Orthopedics - Oleksa A.P. 2006

Spinal conditions causing pain

According to statistical data, 60 to 80% of middle-aged and elderly people experience back pain resulting from pathological Changes in the spine. This pain is a non-specific symptom, as it can be caused by acute or chronic occupational trauma, inflammatory or degenerative-dystrophic processes, tumors, angiopathies, and even the consequences of Dysplasia (Fig. 281).

To establish a correct Diagnosis, the physician must determine which component of the spinal segment or pelvis is affected and what is causing the pain.

In the Water/140.html">Anatomical Structure of the spine, two functionally important columns are distinguished. The anterior Column is formed by the vertebral bodies and intervertebral discs, which are reinforced by strong ligaments, particularly the anterior and posterior longitudinal ligaments.

The posterior column is formed by the vertebral arches with spinous processes and the zygapophyseal joints, which are connected by strong ligaments that ensure spinal stability.

Two adjacent vertebrae form a single spinal segment, which includes the intervertebral disc, two zygapophyseal joints, the arches with spinous processes, and the ligaments that reinforce the segment.

The biomechanics of a spinal segment are determined by the condition and interaction of its components. Pathological changes in one of them alter the function of the others.

As early as the beginning of the last century, physicians attributed back pain radiating to the lower extremities to inflammatory, degenerative-dystrophic, or other processes, as well as spinal instability.

Mixter U.S. and Barr J.S. (1934) described the symptoms of nerve ROOT compression caused by a displaced fragment of a ruptured, degenerated intervertebral disc, which manifests as back and lower limb pain, Muscle weakness, paresthesia in the area innervated by the segmental nerve, and even loss of Reflexes.

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Fig. 281. Diseases of the spine and pelvis causing lower back pain: 1. Tumors in the cauda equina region. 2. Spinal tumors. 3. Tuberculosis spondylitis. 4. Spinal osteoarthritis. 5. Spondylolisthesis. 6. Herniation or Displacement of the intervertebral disc. 7. Ankylosing spondylitis. 8. Occlusion of intrapelvic vessels. 9. Inflammatory processes of the pelvic Organs. 10. Hip joint disease. 11. Tumors of the pelvic bones.

Among all spinal disorders in clinical practice, osteochondrosis and its consequences are the most common.