Most often, osteochondrosis affects the cervical (CV-CVII) and lumbar (LV-SI).
The osteochondrosis of the neck and its symptoms are largely due to the anatomical and physiological features of the cervical spine. Compression-radicular cervical vertebrogenic syndromes are caused by irritation or squeezing of a certain root. This causes pain in the zone of innervation of the corresponding dermatome, sensory and motor disorders. Irritative-reflex syndromes (cervicalgia, cervicocranygia, cervicobrahialgia) are caused by irritation of the sinuvertebral nerve, often with the addition of a vegetative component.
Muscle-tonic syndromes also arise due to the irrigation of pain receptors of the sinuvertebral nerve with the excitation of the segmental apparatus of the spinal cord. They are manifested by prolonged muscle strain, the appearance of pain in them, the development of fibrotic changes. Sometimes this is accompanied by the appearance of reflected pain within segmental vegetative innervation (the Zakharyin-Ged zone). With prolonged irritation of the vegetative-trophic structures of the segmental and supra-segmental apparatus, neurodystrophic syndromes develop (lower oblique muscle syndrome of the head, scapular-rib syndrome, shoulder-scapular periarthrosis, shoulder-brush syndrome, etc.).
One of the most important features of the structure of the cervical spine is the presence of holes in the transverse processes CVI-SII, through which the vertebral artery passes through with the same sympathetic nerve (Frank's nerve). With osteochondrosis of the cervical region, mainly due to the growth of osteophytes, cerebral circulatory insufficiency in the vertebrobasilar basin of compression or reflex genesis can form.
In the case of protrusion or prolapse of the intervertebral disc, a spinal cord compression clinic (compression vertebrogenic myelopathy) with segmental, conductive symptoms, vegetative-trophic disorders and a disorder of pelvic organs may develop.
With lesions of intervertebral discs in the lumbar region, the main complaint of patients is back pain and only in rare cases other disorders appear on the foreground. Usually the pain is localized in the lumbosacral region and irradiates into the lower limbs. In some cases, the disease begins gradually, in others - sharply, with the appearance of sharp pain, which can build up within a few hours, days.
The pathogenesis and character of pain are similar to those in cervical osteochondrosis. When coughing, natuzhivanii pain increases, which is due to increased pressure in the subarachnoid space. In the prone position and in the forced posture, the pain may decrease.
The zones of irradiation of pain in the lower limb have a different topography and almost always have a distinct mono- or biradicular character. On examination, attention is drawn to the presence of a characteristic scoliosis (homo- or goterolateral), more often flattening of physiological lordosis in the lumbar spine. Almost always there is a strain of long back muscles in the lumbar region. With palpation, the soreness of the spinous processes of the vertebrae is determined. A positive Laseg symptom is one of the most constant symptoms with a posterior displacement of the discs of the lower lumbar and first sacral vertebrae.
The second most important symptom of osteochondrosis is a sensitivity disorder in the zones of innervation of the affected roots and the appearance of paresthesia, hypesthesia or anesthesia. Usually the dermatome root for sensitive disorders is defined much more clearly than on irradiation of pain. In addition to sensitive, motor disorders can occur with a decrease in the function of the muscles innervated by the corresponding spine, their atrophy, and a decrease in reflexes.
Occasionally, when the hernia of the LIV or LV root disc is compressed, a spinal cord injury syndrome occurs at the level of the cone and epiconus (acute myeloradiculo-ischemia syndrome). This happens in those cases when this department is supplied with blood by the artery of the root LIV or LV (artery of Deprozh-Gotteron).