Three clinical and biomechanical stages of spinal degeneration have been described
- Initial early changes with mild dysfunction but no instability
- Later degenerative instability
- Disk space collapse.
Loss of water content within renders the nucleus incapable of transferring load to the anulus, and the normal radial stress applied to the anulus is converted into axial stress.
These axial forces on the anulus lead to radial and circumferential tears within the overlapping lamellae.
The disc space diminishes as the extent of the degeneration and injury to the anulus increase. Annular bulging, which is often referred to as a contained herniated disc, into the spinal canal may develop. Disc height collapse leads to reduced stability from the outer anulus-vertebral body attachments, and increased motion may.
End-plate thickening develops secondary to increased loads, bypassing the nucleus and along the periphery of the end plate where traction spurs or osteophytes may form.
The collapse of disk height also results in the load on the posterior facet joints, which undergo a degenerative process. There is an increases cartilage surface erosion and that leads to increased synovial fluid production and eventual osteophtye formation.
Facet joint involvement in the absence of disc degeneration is unusual.
Progressive disc degeneration and facet joint osteoarthritis results in
- Translation of the vertebral bodies in the sagittal, axial, or coronal planes
- Severe disk height loss
- Spinal stenosis of the central canal or foramina.
Popularity: 1% [?]
Related posts:
About Dr Arun Pal Singh
