The mobility of the spinal column is ensured by the good functioning of the discs between the vertebrae. They represent the nucleus pulposus, surrounded by a denser component – a ring of fibrous tissue.
The disc interlayers are designed to provide cushioning between the vertebrae. The health of the ridge largely depends on their condition.
A hernia is formed when the structure of the disc is disrupted as a result of its change or displacement. For various reasons, a rupture of the dense membrane occurs and, as a result, the protrusion of the nucleus pulposus.
Causes of a hernia of the spine
The analysis of the prerequisites leading to disruptions in the disc is divided into internal causes and external ones.
Internal factors:
- hereditary predisposition,
- disorders in the connective tissue,
- poor nutrition of the tissues of the disc, violation of metabolic processes.
External reasons:
- excessive physical activity,
- improper posture
- Unhealthy Lifestyle:
- the ridge receives little physical activity,
- bad habits such as smoking.
A combination of several causes often leads to violations. The disc body has no blood vessels. In this regard, its nutrition depends on the surrounding tissues, from where it receives it by diffusion.
The movement of the spine promotes the supply of nutrition to the disc. With a sedentary lifestyle, conditions are created for an insufficient supply of necessary substances to the body of the disc.
Smoking reduces the oxygen content in the blood and thus also affects the health of the discs, impairing their metabolism.
Physical labor in a position that promotes displacement of the disc at a time can create conditions for the formation of protrusion. The fibers of the outer ring are programmed for loads of a certain vector and magnitude. The creation of pressure in the other direction or exceeding the permissible limits leads to rupture of the fibrous membrane.
Additional factors:
- Excessive weight creates chronic overload in the back. Normalization of this factor provides prerequisites for improving the condition of the spine.
- In people with tall stature, the possibility of a hernia is more pronounced. It is worth paying attention to prevention.
- Age is a risk factor because the disc tissue ages and becomes less protected from deformations.
- Professions that incline people to a sedentary lifestyle or excessive lifting of weights create the prerequisites for the appearance of protrusions of the spinal column.
Features and signs of the development of pathology
Hernia refers to the severe consequences of osteochondrosis. The main sign of its formation is pain.
The development of the disease takes place in two stages:
- When conditions are created for destructive changes in the disc shell, cracks may first appear. The nucleus begins to protrude beyond the boundaries. This is accompanied by adhesions and edema of the tissues. And only when the deformed part of the nucleus in its distribution reaches the radicular nerve, the body will receive a signal that not everything is in order in the spine through the occurrence of pain.
- A destructive effect on the nerve ending caused by a hernia entails consequences. The pain begins to be projected onto the organs that are controlled by the nerve ending affected by the deformation. This means that the development of the disease has passed to the second stage.
Views
Depending on the area of distribution of the hernia, its introduction into neighboring tissues of the body, there is a division into varieties.
Schmorl’s hernia
The nucleus of the affected disc, when protruding, is introduced into the spongy part of the vertebra. The vertebra has a structure of two types of tissues: a dense bony component surrounds the inner cancellous layer.
Prerequisites for the occurrence of this violation:
- the period of growing up, when soft tissues outpace the growth of bone structures,
- hereditary predisposition,
- microtrauma of the ridge.
During examination, a patient may have one Schmorl’s hernia or several such disorders at the same time.
Sequestered
The disc nucleus protrudes into the canal of the spinal cord, affecting the spinal nerves and the lining of the spinal cord.
Prerequisites:
- all factors that relate to adverse effects on the spine in connection with the possibility of a hernia,
- strong emotional outburst,
- prolonged stay in an uncomfortable position,
- excessive hypothermia.
Symptoms
The main signs of a hernia include:
- backache,
- difficulties with back movements,
- persistent soreness of the lower extremities or other parts of the body – depends on the dislocation of the protrusion.
If there is a problem with a hernia in the neck area, there may be symptoms:
- pressure instability,
- feeling of numbness in the fingers,
- frequent dizziness
- soreness in the arm or shoulder
- a simultaneous combination of several of the listed symptoms.
