How is it called – “Osteochondrosis” or “sciatica”? Or the talk is about the experience of approach to terminological dilemma. Experienced reader may be surprised by such a formulation of the question – the paradigm of osteochondrosis has been already ruling over neurological minds, as well as those having a different professional orientation at least a quarter of a century. The magic of it has turned out to be so great that resonant voice, with a call to give osteochondrosis at the mercy of orthopedic industry that could be sometimes heard, is unheard by neurologists who are the specialists traditionally involved in pathology, formerly known as sciatica, radiculitis then, and now it is called osteochondrosis.
Of course, terminological conversion has not influenced the clinical content of disease, which is characterized by pains in the spine and limbs, jet vertebral deformities, proper neural and other violations, but has also exposed a fundamental aspect, relating to understanding of the nosological substance of disorders we are speaking about.
What is the essence of this disease? May be clinical manifestations mentioned above or underlying pathological changes in neural structures, or, finally, abnormal vertebral breaches – the source of vertebrogen neural disorders? This question did not arise today, and we can not reply to it, not remembering its history.
So here is the brief history of the issue. Since the second half of XVIII century the clinical manifestations mentioned above in their entirety were designated according to the understanding of the nature of pathological processes accordingly as sciatica (Cotunnius, 1770), as radiculitis (Dejerine, 1896), and after it – according to syndroms – as lumb- (thoraco-) -algia, sciatica, vertebral pain.
The concept of inflammatory spinal nerves roots lesions was dominant at this stage of the development of pathology theory we are speaking about. The cause of radicular disorders were seen in infectious inflammation of various parts of extradural portion of root, including Ganglionic and funicular ones (according to Sicard, 1918). Reflecting these views the term sciatica was walking among Soviet neurologists (Margulis M.S., 1932).
The science development has identified vertebrogenic of manifested radicular disorders specifically and clinically. To consolidate this achievement, a scientific term was required, which should to mean the connection between the radicular violations and the appropriate type of pathology of the spine. During this period, a roll was made in the direction of mortem (Ch.G. Schmorl) and x-ray-anatomical (Kosinskaya N.S., 1961) studying of the vertebral pathology variety.
R. Beneke (1897) observed degenerative changes in the spine much earlier and collectively labelled them with pretty good term “spondylosis”. Later, Ch.G. Schmorl, having examined the pathomorphological changes in the intervertebral disc and adjacent vertebral bodies carefully, proposed to call them as an interbody osteochondrosis (osteochondrosis intercorporalis), and used the term “spondylosis” proposed by R. Beneke, to denote changes in the area of the anterior longitudinal ligament. Since that time quite bad tradition of naming of their established terms for the scientific and speculative ideas about the nature of pathological vertebral changes started.
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