Degenerative Spinal Conditions Flashcards
What is spondylosis?
Degenerative changes of the CENTRAL intervertebral joints
Why does spondylosis occur?
Part of normal aging - can occur more rapidly and severely in some people
Result of:
- cellular senescence
- altered disc nutrition
- genetics
- mechanical stress
- smoking
What is the process of spondylosis?
Healing capacity of the disc is overwhelmed:
- decreased proteoglycans = loss of water binding capacity
- increased type II collagen, decreased type 3 collagen
- less distinction between NP and AF
What are the overall changes to the disc in spondylosis?
- more rigid (disc dries out)
- less able to transmit weight and deform
- more load transmitted through AF = AF bulding
- loss of disc height
- altered disc nutrition
- disorganisation of collagen and ingrowth of blood vessels
What is the effect of loss of disc height?
Increased segmental movement = increased traction forces on bone = osteophyte fromation
What is the effect of spondylosis on the vertebrae?
loss of trabecular bone = reduced bone density = bowing of the end plate into the vertebral body & trabecular fractures
What are the secordary complications of spondylosis?
Loss of disc height = increased pressure on facet joints = facet joint arthritis = decreased size of IV foramen = compressed spinal nerve roots
What are the signs and symptoms of spondylosis?
Two types of onset:
- sudden onset back/neck pain triggered by unproportionally small stimulus
- gradual onset of stiffness and pain
Why does spondylosis cause pain?
Posterior disc can become compressed - causing somatic or somatic referred pain
May get Radiculopathy in later stages due to spinal nerve root compression
What is facet joint arthrosis?
Degenerative changes in the FACET JOINTS of the spine (similar to OA)
What is the difference between arthritis and arthrosis?
Arthritis - inflammatory
Arthrosis - degenerative
Why does facet joint arthrosis occur?
Degeneration of articular cartilage due to impaired healing capacity (same mechanism as OA)
What are the symptoms of facet joint arthrosis?
- intermittent pain
- Episodic - stiffness in the morning, aching at night
- localised
- worse when standing & extension
- mechanical pain when turning onto back
- increased lordosis
What are the characteristics of people with facet joint arthrosis?
Middle-aged
Overweight
Poor Abdominal tone
More common in women
