Neoarthrosis of the spine: causes, clinical symptoms, treatment methods

Neoarthrosis of the spine is a pathology associated with the formation of a false joint between the vertebral bodies, spinous and arcuate processes. In modern people, neoarthrosis is often associated with increased loads on the bone structures of the spinal column in conditions of insufficient functionality of the muscular corset of the back, collar area and neck.

A false pseudojoint is formed in a place where it should not physiologically exist and creates difficulties in mobility and injures surrounding tissues. This pathology begins with degeneration of the bone tissue of the spinous processes. Long-term dystrophy leads to the fact that the distal ends of the spinous processes come closer together and scar fibrous tissue forms between them. Convergence can occur due to incorrect posture and an increase in the physiological curves of the spinal column. In the middle age group, pathology is often observed in patients suffering from a degenerative dystrophic process in the intervertebral discs. The fibrous ring gradually loses its physiological height and extends beyond the boundaries of the vertebral body. At the same time, the intervertebral spaces are reduced. The spinous and arcuate processes begin to touch. In places of friction of bone tissue, cracks form, which are filled with deposits of calcium salts. On the basis of these processes, a pseudo-joint is formed, covered with a fibrous capsule. With significant convergence of the processes of the vertebral bodies, their complete assimilation occurs and the spinal column loses mobility.

The transverse processes of the spinal column also suffer from a similar pathology. They extend from the vertebral bodies in a posterior direction. When they are connected to each other, mobility is most limited. A detailed diagnosis in most cases reveals a combined form of pathology. Neoarthrosis of the spine usually includes damage to all three types of processes of the vertebral body.

Neoarthrosis rarely develops in the thoracic spine, since here the intervertebral discs are subject to insignificant physical and shock-absorbing load. Osteochondrosis, protrusion and intervertebral hernia develop relatively rarely here. The vast majority of clinical cases occur in the lumbar region - here there are maximum shock-absorbing loads, as a result of which cartilage tissue quickly undergoes degeneration. With the loss of physiological height, assimilation of the spinous and transverse processes begins, and a pseudo-joint is formed.

In medical practice, this pathology can be referred to as Bostrup's symptom. The disease received this name in honor of a radiologist from Denmark who first described the characteristic changes in the spinal column in 1933.

Currently, the disease has been studied quite well. It has no genetic or hereditary predisposition; anyone who suffers from excess body weight and leads a sedentary lifestyle can get sick. Old age, osteoporosis, vitamin D deficiency, thyroid disease, curvature of the spinal column and poor posture are predisposing factors that are highly likely to trigger the development of spinal neoarthrosis in any person.

Modern methods of treating neoarthrosis in official medicine involve surgical intervention. But in the early stages, you can overcome this disease using manual therapy methods. If you have localized pain in the neck, collar area, or lower back, we recommend that you visit a free consultation with a vertebrologist at our manual therapy clinic. The doctor will conduct an examination and tell you what prospects and possibilities for using manual therapy methods exist in your individual case. If necessary, a full course of rehabilitation treatment will be developed.

Causes of interspinous neoarthrosis

Interspinous neoarthrosis is the most common type of pathology. It is localized in the cervical and lumbar spine. Here, normally, there is a natural anterior deflection of the spine. Due to lordosis, there is a maximum convergence of the spinous processes, which in some cases can come into contact with each other.

The reasons for the development of neoarthrosis in these and other parts of the spinal column are as follows:

poor posture and curvature of the spinal column in the form of increased lordosis against the background of increased thoracic kyphosis (round back, stoop);
decrease in the height of intervertebral discs (protrusion) against the background of a long course of degenerative dystrophic disease (dorsopathy);
spondyloarthrosis and spondylolisthesis – provoke the appearance of cracks in the spinous and transverse processes of the vertebrae, which can cause the formation of a false joint;
Ankylosing spondylitis or ankylosing spondylitis - provokes the formation of scar tissue between the vertebral bodies, forms false joints and strong adhesions of the spinous processes, and impedes the mobility of the spinal column;
rheumatoid processes, systemic lupus erythematosus;
diseases of the endocrine system, for example, neoarthrosis of the cervical spine in most cases provokes thyroid disease;
excess body weight;
maintaining a sedentary lifestyle without sufficient physical activity on the back;
incorrect foot placement with uneven distribution of shock-absorbing load;
injuries of the back and collar area (impacts, sprains of ligament and tendon tissue, fractures of the vertebral bodies and their spinous processes, bone cracks);
infections of the spinal cord and tissues of the spinal column (osteomyelitis, tuberculosis, poliomyelitis, etc.).

