Osteosarcoma is a disease of the musculoskeletal system, manifested by thinning of the bones and cartilage of the joints. Usually, patients are diagnosed with osteochondrosis of the spine, in which there is destruction of the discs in the neck, lumbar or thoracic region. Disc cartilage is needed to cushion movements and reduce the load on bone tissues, so the destruction of discs leads to gradual damage to the vertebrae and deformity of the spine. Osteoma can be a complication of trauma, a long-term posture violation, or another medical condition. Treatment is with manual therapy, physical therapy, and surgical intervention for significant spinal deformities.
Osteoarthritis is one of the most common musculoskeletal disorders in the elderly. In adolescents and young adults, pathology is diagnosed less often. Symptoms characteristic of the disease, doctors say, include severe pain in the affected joint area and impaired mobility. Without treatment, osteonecrosis can be complicated by spinal cord compression and dysfunction of internal organs.
Symptoms of osteonecrosis
Manifestations of the disease depend on the area of destruction of the articular discs. The main symptom is aching or sharp pain, which gets worse with movement. Because of this, patients often have a forced posture. With cervical spondylosis, patients have difficulty seeing around, severe headaches appear. If the disease is complicated by compression of peripheral nerves and spinal cord, symptoms of movement disorders and dysfunction of internal organs will occur.
Other symptoms and signs:
- Moderate dull pain during the day, aggravated by exercise;
- Radiating pain in the head, shoulders, pelvis, and lower extremities;
- Constant tension of the muscles involved in the affected disc joint;
- Reduced performance;
- Sleep disorders;
- Changes in posture and awkward gait.
If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.
The disease can progress over several years. In the early stages of cartilage damage, there are no symptoms, but gradually there is a constant pain.
Causes of osteonecrosis
Normally, disc cartilage is supplied with a constant blood supply and receives enough nutrients from the blood to regenerate cells and maintain its own structure. As tissues age, degenerative changes can occur, which are characterized by insufficient cellular renewal. Violation of blood flow occurs when the arteries pressed against the base of the spine are permanently curved or traumatized. Alternatively, osteonecrosis can be the result of overexertion.
Causes of the disease:
- Disc cartilage is gradually destroyed by poor posture, heavy lifting, and movement patterns. The reason for violation of the structure of the intervertebral disc can even be due to wearing shoes with flat soles for a long time;
- Cranial anomalies - violation of the relative position of the structures of the cervical spine and skull. In this case, vascular compression and impaired blood supply to tissues often occur.
- Metabolic disorders, accompanied by insufficient formation of hydrophilic cartilage components;
- Inflammatory or autoimmune damage to cartilage, in which the body's defenses attack healthy tissue;
- A herniated disc is a disease characterized by cartilage displacement and disc protrusion into the spinal canal.
Clarifying the cause of osteonecrosis is important for choosing the right treatment.
Diagnosis of osteonecrosis
When symptoms of osteonecrosis appear, an appointment with a neurologist should be made. The clinician asks the patient about complaints and examines the medical history to identify risk factors for the disease. Then, a general examination is performed to identify external signs of osteonecrosis and exclude symptoms of spinal cord dysfunction. To confirm the diagnosis, the neurologist prescribes special examinations.
Methods of diagnosis of osteonecrosis:
- X-ray of the spine. The neurologist assigned this study to obtain images of the affected spinal segment in two projections. Before the procedure, the patient is asked to undress to the waist and stand in front of the machine. The resulting images allow the doctor to detect a hernia or other pathology, as well as determine the extent of damage to the vertebrae and discs;
- Magnetic resonance imaging is a more informative study that allows a neurologist to study multi-layered images of the spine in different projections. During the examination, the patient is asked to remove all metal jewelry and lie down on the tomography table. Diagnosis takes 15 minutes to an hour. It is a painless and reliable method for the diagnosis of osteonecrosis. An MRI scan can immediately rule out other conditions with similar symptoms, such as bone tuberculosis or melanoma. If MRI is contraindicated, myelogram is indicated.
- Examination of the subarachnoid space of the spinal cord (myelogram). Neurologists prescribe this procedure to rule out myocarditis, cancer, and other medical conditions of the meninges. The method of obtaining images is not different from conventional X-rays, however, before the study, the doctor will inject contrast material into the subarachnoid space. Before the puncture, the doctor treats the skin with an antiseptic and anesthetizes the tissues. The needle is inserted into the disc space of the lumbar spine.
In a specialized clinic, safe and reliable diagnostic tests are performed, which allows you to quickly start treatment for osteonecrosis.
Treatment of osteonecrosis disease
Treatment is carried out after consultation with a neurologist and orthopedist. In cases of instability of the affected cervical spine segment, a Shant collar is applied. A prefabricated orthopedic collar is applied to the neck and reinforced with tape. Wearing a necklace is necessary to reduce the load on the affected spine and prevent the development of complications. In case of severe osteonecrosis of the lumbar spine or thoracic spine, the patient should be rested. The clinic doctor will also prescribe symptomatic therapy and physical therapy to alleviate the patient's condition.
Methods of treatment of osteonecrosis:
- Prescribe non-steroidal anti-inflammatory drugs to relieve pain. The neurologist prescribes nimesulide, celecoxib, or another substance. It is necessary to closely control the dose of analgesics and monitor the liver condition when using analgesics for a long time.
- Traction therapy is a method of stretching the spine to increase the space between the discs to remove the compression of blood vessels and nerves. Before the procedure, massage is performed to relax the muscles. Traction is carried out on a special table or in a bath. The device is fixed on the patient's body in the desired position and gently stretches the spine. This is a very effective and safe procedure to treat osteonecrosis.
- The use of anticonvulsants for complications of osteonecrosis. A neurologist prescribes a short course of carbamazepine or another drug to the patient.
- The use of muscle relaxants. These drugs help relax the muscles involved in the affected area of the spine and relieve pain;
- Use corticosteroids to compress the nerve. These drugs alleviate the inflammatory process in the tissues, including therapeutic massage, special exercises and warm-ups.
The neurologist selects a specific treatment regimen for osteonecrosis, focusing on the patient's condition. Strict medical control during treatment allows you to achieve the best prognosis.
Surgical treatment of osteonecrosis
If the diagnosis suggests a herniated disc or severe compression of the spinal canal, the patient is scheduled to see a neurologist. The doctor evaluates the severity of the identified pathology and, if necessary, conducts surgical intervention.
Surgical treatment options:
- Partial or complete removal of the disc.The operation is performed under anesthesia. After anesthesia, the neurosurgeon treats the surgical area with an antiseptic and cuts the skin at a predetermined position. After pushing the muscle layer with a special tool, the doctor will remove the affected disc. If necessary, removal of the vertebral arch is also performed. Spinal plasty is performed with the implantation of artificial materials. This effective operation is suitable to treat herniated disc and relieve the symptoms of osteonecrosis;
- Surgery to narrow the spinal canal.This intervention helps to remove compression on the nerves and spinal cord. After anesthesia, the doctor treats the surgical area with an antiseptic and makes a wide incision. Pushing back the muscle layer, the neurosurgeon approaches the disc joint and performs manipulation. The intervention involves removing the vertebral arch or the entire joint. The use of X-rays and microsurgical control allows surgery to be performed with minimal risk.
The most complex surgical interventions are performed in the surgical department of modern clinics.