Spondylarthrosis
Ricarda Schwarz studied medicine in Würzburg, where she also completed her doctorate. After a wide range of tasks in practical medical training (PJ) in Flensburg, Hamburg and New Zealand, she is now working in neuroradiology and radiology at the Tübingen University Hospital.
More about the experts All content is checked by medical journalists.Spondylarthrosis is a degenerative disease of the small vertebral joints. It occurs in almost everyone due to age and can cause back pain. If these do not go away on their own, they can be treated well with conservative measures. Surgery is very rarely necessary. Here you can read everything you need to know about spondylarthrosis.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. M47
Spondylarthrosis: general
The term spondylarthrosis is derived from the Greek words "spondylos" for vertebrae and "arthrosis" for joint. Spondylarthrosis is a degenerative disease of the spine. Strictly speaking, it is osteoarthritis of the small spinal joints (facet joints). Symptomatic spondylarthrosis is therefore also known as facet syndrome.
Degenerative changes in the spine such as spondylarthrosis are practically inevitable as you get older. Every second inhabitant in Germany is affected by it at the age of 40. At the age of 60 you can - at least in the X-ray image - detect signs of aging in the spine of around 90 percent of people.
However, not everyone with osteoarthritis in their back suffers from discomfort. Still, degenerative spinal diseases are the leading cause of back pain. Almost 60 percent of adults in Germany occasionally suffer from symptoms of osteoarthritis in the spine. Older people, non-athletes, women and smokers are more often affected. Often the back pain caused by osteoarthritis of the spine is only temporary. Sometimes they set in acutely and then slowly subside. More rarely, the pain persists and turns into chronic back pain.
Spondylarthrosis combined with other signs of aging
Signs of aging in the spine can in principle affect any element of a movement segment. There are usually several elements involved in osteoarthritis in the back. The most serious problem gives the disease its name. In addition to spondylarthrosis, there is also chondrosis, osteochondrosis and spondylosis. These different forms of degenerative changes in the spine can usually not be clearly separated from one another. In the case of an "arthrosis back", they often merge into one another and are mutually dependent.
Chondrosis
If the intervertebral discs lose some of their fluid, they become less elastic. The spine becomes more unstable. This puts more strain on the intervertebral discs with every shock. They develop cracks and gaps and can eventually be completely destroyed. This so-called intervertebral chondrosis contributes to the “arthrosis back”.
Osteochondrosis
If the intervertebral discs can no longer fulfill their function as shock absorbers due to wear, loads are transferred to the bony vertebrae. They also change degeneratively and form a calcium rim (sclerosis) under the cartilage surface - the arthrosis in the spine progresses.
Spondylosis
To compensate for the reduced stability of the spine, bony extensions form on the edges of the vertebral body (spondylophytes). They also rarely arise in the intervertebral space. If you completely bridge the gap between two neighboring vertebral bodies, the spine often deforms and stiffens (spondylosis deformans).
Spondylarthrosis
If the changes described continue, the spine becomes more and more unstable. The vertebral bodies shift against each other, and the small vertebral joints no longer fit together perfectly. The tape connections are continually being pulled. This incorrect loading ultimately causes spondylarthrosis.
Spondylarthrosis: causes
In addition to the inevitable signs of aging, some diseases can promote spondylarthrosis.
If the spine is stressed too much by certain types of sport or occupation, but also by being overweight, "osteoarthritis back" occurs more quickly.Cervical arthrosis (cervical spine arthrosis) is more common, for example, in hairdressers or kindergarten teachers, who often have to lower their heads. On the other hand, overweight patients have a higher risk of lumbar spondylarthrosis (arthrosis in the lumbar spine).
Scoliosis, a herniated disc and rheumatic diseases can also cause spondylarthrosis.
Spondylarthrosis: symptoms
The vertebral joints are in close proximity to the nerve roots of the spinal cord - nerve fibers that enter or exit the spinal cord inside the spine. If the penetration holes of the nerve roots in the spine are narrowed by spondylarthrosis, symptoms can occur. Most often they manifest themselves in the form of back pain. They can appear in individual places on the back (localized) or radiate into the buttocks and legs. Those affected often feel an uncomfortable tingling sensation. These symptoms of spondylarthrosis usually go away at rest and improve overall over a longer period of time.
In addition, spondylarthrosis can limit the mobility of the spine. Affected people can bend down or lean to one side more difficultly. Usually the lumbar spine is most affected by osteoarthritis. The cervical spine (Cervical spine) and thoracic spine (thoracic spine) have to withstand less stress and therefore do not develop spondylarthrosis as quickly.
Neck osteoarthritis can lead to neck pain. Occasionally this pain radiates into the arms.
Spondylarthrosis: diagnosis
How a spondylarthrosis can be diagnosed, read in the article osteoarthritis.
Spondylarthrosis: therapy
Degenerative spinal diseases such as spondylarthrosis are usually treated conservatively at first, for example with medication and physiotherapy. These measures are also used for other forms of osteoarthritis. You can find out more about conservative therapy for joint wear and tear in the article on osteoarthritis treatment.
Spondylarthrosis patients with paralysis or acute vertebral fractures must be operated on. Surgical treatment can also be considered if conservative therapy for spondylarthrosis cannot adequately alleviate the symptoms. There are various options for surgical spondylarthrosis therapy:
decompression
As part of a laminectomy, individual parts of the bone from the spinal column segment are removed. This should relieve compressed nerve parts again. This operation is often used when bony structures constrict the spinal canal.
Function-preserving interventions without fusion
To strengthen an unstable spine, screws can be inserted into the moving parts. These pedicle screws are mainly used for painful movement disorders and should not restrict the mobility of the spine.
fusion
In a fusion operation, two or more spine segments are tightly connected to one another to strengthen an unstable spine. To do this, various screws are fastened in the individual vertebral bodies. Then the screws of the various segments are connected to one another. Sometimes a metal cage or an endogenous bone is also inserted into the spine. This makes the spine more stable and trapped nerves get more space again. However, the spine is permanently stiffened in the operated areas. This operation is therefore usually only carried out if the spondylarthrosis is very advanced.
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