What is fatty bone marrow degeneration? Fatty bone marrow degeneration treatment What is fatty bone marrow degeneration

The main symptom of the disease is pain. Pain can occur both during inflammatory processes of the vertebrae and during abnormal changes in the case of degenerative-dystrophic conditions.

Symptoms of the disease

The presence of painful manifestations in different parts of the spinal column represents pathological changes musculoskeletal system and can lead to disability.

For example, fatty degeneration bone marrow spine is formed during gradual replacement normal consistency fatty tissue.

Degenerative-dystrophic conditions are an irreversible process of metabolic disorders in bone tissue. Thus, it becomes clear that pain in the back muscles, which is often attributed to fatigue or salt deposits, must be sought in the deterioration of the performance of the vertebrae themselves.

Common causes of the disease include:

• incorrect distribution of the load on the spine;
• natural aging;
• change hormonal levels;
• injuries and bruises;
• passive lifestyle;
• genetic factors.

Types of abnormal changes

Deviations in work may occur different areas back muscles, this can be either dystrophy of the thoracic spine or lumbosacral spine. The cervical spine also experiences no less stress.

There may be no pain for a long time, but gradually the patient begins to feel discomfort caused by pain, weakness and muscle strain.

With a sedentary lifestyle, dystrophy of the lumbar spine is often suspected, but in most cases this problem is caused by osteochondrosis.

The main component of hematopoiesis is bone marrow, which is located directly in the bones. With pathological changes in the body, degeneration of the bone marrow of the spine can also be observed, for example, in diseases such as osteochondrosis, spondyloarthrosis, cartilaginous nodes.

In inflammatory processes or incorrect exchange substances, it is possible to replace healthy bone tissue with a layer of fat. Then they talk about fatty degeneration of the vertebral bodies of the bone marrow. This can significantly worsen the composition of the blood.

Treatment methods

Absolute cure of changes occurring in skeletal system, impossible. Modern medical techniques involve only a temporary suspension of the development of pathology and the elimination of pain in the patient.

Therapeutic treatment consists of taking painkillers, which are part of the analgesic group, or using local medications - ointments and gels.

Muscle relaxants also help relieve pain. Doctors advise eating foods rich in B vitamins.

Each case is individual, so in no case should you self-medicate by purchasing from pharmacies. medications without a doctor's prescription! All medications are prescribed only by a physician after diagnosis.

Therapeutic exercise is excellent for strengthening cartilage tissue and back muscles. Exercises are selected individually for each patient, depending on the characteristics of the disease. Nutritionists usually prescribe special diet, rich in gelatin.

In some cases it is used surgical intervention. Thus, with fatty degeneration of the bone marrow of the spine, a severe inflammatory process may begin during movement, which often leads to urgent assistance surgical care, after which the patient will have a long course of rehabilitation.

How to prevent disease

The main preventive methods of maintaining a patient in normal condition with lumbosacral dystrophy are reducing excess weight and moderate but regular exercise stress. To do this you need to eat right and exercise.

Physiotherapy and massage are excellent help. For dystrophy cervical region orthopedic collars are used that fix the cervical vertebrae, which relax the muscles and reduce the load on them.

• Perform a set of exercises daily to strengthen your back muscles;
• always maintain an even posture;
• get comfortable bedding;
• To avoid unexpected stress on the spine when waking up in the morning, get up slowly, preferably on both legs at once.

These simple behavioral techniques will help significantly relieve pain and prolong the lifespan of normal operation spine.

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How to prevent the occurrence of spinal dystrophy?

Most people over the age of 30 experience back pain. Often people who are not related to professional medicine associate such pain with salt deposits and offer various ways to treat this ailment.

In fact, salt has nothing to do with it in this case. The issue is degeneration and dystrophy of the spine.

Causes

Degeneration of spinal tissues is their degeneration, aging, and loss of elasticity. Degeneration cannot be stopped; it can be slowed down as much as possible. Reverse process(regeneration) is not possible.

Dystrophy is understood as a violation of normal metabolism and nutrition of spinal tissues: the nucleus pulposus of the intervertebral disc, nerves, muscles, ligaments. In severe cases, spinal dystrophy can result in disruption of the functioning of internal organs.

After 20 years, the core of the disc begins to dry out and the disc begins to deteriorate, as the tissues are less well supplied with blood. Work deteriorates as you get older blood vessels, it is difficult for nutrients to penetrate into the disc. This causes osteochondrosis - degeneration of articular cartilage.

Rapid wear and tear of the spine is facilitated by its constant overload, including due to excess weight, which affects a large number of people.

Doctors do not agree on what exactly is the exact cause of changes in the spine. Different experts consider different reasons to be the main ones:

• Aging of the vertebrae and intervertebral discs.
• Hormonal changes.
• Pathological processes occurring with blood vessels.
• Infections.
• Injuries.
• Heredity.

In addition, there is an inextricable connection between spinal diseases and profession. For example, accountants usually suffer more from the cervical spine, while miners suffer more from the lumbar spine.

Symptoms

Spinal dystrophy is accompanied by two main groups of symptoms:

• Pain in different parts of the spine, pain can radiate to the limbs (arms, legs). Sharp, sharp pain indicates the development of radiculitis (inflammation of the nerve roots), dull, aching - about osteochondrosis.
• Disruption of the normal functioning of the spine during movements (turns, bends).

Treatment

Treatment of degenerative-dystrophic processes in the spine should be carried out experienced specialists, is based on a set of measures to eliminate the causes of the disease and improve well-being and includes:

• Elimination or significant reduction pain syndrome.
• Extraction of damaged areas.
• Orthopedic massage to improve blood flow in the affected area.
• Drug treatment special drugs– chondroprotectors, which stimulate the normalization of metabolic processes, thus promoting the restoration of the damaged spine.

Treatment of spinal dystrophy is carried out every six months. After two years, there is a significant improvement in the condition of the spinal column, and the shock-absorbing function improves.

Prevention

Degenerative processes in the spine, that is, its aging, cannot be stopped, but this process can be significantly slowed down and the health of the spine can be maintained. To do this, you need to follow a number of simple recommendations:

• Every day, perform a minimum set of exercises to strengthen your back muscles.
• Always keep your back straight.
• Buy a quality mattress.
• In the morning, get up slowly and immediately on 2 legs to avoid sudden stress on the spine.

Following these simple rules will help to significantly extend the period of trouble-free functioning of the spine.

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Fatty degeneration of the vertebrae: why does your back hurt?

Painful sensations in the back are the most common complaint of patients when visiting a traumatologist and orthopedist. Without necessary treatment acute diseases of the spine develop into chronic form and can significantly reduce the patient’s quality of life.

The intervertebral disc is located between the vertebral bodies and consists of three structures - the fibrous ring surrounding the intervertebral joint, the nucleus pulposus and two hyaline plates that close the disc and adjacent to the adjacent vertebrae. The fibrinous ring is needed to keep the nucleus in the correct position, because it is a kind of shock absorber of the spinal column when walking, jumping, bending, and turning.

Intervertebral discs make up almost a third of the entire spinal column. The gelatinous nuclei contained within it are very hydrophilic (they love water), they need it for elasticity and resilience, thanks to which they can serve as a shock absorber.

