Medical history (history of illness) represents an important component in the diagnosis of discopathy (disc damage). Family history Are there any diseases of the bones and joints in your family that are common? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). Where is the pain localized? How long have … Intervertebral Disc Damage (Discopathy): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Marfan syndrome – genetic disorder that can be inherited in an autosomal-dominant manner or occur in an isolated fashion (as a new mutation); systemic connective tissue disorder that is most notable for tall stature, spider-limbedness, and hyperextensibility of the joints; 75% of these patients have an aneurysm (pathologic … Intervertebral Disc Damage (Discopathy): Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by discopathy (disc damage) as well: Brain – Nervous System (F00-F99; G00-G99). Cervicobrachial syndrome (synonym: shoulder-arm syndrome) – pain in the neck, shoulder girdle, and upper extremities. The cause is often the compression or irritation of spinal nerves (spinal cord nerves) of … Intervertebral Disc Damage (Discopathy): Complications
General measures In case of lumbar spine prolapse (herniated disc in the area of the lumbar spine) relaxed positioning (step positioning). This is already at the first warning signs (back pain, paresthesias / misfeelings, etc.) the best immediate help. Nicotine restriction (refrain from tobacco use) – smoking can contribute to pain in the long term; … Intervertebral Disc Damage (Discopathy): Therapy
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin (Normal: intact; [abrasions/wounds, redness, hematomas (bruises), scars]) and mucous membranes. Gait pattern (fluid, limping). Body or joint posture (upright, bent, relieving posture) [postural disorders (pain-related relieving posture → … Intervertebral Disc Damage (Discopathy): Examination
The diagnosis is mostly made only on the basis of the medical history, physical examination and medical device diagnostics. 2nd order laboratory parameters-depending on the results of the history, physical examination, etc.-for differential diagnostic workup Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
Therapy target Drug therapy for nucleus pulposus prolapse is intended to relieve pain and thereby increase range of motion. Therapy recommendations Analgesia (pain relief) according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. If necessary, also antiphlogistics / … Intervertebral Disc Damage (Discopathy): Drug Therapy
Obligatory medical device diagnostics. X-ray of the spine – signs of discopathy: Height reduction Vertebral body defects with sclerosis (“calcification”). Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, i.e., without X-rays); particularly well suited for imaging soft tissue injuries) of the spine – method of first choice, in cases of suspected prolapse … Intervertebral Disc Damage (Discopathy): Diagnostic Tests
A prerequisite for surgical intervention is the presence of appropriate local clinical symptoms or radiculopathy (irritation or damage to the nerve roots) with corresponding imaging findings (CT, MRI). In principle, a meticulous clarification of the surgical indication is necessary! A second opinion may be useful. Indications Absolute indication for emergency surgical intervention Progressive (increasing) and … Intervertebral Disc Damage (Discopathy): Surgical Therapy
To prevent discopathy (disc damage), attention must be paid to reducing individual risk factors. Behavioral risk factors Pleasure food consumption Tobacco (smoking) – may be the cause of degenerative disc processes. Overweight (BMI ≥ 25; obesity) – obesity. Caution!Three months or longer of systemic glucocorticoid therapy increases the risk of osteoporosis by 30-50 percent. This … Intervertebral Disc Damage (Discopathy): Prevention
The following symptoms and complaints may indicate discopathy (disc damage): Back pain, usually affecting the lumbar region (lumbar spine) (lumbalgia). Radiating back pain Postural dysfunction (pain-induced relieving posture → evasive scoliosis/painful scoliosis). Restricted mobility (movement restrictions of the spine). Sensory deficits in the affected dermatome (skin area supplied by the sensitive fibers of a spinal … Intervertebral Disc Damage (Discopathy): Symptoms, Complaints, Signs
Pathogenesis (development of disease) In a herniated disc (BSP; intervertebral disc prolapse), the inner part of the intervertebral disc (discus intervertebralis), the nucleus propulsus (internal gelatinous nucleus), is forced backward by the annulus fibrosus (connective tissue ring of the intervertebral disc) toward the spinal canal (spinal cord canal) out of the bed of the intervertebral … Intervertebral Disc Damage (Discopathy): Causes
