Violation of the ultrastructure of nerve fibers root causes violation of its physiological functions that is conducting electrical impulses and axonal transport. The blockade of electrical impulses causes the appearance of motor and sensory disorders of the myotomes and dermatomes. Block of axonal transport in the direction of ortograsis inhibits trophic influence of nerve on innervated tissues, a block of retrograde transport affects the livelihoods of the nerve cell, suppressing and altering its metabolism and causing an increase of its regenerative capacity. It is noticed that the closer to the cell body damage to the axon is, the more coarse degenerative reaction in the nerve cell and the greater the risk of her death are. Therefore, damage to the nerve root can lead to more significant consequences than damage to peripheral nerves.
Thus, the most frequent and complete pathological result of mechanical or other vertebrogenic effects on root inflammation of root appears to alterative type that is aseptic radiculitis with all pathological stages of inflammation – alterations, exudation and proliferation, expressed in varying degrees in different periods and under different forms of damage to the spine.
The presence of inflammatory changes in the spine when its vertebrogenic damage in different stages of inflammation is, and especially in the stage of exudation and proliferation its connective tissue elements is described in a large number of observations in the surgical and postmortem verification. These observations, in many respects logically explain the formation of primarily radicular pain disorders, frequent chronization of the disease, its recurrent nature of the flow, confirm the validity of using the term to refer vertebrogenous radiculitis acute and chronic radicular disorders in dystrophic pathology of the spine.
Value of radicular and not radicular causes of pain is connected with degenerative spinal column. Actually vertebral pathology that is spondylarthritis, osteochondrosis, etc. when an exacerbation of processes or of some specific conditions is may be a source of pain in the spine. Such pain in its pathophysiological basis is similar to rheumatologic pain phenomena at other sites, and other etiopathogenetical variations.
The presence of symptoms of radiculopathy fully explains the cause of the localized pain in the spine and extremities, but at the same time does not necessarily exclude participation in the formation of pain and other manifestations of other reasons such as not radicular ones pathogenetically related or not related to damage in the spine.
Similarly, sensory fibers in the spine, which are located in close proximity to the bodies of their cells (spinal ganglia) have the worst potential for regeneration after injury in comparison with ventral roots.
On the other hand, the absence of symptoms of loss of the spine or clearly marked symptoms of his irritation does not exclude the genesis of radicular pain in the spine and the extremities. This thesis confirms the phenomenon often observed in practice, that is development of radicular disorders in patients with previous lumbodynia or sciatica, as well as the similarity of the functional changes and x-ray and anatomical patterns in radicular and not root clinical manifestations.
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