The spine is a complex structure in the body that consisting of muscles, vertebrae, cartilage, discs and ligaments making it among the most fundamental component of the human anatomy. It is made of the spinal column and the cord all whose functions are critical and basic for the existence of an organism. The spinal column supports body flexibility twist and turning that one makes voluntarily or involuntarily. The spine column runs from the neck to the sacrum, however, it is divided into sections. The cervical vertebrae are in the neck sections followed by the thoracic vertebrae. The lumbar and the sacrum vertebrae are in the tail of the spine between the hips respectively. The vertebrae are columns of short bones stack on the other with an inter-vertebrae disc in between them that absorbs shock. With all such magnificent purpose, the spine if not properly maintained can suffer from varied diseases that hamper it from performing its functions. One such critical problem is the degenerative spine.
The spinal degenerative is a condition characterized by a gradual loss of the normal form, composition and functions of the spine over time. This condition arises as result of old age, tumor and other infections that exact pressure on the spinal cord nerve roots. In other words, degenerative spine is a health problem that is manifested in the spinal vertebrae particularly in its joints where the inter-vertebrae discs are worn out or deformed to the point of dysfunction. This condition can arise out of the natural conditions such as old or diseases.
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Causes of Degenerative Spine
The causes of the degenerative spine can be categorized into functional or structural. In terms of functional causes, age is the main cause of degeneration of the spine; the conditions are usually more prevalent among the old person in the society. The inter-vertebrae discs are the components of the spine that is most susceptible to dysfunction as result of age than any other part of the spine. The discs tend to undergo age-related changes quite early in the life of an organism, the “age-related changes include increased number and size of fissures, the presence of granular debris, and neovascularization from the outer aspect of the annulus inwards” (Vo et al, 2013). Similarly, the changes may also involve the gradual loss of disc waters and matrix proteoglycan. Vo (2013) further notes that aging is caused at least in part by the time-dependent accumulation of cellular and molecular damage leading to a progressive decline in functional reserve. In term of functional capability, the period or duration of the function of the spinal column can easily to the cause of the disorder.
In terms of structure, the injuries and deformation that may happen particularly in the back region of the body can cause degenerative spine. For the structural causes, age is not a determinant as injuries may occur at any age in one’s lifetime. First, the disease is also related to the genetic factors that influence the structural organization of the cells in the spine, for instance, the 5A allele is a possible risk factor for accelerated degenerative changes of lumbar discs in the elderly, but not in the young (Hadjipavlou, 2008). Similarly, the growth factors also the activities in the spine region. Hadjipavlou (2008) asserts that growth is normally triggered by the changes in the tissue inhibitors of metalloproteinases (TIMP) suppress the activation of MMPs, thereby controlling degradation.
Another structural cause of the condition is the metabolic changes; various metabolic disorders can cause disc degeneration either by interfering with the normal biochemistry of matrix synthesis or by deposition of foreign materials in the disc. Health problems such as diabetes mellitus exhibit the effects and symptoms in which the “nucleus pulposus demonstrates a significant decrease in hexosamine content, an increase in hydroxyproline and enhanced activity of enzymes involved in the metabolism of carbohydrates” (Hadjipavlou, 2008). The effect of this on the inter-vertebrae disc is that there is a great reduction in the deficiency in the incorporation of the essential substances such as sulphate.
The lower back disease is another predisposition for the degenerative spine, under this condition; it is characterized by ailments leading to lots of pain, disability and psychologic distress. The disease puts the patients at risk of acquiring the degenerative disc problem.
The Anatomy and the spine degenerative
The spine column enjoys the support of the vast the muscles throughout the body of an organism. The muscles can be categorized into three dominant categories, the lumbar muscles, thoracic, muscles and the cervical muscles. Under the cervical muscles category, there exist a plethora of muscles; most of these muscles are oriented towards serving the functions of extending and rotating the head, flexes capability and lateral bending of the head. The cervical muscles originate from two major sources, the sternal head involving the manubrium of sternum and the Clavicular head of which the medial part of clavicle gives rise to the muscles. For its distal ends, the mastoid process of temporal bone, lateral half of superior nuchal line of occipital bone serves the purpose.
The thoracic muscle also enjoys the vast collection of tiny muscles such as Longissimus thoracis and the Spinalis Thoracis among others whose key functions include Extending the vertebral column, rotation of the vertebral column and lateral flexion of vertebral column as well as the rotation of the rib (Bridwell). The muscles originate from different points within the thorax, those originating from the medial half of the clavicle, the front of the sternum and costal cartilage have their insertion lateral lip of the bicipital groove. The muscle with insertion at the coracoids process originates from the ribs two, three, four and five. Other significant muscles such Serratus interior originates in the rib 8 rests on the ventral surfaces of the superior and inferior angles and vertebral scapula.
Next, the lumbar muscles have functions limited to lateral flexing of thigh at hip joint, the extension of the vertebral column and to some extent, the rotation of the ribs. Some of the muscles under this class such as Iliocostalis Lumborum have its origins in the os sacrum, crista iliaca and the fascia thoracolumbalis with the insertions 6th-12th ribs, the deep layer fascia thoracolumbalis and the transverse processes of upper lumbar vertebrae.