How does vertebral degeneration develop?

When the spinal column is malnourished, various degenerative diseases, they lead to a decrease in height intervertebral disc and movement disorders in the spine. Gradually, surrounding structures - joints, muscles, ligaments - are also involved in the process. A major role in the pathological process is played by fatty degeneration of the vertebrae, or rather the yellow ligaments that hold the spine. As a result, the spinal canal that runs inside the vertebrae begins to narrow. It is this stenosis (narrowing) that causes back pain.

Due to the fact that the vertebrae do not have their own innervation and blood supply system (it is present only in the outer plates of the fibrous ring), and also due to the fact that during life the greatest pressure is exerted on the spinal column, degenerative processes in it begin much earlier than in other large joints.

This fact is also associated with the fairly young age of the majority of patients; this process gradually intensifies and leads to the fact that by the age of 60–70, more than half of the population has vertebral degeneration to one degree or another. The gradual erasure of the border between the fibrous ring and the nucleus leads to a decrease in the height of the spine and infringement of the inner part of the intervertebral disc - the nucleus pulposus.

In addition, age-related changes occur in blood vessels, which impairs delivery necessary substances(protein glycans) to the internal structures of the ligamentous apparatus of the spine. A complex of factors - deterioration of trophism and compression of the vertebrae, leads to the formation of cracks in the nucleus pulposus, it loses moisture and its elastic properties decrease. In addition, prolapse (protrusion) of the disc into the spinal canal occurs. This is how degeneration of the intervertebral discs develops, and now the vertebrae are not sufficiently cushioned; any careless or sudden movements can cause pain.

However, the process is not limited to spinal disc degeneration. A decrease in the height of the spinal column promotes the involvement of neighboring formations in the process - ligaments, facet joints, this leads to their overstrain and increased removal of calcium from them and the development of osteoporosis. Naturally, the yellow ligaments, which fill the spaces between the vertebrae and are attached to the vertebral arches, weaken, because the spine has become shorter. The yellow ligaments, or as they are also called fatty ligaments, lose their elasticity, thicken and wrinkle. Due to the fact that serious pathological processes occur in the yellow (fatty) ligaments, the disease is called fatty degeneration of the spine.

The main cause of degeneration of intervertebral discs is a deterioration in the nutrition of their cells - they are more sensitive to a decrease in the amount of oxygen, glucose and changes in the acid-base balance in the blood. This in turn initiates degenerative processes in the disc.

What causes eating disorders? There are a lot of reasons, this includes, in addition to metabolic changes, various blood diseases, for example, anemia, also atherosclerotic changes, insufficient or excessive loads on the spine, and unhealthy diet.

Classification of degenerative-dystrophic changes in the spine

Degenerative-dystrophic changes in the vertebrae occur in several stages.

During the transition to the second stage, the outer layers of the fibrous ring are still preserved (which still keeps the disc from protruding into the intervertebral canal), however, back pain appears, which can radiate to the lower limb and knee joint.

The third stage is characterized by extensive ruptures of the fibrous ring along the entire perimeter, as a result of which the disc prolapses into the spinal canal, lumbar pain are intensifying. A tear of the longitudinal ligament is visible.

Treatment of pain caused by vertebral degeneration

To relieve pain, surgical and conservative methods. They are aimed at alleviating the patient’s condition, and therefore can only be considered palliative.

1. Bed rest for the most intense pain. Getting up late aggravates the situation and leads to less recovery of the spine;
2. Nonsteroidal anti-inflammatory drugs - ibuprofen, diclofenac, piroxicam, indomethacin, naproxen, ibuprol, nimesulide, diclofenac patch;
3. Muscle relaxants - baclofen, tizanidine, cyclobenzaprine, tolperisone, methocarbamol;
4. Local anesthesia - novocaine blockades are most often used;
5. Chondroprotectors - chondroitin sulfate, glycosamine sulfate and diacerein.
6. Physical therapy - dosed load on the spine, strength special exercises, warming up, electrical stimulation. Often, the complex of these effects has a more significant result than long-term pharmacological treatment.
7. A specially selected set of exercises, therapeutic massage, in some cases manual therapy.

As for the surgical treatment of this pathology, the attitude towards it in most leading countries of the world is rather restrained; it is used only for a small percentage of patients.

Among the surgical treatment methods that can be used:

• Discectomy with arthrodesis;
• Intradiscal injection of steroids;
• Intradiscal decompression;
• Laser therapy.

IN last years Minimally invasive treatment methods have become widespread - electrothermal plasty of the fibrous ring, laser decompression of discs, percutaneous endoscopic removal of the disc. Methods for replacing the nucleus pulposus with restoring the integrity of the fibrous disc have also begun to be used.

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Spinal dystrophy

Spinal dystrophy is pathological process, which consists of osteoporosis of the spinal column while maintaining, at least initially, the normal morphology and function of the intervertebral discs. The resulting discrepancy between the usual turgor of the gelatinous nucleus and the ability of bone tissue to resist its pressure leads to pronounced secondary deformation of the vertebral bodies and discs.

The vertebral bodies, which are in a state of osteoporosis, gradually flatten under the influence of pressure from adjacent discs. At the same time, the gelatinous nucleus, not encountering the usual resistance, begins to expand and bends the adjacent end plates of the vertebral bodies.

With osteoporosis of the vertebral body, the central part of the end plate is the most pliable; towards the periphery, its stability increases, since the limbus, consisting of compact bone, continues to provide some resistance to the disc. Therefore, the cranial and caudal surfaces of the vertebral bodies become saucer-shaped, and the vertebral bodies not only decrease, but also acquire a peculiar biconcave shape. At the same time, the height of the discs increases and they become biconvex. The vertebral bodies of such patients resemble fish vertebrae in shape, which was the reason for Schmorl’s proposal to call this disease fish-type vertebral deformity.

Due to significant osteoporosis, macerated preparations of such vertebrae are unusually light in weight. On radiographs of living people, the almost complete absence of the bone structure of these vertebral bodies is striking. At the same time, the X-ray image of the surrounding end plate appears very sharply, as is typical for osteoporosis of all localizations.

The integrity and smoothness of the end plates of the vertebral bodies are completely preserved. This is clearly visible both on macerated preparations and on radiographs. Moreover, the deformation of each given segment of the spine, other things being equal, increases until, in the presence of osteoporosis and normal disc turgor, the continuity of the end plate is maintained. The deformation stops increasing if the integrity of the hyaline and end plates is disrupted in any area and the substance of the gelatinous nucleus breaks into the bone tissue, i.e., a Schmorl’s node is formed.

Due to the fact that in osteoporosis of the spine the vertebral bodies are the place of least resistance, the main influence of the turgor of the gelatinous nucleus is felt in this direction and its pressure on the fibrous ring decreases. Therefore, spinal dystrophy is combined only with Schmorl’s nodes, and other forms of degenerative-dystrophic changes and lesions of the spine, in particular spondylosis, are not typical for these patients. Meanwhile, analysis medical practice shows that spinal dystrophy is often mistaken for spondylosis, despite complete absence relevant changes. This leads to further errors in treatment and disability assessment. With this form of degenerative-dystrophic lesion, the pathological process involves the entire spinal column. However, the severity of deformation of the vertebral bodies increases in the caudal direction, corresponding to an increase in load, and is most significant in the lumbar region. The bodies of the cervical vertebrae are usually almost not deformed, the bodies of the thoracic vertebrae are flattened, become biconcave and usually at the same time wedge-shaped. Sometimes wedge-shaped deformation predominates, which is explained by the characteristics of the load. The typical deformity is most significant in the lower thoracic and lumbar vertebrae.

