Rheumatology
Rheumatology

Dorsopathy - what is it? Cervical, lumbar and thoracic dorsopathies

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A little about the terms. ..

Medical science, like other branches of human knowledge, does not stand still. And even in the already familiar diagnostic formulations there are innovations. Old diagnoses recommend "not to write" at first to the faculty who deal with doctors in the faculties of advanced training. Then comes the official letter of the ministry, and, finally, the order.

This happened with "discirculatory encephalopathy", instead of which doctors began to write "chronic cerebral ischemia" or "hypertensive encephalopathy".So it became with the concept of "intellectual - mnestic disorders", which went out of use in the 90s. Now it is customary to write "cognitive disorders" in the case histories.

Finally, the same fate befell all clear diagnosis of "spinal osteochondrosis", but in a special way. Since the osteochondrosis of the spine is an official diagnosis, approved in ICD-10 under code M42, it was necessary to supplement it. Now this disease refers to deforming dorsopathies, and not just to degenerative degenerative lesions of intervertebral discs.

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Deforming dorsopathy, osteochondrosis - these words can be considered almost synonymous, and when a doctor who treated you for osteochondrosis writes you a diagnosis of "deforming dorsopathy" - you can not worry - except for the name, nothing has changed.

It is interesting that to the non-deforming dorsopathies the same ICD of the tenth revision includes spondylosis, spondyloarthritis and spondylopathy, that is, lesions of the vertebrae, as well as dorsalgia. Let's look at this in more detail.

Contents of

  • 1 Dorsopathy - what is it?
  • 2 Reasons or what to consider as dorsopathy?
  • 3 Dorsopathy: symptoms of common manifestations
    • 3.1 Dorsopathy of the lumbosacral spine
    • 3.2 Dorsopathy of the cervical spine
    • 3.3 Dorsopathy of the thoracic spine
  • 4 Treatment of dorsopathy of the spine
    • 4.1 Complications

Dorsopathy - what is it?

Dorsopathy

Compare the two diagnoses on an outpatient card. Here is the first:

Chronic vertebrogenic dorsopathy, left-sided cervicalgia, against the background of cervical spine osteochondrosis, mild pain and muscular-tonic( myofascial) syndrome, incomplete remission stage.

And here is the second formulation:

Osteochondrosis of the cervical spine, left-sided cervicalgia, moderately expressed pain and muscle-tonic( myofascial) syndrome, the stage of incomplete remission.

There are practically no differences: clinical manifestations are soreness( cervicalgia), its localization( the left half of the neck).The mechanism of destruction( discogenic-osteochondrosis), concomitant syndromes( muscular-tonic), stage of the disease( incomplete remission) - all coincide.

Only the first diagnosis is correct, and it will fall into payment after verification by the MHIF, and the second - no, because there is now no such independent diagnosis as "osteochondrosis".Ahead it is necessary to write "dorsopathy".What is this state, or the term?

The whole problem is that he does not mean anything special: dorsopathy is literally a "back problem", since dorsum is "back" and pathos is suffering.

Why was this "diagnostic unit" added if it does not carry any independent value? To denote a larger category in the ICD - 10. Now the section of dorsopathy includes lesions of the vertebrae, discs and dorsalgia, or unspecified back pain.

This section of the ICD-10 classification does not belong to nervous diseases, but refers to lesions of the musculoskeletal system.

Reasons or what to consider as dorsopathy?

Now you can completely officially assume that you have dorsopathy, if there is not only a pathology with vertebrae, or intervertebral discs, but in general, any pain in any part of the back( dorsalgia).Of course, no one can guarantee that this pain is not reflected, and it is not a consequence of coronary heart disease, or chronic pancreatitis.

That is why the term "dorsopathy" became an example of an incredibly broad interpretation. Nevertheless, officially the causes of dorsopathy are:

  • Pathological kyphosis of the thoracic spine, pathological lordosis of the cervical and lumbar spine;
  • Scoliotic deformation;
  • Osteochondrosis of all parts of the spine, with lesions of the intervertebral discs of different parts of the spine now can be diagnosed without a connection with osteochondrosis, for example, due to a car accident and injury;
  • Bechterew's disease, or ankylosing spondylitis;
  • Spondylopathies, including inflammatory: sakroileitis,( including psoriasis), vertebrae osteomyelitis, secondary purulent foci in vertebrae;
  • Disceases, or inflammatory lesions of intervertebral discs in different departments;
  • Spondylosis( arthrosis of the vertebra, arthrosoarthritis), with both myelopathy and radiculopathy.

These conditions develop with the growth of bone substance and the compression of the corresponding structures. Thus, myelopathy develops with stenosis of the central canal( the spinal cord is squeezed), and with radiculopathy, there is a compression of the nerve root emerging from the intervertebral openings.

  • Traumatic spondylopathy;
  • Spinal stenosis;
  • Ankylosing hyperostosis( Forestier's disease).With it, excessive formation of bone tissue takes place at the site of the ligaments, which leads to ankylosis( immobility);
  • Infections( brucellosis, vertebral tuberculosis), as well as neuropathic spondylopathy.

About the occurrence of various dorsopathies

Predisposing factors that often lead to these diagnoses are:

  • "office" lifestyle, inactivity and low motor activity;
  • pronounced osteochondrosis of intervertebral discs( it turns out that one of the dorsopathies leads to other dorsopathies);
  • permanent postural disorders;
  • use of a large number of refined products, sweets, fats, canned foods, smoked foods, alcohol;
  • the presence of bad habits;
  • postmenopausal period in women;
  • the presence of osteoporosis, calcium deficiency in the body;
  • lack of vitamin D3;
  • high levels of uric acid in the blood;
  • harmful working and living conditions( dampness, wind, low air temperature);
  • wearing heavy work clothes, including, and protective.