Signs of a hernia in the thoracic region:
- if the patient works in an uncomfortable position, while experiencing pain in the thoracic region,
- discomfort in the chest area, supplemented by a curvature of the ridge – scoliosis.
Symptoms of protrusion in the lumbosacral region of the spine:
- pain in the lower back,
- the appearance of pain in the leg, which occurs after a short period of time after the previous symptom,
- problems with urination,
- weakening of sensitivity in the legs,
- deterioration of bowel control,
- paralysis is possible.
Diagnostic methods
It:
- The method allows you to see soft tissues, eliminates the harmful effect on the patient’s health – magnetic resonance imaging.
- A type of computed tomography is multispiral. Provides a high level of problem definition and moderate radiation exposure.
- The doctor may prescribe myelography to investigate the problem.
Is it possible to cure
In most cases, it is possible to cure the patient. Much depends on him and his attitude to his health. It is important to see your doctor as early as possible.
Experts agree that, if possible, conservative methods of treating hernia should be used. Surgery is allowed in extreme cases.
If pain and alarms appear, similar to signs of a hernia, you should consult a specialist and undergo a detailed examination. If it is determined that the disease can be treated without surgery, the doctor’s advice should be followed.
Therapy consists of relieving acute inflammation and pain relief. For this, non-steroidal drugs are used:
- celebrex,
- naproxen,
- ibuprofen,
- meloxicam,
- diclofenac,
- acetaminophen.
Usually, injections are first prescribed, after seven days they switch to tablet forms and external preparations. The first three days, you should cancel all loads and give the spine a rest, just lie in bed.
Sometimes, experts prescribe drugs that relieve muscle tension, spasm. When the acute phase of the disease has passed, the following procedures are connected to the treatment:
- spinal traction,
- special gymnastic exercises for hernia,
- manual therapy,
- physiotherapy,
- wearing corsets.
If the treatment does not bring relief, an epidural block is prescribed.
Under the control of an X-ray device, anesthetic substances and hormones are injected with a special needle into the place of the problem. The procedure is performed under local anesthesia. In half of the cases, this treatment leads to recovery.
Surgical intervention
One tenth of patients are forced to undergo surgery. These patients may have severe damage to the nerve fibers.
A modern, gentle method of surgical intervention is microdiscectomy. The procedure is performed with microinstruments under observation through a microscope. Removal of a hernia occurs without injury to the surrounding tissue.
The postoperative period is minimal. The patient leaves the hospital on the second day after the procedure.
| Description of the size of the hernia | What is the size of the protrusion, mm | Necessary treatment | |
| Cervical | |||
| Large protrusion size | 6 and more | Surgery required. | |
| Belongs to large size | 5 | It can be treated on an outpatient basis, if there is no success, then surgery. | |
| average value | 3 to 4 | Complex treatment is urgently needed. | |
| Slight protrusion | 1 to 2 | The same recommendations as in the previous case. | |
| lumbar and thoracic region | |||
| Large hernia | More than 12 | If a spinal cord injury is found, the operation should be carried out as quickly as possible. In other cases, it can be treated on an outpatient basis. | |
| Large hernia | 9 to 12 | The same recommendations as in the previous case. | |
| The average size | 6 to 8 | It must be treated on an outpatient basis. | |
| The size of the protrusion is small | 1 to 5 | It is possible to fulfill the doctor’s recommendations at home or outpatient treatment. | |
Where to treat
If the diagnosis has established a slight protrusion, then you can be treated at home by necessarily showing a doctor for observation. To perform the procedures, you will have to visit the outpatient clinic during treatment.
In case of serious problems with the spine, you should trust the specialists and choose a clinic with extensive experience in treating patients.
Consequences of the disease
A neglected sequestered hernia can create problems:
- decreased tendon reflexes,
- backache,
- an aseptic inflammatory process may occur,
- limiting the ability to move to paralysis,
- the appearance of pain in the legs,
- discomfort in other parts of the body.
Schmorl’s hernia is fraught with consequences:
- often does not give a pain symptom and is detected during the examination,
- reduces the strength of the spine,
- creates the prerequisites for limiting freedom of movement in the affected segment of the spine.