Lumbosacral Spondylosis without Myelopathy

The disease resulting in symptoms like numbness or weakness in muscles when caused by irritation or injuries of spinal nerves or spinal cord is known as myelopathy. Symptoms of myelopathy are not observed in few cases of degenerative diseases of vertebral column resulting in disc degeneration and facet joint osteoarthritis because of absence of irritation of spinal nerve or spinal cord.

Our backbone is made of a series of vertebrae through which the spinal cord passes. Each vertebra is separated from one another by means of a disc known as intervertebral disc which allows the smooth movement of vertebrae to take place. These also act as shock absorbers. Due to various factors, over time, these intervertebral discs undergo degeneration leading to thinning of intervertebral disc. The diseases is known as lumbar spondylosis when mild to severe degeneration of the lumbar intervertebral disc causes severe lower back pain and restricts the bending movements of lower back. It is a painful condition and can affect any region of the spine such as cervical, thoracic, lumbar, sacral or even coccyx which is rare. The mild to severe back pain in few cases is diagnosed as lumbosacral spondylosis without myelopathy when mild to severe disc degeneration associated with disc herniation or bulge disc does not cause any abnormal sensory or motor symptoms. Thus, in few cases of lumbosacral spondylosis, the disease does not cause any harm to spinal cord or spinal nerve and hence is called as lumbosacral spondylosis without myelopathy.

Due to aging, the intervertebral discs in between each vertebrae gets worn out or degenerated which leads to bulging or disc herniation. As a result during movement, this leads to rubbing of the vertebrae over each other. This is a form of osteoarthritis also called as spondylosis. The lower back region is also called as the lumbar and sacral area. Thus, the condition occurs in the lower back, it is also called as lumbosacral spondylosis which is osteoarthritis of the lower back region.

When bulging of discs causes pain and damage to the nerves lying in the lower back region of spinal cord, it is called as myelopathy. Lumbosacral spondylosis without myelopathy occurs in 80% of the people >50 years of age. If the condition is not treated on time, it can lead to nerve damage causing myelopathy.

• Pain
• Stiffness in lower back which worsens while getting up in the morning or while getting up after sitting for prolonged period of time is a very common symptoms of lumbosacral spondylosis without myelopathy.

In advanced cases of Lumbosacral spondylosis without myelopathy, progressive bone changes can result in pinching of the nerves which branch out from the spinal cord.

If treated early then the prognosis for Lumbosacral spondylosis without myelopathy is good for the patient and they can live a healthy life-style. However, if ignored, the pain associated with Lumbosacral spondylosis without myelopathy can be debilitating and severe.

The most common causative factor for lumbosacral spondylosis is aging which leads to degeneration of bones resulting in spondylosis. Lumbosacral spondylosis without myelopathy can also occur due to lower back injury or over straining in the area.

The risk factors for Lumbosacral spondylosis without myelopathy include age, repetitive strain injury, and history of osteoarthritis in self or in family.

The physician takes a detailed medical history and performs physical examination to look for symptoms of muscle spasms and tenderness. Further imaging tests such as x-ray and magnetic resonance imaging (MRI) are done.

In majority of the cases of lumbosacral spondylosis without myelopathy, the treatment is non-operative. The treatment for Lumbosacral spondylosis without myelopathy cannot reverse the symptoms but provides symptomatic relief.

• Medications: Anti-inflammatory, pain relievers, muscle relaxants are given to the patient to provide relief from pain associated with Lumbosacral spondylosis without myelopathy.
• Injections to Manage Lumbosacral Spondylosis without Myelopathy: Steroids are injected into the affected site to provide pain relief.
• Physical Therapy: This includes physical manipulation, massage, hot and cold treatments and electrical stimulation to treat Lumbosacral spondylosis without myelopathy.
• Exercise: Walking, stretching exercises and yoga are beneficial. Exercises also help in strengthening the back and abdominal muscles. Performing a less stressful job may be very helpful to relieve back pain caused due to Lumbosacral spondylosis without myelopathy.
• Self-Care and Lifestyle Changes: There are simple tips to reduce symptoms such as weight loss which reduces strain over the back. Also following alternative therapies such as acupuncture, acupressure and herbal remedies can be beneficial.
• Surgery: When there is no improvement with the non-surgical procedures, one needs to consider surgical intervention to treat Lumbosacral spondylosis without myelopathy. This helps to relieve pressure over spinal nerves and helps is stabilizing the spine.

Lumbosacral spondylosis without myelopathy is a progressive disease which starts after 40 years of age and its symptoms are observed only in the old age. In order to treat it better, there is a need to understand the pathogenesis of this disease. Some researchers have identified eight genes which are linked to disc degeneration. This finding may help in understanding the mechanism of the degeneration and help in developing the right treatment plan.