With spinal dystrophy, the height of the central sections of the disc, pressing into the vertebral bodies, increases, and the height of the peripheral sections of the fibrous ring remains normal, and sometimes even decreases. Therefore, the resulting flattening of the vertebral bodies leads to a general decrease in the spinal column and a decrease in the patient’s height.

With severe osteoporosis, the vertebral bodies can decrease to 1/3-1/4 of their normal height, become equal to the height of the enlarged discs, and often even turn out to be lower than them. Therefore, the overall decrease in the patient’s height can reach 10-12, and in some cases even 20 cm. This form of degenerative-dystrophic lesion of the spine was first discovered by Schmorl (1932) as a manifestation of asynchronous aging in elderly and old age With systemic osteoporosis, but without significant degeneration of the intervertebral discs. However, the same lesion can develop at any age (most often after 40 years) with disorders of mineral metabolism of various origins, leading to osteoporosis. Most often, this form of spinal damage was observed in people who suffered from nutritional dystrophy, but continued to lead an active lifestyle.

With nutritional dystrophy, profound metabolic disorders occur, sometimes accompanied by systemic osteoporosis, which, due to unclear circumstances, may be expressed predominantly in the spine. At the same time, it is with osteoporosis of this origin that patients usually lead an active lifestyle. Under the influence of continued loading of the spine, dissociation in the condition of the vertebral bodies and discs is most clearly revealed and sharp deformations occur.

Spinal dystrophy of this origin was described in Austria and Germany after the first imperialist war. Such patients were observed in Leningrad during its siege, as well as among people who were in the territory temporarily occupied by the Nazis and among those who were captured by them.

Patients suffering from spinal dystrophy experience constant pain in the back and lower back, which increases not only after deadlifting or walking, but even after sitting in a sitting position for several hours. Therefore, even in a corset, many of them can sit for no more than 3-4 hours at a time. These pains are often accompanied by the phenomena of secondary chronic radiculitis.

In addition, due to significant osteoporosis, increased fragility of the vertebral bodies occurs and they are easily subject to compression fractures under the influence of very minor trauma or at times of increased load. Some patients consistently experience compression fractures of the bodies of several vertebrae, most often the middle thoracic ones.

A general decrease in the spinal column changes the appearance of the patient and occasionally causes various dysfunctions of the cardiovascular, respiratory and digestive systems due to disruption of the topography of the corresponding organs.

The deformation that occurs as a result of spinal dystrophy is irreversible and persists throughout later life sick. Osteoporosis gradually decreases significantly. However, sometimes the reparation processes drag on for a number of years. Therefore, spinal deformity. may increase despite the complete elimination of nutritional dystrophy.

Persons suffering from spinal dystrophy usually lose their ability to work. They can perform only light manual or intellectual work in specially created conditions, near their place of residence or at home, while sitting in a dry, warm room, with breaks from work to lie down. They must constantly use a corset that transfers the load of the spine to the pelvic bones. After the elimination of osteoporosis, when the deformity no longer increases and the clinical symptoms of radiculitis have smoothed out, the ability to work is largely restored. With such residual phenomena, ability to work is limited only in professions in which work requires a constant backload, even a moderate one. Currently, almost only such patients are observed.

Similar deformation of bodies and discs is also found in persons suffering from various diseases, often systemic, accompanied by severe osteoporosis of the vertebral bodies (hyperparathyroid osteodystrophy, osteomalacia, etc.) or destruction of their spongy substance while maintaining end plates and discs (metastases of malignant tumors, etc. . P.).

However, in such patients, spinal deformity does not reach the degree observed in nutritional dystrophy, since, due to the characteristics of the underlying disease, they are excluded from normal life and are on bed rest. Treatment of spinal dystrophy and the working capacity of such patients are determined by their underlying disease.

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Fatty degeneration of the vertebrae

Adenoids - treatment with folk remedies

Treatment of adenoids with folk remedies was relevant at a time when homeopathy had not yet “invented” anything, and operations could not yet be performed due to the lack of necessary equipment. In the meantime, there is nothing complicated in such treatment. ethnoscience I managed to find a huge number of effective recipes to eliminate this unpleasant disease without such radical intervention as surgery.

Adenoids are pathological growths of the nasopharyngeal tonsils. This phenomenon does not pose an immediate danger, but it creates the preconditions for the development of otitis media, hearing problems, chronic illness and other unpleasant consequences. To avoid all this, adenoids need to be treated as quickly as possible after the problem is identified.

Why not surgery?

Treatment of adenoids with propolis, methods of application and reviews

Treatment of adenoids with propolis, methods of use and reviews

Children aged 3-7 years are very prone to such a phenomenon as hypertrophied adenoids. Treatment with natural bee propolis helps very well with adenoids.

Of course, adenoids worry both children and their parents. Typically, this disease is accompanied by breathing problems; during sleep, a person may snore, sleep with open mouth. Adenoids can cause hearing loss by blocking the pharyngeal openings auditory tubes. The tongue becomes nasal. Even the face takes on a special expression; there is such a thing as “adenoids face.” In some cases, asthma attacks may even occur. Therefore, it is necessary to treat the disease on time!

Which treatment method should I choose?

Before 4 years of age, surgery is usually not performed.

What is the duration of treatment for uterine fibroids with propolis?

The main reasons for which uterine fibroids occur have not yet been studied, but it is known for sure that the appearance of the tumor is associated with an increase in the amount of estrogen in the female body. As a result, at a certain stage, a disruption occurs in the normal distribution of cells, and a tumor appears, which can very quickly increase in size. Taking hormonal contraceptives activates and accelerates the growth of fibroids.

Fibroids bring quite a lot of discomfort to a woman; there are nagging pains in the lower abdomen, unpleasant painful sensations in the vagina, menstruation becomes light, which leads to excessive blood loss and anemia in the future. One of the effective means of treating a tumor is surgical treatment. It can be avoided by taking hormonal drugs, but many are afraid of their side effects and refuse such treatment. As a folk remedy, you can try a course of propolis therapy. If you believe the reviews, the method is quite effective, and many women have been cured thanks to it, but there are some nuances.

Features of treatment of uterine fibroids

Why is propolis effectively used in the treatment of fibroids? The main properties that propolis has on the human body are:

Ginger tea for colds is an effective remedy

Ginger - unique product, which allows you to cope with various diseases. Most often used ginger tea against colds, since it can eliminate almost all the symptoms of this disease. This product is endowed with impersonal beneficial properties, due to which it is widely used in the treatment of many diseases. Drinking ginger tea daily for colds, this medicine has the following complex effect on the body:

Thus, you can use ginger root for a cold practically regardless of its symptoms - at elevated body temperature, at sore throat, cough, runny nose. The popularity of this natural product is due to the fact that it not only provides therapeutic effect on the body of a sick person, but has immunostimulating properties, therefore it is used for preventive purposes. If you need to treat a cold with ginger, it is best to buy not the powder, but the root of this plant, since it contains many useful substances and is also endowed with high taste.

