LUMBAR SPONDYLOSIS

Dr DEEPAN P SHAH (MD)

Degenerative changes in vertebral bodies and intervertebral disc at the level of L1 to S1 in vertebral cloumn affecting lumbar region of spine is called Lumbar Spondylosis.

It is characterised by degenerative changes of Lumbar vertebral bodies like osteophyte lippings and spur formation, degeneration of  intervertebral disc, narrowing of intervertebral space, Intervertebral disc bulging, intervertebral disc herniation.

It can also be called Osteoarthritis of Lumbar Spine.

CAUSES OF LUMBAR SPONDYLOSIS

Lumbar Spondylosis may be caused due to many factors that can be broadly classified into Mechanical, Congenital or Acquired Anatomic anomalies, Metabolic, Immunologic, Genetic, Nutritional, Ageing and Septic reasons.

Most common of all are ageing and mechanical reasons like excessive wear and tear due to wrong postural habbits, type of work like driving for long duration regularly, sitting for long hours, lifting weights or working with bent posture etc. that exerts much pressure on lumbar spine on regular basis so as to not giving much time to recover again and resulting into accumulation of wear and tear finally damaging the spine and causing lumbar spondylosis.

Metabolic problems like Hyperuricemia/Gout where high level of uric acid in blood damages lumbar spine also this uric acid may get crystalised to form monosodium urate monohydrate and settle in the intervertebral joints and damage them.

Immunologically mediated chronic inflamation in lumbar spine like in Rheumatoid Arthritis, Chickenguniya, Systemic Lupus Erythematosus etc.

Genetic Complaints like Ankylosing Spondylosis etc

Vitamin D deficiency causes reduced calcium assimilation resulting into reduced bone mineral density causing weak bones easy to damage. Insufficient nutrition compared to requirement, which prevents repair work of regular wear and tear of lumbar spine, due to which damages tend to get accumulated resulting into lumbar spondylosis.

Congenital or acquired Anatomical anomalies in musculoskeletal framework that may cause abnormal posture or abnormal weight distribution which results into pressure on spine in wrong fashion gradually facilitates development of Lumbar spondylosis.

Septic Conditions of spine like Tuberculosis of spine may result into lumbar spondylosis due to tissue lysis as result of infection.

SIGNS AND SYMPTOMS OF LUMBAR SPONDYLOSIS

  • Pain and Stiffness  in lower back or Lumbar Region.
  • Sciatica due to compression of nerve roots of sciatic nerve.
  • Pain stinging pain in lumbar spine
  • Pain radiating from lumbar spine to lower limbs
  • Paraesthesia in lower back genitals or lower limbs
  • Cramps calfs, thighs and other muscle and muscle groups of lower limbs
  • Difficulty in walking and maintaining posture and balance.
  • Lack of control on urinary spincter or anal spincter resulting into either retention of urine or bowel or involuntary expulsion of urine and bowel
  • Sexual debility Tabes Dorsalis

COMPLICATIONS OF LUMBAR SPONDYLOSIS

Myelopathy – When there is damage to spinal cord it causes Myelopathy.

Raduclopathy – compression of nerve near nerve root where it emerges out of spinal cord.

Vertebrobasilar insufficiency – Vertebral artery insufficiency due to its occulusion while it passes through vertebral foremen sue to degenerative changes for lumbar spine causes vertebrobasilar insufficiency leading to death of condrocytes of intervertebral disc and osteophytes starts accumulating and depositing.

DIAGNOSIS OF LUMBAR SPONDYLOSIS

  • Clinical symptoms if indicate towards Lumbar spondylosis it can be then confirmed with X ray.
  • MRI and CT scan gives us better imaging which helps  judge and evaluate the extent of damage and condition
  • Myelograph is dye injected while Xray and CTscan this gives detailed shadow to understand even better
  • Electromyography helps evaluate nerve involvement in spondylosis.

HOMEOPATHIC MEDICINES FOR LUMBAR SPONDYLOSIS

  • HYPERICUM PERFOLIATUM
  • CALCAREA CARBONICA
  • GNAPHALLIUM
  • CALCAREA PHOSPHORICA
  • MAGNESIA PHOSPHORICA
  • ARNICA MONTANA
  • NATRUM SULPHURICUM
  • RHUS TOXICODENDRON
  • SILICEA
  • MEDHORRINUM

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