A vertebral hernia is a rather dangerous disease, often leading to serious consequences with the end result being complete or partial disability. Registration of disability after surgery to remove a herniated disc, as a rule, is possible without any special problems only in the most difficult cases; in other cases, deciding on the issue of obtaining the status of a disabled person involves collecting the necessary package of documents and mandatory completion of the medical examination. Undoubtedly, every patient who has undergone surgery to remove an intervertebral hernia should know his rights and conditions for registering disability.
What is an intervertebral hernia?
Intervertebral hernia refers to diseases of the spinal column in which inflammation and destruction of the intervertebral disc occurs. In this case, destructive processes are accompanied by destruction of the fibrous ring and displacement of the vertebrae from the main axis of the spine . Most often, intervertebral hernia appears in the lumbar region. It can occur in the cervical and chest, but this phenomenon is less common.
Intervertebral hernia is the most popular spinal disease for which surgical intervention is performed. The most common reason for surgery is severe back pain, as well as exacerbations even with minimal physical exertion.
Rules for performing exercises
- On the first day, classes are carried out in bed, and they start with the simplest - movements of the hands, feet, flexion/extension of the knees and elbow joints, breathing exercises and controlled contractions/relaxations of individual muscle groups. Gradually and very carefully, the spectrum of exercise therapy is expanding in the future.
- Each element of the movements is performed calmly, slowly and smoothly, while you cannot force the amplitude and do the recommended exercises more than the prescribed number of times.
- Exercise should not provoke pain or lead to an increase in any discomfort that you still have. If this happens, immediately stop doing the painful exercise and consult your doctor immediately. It may be too early for you to undertake such a task. In any case, do not do anything through pain and, especially, do not ignore this fact!
- If, during any physical activity, you feel severe pain with a rapid increase, sharp severe pain or crepitus (unnatural sounds, such as crunching, clicking, etc.) in the place where the metal structure is located, immediately inform your doctor! It is possible that the unfavorable pathogenesis is associated with breakage or loosening of the installed implant.
Stages of hernia
The course of the disease can occur with different symptoms depending on its stage.
Stages of development of a spinal hernia
There are the following stages of intervertebral hernia::
- vertebral disc protrusion . Accompanied by incomplete rupture of the fibrous ring, in which part of the nucleus can come out. At this stage, the pain is mild, there are lumbago, which intensify after physical exertion;
- partial prolapse of the intervertebral disc . Protrusion of the nucleus pulposus is most pronounced. The pain becomes chronic and localized in the affected area. The blood supply to the intervertebral disc is disrupted;
- complete prolapse of a vertebral disc . The nucleus almost completely leaves the annulus fibrosus and extends beyond it. With constant pain, limited mobility occurs due to severe pain. Shooting may occur in the leg or thigh. With a cervical hernia at this stage, a severe headache appears, the scapular area goes numb;
- flow of the nucleus beyond the ring (sequestration) . The intervertebral disc is displaced, causing pinching of the nerve endings of the spine. The syndrome is accompanied by severe and constant pain, leading to limited mobility of the spine in the area of pathology.
When the pain syndrome does not respond to conservative treatment, surgical intervention is resorted to.
Important! The effectiveness of treatment for intervertebral hernia depends on the stage of detection of the pathology and the start of treatment. The earlier the disease is detected, the greater the chances of recovery.
Complications after installation
There is no need to immediately panic if the temperature rises in the early phase after the intervention, you feel a foreign object in the operated area, swelling and pain. All these early reactions are not always interpreted as complications, but for the most part are the body’s natural physiological response to surgical trauma. In the hospital, and after discharge, in the rehabilitation center, they will create an effective recovery program for you. Therapeutic measures will help strengthen nutrition, activate regenerative and reparative processes in the problem area, strengthen the muscular frame of the back, which will gradually lead you to the desired recovery.
At what stage of intervertebral herniation do people become disabled?
Intervertebral herniation can lead to disability even at the stage of intervertebral disc protrusion . Despite the fact that protrusion can be successfully treated, if the disease limits motor function, disability may be prescribed.
Disability for a herniated disc is assigned depending on the symptoms of the disease:
| First disability group | Assigned when it is impossible to recover at the main place of work due to partial or complete paralysis. Most often this occurs at the sequestration stage. |
| Second disability group | It is prescribed for prolapse of the vertebral disc core in the postoperative period, with persistent pain syndromes, limited mobility of the spine, when combined therapy and surgery do not bring results. |
| Third disability group | This category includes patients who experience mild pain in the presence of an intervertebral hernia, which worsens systematically. This condition is observed with disc protrusion. In such a situation, the patient is transferred to light labor. When adapting to new working conditions, disability can be removed. |
Please note in what cases in case of a herniated disc you can apply for disability. Indications for obtaining disability in case of intervertebral herniation may be:
- severe, constant, often with acute periods of back pain;
- frequent requests from the patient for a certificate of incapacity for work;
- ineffectiveness of continuous conservative treatment for more than four months;
- impaired coordination of the limbs, which negatively affects the quality of life;
- complications that disrupt the functioning of internal organs (genitourinary, cardiac, respiratory systems).
