Email this article Evolution of structural and functional changes in the lumbar segment in dysplastic diseases of the spine
- Authors: Prodan A.I.1, Kolesnichenko V.A.1
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Affiliations:
- Institute of Pathology of the Spine and Joints. M.I. Sitenko
- Issue: Vol 9, No 3 (2002)
- Pages: 36-41
- Section: Articles
- URL: https://ogarev-online.ru/0869-8678/article/view/99935
- DOI: https://doi.org/10.17816/vto99935
- ID: 99935
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Abstract
Structural and functional changes of the lumbar segments in dysplastic spine diseases are considered as a continuous dysplastic dystrophic process. The background of this process is a structural abnormality of the spine segment. Destructive effect of external factors (e.c. loading) results in the adaptative remodeling, development of compensatory accommodative reactions followed by their exhaustion and decompensation with corresponding clinical manifestations.
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##article.viewOnOriginalSite##About the authors
A. I. Prodan
Institute of Pathology of the Spine and Joints. M.I. Sitenko
Author for correspondence.
Email: info@eco-vector.com
Ukraine, Kharkiv
V. A. Kolesnichenko
Institute of Pathology of the Spine and Joints. M.I. Sitenko
Email: info@eco-vector.com
Ukraine, Kharkiv
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Rice. Fig. 1. Mechanism of redistribution of compression loads in the intervertebral disc–vertebral body system: a — in the intact vertebral segment, b — in the segment with a structural anomaly of the endplates of the vertebral bodies.
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Rice. 2. Lateral radiographs of the lumbar spine of patient K.: the formation of structural changes in osteochondropathy of the spine. a — violation of the contours of the endplates of the bodies of L2-5 vertebrae at the age of 8; b — Schmorl's hernia, osteoporosis of the L2 vertebral body, decrease in the height of the L2~3 intervertebral disc at the age of 13.
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Rice. Fig. 3. The nature of the distribution of compression loads: a — in the intact vertebral segment, b — in the segment with wedge-shaped deformity of the vertebral body.
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Rice. Fig. 4. Epidurograms (a — direct, b, c — lateral) of patient 3. 28 years old. Dysplastic stenosis of the spinal canal: decrease in the density of the contrast shadow in the area of stenosis of the spinal canal; a relative increase in the density of the contrast shadow proximal and distal to the stenosis site; an increase in the length of the contrasted section of the spinal canal up to the thoracic region with the introduction of a standard volume of contrast agent.
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Rice. Fig. 5. Radiographs (a — direct, b — lateral) of the lumbar spine of patient M., 16 years old. Osteochondropathy in segments L2-3, L3-4; decrease in the height of L2 ~ 3, L3_4 intervertebral discs, spondylarthrosis.
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Rice. Fig. 6. Epidurograms (a — direct, b — lateral) of patient S., 51 years old. Outcome of osteochondropathy of the spine: fibrosis of the lumbar discs, diffuse osteoporosis, hyperplastic degenerative stenosis of the spinal canal - an increase in the length of the contrasted section of the canal with the introduction of a standard volume of contrast agent; spotting and uneven edges and a decrease in the density of the contrasting shadow in the central part of the spinal canal; lack of contrasting lateral depressions and foraminal areas; reduction of the posterior epidural space (due to hyperplasia of the arches and articular processes).
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Rice. Fig. 7. Variants of intervertebral disc dysplasia: a — with a decrease, b — with an increase in the volume of the nucleus pulposus.
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Rice. Fig. 8. Radiographs (a — direct, b — lateral) of the lumbar spine of patient O., 28 years old. Diffuse degeneration of the lumbar discs, spondylarthrosis.
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Rice. Fig. 9. Radiographs (a — direct, b — lateral) of the lumbar spine of patient A., 49 years old. The outcome of osteochondrosis: fibrosis of the L3-4 disc, degenerative spondylolisthesis of the L3 vertebra, osteophytes, compensatory restructuring of the cancellous bone of the bodies of L3, L4 vertebrae.
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Rice. Fig. 10. Radiographs of the lumbar spine of patients with asymmetric hypo- and hyperplasia of the articular processes. a — asymmetric hypoplasia of the articular processes of N~3 vertebrae, anomaly of tropism in the L3-4 segment; b — asymmetric hyperplasia of the articular processes of L3-5 vertebrae, sagittalization of the articular facets in segments L2-3, L4-5. Polysegmental spondylarthrosis.
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