It is very difficult to exclude all possible causes of the development of this pathology. You need to monitor your weight and posture, properly organize your sleeping and working space, and promptly contact a vertebrologist if you experience any pain in the spinal column.

What is TFP

The essence of the surgical intervention is to fix damaged vertebrae using pedicles - special screws that are implanted into bone tissue and connected with fasteners, which gives the patient a chance to restore normal functioning of the musculoskeletal system.

Transpedicular fixator

Compared with other methods of restoring the integrity of the spine, TFT has the following advantages:

full biological compatibility with tissues, minimal risk of implant rejection;
preservation of the anatomical structure and functions of the spine, stability of the vertebrae and normal height of the intervertebral discs;
resistance to mechanical damage and wear;
ease of installation (the spinal fixation system can be installed without skin incisions through small punctures, and its design exactly follows the curves and anatomical features of the spine);
the possibility of performing an MRI on the patient in the future.

TPF is the only opportunity to preserve the patient’s mobility, quality of life, and often life itself

The use of TPF technology significantly reduces the period of treatment of the spine and subsequent rehabilitation, and when using so-called cemented screws, surgery can be performed in patients with osteoporosis.

For reference: the above advantages of TFP systems are largely provided by a special titanium alloy, which is used for the manufacture of screws - when using steel and other metals, the design characteristics deteriorate significantly.

Video – Transpedicular fixation system

Uncovertebral neoarthrosis of the cervical spine

Uncovertebral neoarthrosis often affects the cervical spine. This disease is characterized by the formation of pathological protrusions on the posterior surfaces of the vertebral bodies. This is the deposition of calcium salts. They come into contact with neighboring vertebral bodies and provoke their destruction due to friction of bone tissue. As a result, false bone processes also form on the opposite side. As a result, they are connected to each other using dense fibrous tissue. The spine loses its usual mobility. Any movement of the head begins to cause pain.

Uncovertebral neoarthrosis of the cervical spine is provoked by the following clinical symptoms:

frequent headaches localized in the back of the head;
dizziness, weakness, drowsiness, decreased mental performance, feeling of chronic fatigue;
crunching in the neck when trying to make circular movements with the head;
increased blood pressure for no apparent reason.

Neoarthrosis of the cervical spine forms at the age of 30–40 years. At first it doesn't cause any problems. But as the fibrous capsule of the pseudarthrosis thickens, the symptoms increase. There is a constant aching pain in the back of the neck. There is a feeling of tightness, excessive muscle tension in the neck and collar area.

Neoarthrosis of the cervical spine affects the vertebrae C3 - C6, so a disruption of the innervation of the thyroid gland, throat tissue and brachial nerve plexus quickly occurs. Patients experience difficulty swallowing solid food. Paresthesia appears in the upper extremities, a feeling of numbness in the little fingers and thumbs.

If uncovertebral neoarthrosis of the cervical spine is not treated in a timely manner, then gradually osteophytes will completely limit mobility and secondary degenerative destruction of cartilage and bone tissue will begin. For treatment, it is best to contact a vertebrologist. A local therapist in a city clinic is unlikely to be able to prescribe effective and safe treatment. As a rule, patients with such deformities are given an inaccurate diagnosis – osteochondrosis. Accordingly, treatment is prescribed that cannot give a positive result.

Neoarthrosis L5 of the lumbar region between the spinous processes

Neoarthrosis of the lumbar region is characterized by rapid progression of immobility. Neoarthrosis of L5 often forms - this vertebra bears the maximum shock-absorbing load. This is the conditional center of gravity of the human body. Therefore, regardless of whether a person is standing, sitting, lying or walking, this vertebra is subject to constant pressure.

L5 is adjacent to S1 (first vertebra of the coccyx). By the age of 25, all the vertebrae of the coccyx fuse into a single bone. By this time, there is a significant deviation relative to the central axis of the last lumbar vertebra. Its spinous processes begin to come into contact with similar processes of L4 and S1.