Connective tissues
The spine has several connective tissues that help in the delivering its functions. The ligament systems consist of tendons and muscles that function to protect the spine from injuries. There are at least five ligaments in the spine column; the Anterior Longitudinal Ligament and Posterior Longitudinal Ligament is also known as primary spine stabilizer. The more pronounced fascia is found in the lumbar region, it consists of connective tissues and its functions includes the stabilizing, enclosing and separating the muscles not only in the lumbar regions but also extended in the neck and thoracic regions.
The spinal column is also characterized by a number of cartilages whose functions include absorbing shock, providing support and aiding the movement as there are various muscles of the spine that support the movement. For the efficient movement of the spine, the bursae which is fluid-filled sac cushions the tendons and protect them from injuries and prevent the adjacent structures from rubbing against each other. Similarly, the spinal column is made of bones and joint throughout its entire length. The joints include, Ligamentum Flavum, Interspinous and Supraspinous ligaments and Intertransverse ligaments as well as the face joints linking articular facets. For bones, the coccyx, sacrum and atlas and axis are some of the common bones of the spine column
Physiology and Spine degeneration
The tissues of the spinal column are constant configuration with each to enable the spine to perform its functions. The spinal column is a complex structure consisting of joints, bones, tissues, bursae among other components; its coordination, therefore, is based on the central point of coordinating the actions of each component simultaneously. However, there is great aspect of specialization, for instance, the “seven cervical (neck) vertebrae support the head; the 12 larger thoracic (chest) vertebrae bear the weight of the arms and trunk; and the five thickest and sturdiest lumbar (lower back) vertebrae carry the weight of the entire body” (healthcentral.com). The movements and actions of bones and tissues and joint are initiated the contraction and relaxation of various muscles within the system.
The tissues and bones also function as protective layers of the essential components of the spine such as protecting the spinal cord. The vertebrae are stacked together such that they form a hole through which the spinal cord passes through. On the other hand, gel-like nature of the nucleus pulposus also allows the intervertebral disc to change shape as one vertebra rocks side to side or forward and back in relation to its neighbors during movements of the vertebral column (opentextbc.ca). Generally, the movement along the vertebral column is caused by the alteration of the compression and relaxation force exerted on the intervertebra discs.
Pathology
The degenerative spine depicts unique signs and symptoms, commonly, those suffering from this disorder lament of increased pains that accompany basic activities such as twisting, bending or lifting heavy substances. For the disorder that attacks the neck part of the vertebrae, there could an instance of spinal instability in which the spine could not provide basic support to the body. Similarly, the problems that relate to the lumbar depict symptoms such as “increased pain when holding certain positions, such as sitting or standing for extended periods” (McHugh). Generally, the degenerative spines cause the patient to sit in a reclining position.
However, if the condition is not controlled in its earliest stage, the patient may find their problems doubled. The nature of the condition depends on the level of the spine affected; the extreme pain is usually the characteristic of the later stages of the condition. The pain is usually continuous and can radiate into other parts of the body. On the extreme case, the patient can develop sensory dysfunctions in the back, leg and arms, paralysis is the eventuality.
Conclusion
The spine region serves a variety of essential functions in the body; it is composed of the various components that though independent, they are quite depended and works in collegiality. The degenerative spine is a condition that arises due to both factors within and without the reach of the patient. Treating the conditions should start from the administration of the conservative therapies to relieve the pains. A treatment is possible through injection of the various medicines through the body or into the spine directly, however, the mild conditions, call for the surgery in which the degenerated discs are removed. Going forward, doing exercise and avoiding the laborious duties that overstretch and strain the spine column should be emphasized.
References
H. (2016, June 14). Spine Anatomy: Your Back as a Shock Absorber | HealthCentral. Retrieved February 13, 2018, from https://www.healthcentral.com/article/spine-anatomy-your-back-as-a-shock-absorber
Hadjipavlou, A., Tzermiadianos, M., Bogduk, N., & Zindrick, M. (2008). The pathophysiology of disc degeneration. The journal of ball and joint surgery, 90-B (10), 1261-1269.
McHugh, M. B. (n.d.). Common Symptoms of Degenerative Disc Disease. Retrieved February 13, 2018, from https://www.spine-health.com/conditions/degenerative-disc-disease/common-symptoms-degenerative-disc-disease
Vo, N., Niedernhofer, L. J., Nasto, L. A., Jacobs, L., Robbins, P. D., Kang, J., & Evans, C. H. (2013). An overview of underlying causes and animal models for the study of age-related degenerative disorders of the spine and synovial joints. Journal of Orthopaedic Research, 31 (6), 831-837. doi:10.1002/jor.22204
Written by Keith Bridwell, MD; Reviewed by Mary Rodts, DNP. (n.d.). Spinal Muscles: A Comprehensive Guide. Retrieved February 13, 2018, from https://www.spineuniverse.com/anatomy/spinal-muscles-1
