Slipped disc Discopathy Intervertebral disc
Discopathy is a term used by doctors to indicate a generic alteration of the intervertebral disc, that kind of cushion placed between one vertebra and the other with the aim of facilitating movement and absorbing shocks.
The intervertebral discs are flexible fibrocartilaginous structures, interposed between the bodies of the vertebrae. In young people they make up 25% of the height of the entire column, but this percentage decreases significantly over the years.
The central part of the disc, called the nucleus pulposus, has a spherical shape and contains a gelatinous substance, composed of about 88% of water (in the elderly this percentage falls below 70%).
The ring surrounding the nucleus pulposus is formed by a series of concentric fibrous bundles. Their particular arrangement prevents the forces affecting the column from causing the nucleus to escape.
During the various vertebral stresses the nucleus pulposus acts as a shock absorber, distributing the loads to the fibrous ring. These continuous compressions reduce its water content, with consequent dehydration and loss of thickness. During the night, not undergoing significant forces, the pulpy nuclei become rehydrate by osmosis, regaining the original thickness.
If the efforts exerted on the spine are considerable and repeated, the disc undergoes a rapid aging and degeneration process, thus giving rise to disc disease.
When following a diagnostic study, performed to ascertain the causes of back pain, the simple term "discopathy" is read on the report, there is no need to be alarmed. It is in fact a simple condition of disc pain that probably lies at the basis of a pain that cannot be explained by other degenerative pathologies of the vertebral structures. In other words, not noticing significant anomalies of the spine, the origin of the pain is attributed to one or more discs which, upon diagnostic examination, appear slightly flattened. This diagnosis is quite vague and imprecise.
The speech changes radically when we talk about degenerative disc disease or when the term is inserted in a broader context (protrusion, herniation, strong reduction in thickness, arthritic changes, etc.).
Over the years, the intervertebral discs lose water and collapse, practically becoming discharged shock absorbers. Through magnetic resonance it is possible to appreciate this involution and hypothesize that this is at the basis of back pain not associated with sciatica. In these cases we speak of discopathy.
The most serious consequences of a disc disease are related to the reduction of the cushioning capacity of the disc and the simultaneous loss of normal relationships between one vertebra and the other.
The combination of these processes favors disc herniation and can lead, over the years, to the appearance of vertebral arthrosis.
These abnormalities can irritate adjacent nerve structures, triggering pain. Although back pain is the most common symptom associated with discopathy, in most cases the pathology proceeds completely asymptomatically.
CAUSES: prolonged maintenance of static positions, such as sitting, aggravated by axial stresses such as those to which the column is subjected while driving. Other possible causes of the disease are to be found in the normal aging process, in the sedentary lifestyle and in the reduction of physical performance.
The therapy of a generic disc disease is fundamentally non-invasive and based on the use of physiokinesitherapy, possibly associated with pharmacological treatment with analgesics and anti-inflammatories. Even in the most serious cases (disc disease associated with herniation) there is often a spontaneous improvement, which is favored from partial rest and rehabilitation exercises.
In the presence of disc disease it is therefore important to try not to worsen the situation through good prevention (see: back pain and prevention).
Only in the most severe cases, after the failure of conservative treatment, is it necessary to intervene surgically.
Discopathy associated with ...
Herniation (disc herniation): degenerative alteration of the intervertebral disc (discopathy), caused by the collapse of the fibrous ring and the consequent leakage of the semifluid substance present in the nucleus. The migration of this semifluid content causes pressure and chemical insults to the nerve roots adjacent, triggering pain.
Often this particular type of disc disease has as its causative agent the act of bending forward and sideways to lift heavy objects.
Different degrees and types of disc herniation can occur:
DISC PROTRUSION: the disc in question appears more crushed than the adjacent one; the fibers that make up the fibrous ring wear out, without tearing
DISC PROLAPSE: the fibrous ring cracks but the posterior longitudinal ligament manages to contain the nucleus pulposus
DISC EXTRUSION: the nucleus pulposus comes out also perforating the posterior longitudinal ligament
DISC EXPULSION: part of the herniated material is completely expelled and loses continuity with the nucleus pulposus from which it migrated
Reduction of the space between the X vertebrae and the Y vertebrae: it means that the intervertebral disc interposed between these two vertebrae is crushed. Thanks to magnetic resonance it is possible to recognize this generic disc disease even at an extremely early stage.
Spondylosis: defect of the vertebral arch, an anatomical structure located posteriorly. Together with the body, the vertebral arch forms a hole which, thanks to the overlapping of the various vertebrae, gives rise and protection to a canal, called vertebral, in which the spinal cord. Spondylolysis promotes spondylolisthesis.
Spondylolisthesis: slipping of one vertebra over the other. It can cause compression of the nerve roots and trigger pain.
Osteoarthritis: degenerative process of the joints associated with aging. Sometimes it begins as early as the third decade of life and, in an advanced stage, causes stiffness, pain and limitation of movement. Vertebral osteoarthritis is often associated with degenerative disc disease.
