Medical history (history of illness) represents an important component in the diagnosis of osteochondrosis of the spine. Family history Is there a history of frequent bone/joint disease in your family? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). How long have the complaints existed? Where is the pain localized? … Osteochondrosis of the Spine: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Malformations of the vertebral bodies, unspecified. Musculoskeletal system and connective tissue (M00-M99). Bacterial spondylitis – inflammation of the vertebrae caused by bacteria. Damage to the intervertebral disc, unspecified Rheumatoid arthritis (synonym: chronic polyarthritis) – most common inflammatory disease of the joints. Spondyloarthritis – reactive spondylosis Spondylitis (inflammation of … Osteochondrosis of the Spine: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by osteochondrosis of the spine: Musculoskeletal system and connective tissue (M00-M99). Chronic back pain Restriction of mobility due to pain Muscle hardening Radiculitis (inflammation of the nerve roots). Cervicobrachial syndrome (synonym: shoulder-arm syndrome) – pain in the neck, shoulder girdle and … Osteochondrosis of the Spine: Consequential Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, relieving posture). Initial stage [postural weakness; hollow back]. Florid … Osteochondrosis of the Spine: Examination
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Rheumatoid factor (RF), ANA (antinuclear antibodies, anti-citrulline antibodies – if a rheumatological disease is suspected.
Therapeutic target Pain relief and increase in 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 / drugs that inhibit inflammatory processes (ie, non-steroidal anti-inflammatory drugs, … Osteochondrosis of the Spine: Drug Therapy
Obligatory medical device diagnostics. Radiograph of the spine, in two planes – to evaluate bony structures; typical radiographic findings include: Decreased height and wedge-shaped deformation of the vertebrae. Reduced intervertebral spaces (intervertebral spaces). Extension of the vertebral bodies dorsally (to the front). Occurrence of so-called Schmorl nodules (displacement (herniation) of disc tissue in the vertebral … Osteochondrosis of the Spine: Diagnostic Tests
1st order In cases of marked deformity, stabilization/erection surgery (ventral erection osteotomy combined with dorsal spondylodesis/stiffening) may be induced if conservative therapy is unsuccessful. Indications Severe progression and discomfort Spinal cord irritation
The following symptoms and complaints may indicate osteochondrosis of the spine: Pain in the area of the spine Painful restriction of movement of the spine. Symptoms of adolescent kyphosis depending on age/stage: Early stage/functional phase (<10th LJ) [the disease usually goes unnoticed at this stage]: Disc narrowing and decreased distensibility of the intervertebral space (intervertebral … Osteochondrosis of the Spine: Symptoms, Complaints, Signs
Pathogenesis (disease development) In osteochondrosis, degeneration of the cartilaginous portions of the vertebral bodies results in their reactive deformation. Etiology (causes) Biographic causes Age of life – increasing age Causes due to disease Spinal deformities, unspecified.
General measures Avoiding overloading! Nicotine restriction (refrain from tobacco use). Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis. BMI ≥ 25 → participation in a medically supervised weight loss program. Medical aids In special cases, a support corset is needed (rather … Osteochondrosis of the Spine: Therapy
