Intervertebral disc lesions (discosis, discitis) develop, as a rule, in the lumbar region, due to degenerative-dystrophic processes, which are based on a decrease in water content and a change in the biochemical composition of the disc tissue. As a result, the elasticity of the disk is lost, and its damping capacity is reduced. Then, during physical work, injury, hormonal disorders, a disc bulging into the lumen of the spinal canal may develop, and if the integrity of the annulus is disturbed, a disc herniation is formed. There are violations of statics and dynamics, there are pains, disorders of sensitivity, changes in the motor-reflex sphere. To reduce pain, patients take various forced positions. Straightening of normal lumbar lordosis is noted, then scoliosis , muscle wasting, reduction of their tone develops. The diagnosis is specified by liquorodynamic tests, x-ray examinations, isotope diagnostics. Conservative treatment - bed rest, thermal and physiotherapy therapy, various types of traction, painkillers, blockades, etc. Operational treatment - laminectomy (see) with the subsequent removal of the fallen part of the disc and pulpous nucleus (discectomy). Bed rest after surgery for about 3 weeks.Go
Spinal echinococcosis is rare, but the destruction of the vertebrae and compression of the spinal cord can be caused by an echinococcal cyst localized in one of the neighboring organs. Treatment is operational (see Echinococcosis ).
The spine is the most frequent of the bone localizations of the echinococcus. Flows slowly, without causing complaints, until the neurological symptoms associated with pressure on the spinal cord or its roots. Possible pathological fracture of the vertebra and without prior manifestations of the disease. Diagnosis is based on the characteristic X-ray picture, Kasoni's reaction is not always positive. Treatment is only operative (see Echinococcosis).
Spinal tuberculosis - see Spondylitis .
Acquired spinal deformities are schematically divided into curvatures in the anterior-posterior and lateral directions. The first group of deformities includes kyphotic curvatures (see Kyphosis), in particular, curvatures that occur as a result of osteochondropathy of the vertebral body (Calve's disease) and in osteochondropathy of the apophyses of the vertebrae (Scheuermann's disease — May). The disease is based on aseptic osteonecrosis, which develops, it is believed, as a result of neurovascular disorders (see Osteochondropathy).
Lateral spinal curvature - see Scoliosis.
Spinal tuberculosis - see Spondylitis.
Spinal osteomyelitis occurs more often as a metastatic focus in the presence of pelvic osteomyelitis, tubular bones. The arms and processes of the vertebrae are affected more often than the body. When a vertebral body is damaged, its destruction occurs, which can lead to spinal deformity and the occurrence of functional disorders of the spinal cord and its roots.
Treatment consists of general effects (antibiotics, vitamins, high-calorie nutrition) and special measures aimed at immobilization and unloading of the spine: position in a bed with a shield, in a gypsum crib, light stretching with a glisson loop or for axillary straps (for the upper spine), pelvic girdle (for the lumbar spine). In the Acute stage it is sometimes necessary to open an abscess. In the chronic stage, sequestrectomy indications may occur. If the lesion is located in the body of the vertebra, it is most often accessed through a cosotransversectomy (see), however some surgeons prefer to approach the lumbar vertebrae anteriorly with extraperitoneal access. Some patients have to further appoint the wearing of a hard corset.