Medicinal properties of violet tricolor

We all know the violet as a beautiful indoor plant, however, not many of us realize that in addition to beauty, this compact and beautiful flower has a huge number of medicinal properties.

The tricolor violet is found in many countries of the world; it does not require special care; it feels good both in forests and in living spaces of houses and apartments.

Since ancient times, the tricolor violet has been considered a symbol of love and fidelity. Perhaps this is why the plant can still be found in the home of almost every family. A violet addressed to a person on Valentine's Day could make up for everything former quarrels, grievances, and again reunite loving hearts.

Bone marrow plays an important role in the formation and maintenance of immunity.

Problems that arise in the bone marrow inevitably affect hematopoiesis, blood composition, the state of blood circulation, blood vessels, and soon the entire body. When bone marrow functions are impaired, the number of leukocytes, platelets, and red blood cells in the blood decreases. The composition of the blood changes, and therefore the nutrition of the organs, that is, their functions also suffer. Due to changes in the composition of the blood, the nature of its movement through the vessels also changes, which also causes many unpleasant consequences.

Bone marrow degeneration

Degenerative processes begin sooner or later in any organism. Similar processes also occur in the bone marrow. To a certain extent, they are normal physiological processes, of course, if they begin in due time. During degenerative-dystrophic processes, normal (myeloid) bone marrow tissue is gradually replaced by connective and adipose tissue. Moreover, it is fat replacement that predominates.

With age, such processes increase and accelerate. Thus, by the age of 65, approximately half of a person’s bone marrow is replaced by adipose tissue. At an older age, fat cells can occupy half of its volume. Fatty bone marrow degeneration is the focus of medical science today. An earlier and more intense process of such replacement of one tissue by another causes the development of various diseases.

Where do fat cells come from?

When scientists studied the precursor cells of fat, the first “suspects” were bone marrow myeloid cells. These cells give rise to blood cells (except lymphocytes), cells from which muscles are formed, liver cells, and can also be the progenitors of fat. Thus, perhaps due to the low “specialization” of myeloid cells in the bone marrow, they are significantly replaced by fat cells.

Pathological replacement of myeloid tissue with adipose tissue can occur due to metabolic disorders in the body, bone marrow lesions by metastases, infectious processes, especially chronic ones.

What diseases are accompanied by fatty degeneration of the bone marrow?

• Simmonds-Sheehan syndrome,
• Hypoplastic and aplastic anemia,
• Osteoporosis.

This is a list of diseases in which a link has been established between bone marrow degeneration and symptoms or causes of the disease.

Simmonds-Sheehan syndrome

Another name for this disease is hypothalamic-pituitary cachexia. It most often affects older women. Initially, the pathological process occurs in the adenohypophysis and hypothalamus. Further, the secretion of hormones, including growth hormone, is disrupted. This causes degenerative-dystrophic and atrophic processes in tissues and organs and a wide variety of symptoms.

Hypoplastic and aplastic anemia

This group of anemias develops as a result of inhibition of hematopoiesis, which, in turn, is caused by the replacement of myeloid tissue in the bone marrow with fatty tissue. The reasons for this may be toxic or infectious and viral effects.

Among the substances that negatively affect the condition of the bone marrow are arsenic, benzene, and some medications. This is one of the arguments that you should not self-medicate; any medicine should be prescribed by a doctor. He does this taking into account the possible consequences.

Medicines that may cause or accelerate bone marrow degeneration:

• Cytostatic agents,
• Nonsteroidal anti-inflammatory drugs, e.g. acetylsalicylic acid, analgin,
• Sleeping pills (barbiturates),
• Medicines to lower blood pressure, such as captopril,
• Thyrostatics,
• Anti-tuberculosis drugs,
• Sulfonamides,
• Some antibiotics, in particular chloramphenicol,
• Antiarrhythmic drugs.

The main manifestation of hypoplastic and aplastic anemia is thrombocytopenia, manifested hemorrhagic syndrome. Bleeding, bleeding of the skin and mucous membranes, hemorrhagic rashes - these are the most frequent symptoms this type of anemia.

Osteoporosis

Until recently, it was believed that a large amount of adipose tissue protects the body from osteoporosis, since it helps compensate for missing hormones. However, recent research has revealed that this is not entirely true. Excess fat cells interfere with the body's production of collagen and calcium absorption. This leads to weakening of bone tissue, to degenerative processes in it, that is, to bone fragility - the main manifestation of osteoporosis.

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brain. Most common reasons this condition are aplastic

anemia, consequences of radiation or chemotherapy. This condition manifests itself

the appearance of areas of high-intensity MR signal on T1- and T2-weighted images,

corresponding to adipose bone marrow in those parts of the skeleton where normally

contains red bone marrow.

Bone marrow reconversion – reverse replacement of fatty bone marrow

hematopoietic in pathological conditions accompanied by increased

the body's needs for hematopoiesis. Observed in chronic anemia,

bleeding disorders, prolonged hemorrhagic conditions.

The duration of anemization directly affects the prevalence and reversibility

bone marrow reconversion. Regardless of the age of the patients, reconversion to MRI

MR signal intensity on T1-WI against the background of normal high-intensity

fatty bone marrow.

Bone marrow infiltration is observed in tumor, degenerative

dystrophic, inflammatory and systemic processes. MRI picture of infiltration

depends on the type of pathological tissue infiltrating the bone marrow, the presence

concomitant edema, necrosis or fibrosis of the bone marrow, reactive processes

calcification and ossification. In most cases, this condition

characterized by lower intensity on T1-WI, and higher intensity on T2-WI

in relation to the image of fatty bone marrow.

Inflammatory infiltration of the bone marrow is characterized by replacement

bone marrow purulent exudate, granulation tissue, accompanied

destruction of bone tissue, formation of sequestration. There may be inflammation around

zone of edema, osteosclerosis and bone marrow fibrosis.

Tumor infiltration of bone marrow in the MR - image depends on

the degree of aggressiveness of the neoplasm, the nature and speed of its growth in

Expansive neoplasms (benign and slow growing)

malignant) on MRI are manifested by the presence of a space-occupying formation

homogeneous or cellular-trabecular structure, delimited by a zone

endosteal ossification in the form of a hypointense rim on T1 and T2-weighted images;

Infiltrative neoplasms (malignant) are characterized by

rapid spread in the bone marrow canal in the longitudinal and

transverse direction with elements of necrosis in the center;

On MRI, tumors appear small-focal or diffuse

infiltration of the bone marrow, often with unclear contours, surrounded by

periphery with an area of ​​edema that is hypointense on T1 and hyperintense on T2-

The tumor focus can be of a homogeneous or heterogeneous structure in

depending on the presence of necrosis, hemorrhages and gives an MR signal on T1-VI

often hypointense, hyperintense on T2-WI.

