called cervical spine, twelve thoracic vertebrae of the so-called thoracic spine, five lumbar vertebrae of the lumbar spine, five sacral and coccygeal vertebrae. The last two vertebrae mentioned above merge at the age of 20 to 25 years to form the sacrum and coccyx. The spinal column forms the so-called spinal canal in which the spinal cord is located.
Pathology
The wear and tear of the intervertebral disc begins as early as in the 1920s of a person. It can lead to a bulging or herniated disc (med. Nucleus pulposus prolapsus or NPP).
The increasing water loss of the intervertebral discs leads to a decrease in height of the intervertebral body section (osteochondrosis). The consequences are overloading of the small vertebral joints, malfunctioning of the spinal ligaments and a creeping instability of the spinal motion segment, consisting of two vertebral bodies and the intervertebral disc between them. The base and top plates of the vertebral bodies are subjected to more stress due to the lowered intervertebral disc.
The body reacts to this by compressing the bone in the area of these structures (sclerotherapy), which can be seen on X-rays. The body tries to counteract the creeping instability of the spinal column by producing bony attachments on the vertebral bodies (osteophyte exophytes), which seek support in the surrounding area. In very advanced instability, a wear-related curvature of the spinal column can develop, further weakening the statics of the spinal column (degenerative scoliosis).
The altered spinal column statics also changes the points of origin and attachment of the muscles and ligaments of the spinal column, with some muscles and ligaments becoming too close and shortened and others being stretched too much. Both of these factors lead to the weakening of these structures through the loss of function. Painful muscle hardness (muscle hard tension myogeloses) can develop.
An incongruent position of the vertebral body joints in relation to each other leads to premature cartilage abrasion of the joint partners. The same processes that are well known for knee or hip joint arthrosis then occur. This leads to joint inflammation, capsule swelling and thickening, and even more quickly than in the large joints, to joint deformation. The overall picture of a vertebral joint arthrosis (spondylarthrosis = facet syndrome) has emerged. Instability-induced shifts in the vertebral bodies (spondylolisthesis-pseudospondylolisthesis), thickening of the vertebral joint structures, bony spinal canal attachments, disc protrusions and thickening of the vertebral ligaments (ligamentum flavum) can ultimately lead to a considerable narrowing of the spinal canal (spinal canal stenosis) and put pressure on the spinal cord itself or the outgoing nerve roots.
