Conservative treatment and rehabilitation
Therapy for osteochondrosis during remission is aimed at relieving muscle contractures and restoring the tone of the paraspinal muscles.
- Basis of treatment: regular exercise therapy sessions (45 to 60 minutes daily) and massage. Breaststroke swimming is recommended to strengthen the back muscle corset.
- Pharmacological support: includes agents to improve disc metabolism (NSAIDs, muscle relaxants), stimulating therapy (vitamins $B_6$, $B_{12}$), correction of vascular disorders, and administration of chondroprotectors.
- Traction therapy: spinal traction is used for pronounced muscle spasm. The procedure is often combined with hydromassage, followed obligatorily by the use of soft or semi-rigid neck orthoses.
- Physical therapy and manual techniques: electrophoresis and diadynamic currents produce deep hyperemia, while kinesiotherapy (where the patient actively participates in the process) helps restore movement biomechanics.
Surgical treatment of the cervical spine
Surgery is indicated if conservative methods fail, the patient is incapacitated for a prolonged period, or compression of neural structures is confirmed by MRI results. The main goal is to remove the altered intervertebral disc and eliminate compression.
Anterior decompression is the most common approach in the cervical spine. The classical method is Yumashev's fenestrated spinal fusion, which includes:
- Transection of the anterior longitudinal ligament.
- Removal of the affected disc.
- Creation of a bone "window" using a hollow burr.
- Rotation of bone fragments by 90° and placement of the graft.
Modern modifications involve fixing the autograft with a metal plate, which spares the patient from wearing bulky postoperative braces for a long time. Microsurgical techniques are particularly indicated when there is a risk of myelopathy or compression of the vertebral artery by bone overgrowths (osteophytes).
Minimally invasive techniques and stabilization
For radicular syndromes, minimally invasive approaches are actively used — microsurgical discectomy and percutaneous endoscopic disc decompression, which is necessarily performed under fluoroscopic control.
Advantages of the minimally invasive approach: the patient is mobilized as early as the second day after surgery, and the total duration of sick leave is reduced to six weeks.
To create a reliable bone block (arthrodesis), surgeons use special cages (cages) filled with autologous bone or ceramic granules. A new trend in treatment is the replacement of destroyed discs with artificial disc arthroplasties.
Sanatorium-resort treatment and prevention
Resort treatment, including radon, conifer-salt, and hydrogen sulfide baths, is strictly carried out during the remission phase, completing the outpatient and inpatient management cycles for the patient.
The traumatic factor is considered the main trigger for the development of osteochondrosis. Therefore, the basis of prevention is the avoidance of injuries and microtraumas to the spinal column in daily life.
Briefly: answers to topical questions
What are the absolute indications for surgical intervention in cervical osteochondrosis?
Surgical intervention for osteochondrosis is indicated in case of ineffectiveness of conservative therapy, prolonged disease course, and the presence of compression.
- Failure of conservative treatment — lack of positive dynamics from non-surgical methods.
- Prolonged disease course — a condition leading to persistent impairment of the patient's working capacity.
- Verification of compression syndrome — the presence of compression requiring mandatory confirmation via MRI.
What types of physical therapy procedures are prescribed to induce deep hyperemia?
To induce deep tissue hyperemia and normalize biochemical disorders in the affected spinal segments, the following are prescribed:
- Diadynamic currents.
- Electrophoresis with hydrocortisone, lidase, lithium salts, or trilon B.
Class and exam questions
Why is spinal traction necessary and how is it performed?
Traction is used to relieve severe muscle contractures. Immediately after the procedure, immobilization of the segment using an orthosis is mandatory.
What swimming style is recommended for osteochondrosis?
During remission, patients are recommended to swim using the breaststroke style, as it optimally strengthens the muscles supporting the spine.
What else to study on this topic
- Features of lumbar microdiscectomy
- Principles of pedicle screw fixation after laminectomy
- Mechanism of action of physical therapy procedures (electrophoresis with lidase, currents)
- Types of orthoses for the thoracolumbar and sacral regions (Leningrad-type brace)
- Pharmacodynamics of metabolic stimulators and chondroprotectors
Master the entire topic in the "Traumatology" course
This is a summary. The course covers everything tested in classes and exams.
- Full textbook on «Cervical osteochondrosis» and 812 more pages on the subject
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 35 video lessons on the subject
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Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.