Systemic bone marrow infiltration is characterized by multiple

polyostotic lesion. It is observed in secondary metastatic

tumors, neoplasms of lymphoid and hematopoietic system, histiocytosis,

lipid metabolism disorders. Distribution of sites of infiltration in the bones of the skeleton,

usually corresponds to the normal distribution of red bone marrow –

bone marrow neoplastic processes primarily develop from cells

hematopoietic bone marrow. Image characteristic of a tumor

infiltration, may not differ from normal distribution or reconversion

hematopoietic bone marrow.

characterized by replacement of bone marrow with defective osteoid or

fibrous connective tissue, accompanied by hemorrhages and areas

liquefaction necrosis. Bone marrow fibrosis may have multiple

diffuse or focal in nature in chronic inflammatory and tumor diseases

processes, Paget's disease, fibrous ankylosis. Subchondral fibrosis

determined in arthritis and osteoarthrosis. It appears hypointense

areas against the background of high-intensity fatty bone marrow on T1-weighted images.

Cyst-shaped cavities of degeneration have a homogeneous or cellular-trabecular

structure with fluid or hemorrhagic contents and give a hypointense

signal on T1-WI, reverse signal on T2-WI.

1. MRI demonstrates high informativeness in identifying pathological

changes in bone marrow various types pathological conditions.

2. The MRI picture of changes in the bone marrow is not very specific, so the goal

MRI is the earliest detection of bone changes

brain or assessment of their prevalence in an established disease.

1. Bryukhanov A.V., Vasilyev A.Yu. Magnetic resonance imaging in

osteology. – M.: Medicine, 2006.- 200 p.

2. Trofimova T.N., Karpenko A.K. MRI diagnosis of knee joint injury. –

SPb.: Publishing house SPbMAPO, 2006 – 150 p.

Youth Conference on organic chemistry continues a series of school conferences held annually since 1998 (Ekaterinburg.

State educational institution of higher professional education

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What is vertebral fatty degeneration?

Fatty degeneration of the vertebrae is an age-related process of replacement of hematopoietic bone marrow tissue with fatty tissue. In some cases, it begins earlier due to cancer or infectious diseases, uncontrolled drug therapy. This natural process may occur with complications. These include osteoporosis, anemia, hormonal imbalance and spinal canal stenosis. In most cases, no specific therapy is required, but if complications threaten the patient's quality of life, surgery may be prescribed.

Causes

The main risk factor is age. Tissue degeneration begins to occur, including the bone marrow of the spine. This is natural, and if the patient is over seventy, often his bone marrow is half fat.

The process is initiated by myeloid cells. They are found in the bone marrow and create all blood cells. They also form muscles and internal organs, such as the liver.

In some cases, degeneration occurs much earlier. The cause may be metabolic disorders, malignant neoplasms and metastasis, infections. Unfortunately, such changes can occur regardless of age.

An accelerated process of “obesity” of the vertebrae can occur due to the intake of certain medications. These include non-steroidal anti-inflammatory drugs. This is especially bad considering that many people suffering from osteochondrosis mainly use NSAIDs - this results in a vicious circle of degeneration of back tissue. You can also list blood pressure-lowering medications, cardiac medications, and antibiotics here.

How it develops

When blood circulation and metabolism of the spine are disrupted, osteochondrosis does not remain the only problem. An additional pathology may be fatty degeneration of the bone marrow and ligaments that fix the back. The result of this pathological process may be stenosis of the spinal canal, and subsequently compression of the spinal cord. And if there is some kind of mechanical impact on the spinal cord, a whole bunch of severe neurological symptoms. Including partial and complete paralysis.

Due to the fact that the vertebral bodies do not have independent internal nerves and blood vessels, but are fed through endplates, fatty degeneration begins quickly in them. In addition to the vertebrae, the arteries also change. The path of nutrients to the vertebrae and discs is complicated. This is another reason why the nucleus pulposus loses its shock-absorbing properties.

Osteochondrosis and fatty degeneration lead to a decrease in the space between the vertebrae. To reduce spasms of the spinal ligaments, the body tries to get rid of calcium. This leads to a disease such as osteoporosis.

Prognosis and complications

Fatty bone marrow degeneration results in poor blood cell production. Anemia and decreased immunity are observed. Vascular tone decreases. The condition of not only the spine, but also the entire human body deteriorates. The tissues of the internal organs begin to “suffocate” without receiving enough oxygen.

Fatty degeneration of the vertebrae can lead to the development of diseases such as:

• Simmond-Schien disease. Middle-aged females are usually affected. Begin hormonal changes, due to which a large number of body tissues suffer;
• Anemia. The degeneration of the cells that create blood cells does not go away without a trace;
• Osteoporosis. Too much fat in bone prevents the body from producing collagen. Because of this, a person stops processing calcium correctly, and the vertebrae become fragile.

Blood clots worse, and as a result, traumatic effects can be fatal. Particularly severe consequences can occur if such a symptom accompanies osteoporosis - bone degeneration. Bones break easily, and if a fracture occurs, internal bleeding may begin non-stop.

Treatment

Used as conservative curative measures, and operations. But unfortunately, they are largely only symptomatic. Degeneration of vertebral tissue due to aging is an irreversible process. But if complications occur, inflammatory processes, pinched nerves – the following recommendations are suitable:

• In the acute period, when attacks are constantly tormenting, you need to give the patient complete rest. Eliminate both mental and physical stress factors;
• Nonsteroidal anti-inflammatory drugs (Ibuprofen, Diclofenac);
• Muscle relaxants to relieve painful muscle spasms (for example, Sirdalud);
• Injection spinal blockades with novocaine;
• Chondroprotectors are drugs that help regenerate cartilage tissue;
• Physiotherapy (Magnet, Electrophoresis, Low-frequency current, Shock wave therapy);
• Physical therapy (after the acute period has ended);
• Massage procedures, acupuncture.

• Read also: Vertebral instability.

Surgical intervention is justified only if there is narrowing of the spinal canal. Here the work of a surgeon is necessary, because otherwise the patient will experience loss of sensitivity and mobility, and possibly paralysis.

What is uncovertebral arthrosis of the cervical spine?

What is spinal epiduritis?

Spinal tuberculosis: how to overcome the disease?

MRI of the spinal cord, MR myelography, which reveals when it is contraindicated

What is MR myelography

MR myelography is a study of the spinal canal, the spinal cord with its membranes. Its difference from traditional X-ray myelography is that MR myelography is a non-invasive, highly informative procedure, and, therefore, completely safe and harmless for the patient.

Indications for scanning are:

• pain in the back, in the lower extremities, of varying severity, unilateral or bilateral
• sensory disturbance (paresthesia, numbness) or movement disorders in the legs (up to paresis/paralysis)
• previous spinal injury
• search for metastases or primary cancerous node
• upcoming or previous surgery
• presence of signs of neurological impairment of other organs (for example, breathing problems, vision problems, heat intolerance)

What does a spinal cord MRI show?

