What are the symptoms of lumbar degeneration?

Lumbar degeneration is common among the elderly. At this age, the lumbar spine is prone to aging. If there is external force, it will cause some lesions. Lumbar degeneration can cause low back and leg pain, and severe cases can cause sexual function or urination and defecation disorders.

1. Clinical manifestations

1. Low back pain and decreased lumbar support function

This type of symptoms is mostly caused by degeneration of the intervertebral disc, wear and hyperplasia of the lumbar facet joints, lumbar scoliosis, lumbar spondylolisthesis, etc., and is characterized by worsening after standing fatigue and relief after bed rest.

2. Lower limb pain and numbness, intermittent claudication

This type of symptom is mainly related to intervertebral disc herniation, osteophyte hyperplasia or spinal canal stenosis compressing the nerves and affecting the nerve blood supply. The leg pain caused by typical lumbar disease is often manifested as sciatica, that is, pain starting from the waist or buttocks, radiating from the back of the thigh and the outside of the calf to the foot. The main symptom of intermittent claudication is that after walking a certain distance (usually as the disease worsens, the walking distance gradually shortens), the lower limbs experience soreness, numbness, swelling and pain, as if filled with lead, making it difficult to walk. At this time, the symptoms can be relieved after bending over, sitting down or squatting to rest for a while, but they will worsen again after starting to walk.

3. Urinary and sexual dysfunction

This type of symptoms may manifest as weak defecation and urination, incomplete defecation, urinary retention, decreased sexual sensitivity, impotence, abnormal erection, etc. Male urinary problems are sometimes difficult to distinguish from prostate hyperplasia. Some scholars believe that male urinary problems caused by lumbar spine diseases are often mild or severe, while the severity of urinary symptoms caused by prostate diseases is relatively constant.

2. Causes

1. Degeneration of the lumbar disc annulus

The intervertebral disc tissue bears the weight of the human trunk and upper limbs, and is more susceptible to strain than other tissues in daily life and labor. The lumbar intervertebral disc has a small blood supply and extremely limited nutrition, making it very prone to degeneration. Studies have shown that the intervertebral discs have already started to degenerate when people are approaching their 20s, and some have already experienced obvious degeneration between the ages of 20 and 30, with cracks forming in the annulus fibrosus. The intervertebral discs of people over 30 years old all have degeneration. As age increases, the annulus fibrosus of the intervertebral disc undergoes reticular degeneration and hyaline degeneration, loses its original layers and toughness, develops various cracks, and then completely ruptures.

2. Degeneration of the nucleus pulposus of the intervertebral disc

The nucleus pulposus of the intervertebral disc is a tissue rich in water and small molecular elastic mucoglycoprotein. It contains chondrocytes and fibroblasts. The water content can reach more than 80% in childhood, which decreases with age and can reach 70% in old age. The amount of water content in the intervertebral disc determines its intrinsic pressure level and elastic state. Degeneration of the nucleus pulposus often occurs on the basis of degeneration of bone joints and annulus fibrosus. When the load on the lumbar spine increases, the intervertebral space pressure increases and the degeneration of the intervertebral disc accelerates, the cracks in the annulus fibrosus deepen, and the degenerated nucleus pulposus protrudes to the edge along the cracks, which causes lumbar disc herniation.

3. Degeneration of cartilage endplate

The cartilage endplates of the intervertebral disc become thinner, calcified, and incomplete with age, and produce cystic changes and chondrocyte necrosis. The attachment points of the annulus fibrosus loosen, accompanied by a decrease in the water content of the nucleus pulposus, and the cartilage endplates cannot be regenerated and repaired. Degeneration of the cartilage endplate will reduce the function of the translucent membrane in the exchange of intervertebral disc fluid and accelerate the degeneration of the lumbar disc.