In some patients, with poor posture, sacralization is formed - absorption of the L5 vertebral body by the sacral bone. They grow together due to total degenerative destruction of the intervertebral disc. The second variant of mobility impairment is the formation of a false joint (neoarthrosis of the spinous processes) between the vertebrae L4, L5 and S1. This leads to compression of the radicular nerves, changes in posture, straightening of physiological lordosis, and divergence of the joint space in the iliosacral joint.

Fully formed lumbar neoarthrosis between the spinous processes leads to the fact that a person has problems performing basic movements: bending forward, turning the body. In later stages, the work of the pelvic organs may become difficult, and blood supply to the lower extremities may be impaired.

Causes of spinal osteochondrosis

Osteoarthritis of the spine can develop under the influence of the following provoking factors:

Heavy physical activity combined with monotonous movements (lifting weights during sports or work);
Static loads on the cervical spine during sedentary work;
Sedentary lifestyle;
Overweight.

With osteochondrosis of the spine, the facet (facet) joints are primarily affected. Their synovial capsule is richly innervated by articular nerves, which are branches of the posterior rami of the spinal nerves, and small accessory nerves from the muscular branches. Due to their vertical orientation, the facet joints offer very little resistance to compressive forces, especially during flexion. During extension, the facet joints account for 15 to 25% of the compressive forces. They can increase with disc degeneration and narrowing of the intervertebral space.

Osteoarthritis of the spine of any location develops if functional overload occurs. It is more often observed in older people, since they have less anatomical and functional reserves and irregularities in the shape of the spine are more common. In a normal spinal motion segment, which includes a three-joint complex, 70-88% of gravity forces occur in its anterior sections, 12-30% - in the posterior, mainly intervertebral joints.

When the position of the articular facets changes, a redistribution of gravity forces occurs within the spinal motion segment. The mechanical load on the cartilage surfaces increases. When discs are damaged, the weight load gradually transfers to the intervertebral joints. It reaches from 47 to 70%. Due to overload, the following changes sequentially occur in them:

Synovitis with accumulation of synovial fluid between facets%
Degeneration of articular cartilage;
Stretching of the joint capsule and subluxations in them.

Continued degeneration due to weight-bearing and rotational overloads, repeated microtraumas, leads to fibrosis around the joints and the formation of subperiosteal osteophytes. They increase the size of the upper and lower facets, which take on a pear shape. Over time, the joints sharply degenerate and almost completely lose cartilage.

The degeneration process quite often occurs asymmetrically. This is manifested by uneven loads on the facet joints. Due to a combination of changes in the disc and facet joints, there is a sharp restriction of movements in the corresponding motor segment of the spine. The intertransverse, interspinous and rotator muscles, under the influence of impulses from the affected spinal segment, reflexively tense, which leads to the formation of muscular-tonic syndrome.

The development of spinal osteoarthritis in young people is usually preceded by trauma, increased mobility of spinal segments, or congenital skeletal abnormalities:

Nonfusion of the arches of the lumbar vertebrae;
Sacralization is the fusion of the first sacral and fifth lumbar vertebrae;
Lumbarization – loss of the relationship of the first sacral vertebra with the sacrum and the formation of an additional lumbar vertebra;
Violation of articular tropism - asymmetrical arrangement of the facet joints.

Osteoarthritis of the spine is rare in young people.

Formation of supporting neoarthrosis

In children, the formation of neoarthrosis may be associated with rickets and defective structuring of the bone tissue of the spinal column. They have so-called supporting neoarthrosis, which leads to poor posture and curvature of the spine.

Neoarthrosis in childhood is quite difficult to identify. Parents constantly point out to the baby that there is no need to slouch, but he stubbornly continues to round his back in a sitting position. The fact is that the supporting function of the lumbar spine is impaired. Therefore, the child is unable to keep his back straight and constantly hunches it while sitting. Gradually he gets used to this position and already in a standing position begins to maintain an unnatural posture.

If your child has these signs, immediately visit a vertebrologist. There is a high probability that he will develop neoarthrosis. At an early stage, you can cope with such an illness with the help of therapeutic exercises, osteopathy and manual therapy.

In Moscow, you can get a free consultation with a vertebrologist in our manual therapy clinic. We accept children over 5 years of age. During the appointment, the doctor will make a preliminary diagnosis and tell you what additional examinations will be required and how to properly carry out effective treatment.