1. Degenerative diseases of the spine, namely compression of the brain by a ruptured hernia. Depending on the degree of compression, patients will experience pain (such as electric shocks, lumbago), numbness, and impaired motor functions.
2. Spinal cord injury. Injuries are divided into concussion, bruise and traumatic compression. Shake may not manifest itself at all, or may manifest itself as short-term motor and sensory disturbances. At bruise, And traumatic compression spinal shock develops with peripheral (hypotonic) paralysis and pelvic dysfunction. The shock goes away on average after 3-8 weeks.
3. Spinal cord tumors, primary/secondary. For every 6 brain tumors there is 1 spinal tumor. It should be noted that primary vertebral tumors affecting the spinal cord are not brain tumors. They are divided into intra- and extramedullary (from the tissues surrounding the brain - membranes, roots, vessels, fiber). For extramedullary tumors(meningiomas, neuromas) characterized by half conduction disturbance, radicular pain; when sneezing or coughing, the pain is reflected at the site of the tumor, the same happens when tapping on the spinous processes. intramedullary tumors(ependymomas, astrocytomas, hemangiomas, granulomas) there is no pain, but there are motor and sensory disorders. Metastatic(secondary) lesion is characterized by rapidly progressive flaccid (hypotonic) paraparesis (of both limbs), which then turns into spastic paralysis. In these pathologies, bone marrow fibrosis is often detected on MRI, as well as bone marrow edema, although these changes may be signs of other diseases.
4. Demyelinating diseases of the brain (both spinal and brain). These include multiple sclerosis and acute disseminated encephalomyelitis. Multiple sclerosis is a chronic autoimmune, constantly progressive disease that affects the myelin sheath of the nerves, which is responsible for the rapid passage of nerve impulses. This pathology can have many clinical pictures, but they all have similarities. Both debut and exacerbation in patients are caused by: previous viral infections; hyperinsolation, taking hot baths, saunas, etc.; pregnancy. This can manifest itself as spasticity in the lower extremities (most often), pelvic disorders (empirical urges, incontinence), headaches, and later they are joined by disturbances in swallowing, vision, hearing, and breathing. Currently, MRI is the only way to visualize foci of demyelination, in its This time marked a breakthrough in the diagnosis of MS. After the first onset, the patient is required to undergo an MRI; it is based on the scan results that a final diagnosis is made if the criteria for the detected number of lesions are met. Each focus of demyelination of the spinal cord on MRI is equivalent to that in the brain, which is taken into account when making a diagnosis. MRI of the spinal cord in multiple sclerosis is carried out simultaneously with a study of the brain, and gadolinium-containing contrast is used to search for fresh lesions. Acute disseminated encephalomyelitis has a benign course, it appears after a viral neurotropic infection (measles, influenza, rubella, herpes and others, including after vaccinations). It is characterized by an acute onset with fever, signs of encephalitis, paresis, and paralysis. At adequate treatment symptoms disappear within a month. A distinctive feature of MRI of the spinal cord with contrast is the “symptom of rings, half rings.”
5. Side amyotrophic sclerosis , or motor neuron disease, or Charcot's disease, is characterized by damage to the motor pathways, as a result of which a person slowly develops paralysis of all muscles. Presumable reason - mutation genes. Debuts at age. MRI of the spinal cord in ALS reveals pathology of the anterior horns of the spinal cord, especially diffusion tractography helps in diagnosis.
6. Bone marrow ischemia or infarction develops when the artery supplying the spine is blocked, spasmed or compressed. In this case, an MRI of the spinal cord vessels is performed to identify the location of the source of the impaired blood supply.
7. Chronic anemia, or rather, one of its signs is bone marrow reconversion (replacement of adipose tissue with blood-forming cells as an attempt by the body to increase the production of red blood cells).

Benefits of MRI

MRI of the brain and spinal cord is always preferable to other diagnostic methods. It allows not only to perform myelography with three-dimensional reconstruction, but it can also be used to perform MR myelography in diffusion tractography mode, which makes it possible to study pathways that are affected in many pathologies (for example, ALS, multiple sclerosis). For demyelinating diseases, MRI is the only option for visualizing lesions; Before the advent of MRI, this diagnosis was made only when significant clinical manifestations appeared.

Such excellent information content is due to the fact that the spinal cord is a soft tissue structure, and MRI, as is known, reveals its full diagnostic potential precisely when scanning soft tissues.

Whether surgical intervention is required or whether surgery can be done without surgery, myelography of the spine will help determine the indications.

A significant advantage to the above is the fact that during magnetic resonance scanning there is no exposure to ionizing X-ray radiation, which allows MRI of the spinal cord to be performed on children.

Where to do myelography of the spine

If you are faced with the question of the need for an MRI of the spinal cord, you must choose a center with a high-field tomograph closed type(from 1.5 Tesla). Only a device of this class can provide the information content necessary when scanning a given area. The procedure takes about minutes, decoding takes another 30 minutes.

Remember that the presence of metal objects in the body (stents, vascular clips, pacemaker, metal structures, etc.) is absolute contraindication to scanning.

or CT examination

All rights reserved © MRI and CT of the spine, 2018

And that many hackneyed and streamlined formulations in expert opinions (as well as all these universal terms “more likely; more likely”, as well as “trabecular edema”, in different descriptions and declinations), only indicate that the exact picture of MRI changes is more often I am not able to install everything. And the final result is left entirely to the experience and/or subjectivity of the doctor himself at the computer. You just need to understand that such favorite topics “nothing” exist in any diagnostic path. But if in classical X-ray they like to incline the pulmonary pattern in this way: strengthened - deformed - enriched (options: perivascular / peribronchial type - and it’s good if they see all this on real images!), then in MRI this is such a strong point and a favorite topic, of course. are trabecular edema. That is, changes in the very bone tissue that MRI, strictly speaking, sees worst of all, giving the absolute palm here to MSCT and standard X-ray. Therefore, it is clear that putting a good face on a bad game would be most appropriate and pleasant here.

“The earliest NON-SPECIFIC (highlighted in capital letters in the same place! – A.K.) syndrome of a large number of CSS diseases.

Edema is a characteristic manifestation of traumatic contusions, hidden subcortical and stress fractures, and an early (reversible) stage of avascular necrosis.

It is the only MRI-tomographic manifestation of such processes as idiopathic transient osteoporosis and transient bone marrow edema syndrome...” (From the manual “MRI-Expert: “MRI diagnostics in onco-osteology” (a manual for oncologists, traumatologists. Authors: Ph.D. Pasechnaya V.G., Ph.D. Korobov A.V., Karavaev A.A., Voronezh. 2011)

Option 2: A mild, heterogeneous increase in the intensity of the MR signal on T2 with fat suppression is determined. No signs of bone destructive changes were identified, cortical layer not changed. More likely, these changes reflect residual red bone marrow; for trabecular edema, the above changes are nonspecific ... "

There is no effusion in the joint cavity or in the subdeltoid bursa. A small amount of effusion is detected in the subcoracoidal bursa and in the area of ​​the biceps tendon...”

Conclusion: MRI picture partial rupture rotator cuff tendons (supraspinatus, subscapularis muscles), subcoracoidal bursitis; Tenosynovitis. Impeachment syndrome stage II-III.”

Stage 1 - suspicion of changes (blurred edges of the joints)

Stage 2 - minimal changes (small localized areas of erosion or sclerosis with no change in gap width)

Stage 3 - moderate to significant sacroiliitis with erosions, sclerosis, widening, narrowing or partial ankylosis

Stage 4 - significant changes with complete ankylosis of the joint

Stage I - changes suspicious for sacroiliitis, i.e. subchondral osteosclerosis, some unevenness and blurriness of the articular surfaces, which does not exclude the possibility of a normal age-related X-ray picture;

Stage II - obvious pathological changes (severe osteosclerosis not only on the iliac, but also on the sacral sides of the joint space, pseudo-widening of the joint space and/or limited areas with erosions)

IIa (unilateral changes) and lIb (bilateral changes).

