Dorsopathy of the cervical spine means degenerative changes in the tissues of the column of spine. Term “dorsopathy” means a range of pain syndromes. The main reason for degenerative changes is wearing out and ageing of the spine. According to modern researches a vertebral column is totally formed at the age of 20 – 22 years, and already from at 30 years there appear the first signs of ageing and wearing out.
All kinds of dorsopathy are divided into three groups:
- Deforming: That is kyphosis, lordosis, osteochondritis, spondylosis, sponylolisthesis and pseudo luxation.
- Inflammatory, degenerative and traumatic spondylopathies.
- Other degenerative processes of the intervertebral discs, which includes dorsalgia, it is dorsopathy under which there is no damage of the intervertebral discs.
Causes of cervical spine dorsopathy
The following factors contribute to the development of dystrophic processes in the spine column:
- Mechanical traumas, infections, metabolic disorder.
- Influence of difficult environments (low temperature, vibration).
- Irregularly distributed load on the spine, for example when the patient have a postural disorder.
- Inherited predisposition to the development of degenerative changes.
The cervical spine is the most vulnerable part of the spine, because of its mobility, heavy load o muscles and anatomic peculiarities (height of the neck depends on the intervertebral discs).
The most widely-spread dorsopathies
The best known state of dorsopathy is osteochondritis, it is a complex of dystrophic changes in the intervertebral discs. If it is not treated and preventative measures against the complications are not performed then spondylosis will develop; when dystrophic changes will spread to the whole disc including membranes. After that the process is progressing and the vertebrae may shift forward (sponylolisthesis). On this stage protrusion or a herniated disc are often observed, as a final stage of degenerative changes. An isolated dorsopathy of the cervical spine is not so often met; usually doctors observe dorsopathy of the cervical spine.
Process of treatment of this pathology is a long-standing process and it depends on the stage of the disease. The main methods of treatment are the following:
- In the period of acute condition a bed rest is prescribed. It is important to arrange functional rest for the spine. It can be achieved with a special cervical collar – Schantz collar.
- In order to arrest the pain syndrome and to remove muscles tension the doctors usually prescribe non-steroidal anti-inflammatory medicines. They are applied in the form of pills or injections (intramuscularly or intravenously), and also locally (ointments, creams, gels). Diclofenac, Voltaren, Nurofen are classified as non-steroidal anti-inflammatory medicines. Application of these medicines leads to a high risk of stomach diseases development, for example, ulcers, accomplished by bleeding. So, these medicines must be used with precautions and in complex with protection of the stomach by special medicines. In order to arrest pain the doctors prescribe anesthetics (baralgin) и muscles relaxants (mydocalm).
- Warming ointments, such as Fastum gel, Efcamon, Efcamon and Espol, which have a distraction effect, improve blood circulation to the pathologically changed area, at the same time they promote swelling and inflammation of the tissues reduction, improving innervations.
- If these methods have not been effective then blockings are prescribed, mainly paravertebral applying lidocaine, novocaine or dexamethasone. In order to reduce a significant swelling of the nervous root while stationary treatment epidural block with corticosteroids is applied.
- Anti-ischemic medicines improve disorders of blood circulation in tissues and restore metabolic processes. With this aim the following medicines are also applied (vitamine Е), antihypoxant (Cytochrome, Hypoxien), vasoactive medicines (Pentoxyfilline, Nicotine acid); these medicines are prescribed when the syndrome of the compressed nervous roots is developing and progressing.
Cartilage protectors are prescribed for chronic pain prevention. These medicines (Chondroitin Sulfate, Structum, or Dona and etc.) contain components of cartilage articularis and that is why they increase resistance of cartilage cells (chondrocytes) to the influence of inflammatory factors. Chondroprotectors have beneficial effect on tissue structure of a cartilage, they activate metabolic process in its matrix, stimulate cellular turnover of chondrocytes, so they have stimulating, regenerating (renovating) and anti-inflammatory actions. Structum reduces considerably degenerative-dystrophic changes in cartilaginous tissue of intervertebralis, delays destruction of bone tissue and regulates calcium loss. An additional point is that it accelerates regeneration of bone tissue. On the top of already administered medicine pain reduces in joints and their mobility grows. Therapeutic effect of chondroitin remains for a long time after treatment.
Course of chondroitin treatment is longstanding and continuous. These medicines in order to reduce affect on gastro-intestinal tract may be used topically in the form of ointment of chondroitin sulfate, which is spread on the skin above the affected joint till its full absorbtion. Besides, this medicine is used during physiotherapy (magnetophoresis). The course of treatment should be repeated once half a year if necessary.
- Remedial gymnastics is the main method, it stipulates for creating adequate graduated physical activity, its task is to remove muscles tension and nervous roots compression, to strengthen muscles corset of the spine and to make this corset elastic. In the result of regular trainings blood circulation of the spine improves, metabolic processes in the intervertebral discs and their nutrition.
- Physiotherapy is used in order to remove pain and inflammatory processes (electrophoresis, magnetotherapy, laser therapy).
- Massage helps to remove muscles tension, improve blood circulation in tissues, and overall health.
- Manual therapy.
- Spinal column traction with the help of special equipment. The aim of this procedure is to enlarge the gap between spinal bones, to lessen the pain syndrome and to restore normal functioning of the spine column.
- Reflexotherapy is a method applying specific influence on different reflexogenic zones and biologically active points of the body. Courses of acupuncture should be repeated several times a year as a supportive treatment.
- Patients with protrusions and herniated discs should be treated operatively in order to restore continuity of fibrous membranes of a cartilage. Surgical interference is recommended also in those cases, when dorsopathy of the cervical spine manifests itself during five or more months and standard conservative treatment turned out to be ineffective.
Dorsopathy preventative measures
- Day regimen and physical activity. Special gymnastics for muscles strengthening stabilizes the cervical spine.
- Healthy diet and weight correction, because overweight and metabolic changes will promote further progressing of dystrophic processes.
Every method from the above mentioned list is effective and relevant for treatment of this pathology; rational combination of methods will promote significant and fast therapeutic effect. It is very important to combine these methods with exercises on special rehabilitation equipment for muscles corset building.