OrthoNeuroSpine & Pain Institute
Osteochondrosis can occur in any segment of the spine, i.e. in the cervical spine, thoracic spine and lumbar spine. This is in most cases a creeping process that involves back pain which initially only occurs during exertion. This degeneration increases significantly with age. Back pain is very common in adults. To a certain extent, signs of degeneration in the spine are normal signs of ageing. For example, marginal serrations associated with spondylolysis in 90 % of men over 50. Only a certain number of these cases are also clinically relevant, i.e. associated with pain for the patient. A disease occurs when massive changes result in severe problems unusually early on. This tendency is possibly promoted by the civilised lifestyle. It results in degeneration in the vertebral joints, causes wear and tear to the cartilage on the joints and leads to arthritis. The result is stiffening of the joint and the formation of marginal ridges. The end stage of osteochondrosis ultimately results in the complete stiffening of the mobile segments affected.
Osteochondrosis: What is that?
Osteochondrosis (from the Greek "osteon" = bone and "chondron" = cartilage) is caused by changes to the disc´s cartilage, with an accompanying reaction in the vertebral body taking place. In this disease, degenerative changes occur in the disc. The height of the disc is reduced and the disc´s physiological function is lost, resulting in instability and changes in the vertebral joints. As the disease progresses, a reaction occurs in the end plate of the vertebral body. This reaction can be divided into three stages:
- Modic I = oedema formation,
- Modic II = fatty degeneration and
- Modic III = sclerosis.
What are the symptoms of osteochondrosis?
The disease manifests itself as intractable back pain that is difficult to affect and which depends on the segment of the spine (neck or lower back). The symptoms may remain limited to the spine or radiate into the legs (if they originate in the lumbar spine) or arms (if they come from the cervical spine). The symptoms may occur during rest, exertion or movement. There may be radicular symptoms (caused by pressure on the nerve root) or pseudoradicular symptoms (if the cause is in the facet joint or the musculature). If spinal canal stenosis is present, the distance the patient can walk will be limited. There is frequently a mixed clinical picture. In other words, it is not just one mobile segment that is affected. The condition is also known as degenerative lumbar spine disease or degenerative cervical spine disease. These reflect the associated complex of symptoms.
What are the causes?
Stressed discs lead to pain development.
Our discs start to degenerate when we are 20-years old. The increasing loss of water leads to a reduction in the height between the vertebrae (chondrosis). This means that the disc is no longer able to function as a shock absorber and the tension in the anterior and posterior longitudinal ligaments is lost. As a result, excessive stress is placed on the vertebral joints, the ligaments of the spine are loaded incorrectly and the mobile segments of the spine become gradually unstable. A spinal segment is always comprised of two vertebral bodies and the disc in-between. The superior and inferior endplates in the vertebral body are placed under more stress, areas of thickening (sclerosis) and ridges at the edges (spondylophytes) develop.
What are the consequences?
Changes in the statics of the spine occur, with changes to the muscles and ligaments, including the shortening of these tissues. This is accompanied by a loss of function and tension in the muscles (myogelosis). A slipped vertebra (pseudospondylolisthesis) may also develop. The cartilage in the vertebral joints degenerates earlier than usual due to the incongruent position of the joint surfaces. In addition to this, massive instability causes a degenerative increase in spine curvature (scolioses, kyphoses). Hypertrophic degeneration of the joint (spondylarthroses) causes narrowing in the spinal canal (spinal canal stenosis).
The natural stiffening of the sections of the spine are divided into the following stages:
- First stage: Instability
- Second stage Bony reaction
- Advanced stage: Complete stiffening
- Intervertebral disc surgery
- Intervertebral disc inflammation
- Driving, esp. trucks, heavy vehicles
- Smoking, chronic cough
- Physical labour, heavy lifting and carrying
- Building and transport trades