Osteoarthritis or lumbar spondyloarthrosis begins with the deterioration of the mobile structures that make up the lumbar spine, these are the discs and the posterior joints. A disc disease is produced together with a degeneration of the cartilage of the joints. As the disease progresses the joints increase in size and there is a calcification of the ligaments surrounding the disc as well as a widening of the plates of the bodies of the vertebrae. All this occurs in an attempt to stabilize the movement of a damaged segment. In the more advanced stages, there may even be fusions of contiguous vertebrae (ankylosis).
The causes are similar to the rest of the osteoarthritis, that is to say an excessive overload (labor, obesity, deformities of the spine) or an alteration of the cartilage (rheumatism, collagen diseases). All these factors can accelerate the development of spondyloarthrosis. Although age is the main factor that influences the appearance of lumbar osteoarthritis.
Lumbar osteoarthritis as in other locations demonstrates what in medicine is called clinical-radiological dissociation. In other words, the symptoms produced by the disease do not correspond exactly with the degree of deterioration that appears on the radiograph.The most frequent symptom is lumbar pain that increases with trunk extension movements. The pain is usually located in the lower back and usually extends to the buttocks and in some cases to the legs. Pain typically increases when getting out of a chair and improves when walking. There is also very often lumbar stiffness that becomes evident with the limitation both to perform the movements of flexoextension of the trunk as well as the movements of torsion. The symptoms will depend above all on associated factors that can range from the involvement of a nerve root to psychological and emotional factors.
The initial treatment should be with medication and physiotherapy, with improvement of physical conditions (weight loss, abdominal and lumbar muscle training). Change or re-education in work activities. Almost always, patients are advised to perform gentle exercise such as walking or swimming. Surgery is reserved for cases of persistent and uncontrollable pain with medication and consists of fusing the spaces with osteoarthritis by means of screws and rods (arthrodesis).