Dorsopathy: symptoms of common manifestations

Dorsopathy-Symptoms

When should I see a doctor? After all, every person ever had back pain, what signs should alert the patient? These are the symptoms that you should pay attention to, and do not delay the visit to the doctor:

  1. Back pain has become permanent, especially when it intensifies at night, and is not stopped by any drugs.
  2. Painful sensations are radicular in nature, that is, they are sharply and suddenly amplified by concussion, coughing, sneezing, laughing, straining, sharp movement.
  3. There is a sensitivity disorder associated with pain or discomfort in the back( numbness, "crawling"), reducing pain and temperature sensitivity.
  4. Appearance of weakness in the muscles of the arms and legs, muscle hypotrophy( one arm or leg "lost weight").
  5. Violation of trophism in the extremities( dryness and peeling of the skin, hair loss, dullness and brittle nails).
  6. Reduction in the amplitude of movements in the joints, pain in the muscles.

Since now almost all the spectrum of vertebra and disk lesions belongs to dorsopathy, as well as the biomechanics of the spine, we will analyze the most frequent manifestations of dorsopathies at all levels of the spine

Dorsopathy of the lumbosacral spine

The most famous osteochondrosis, this dorsopathy of the lumbosacral spine is found in every adult. Even in the event that there are no signs of the disease, then all the same, intervertebral discs are in a dehydrated state.

From deforming dorsopathies in the lumbar region, there is often a change in lordosis, both in the direction of increase and in the direction of flattening.

Relatively often there are manifestations of radicular symptoms in the form of a painful lumbago slide. Often, with the defeat of this particular department, Bekhterev's disease and psoriatic polyarthritis manifest. The criterion of the system process is the appearance of signs of sacroiliitis, or inflammation of very strong sacroiliac joints.

Sometimes with dorsopathy at this level, shooting pains occur in the pelvic area, the waist, with irradiation into the bladder and rectum.

Dorsopathy of the cervical spine

Dorsopathy of the cervical spine is most often manifested by a secondary myofascial syndrome, in which the tone of the neck muscles is much higher than normal. This leads to headaches and neck pain, impaired blood circulation in the upper limbs, sensitivity disorders( for example, "crawling craw" in the hands).

Often there is instability of the cervical spine, various protrusions and hernias of the lower( C5-C7) cervical vertebrae.

Also in the cervical spine, there are violations of the physiological curves of the spinal column, consisting of hyperlordosis or flattening of its arch.

Dorsopathy of the thoracic spine

Breast dorsopathy may be more diverse than the cervical dorsopathy. In fact the thoracal department of a backbone the longest, and he owing to it can be deformed. As a result, there is either kyphosis or kyphoscoliosis( especially in young men), as well as scoliotic acquired deformity.

It is the thoracic vertebrae that are most vulnerable to tuberculosis and brucellosis spondylitis, the metastases of the tumor can penetrate into the thoracic vertebrae.

Dorsopathy of the thoracic spine often creates a pronounced pain syndrome, also due to muscle tissue. Often there are signs of intercostal neuralgia, which must first of all be differentiated from acute heart pathology( myocardial infarction, an attack of coronary heart disease).

It is at the level of the thoracic vertebrae that compression fractures often occur with accidental falls, with the development of subsequent traumatic spondylopathy.

Treatment of dorsopathy of the spine

Treatment of dorsopathy of the spine

Almost all types of dorsopathy are treated conservatively. Exceptions are posttraumatic spondylosis and marked disruption of intervertebral discs. Such a discogenic lumbar dorsopathy, which is in need of surgery and has not been treated in a timely manner, may even cause a disruption in the pelvic organs.

The main principles of treating dorsopathy are:

  1. Elimination of pain and inflammation, which often joins the phase of chronic disease;
  2. Elimination of chronic muscle spasm;
  3. Improvement of microcirculation of tissues;
  4. Assignment of chondroprotectors to improve the metabolism of cartilaginous tissue;
  5. Antioxidant therapy and multivitamin preparations, control of sensitivity disorders;
  6. Replenishment of mineral deficiency;

A large( and of paramount importance) is non-drug therapy, which includes therapeutic gymnastics, physiotherapy techniques, massage, acupuncture, balneotherapy, swimming, manual therapy and other effective ways to relieve intervertebral discs and improve the function of the muscular back skeleton.

Orthopedic pillows and mattresses for normalization of sleep are very popular, cervical dorsopathy treatment provides short-term use of the Shanz collar - to protect against the occurrence of pain, if necessary physical activity, and to reduce the pain syndrome during exacerbation.

Complications

Since the diagnosis of "dorsopathy" is a collective term, and unites many diseases only on one feature - localization, it is impossible to give a general and correct picture of the complications.

It is probably necessary to explain that in most cases they lead to disability and deterioration of the quality of life, because the outcomes of the processes are scoliosis, ankylosis, melting of the vertebrae, the appearance of transverse myelitis, which can pinch a person and a wheelchair for many years.

In conclusion, it should be noted that dorsopathy is a whole "family" of painful conditions of the spine, ribs, and muscular back skeleton. Like any disease, dorsopathy is easier to prevent than to be treated. Therefore, it is worth taking care of your back health in advance from a young age, so as not to regret it in the mature years.

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