Stage III reflects in more detail the possibility of regression of subchondral sclerosis and the presence of erosions;

Stage IV - partial ankylosis (formally corresponds to stage III according to Kellgren).

Stage V - complete ankylosis.”

"In the acute phase ischemic stroke pathological signs brain lesions are better and earlier (the exception is CT perfusion!) detected with MRI

(Source: V.G. Kornienko, I.N. Pronin “Diagnostic neuroradiology” M., 2003)

CT – CT + CT angiography + CT perfusion

MRI – standard MRI on a high-field tomograph /DWI, Flair, T2/

Again about the dubious value of MRI-4

spinal health ©

All information on the site is for informational purposes only. Do not use this information for self-medication. Possible contraindications. Be sure to consult your doctor.

Bone marrow reconversion?

Zones of change in the intensity of the MR signal from the bone marrow of the femur and tibia (hypointense on T1 and T2 VI) - bone marrow reconversion? Are there other options?

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I am for reconversion

It also seems to me that this is a reconversion.

Thanks a lot! And what is the longitudinal linearly curved zone of the hypointense MR signal on T1 and T2 VI in central departments diaphysis femur, a vessel perhaps? Not a fracture?

Where is the swelling then if there is a fracture?

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What is bone marrow reconversion?

MRI imaging of normal spinal bone marrow (BM) is mainly dependent on the appropriate proportion of blood-forming cells and fat cells (adipocytes) within the vertebral body medulla. MRI usually reveals two types of bone marrow - active, functioning red bone marrow (RBM) and inactive, yellow bone marrow (YBM). The latter, due to the high content of adipose tissue, has an MR signal intensity similar to subcutaneous fat. A significant help in describing the state of the bone marrow during an MRI study is the well-known phenomenon of age-related, progressive transformation of CCM into GCM - the so-called CM conversion. Several options for these changes (conversions) have been identified:

Option II (peripheral): the vertebral body has areas of high signal intensity of a ribbon-like and triangular shape of the gastrointestinal tract, located in the peripheral parts of the vertebral bodies under both endplates; this variant may be caused by mechanical damage, which is usually less intense in the thoracic region due to the stabilizing effect of the rib cage, and may also be associated with degeneration of adjacent intervertebral discs; the frequency of this conversion variant increases with age, reflecting a gradual increase in the replacement of CMC with yellow CM in the peripheral variant, reaching its maximum manifestations in individuals under 70 years of age;

Option III (diffuse-fine-focal or “variegated pattern” type): the vertebral body has small, diffusely located point areas of high signal intensity (from 1 to 3 mm) due to inclusions of gastrointestinal tract; this conversion option reflects the replacement of CMC by yellow CMC with its maximum prevalence in older people;

IV variant (diffuse-focal): the vertebral body has a few, usually round-oval, foci of high signal intensity, in places confluent in nature, with fuzzy, uneven contours with sizes ranging from 10 to 40 mm with a predominant orientation along the basivertebral vein; the frequency of this conversion option is increased in age categories with the greatest manifestations of this option in patients in the fifth and sixth decades and in its absence in young people (up to 30 years);

V variant (vascular): the vertebral body has in the center, which is represented by a flask-shaped dilated basivertebral vein, along which linear, thin (2 - 3 mm) sections of the gastrointestinal tract are located (this variant is visualized mainly in patients of older age categories and is accompanied by osteoporosis [osteopenia); this conversion option is not detected on images of the lumbar spine in patients under 50 years of age, but is most clearly represented in patients after 60 years of age.

[read] article “Magnetic resonance imaging in the diagnosis of bone marrow conversion of the lumbar spine” Myagkov S.A., State Institution “Zaporozhye Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine” (magazine “Pain. Joints. Spine” No. 3(11), 2013 )

Bone marrow accounts for approximately 5% of the total body weight and plays an active role in hematopoiesis (blood formation). Bone marrow consists mainly of stem cells (all types of blood cellular elements), surrounding supporting cells - macrophages, adipocytes and a large number of others involved in nutrition, proliferation (growth) and differentiation of stem cells. Red bone marrow contains about 40% fat, yellow bone marrow contains up to 80%. This feature helps in identifying various pathologies associated with changes in this ratio during MRI of the spine.

T1-weighted MRI is most sensitive to adipose tissue. They are the basis of the MRI protocol. In addition, T2-weighted MRI with fat suppression is used. Below we will focus on the main pathologies that appear on MRI of the spine, such as bone marrow pathology in the first place.

• Hemangioma, single or multiple, accounts for 10-12% of changes in the vertebrae. It belongs to vascular anomalies and has characteristic signs on MRI of the spine - round or trabecular, light on T1-weighted and T2-weighted MRI, does not change with MRI techniques for suppressing the signal from fat.
• Local fat deposits appear with age and are a variant of the norm. Fatty deposits are also observed in osteochondrosis along the endplates (fatty degeneration, or Modic type 2). They are bright on T1-weighted MRIs of the spine and become dark on fat-suppressed MRIs. Sometimes they meet mixed options changes in the bone marrow in osteochondrosis, which are not completely suppressed by the use of STIR MRI sequences.
• Paget's disease refers to metabolic disorders and is observed in 1-3% of people over 40 years of age. Damage to the vertebrae ranks second after the pelvic bones. In diagnosing Paget's disease, identifying lytic foci in the bones of the skull is very helpful. Paget's disease goes through 3 stages - lytic, mixed and blastic. In accordance with these stages, MRI of the spine shows a different picture. In the lytic stage, the lesion signal is bright on T2-weighted MRI and low on T1-weighted MRI, then becomes hypointense on both types of MRI as sclerosis and fibrosis increase. MRI of the spine reveals other characteristic features of Paget's disease - thickening of the cortical plates of the vertebral bodies, fatty degeneration at a late stage and during successful treatment.

MRI of the spine. T1-weighted sagittal MRI of the lumbosacral region. Replacement of sacral bone marrow with fat in Paget's disease.

• Lipoma refers to benign tumors from adipose tissue. They make up about 1% of all primary bone tumors and no more than 4% of them are localized in the vertebrae. On MRI of the spine, lipomas are difficult to distinguish from fat deposits, however, they are more clearly defined and may undergo internal necrosis and calcification
• hemorrhages in the vertebrae occur with injuries. MRI of the spine reveals characteristic blood dynamics depending on the duration of the hemorrhage.
• The consequences of radiation therapy are reduced to replacing red bone marrow with yellow one. When the absorbed dose exceeds 36 Gy, this process becomes irreversible. MRI of the spine shows diffuse signal enhancement on T1-weighted MRIs with a clear border corresponding to the irradiation field. After radiation therapy and chemotherapy, myelofibrosis - bone marrow replacement - can also develop fibrous tissue. In MRI of the spine, the signal is very low on both T1-weighted and T2-weighted MRIs.

MRI of the spine. T1-weighted sagittal MRI of the thoracic region. Fatty bone marrow degeneration after radiation therapy.

