Pathogenesis of degenerative changes
Pathological processes in the spine affect the intervertebral discs and surrounding tissues:
- Intraspinal disc herniations: appear upon ruptures of the hyaline plate, penetrating into the cancellous bone of the vertebral body.
- Osteophytes: form under the influence of chronic irritation, consist of compact bone, and are located perpendicular to the axis of the spine.
- Biomechanic disorders: disc degeneration combined with loads alters the distribution of dynamic forces and reduces the height of the intervertebral space.
Reflex pain syndromes
These syndromes are formed due to pathological impulses from the receptors of the affected segment. The main receptor zone is the posterior longitudinal ligament.
- Innervation: is provided by Luschka's sinuvertebral nerve (the recurrent meningeal branch).
- Irritation foci: posterior longitudinal ligament, annulus fibrosus, articular-ligamentous apparatus, and periosteum.
- Neuroosteofibrosis: dystrophic changes in the fibrous tissues of ligaments and tendons.
The classification of reflex vertebrogenic syndromes includes:
- Musculotonic
- Neurovascular
- Neurodystrophic
Compressive and myoadaptive syndromes
Compressive syndromes are caused by mechanical compression of the spinal canal contents by a herniated protrusion, osteophyte, or the edge of a displaced vertebra.
- Radiculopathy: root compression.
- Myelopathy: spinal cord compression.
- Radiculomyeloischemia: compression of feeding blood vessels.
Myoadaptive syndromes develop as a consequence of pain syndromes causing spinal deformation and secondary muscle changes.
Clinical examination
Clinical examination allows the detection of sensory, motor, and reflex disorders strictly corresponding to the level of the lesion. The detection of pronounced static and biomechanical spinal disorders is of paramount importance.
Class and exam questions
Which spinal structure is the main receptor zone in reflex syndromes?
The main receptor zone is the posterior longitudinal ligament, which is the richest in receptors.
Which nerve provides innervation to the posterior longitudinal ligament?
Innervation is provided by Luschka's sinuvertebral nerve, which is a recurrent meningeal branch.
What are the types of compression causing pain syndrome?
Compression variants include root compression (radiculopathy), spinal cord compression (myelopathy), and compression of feeding blood vessels (radiculomyeloischemia).
What else to study on this topic
- Mechanisms of osteophyte and intraspinal disc herniation formation
- Anatomy and pathway of Luschka's sinuvertebral nerve
- Pathogenesis of reflex musculotonic reactions
- Detailed classification of reflex vertebrogenic syndromes
- Diagnostics of static and biomechanical spinal disorders
Master the entire topic in the "Neurology" course
This is a summary. The course covers everything tested in classes and exams.
- Complete study guide on "Vertebrogenic pain syndrome" and 907 more subject pages
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 32 video lessons for the subject
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.