How to understand whether there is neoarthrosis or not?

Mikhail, Rostov

January 27, 2020

Hello. For about two years now I have been experiencing chronic back discomfort, which cyclically develops into mild-to-moderate pain and then fades away almost completely. My diagnosis began in 2021 when I took an x-ray of the lumbosacral spine and the word “neoarthrosis” appeared in the conclusion. I don’t have those pictures and the report, but a year later I did an MRI of the same department and I’m attaching its report to this question. Naturally, I am not a doctor and therefore it is difficult for me to conclude whether the conclusion is “good” or “bad” and where is the connection with neoarthrosis. The situation is a little complicated by the fact that there is little information on this pathology on the Internet, and as I understand it, it has many pseudonyms (pseudoarthrosis, Bostrup disease). And in general, I’m not even sure that I really have this problem and not some other one. But here are my main observations: 1. The condition improves from any activation of blood circulation (workout, fast walking) and often worsens in moments of calm and cooling, after sleep. 2. The pain does not interfere with sleep, since it is far from severe in severity; severe severity appears only with significant deflections in the lower back. 3. How would I describe the pain - nasty, weak, aching. Poses in which the pain is “sharp” - on the back with arching of the lower back (the pain is the worst, it even radiates a little to the groin), on the stomach with complete relaxation and deep diaphragmatic breathing, with strong extensions in the lower back. 4. Localization to the left of the coccyx-sacrum, that is, in the area of the very bottom of the lower back and the top of the buttock. 5. During periods of “exacerbations,” a significant depression of intestinal functions is felt 6. A significant crunch is felt when twitching the left leg (there is no such thing on the right), which in theory should come from the hip joint, just in case, I recently took an X-ray of it - no pathologies were found and There is not a single “bad” wording in the conclusion either. Attempts at treatment mainly consist of performing a variety of exercises - simple physical exercise, going to the gym and working on exercise machines, developing the elasticity of the muscles of the legs and back. I also recently started adding massages and self-massages (lying on a firm massage ball on the sore spot). If possible, I ask you to comment on the MRI; I will also be glad to hear any comments and advice on the situation described and where to move next. And one last thing. As I guess, the MRI I took most likely does not even completely cover the problem area, because it also extends to the tailbone area. In this case, does it make sense to also do an MRI of the coccyx (as I understand, this study is also called “MRI of the sacrococcygeal region”)?

The question is closed

small of the back

coccyx

sacrum

neoarthrosis

Treatment of spinal neoarthrosis

It is necessary to begin treatment of neoarthrosis with a thorough diagnosis. An x-ray in different projections, CT myelography and MRI examination are prescribed. After clarifying the diagnosis, a decision is made on conservative treatment of spinal neoarthrosis or the need for surgical intervention.

For the first and second degrees of development of pseudarthrosis, conservative therapy is recommended. At our manual therapy clinic, a course of rehabilitation treatment may include:

traction traction of the spinal column, which allows you to restore the physiological position of the vertebral bodies, straighten the intervertebral discs and eliminate compressive pressure on the radicular nerves;
osteopathy and massage to restore tissue elasticity, enhance microcirculation of blood and lymphatic fluid;
therapeutic exercises and kinesiotherapy - to stop the formation of the fibrous capsule and increase the range of mobility of the spine;
reflexology, physiotherapy, laser therapy and much more.

Treatment of uncovertebral neoarthrosis of the cervical spine also includes massage of the collar area and a special course of therapeutic exercises, which is aimed at restoring mobility and increasing the amplitude of head movements.

If you require treatment for spinal neoarthrosis, we recommend that you make a free appointment with a vertebrologist at our manual therapy clinic. Here you will receive comprehensive information on your case of illness from your attending physician.

Classification

Depending on the characteristics of the clinical course of the disease, there are several types of arthrosis of the cervical spine .

Type of disease	Peculiarities
Primary (idiopathic)	It is customary to talk about the idiopathic form of arthrosis when it is not possible to establish the exact causes of the disease.
Secondary	It develops against the background of pathological processes, due to injuries and other negative factors.
Localized	It affects one of the seven cervical joints of the spinal column.
Generalized	Bone spurs form on several joints.