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},
"code": "M47",
"name": "Спондилез",
"icd_name": "Спондилез",
"gender": 0,
"age_min": 20,
"age_max": 100,
"cause": [
"0"
],
"periodicity": 3,
"slug": "m47_spondilez",
"lead": "хроническая болезнь, которая характеризуется дистрофическими изменениями в дисках, суставах и связочном аппарате позвоночника",
"description": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Спондилез — это обобщенный термин, которым называют хроническое невоспалительное заболевание позвоночника, которое сопровождается постепенным изнашиванием и разрушением фиброзного кольца межпозвонкового диска, уплотнением передней продольной связки и образованием краевых костных разрастаний (остеофитов) тел позвонков вдоль оси позвоночника.</span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причины возникновения спондилеза</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">остеохондроз позвоночника (из-за нарушения амортизирующей функции межпозвонкового диска травмируются окружающие ткани, вследствие чего образуются остеофиты, которые в свою очередь раздражают нервные окончания в связочном аппарате позвонков и поддерживают стойкий болевой синдром);</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">нарушение метаболизма, эндокринные заболевания (нарушение обменных процессов в межпозвонковых дисках, а особенно в фиброзном кольце и в области передней продольной связки приводит к постепенному снижению эластичности и способности к амортизации межпозвонковых суставов);</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">переохлаждение (при нем нарушается иннервация и кровоснабжение позвонков и связок);</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">тяжелые физические нагрузки (давление на позвонки значительно усиливается, что приводит к более быстрому стиранию позвонков);</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">возрастные изменения;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">травмы и деформации позвоночника.</span></li>\r\n</ul>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В норме межпозвоночные диски (МПД) и мелкие дугоотростчатые (фасеточные) суставы смягчают их и обеспечивают подвижность шейного и поясничного отделов.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">С возрастом в сосудах начинаются возрастные изменения, постепенно ухудшается кровоснабжение. МПД теряют эластичность, нарушаются механизмы их регенерации. Кроме того, в хряще (диске) снижается уровень гликозамингликанов: хондроитинсульфата, кератансульфата, гиалуроновой кислоты. Это приводит к постепенному обезвоживанию хряща, вторичному \"сморщиванию\" и последующему разрушению. Такой диск хуже выдерживает нагрузку, сдавливается и не выполняет свои функции.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Помимо этого, при деградации хрящевой ткани, нарушается выделение цитокинов — молекул, обеспечивающих передачу сигналов между клетками. В результате образуются аутоантитела (соединения, которые борются против клеток организма), и возникает местное воспаление. В ответ на это костная ткань разрастается — формируются остеофиты. Организм \"выращивает\" их для защиты, чтобы ограничить движения в позвоночнике и уменьшить нагрузку. Выраженные остеофитные комплексы могут обездвижить некоторые отделы, а их воздействие на окружающие мягкие ткани вызывает боль.</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Перед назначением лечения пациента обязательно направляют на дополнительные обследования для подтверждения факта наличия у него заболевания и определения степени сложности нарушений. С целью диагностики у человека спондилеза врачи назначают такие мероприятия, как:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">рентгенография позвоночника, которая позволяет выделить участки утолщения суставов и остеофиты;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">компьютерная томография для диагностирования сужения позвоночного канала и измерения высоты щелей между позвонками;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">МРТ, как наиболее информативный метод исследования состояния позвоночного столба, который помогает оценить истинные причины патологического процесса и определить наличие защемленных нервов, сдавленных межпозвонковых дисков, тому подобное.</span></li>\r\n</ul>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В настоящее время медицина не обладает средствами для полного излечения спондилеза позвоночника. Поэтому терапия заболевания сводится к облегчению симптомов болезни и предупреждению ее последствий.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Медикаментозное лечение спондилеза – это применение эффективных лекарственных средств, действие которых направлено на купирование основных признаков патологического процесса. При спондилезе пациенту могут быть назначены следующие лекарства: </span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">обезболивающие препараты для устранения болевого синдрома;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">нестероидные противовоспалительные средства, которые помогают купировать местное воспаление тканей, устранить отек, снизить болевые ощущения и улучшить подвижность в суставах;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">хондропротекторы для предупреждения дальнейшего разрушения хрящевой ткани;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">миорелаксанты, которые надежно снимают мышечный спазм при спондилезе и уменьшают боль, связанную с защемлением нервных корешков;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">анальгетики наркотической группы при очень сильных болях в позвоночнике.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> Важно помнить, что причину спондилеза и препараты для его лечения может озвучивать пациенту только квалифицированный врач после проведения детальной диагностики заболевания с определением его стадии, наличия осложнений, характера течения патологического процесса. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> Лечение спондилеза позвоночника всегда подразумевает назначение курса физиотерапии, которая включает в себя несколько действенных методик, направленных на купирование болевого синдрома, устранение отечности мягких тканей, улучшение местного кровотока. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> Среди наиболее эффективных физиотерапевтических процедур при спондилезе важно отметить:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">ЛФК, которая представляет собой аккуратно подобранную индивидуальную программу упражнений для улучшения функциональности позвоночника;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">массаж, предназначенный для усиления притока крови к пораженным участкам, снижения мышечного напряжения, достижения мобилизации двигательных сегментов; </span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">иглорефлексотерапия, с помощью которой удается снизить боль и улучшить проводимость по нервным волокнам.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> При неэффективности консервативного лечения или при появлении опасных для нормальной жизнедеятельности пациента осложнений врачи предлагают ему хирургическое исправление проблемы.</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"prevention": "<ul>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">вести здоровый образ жизни (не нагружать позвоночник, правильно и полноценно питаться, умеренно заниматься физкультурой и спортом);</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">своевременно обращаться к врачу и соблюдать его рекомендации;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">при необходимости проходить профилактические курсы лечения.</span></li>\r\n</ul>\r\n<p><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Клинические проявления заболевания зависят от разновидности и степени спондилеза. На начальных стадиях формирования патологического процесса симптомы спондилеза являются слабо выраженными и могут восприниматься как признаки других болезней. Со временем в результате прогрессирования нарушений они становятся более ощутимыми и серьезно изменяют привычный образ жизни больного человека.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Наиболее характерным симптомом спондилеза - боль в области позвоночника. Она может иметь разную интенсивность в зависимости от характера патологического процесса и степени защемления нервных корешков. Среди других признаков, указывающих на развитие дегенеративно-дистрофического заболевания, выделяют: </span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">ограничение возможности совершения полноценных движений в области спины;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">снижение амортизирующих свойств;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">появление хруста в области спины и шеи;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">развитие интенсивных головных болей и головокружения;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">шум в ушах;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">ухудшение зрения;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">возникновение парастезий в виде ощущения онемения в конечностях, «ползания мурашек»;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">изменение нормальной осанки, искривление позвоночника;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">снижение работоспособности.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> В случае отсутствия своевременного и корректного лечения нарушений при спондилезе происходит полное окостенение позвоночника, которое сопровождается полной потерей его подвижности. При таком варианте развития событий человек теряет возможность работать и становится инвалидом. </span></p>",
"image": null,
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"block_rubric": 136,
"standards": [
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}
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}