• Osteoporosis leads to a decrease in the cellular composition of the bone marrow and an increase in fat. MRI of the spine often shows diffuse increased signal from the vertebral bodies on T1-weighted MRI. There are also focal changes, requiring MRI of the spine differential diagnosis with hemangiomas. MRI diagnostics for osteoporosis is also presented in a separate article.
• Spondyloarthropathy on MRI of the spine often manifests as “glowing” angles on T2-weighted MRI. This is especially true for the acute stage of ankylosing spondylitis. The change from the acute phase to the chronic phase leads to the transformation of the inflammatory reaction into a depot of adipose tissue, which is light on T1-weighted MRI. MRI of the spine for various diseases belonging to the group of spondyloarthropathies is discussed in a special article on our other website.
• Anorexia is accompanied by various changes in the body, including osteoporosis and decreased signal intensity on T1-weighted MRI, as well as bone marrow edema, which is referred to as “gelatinous transformation.” On T2-weighted MRI (especially fat-suppressed MRI), there is a slight diffuse increase in signal from the vertebrae. MRI of the spine with contrast shows amorphous signal enhancement.

MRI of the spine. T2-weighted sagittal MRI. Gelatinous transformation due to malnutrition.

• Hemosiderosis is a phenomenon observed in hemolytic anemia. MRI of the spine shows low signal in the bone marrow. In differential diagnosis, it is important that the liver and spleen acquire the same low signal.
• Gaucher disease is an autosomal recessive disorder hereditary disease classified as sphingolipidosis and manifested by the accumulation of glucocerebrosides in histiocytes. The diagnosis is made based on puncture of the spleen and detection of specific cells. On MRI of the spine, red bone marrow is replaced by Gaucher cells, which are hypointense on T1- and T2-weighted MRI. In addition, bone infarcts are often observed on MRI of the spine.

MRI of the spine. T1-weighted MRI of the thoracic spine. Gaucher's disease.

• Myeloproliferative and myelodysplastic syndromes, which include chronic myelogenous leukemia and other chronic leukemias, polycythemia, mastocytosis, essential thrombocytopenia on MRI of the spine, are manifested by a uniformly reduced signal on T1-weighted MRI. On T2-weighted MRIs of the spine, a “reverse” brightness of the intervertebral discs is often observed; they become lighter than the vertebral bodies. MRI of the brain for tumors of the hematopoietic system can also reveal its damage.

MRI of the spine. T2-weighted sagittal MRI of the cervical spine. Chronic myeloid leukemia.

• Sarcoidosis affects the bone marrow in 1-3% of cases. Damage to the brain and spinal cord is much more common in sarcoidosis. MRI of the spine reveals sclerotic foci that closely resemble metastases, often multiple. The lesions can be mixed lytic with sclerotic rims. MRI of the spine with contrast may show increased signal from lesions.
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Fatty degeneration of the vertebrae or other organs is a pathological process in which normal organ tissue is replaced by fatty tissue. In the case of vertebrae adipose tissue replaces hematopoietic bone marrow tissue. Typically, degeneration is associated with aging of the body. For example, in some patients who have reached 60-70 years of age, the bone marrow consists of 50% fat.

If the patient's quality of life does not deteriorate, some specific treatment fatty degeneration is not required. But in some cases, replacement of normal tissue may begin in more early age. In such patients, the onset and development of the disease does not depend on the age factor, but occurs for other reasons. The process is often accompanied by complications and poses a threat to the life and health of the patient - in this case, conservative or surgical treatment may be necessary. It often happens that therapy is effective only at the initial stage of the disease. If the process has progressed greatly, it may be possible to only stop the development of the pathology, but not eliminate it completely.

Causes and mechanism of development of the disease

To better understand what fatty degeneration of the vertebrae is, let’s consider the mechanism of development of the pathology and the reasons that initiate the process. The mechanism of degeneration of vertebral tissue is triggered by myeloid cells contained in the bone marrow. These cells are responsible for the production of blood cells. Very slowly, but irreversibly, fatty grains penetrate into the cells of the vertebrae, as a result of which the cell sooner or later dies, and adipose tissue takes its place. Not only the vertebrae, but also the tissues surrounding them can be subject to degeneration - intervertebral discs, muscles, ligaments.

Such complex pathological changes in the tissues of the musculoskeletal system primarily affect the condition of the spine. Additional diseases of the spinal column are actively beginning to develop -,. Changes may also begin in other organs and tissues of the body. The consequences of fatty degeneration of the vertebrae are anemia, anemia, Simmonds-Schien disease, deterioration of blood vessels and other pathologies.

Causes of fatty degeneration of the vertebrae (if the process is not associated with the patient’s advanced age):

1. Oncological pathologies, especially with metastases to the bone marrow.
2. Infectious and inflammatory diseases.
3. Metabolic disease.
4. Impaired blood circulation and/or trophism of musculoskeletal tissues.
5. Systematic use of certain medications (NSAIDs; drugs prescribed for hypertension or other diseases of cardio-vascular system, antibiotics, barbiturates).
6. Alcohol, medication, chemical intoxication of the body.

In some cases, osteochondrosis becomes not a consequence, but a cause of fatty degeneration of the vertebrae. The fact is that with osteochondrosis, patients are often prescribed NSAIDs, long-term use of which provokes the onset of the process of tissue replacement.

Symptoms of fatty vertebral degeneration

It is very difficult to diagnose fatty degeneration of the vertebrae on your own, since the symptoms of the pathology are similar to those of other diseases of the musculoskeletal system:

• back pain, most often in the neck and chest;
• lack of coordination;
• headaches, fatigue;
• decreased sensitivity in the extremities, a feeling of coldness or numbness, “crawling goosebumps”;

The main symptom of fatty degeneration of the vertebrae is limited movement, a feeling of stiffness, decreased motor activity. In order to accurately diagnose the disease, you need to consult a specialist. The doctor will conduct an external examination, order an MRI and, based on its results, make a diagnosis and prescribe treatment.

Treatment of fatty vertebral degeneration

Treatment of pathology can be either conservative or surgical. It is worth noting that conservative methods are mostly aimed at relieving pain, stopping the progression of the disease, and preventing possible complications.

Conservative therapy:

1. During an exacerbation of the disease - bed rest, muscle relaxants, novocaine blockade.
2. During the period of remission - NSAIDs, chondroprotectors, physiotherapy, manual therapy, exercise therapy, spinal traction, massage, kinesiotherapy.

Surgical methods of treatment:

1. Discectomy.
2. Intradiscal decompression, laser decompression, or steroid management.
3. Laser therapy.
4. Electrothermal plastic surgery of the fibrous ring.
5. Replacement of the nucleus pulposus (this restores the integrity of the fibrous disc).

The choice of treatment method is within the competence of the doctor and depends on many factors - technical capabilities, age and health status of the patient, and the prognosis of the success of a particular method of therapy.

Fatty degeneration of the vertebrae, if it is associated with the aging of the body, is an irreversible process and a normal variant. If the replacement healthy tissue occurs in middle age and threatens to develop serious complications, immediate treatment will be required. Conservative therapy will help alleviate the patient's condition. Surgical methods are used in the most severe and dangerous cases of the disease.