What is vertebral, discogenic, spondylogenic radiculopathy and how they are treated

Radiculopathy (sciatica) – degenerative disease of the vertebrae or intervertebral discs, which leads to a sharp pain along the spinal nerves.

This pathology is well studied by medicine, there are many methods and treatment regimens. But to have a good understanding of a radiculopathy, it is necessary to know the mechanisms of its occurrence.

discogenic radiculopathy

Except the names of the sciatica and radiculopathy, in the medical literature there is another synonym – radicular syndrome.

Classification

Clinicians use multiple classifications radicular syndrome. It is an international classification of diseases (ICD-10), topographic classification and the classification on the affected area.

Topographic classification divides radiculopathy at the place of their localization:

  • neck;
  • breast;
  • lumbar
  • lumbosacral
  • misc.

Relative to the location of the lesion distinguish 3 forms of radiculopathy:

  • spondylogenic or discogenic radiculopathy;
  • vertebrogenic radiculopathy;
  • misc radiculopathy, which occurs when simultaneous lesion of the intervertebral disc and vertebra.

Thanks to these classifications, one can clearly differentiate the main features of radiculopathy in each individual patient.

Cause of disease

vertebrogenic radiculopathy

The Reason for the development of pathology can be a huge number of factors. But it should be noted the most frequent causes of radicular syndrome:

  • injuries and fractures of the spine;
  • degenerative-dystrophic changes of discs and vertebrae intercostal;
  • congenital anomalies of the spine;
  • heavy physical work, particularly associated with the manual transport of heavy loads;
  • autoimmune diseases that affect the structure of the spine;
  • herniated discs
  • pregnancy
  • osteoporosis and osteochondrosis;
  • prolonged sedentary work in non-physiological position of the body;
  • cancer adjacent tissues to the spine.

In Addition to these reasons, there are many, but for starters it would be good to understand all of the above. From the correct identification of the cause of radiculopathy depends on the subsequent treatment.

Pathogenesis in the mixed form of sciatica

There are many mechanisms of development of this pathology, and they directly depend on its causes.

Anatomically the sacrum (lumbalis) is a continuation of the lumbar (sacralis). The vertebrae of these departments are listed in a shortened form, which fits into the first letter with the Latin name of the spine and number of vertebral. For example, L5 and S1 denote the fifth lumbar and first sacral vertebrae.

Consider a situation, when because of a spinal injury damage 3 anatomical structure: vertebrae L5, S1 and the intervertebral disc between L5 and S1. In this case, there is a mixed form of radiculopathy, because it is as vertebrogenic and discogenic in nature.

In this situation most likely will suffer immediately two pairs of spinal nerves – between L5 and S1. These roots are formed at the outlet of spinal cord and head for the exit from the spinal canal through a special intervertebral foramen. It just so happened that the hole was relatively small, so if the damage L5, S1 intervertebral disc and the nerve is trapped.

Pinched nerve immediately responding to the malicious factor inflammation. The inflammatory process quickly covers all the nerve endings and causes pain.

Symptoms and diagnosis

spondylogenic radiculopathy

The Damage to L5, the intervertebral disc and S1, causing inflammation in the spinal nerve, leads to very severe pain. In the clinic a pinched nerve between L5 and S1 can generate specific types of pain – lumbago and sciatica. The pain is so intense that the patient often cannot get to the clinic for help.

When you contact such patients complain of severe pain and other symptoms are just noticeable on the background of pain. History taking will help to know the possible cause of the onset of the disease, which will lead to subsequent adequate treatment.

In case of damage to the L5 S1 and the pain will be mixed, because in addition to the radicular syndrome in a patient pathologically altered these vertebrae. Damage to the L5 and S1 often mimic renal colic, pathology of the gastrointestinal tract. If the pathology is not in L5 and S1, and in the thoracic region, patients complain of specific intercostal neuralgia.

Looking around the patient can note the discoloration of the skin in the projection of the affected nerve. Besides inflammation of the nerve leads to hypertonicity of the muscles adjacent.

To confirm the diagnosis it is necessary to conduct x-rays of the affected spine. Itwill not only learn the location of the damage, but also its prevalence. Other additional methods include CT and magnetic resonance imaging, General blood analysis, biochemical blood analysis, etc.

Treatment and methods of rehabilitation

Vertebrogenic radiculopathy requires immediate treatment. Therapy depends on the etiology of the radicular syndrome.

The First step is to get rid of the main symptoms – of pain. Its complete elimination is possible if prescription nonsteroidal anti-inflammatory drugs. The selection of these means should be appropriate, because they have severe side effects.

In the case of a herniated disc, compression fracture vertebra, cancer patient, surgery is indicated. The postoperative period requires careful supervision of doctors.

Rehabilitation of patients after radicular syndrome complex. These patients visit a health center, go to the techniques of therapeutic massage, exercise therapy.