Lumbar Spondylosis: Causes, Diagnosis and Treatment

by Johnny Jacks

Degenerative disc disease in the lumbar spine (Lumbar spondylosis) is a result of the natural aging process, where the spinal bones gradually degenerate. This natural aging process includes osteoporosis and cartilage erosion. The condition is common in individuals with jobs that involve heavy lifting, bending, twisting, and frequent neck and back extension.

What is degenerative disc disease in the lumbar spine?

Degenerative disc disease in the lumbar spine (Lumbar Spondylosis) is a chronic joint disease characterized by gradually increasing pain, reduced mobility, and non-inflammatory deformation of the lumbar spine. The disease includes degeneration of the vertebrae and intervertebral discs, with or without nerve compression, and spinal instability.

What is degenerative disc disease in the lumbar spine?

What is degenerative disc disease in the lumbar spine?

Causes of Lumbar Spondylosis

In general, degeneration of the spine occurs as people age. This natural aging process includes conditions such as bone loss and erosion of joint cartilage. The disease is often found in patients who have physically demanding jobs that involve lifting, bending, twisting, or repeatedly flexing and extending the neck.

Younger individuals may also develop the disease due to various other causes such as trauma or genetic defects related to joint cartilage.

In individuals under 45 years of age, degenerative joint disease is more common in males. After the age of 45, it becomes more prevalent in females. Arthritis occurs more frequently in overweight individuals. It also occurs more frequently in individuals with jobs or sports activities that put repeated stress on specific joints.

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Diet and obesity are also directly related to the development of bone and joint diseases. Risk factors for metabolic syndrome are independently associated with the development of arthritis, including obesity, diabetes, high blood pressure, and elevated lipid levels. Atherosclerosis, venous disease, and stasis can also increase the development of arthritis by exacerbating local bone and cartilage under ischemic conditions.

Localized ischemia leads to the apoptosis of bone cells and chondrocytes, stiffening the bone beneath the cartilage. The inflexibility of the cartilage leads to mechanical load-induced damage. Obesity (releasing inflammatory cytokines) is highly correlated with inflammatory arthritis. In fact, leptin affects the synthesis of growth factors, chondrocyte proliferation, and differentiation through the regulation of STAT molecules. Leptin levels are proportional to the severity of cartilage destruction in tissues. Reactive oxygen species produced by chondrocytes may also damage joint cartilage. A diet supplemented with antioxidants, including vitamins C and K, may help prevent arthritis.

How is lumbar spinal degeneration diagnosed?

How is lumbar spinal degeneration diagnosed?

How is lumbar spinal degeneration diagnosed?

The diagnosis of lumbar spinal degeneration is based on the clinical and paraclinical symptoms of the patient.

Lumbar spinal degeneration rarely occurs in isolation, but is mainly a combination of spinal disc degeneration and in some cases, herniated discs. In older individuals, lumbar spinal degeneration is often accompanied by osteoporosis and vertebral compression fractures.

Some patients experience stiffness in the spine in the morning, low-grade back pain that increases with activity and decreases with rest. In severe cases of degeneration, patients experience constant pain, leading to sleep disturbances. Additionally, patients may hear cracking sounds in the spine during movement.

Most cases of lumbar spinal degeneration do not have systemic symptoms such as fever, anemia, or weight loss, and the pain is localized. Some patients with nerve root pain may also have symptoms of spinal stenosis or disc herniation. In some cases, patients may also have spinal deformities such as scoliosis or kyphosis. Patients with spinal stenosis often experience radicular pain, pain along the nerve pathway, and pain that worsens with movement and improves with rest.

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In individuals who are suspected of having lumbar spine degeneration, X-ray imaging in both the straight and tilted positions may reveal: narrowed intervertebral disc spaces and facet joint spaces, flattened intervertebral discs, and the presence of osteophytes on vertebral bodies. In cases where there is vertebral slippage, a lateral X-ray may reveal a “broken dog’s neck” appearance.

In individuals with lumbar spine degeneration, blood tests and biochemical markers are typically within normal limits.

For individuals suspected of having a herniated disc, magnetic resonance imaging (MRI) of the spine is indicated.

If these patients exhibit signs of inflammation, such as fever, anemia, weight loss, and other symptoms, other diseases such as seronegative spondyloarthropathies, infectious spondylodiscitis, and metastatic bone cancer should be considered.

Can spinal degeneration in the lumbar spine be cured?

Can spinal degeneration in the lumbar spine be cured?

Can spinal degeneration in the lumbar spine be cured?

The principle of treating spinal degeneration in the lumbar spine is to alleviate symptoms and prevent further degeneration using slow-acting medications. The treatment of lumbar spinal degeneration requires a combination of internal medicine treatment, physical therapy, functional recovery, and surgical intervention in cases of nerve root compression.

Physical therapy for lumbar spinal degeneration

Physical therapy methods that support the treatment of lumbar spine degeneration include exercise, massage, traction, hot compresses, shortwave therapy, electrical therapy, mineral water therapy, and spinal stretching. These methods stimulate soft tissue in the body, leading to pain relief and improved blood circulation.

Internal medicine treatment for lumbar spinal degeneration

Pain relief in lumbar spinal degeneration is treated according to the WHO protocol as follows:

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For Grade 1 pain relief, the patient is given a paracetamol-containing product with a dosage of 500 mg per dose, taken 4-6 times a day. For Grade 2 pain relief, the patient is given paracetamol in combination with codeine or tramadol. If the above two pain relief methods do not work, a Grade 3 pain relief protocol using opiates and their derivatives is used. Non-steroidal anti-inflammatory drugs used in the treatment of lumbar spinal degeneration include:

Diclofenac with a dosage of 100mg/day, divided into two doses, taken after a meal or injected with a dose of 75mg/day for 2-3 days, then switched to oral medication. Meloxicam with a dosage of 15mg/day, taken after a meal or injected with the same dosage for 2-3 days if the pain is severe, then switched to oral medication. Piroxicam with a dosage of 20mg/day, taken after a meal or injected with the same dosage for the first 2-3 days if the pain is severe, then switched to oral medication. Celecoxib with a dosage of 200-400mg/day, taken after a meal. Patients with muscle spasms can use muscle relaxants such as Eperisone or Tolperisone.

Slow-acting medications used to treat symptomatic effects for patients with lumbar spinal degeneration include Glucosamine Sulfate and Chondroitin Sulphate or Diacerhein – which inhibits IL-1.

If a patient with lumbar spinal degeneration has sciatica, corticosteroids are injected as directed outside the dura mater, next to the spinal cord, or in the facet joint.

Surgical treatment

Surgical treatment for lumbar spinal degeneration is only used when the patient has a herniated disc, a slipped vertebrae, and long-lasting sciatica or spinal stenosis.

“Lumbar spondylosis” or “degenerative disc disease in the lumbar spine” Both terms are used in medical literature to describe the degenerative changes that occur in the lumbar spine.

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