Spinal hernia treatment
Chronic back pain radiating to the chest or leg is an alarming symptom. Often they point to very dangerous ailments of the ridge, including spinal hernia. This disease without the timely start of therapy can lead to paralysis.
Therefore, treatment of hernia of the spine should be competent and operational. This is the only way to stop the symptoms and stop the progression of the disease.
Concept and types
Intervertebral hernia - the process of displacement of the pulpous nucleus in the region of the intervertebral disc, accompanied by the breakthrough of the fibrous ring. The bulging out contents can put pressure on the nerve roots and on the spinal cord, which is fraught with the development of paralysis. Therefore, intervertebral hernia requires treatment to begin urgently.
Doctors distinguish 4 stages of disease progression:
- the presence of degeneration in the fibrous ring;
- appearance of protrusion;
- extrusion or breakthrough fibrous ring;
- development of sequestered damage.
Depending on the area of the ridge in which the damage is located, they distinguish the following types:
- cervical disease;
- thoracic disease (occurs less frequently than other types);
- affecting the lumbosacral region (the most common type).
Depending on the severity, in addition to the usual and uncomplicated damage to the spine, physicians distinguish such varieties:
Sequestered intervertebral hernia.
It is a disease accompanied by rupture of the fibrous ring, with complete loss of pulp content. The presence of sequestered intervertebral hernia - an indication for surgery.
Wandering sequestrated pathology.
This is the process of complete separation of the pulpal component with its migration beyond the affected disk. This pathology requires an urgent operation in an institution that has the appropriate equipment. It is important to pre-do not only MRI, but also CT. So, during the operation, the surgeon will not have unpleasant surprises for which he is not ready in material terms.
Calcified intervertebral hernia.
This is the presence of bone components that require removal.Usually this problem also requires surgery.
Pathology of Shmorlya.
This is a hereditary pathology, in which the bone component does not keep pace with the muscle frame, in connection with which voids form in the vertebral bodies. Modern treatment of this pathology is reduced to the observation of its dynamics.
There is also a classification of such diseases of the spine, depending on the location relative to the longitudinal ligament:
This is one of the most simple pathologies, the treatment of which is usually conservative. Symptoms of the disease are often absent and usually the problem is discovered by chance.
Loss is carried out from behind, into the lumen of the spinal canal. This is the most common location of the lesion. Treatment may be conservative. However, if the result is absent within 1 - 2 months, then the appointment of the operation is recommended.
The disease is localized in the lumbosacral region and is located, in particular, on the transitional vertebra (L5 / S1). Treatment is usually radical. The operation is prescribed in the presence of a large protrusion.
This is the most painful type of disease.The symptoms are extremely intense, since the protrusion of the pulpal content occurs in the region of the cuff of the nerve root and is accompanied by squeezing of the dural sac. With this arrangement, the spinal lesions recommended surgery.
Symptoms of the disease are expressed by radiating pain. Most often, the pathology is located in the lumbosacral region. Unpleasant sensations can not be completely eliminated with analgesics. Such pronounced symptoms are a consequence of the fall of the pulpal contents into the lateral pocket. The treatment of this pathology is an operation.
Localization may be in the region of the cervical, thoracic and lumbosacral spine. At the same time, the hernia is small and bulges in a narrow foral foramen.
This damage to the spine is extremely difficult to diagnose, it is rare. The treatment of this pathology of the spine is surgical.
The most common lesions of the lumbosacral region of the ridge (up to 96% of cases). The second place in terms of incidence is hernias of the cervical region (up to 5% of cases), and the most rare are the lesions of the thoracic spine (up to 2% of cases).The most rare is the thoracic pathology of intervertebral discs.
Symptoms of the disease
The manifestations of this disease is extremely extensive. They mainly depend on the affected area. So, if you have an intervertebral hernia of the lumbosacral spine, the symptoms will be as follows:
- pain in the lumbar region, which has a tendency to increase after exercise;
- a sign of damage to the lumbosacral region is the appearance of numbness in the lower extremities;
- pain sensations extending to the area of the buttocks, the posterior surfaces of the thighs and the legs;
- a sign of damage to the lumbosacral region is weakness of the lower extremities, accompanied by problems with the sensitivity of the legs;
- problems with urination, acts of defecation and potency;
- symptom of lesion of the lumbosacral spine - the presence of numbness in the genital area, perineum and anus.
With the defeat of the neck zone of the ridge, the following signs of illness can be observed:
- pain syndrome with irradiation to the arm or shoulder;
- dizziness may indicate a lesion in the cervical region;
- frequent increases in blood pressure may indicate a breakthrough fibrous ring;
- manifestation of protrusion in the area of the cervical region is a combination of dizziness, migraines and high blood pressure;
- presence of numbness in the fingers.
As you can see, signs of damage to the cervical spine are highly non-specific.
Patients complain of such problems:
- the presence of persistent pain in the retrosternal space;
- change in the severity of unpleasant sensations when changing the posture is a sign of pathology of the thoracic region of the ridge;
- thoracic spinal hernia is often complemented by scoliosis or kyphoscoliosis.
To distinguish the defeat of the thoracic ridge from other ailments is quite difficult. This is due to the fact that this pathology is extremely rare, so doctors prescribe important studies (MRI and CT) only in the last place.
Features of therapy
When an intervertebral hernia is detected, complex therapy is prescribed. In the absence of indications for surgery, conservative treatment and observation are recommended.After all, most hernias self-dry within 6 - 12 months. If the dynamics worsens, the lesions of the cervical, thoracic or lumbosacral parts require surgical intervention.
Non-surgical treatment of this pathology is reduced to the use of such methods:
- taking nonsteroidal anti-inflammatory drugs;
- local blockade;
- Exercise therapy.
If conservative treatment of the disease does not produce results within 4 to 12 weeks, surgery is indicated. It does not matter if a lesion of the cervical, thoracic or lumbar region was found.
In the absence of improvements after the conservative treatment of intervertebral hernia, doctors recommend surgery. Also indications for urgent surgical intervention are the following symptoms:
- loss of control of feces;
- there is no effect from analgesics and local blockades;
- numbness in the perineum and legs;
- weak legs;
- development of paralysis.
Usually, such symptoms are observed only in an insignificant number of patients with a diagnosed intervertebral hernia (up to 10%), and require microdiscectomy.This is a minimally invasive surgery, the duration of which is no more than an hour (usually about 30 minutes). As a rule, patients are discharged after it on the second day and further rehabilitation takes place at home.