Important! Disability due to intervertebral hernia is assigned based on the results of a multi-stage examination, which is carried out by specialists in the field of spinal diseases. The medical examination provides for several provisions that must be met in order to assign a disability.
Indications for passing the ITU
Experts advise applying for confirmation of disability in cases where:
- severe pain periodically worsens;
— conditions often occur that interfere with work, etc.;
- signs of the disease have become more pronounced;
- diseases of internal organs have developed;
- it became difficult to control movements.
In other words, the pain should not be controlled by medications (they no longer work). It is also necessary that the symptoms and discomfort last up to 4 months. Lack of motor control (for example, arms or legs) and problems with coordination in combination with other conditions (for example, problems with the heart, kidneys, etc.) are an indisputable reason for undergoing an examination.
It is worth keeping in mind: to assign a disability, the presence of a clear clinical picture is not at all necessary; the absence of a good result from the therapy is sufficient.
What examinations are needed to obtain disability?
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Next fact
In order for a medical commission to assign a disability to a patient, a whole range of measures must be completed , the results of which can confirm the need for disability. In addition, you should collect a package of necessary documents.
Medical measures include:
- examination of the spine using magnetic resonance imaging;
Intervertebral hernias are clearly visible on MRI
- X-ray examination of the spine;
- if there are circulatory disorders due to protrusion of the nucleus of the annulus fibrosus, it is necessary to conduct electromyography (study of the cerebrospinal fluid channels of the spinal cord);
- rheovasography (study of blood circulation in the pathological part of the spine), in the presence of a cervical hernia - rheoencephalography (study of the vascular system of the brain);
- lumbar puncture (extraction of cerebrospinal fluid for examination).
If an operation is performed, a neurosurgeon's report must be provided. In addition, you must provide the results of urine tests and a general blood test.
In addition to the conclusions of a medical examination of the spine for a hernia, in order to obtain disability, you must collect a package of documents:
- referral for medical and social examination;
- a certificate from a doctor confirming incapacity for work;
- patient's medical record;
- an extract from the medical record if there is no medical record.
If the patient confirms his disability or re-passes the commission, he should provide:
- certificate of disability;
- conclusion on the process of the rehabilitation period;
- examination results;
- passport, pension certificate, insurance policy.
Important! The presence of all documents does not guarantee the assignment of disability. This is especially true in cases where the patient refused to carry out procedures prescribed by the doctor or from inpatient treatment. In this case, the application for disability will most likely be denied due to the patient’s refusal of the recommended treatment.
Video: “Treatment of spinal hernia: opinion and personal experience”
Find out how therapy is carried out for a herniated disc:
- How much does surgery to remove a herniated disc cost?
- The surgical treatment of cervical hernia is described in the following article
- How to remove a hernia of the lumbar spine can be read here
- Drugs for the treatment of hernia in the lower back are described on the page pozvonochnik/drugie-zabolevaniya/mezhpozvonochnaya-gryzha/medicamentoznoe-lechenie-gryzhi-poyasnichnogo-otdela-pozvonochnika.html
- Physiotherapy, magnetic therapy and electrophoresis for spinal hernia
Operation
Surgical intervention consists of excision of the hernial sac and strengthening of the inguinal canal in the area of the hernial orifice using local tissue plastic surgery or using a mesh implant - this operation is called inguinal allohernioplasty. Our clinic uses the latest generation of synthetic implants; over time, the mesh elements grow with the patient’s own tissues and it becomes impossible to distinguish the implant even with the use of equipment. Due to the exceptional strength of the implant, the likelihood of future relapse is minimized.
The operation in our clinic is usually performed using laparoscopy. Inguinal allohernioplasty is performed using video endoscopic equipment through small incisions, the length of which does not exceed 5 mm. It is worth noting that surgical treatment in men presents certain difficulties due to the close localization of important anatomical structures. However, our surgeons perform operations under visual control using modern equipment, so the likelihood of complications is excluded.
Painlessness and lack of blood loss, a short rehabilitation period and quick recovery are the main advantages of the laparoscopic method. In our clinic, patients can go home already on the second day after surgery.
The sequence of the procedure for obtaining disability for a herniated disc
The main basis for obtaining disability due to a hernia is an entry on the patient’s chart about the presence of an intervertebral hernia . This indicates that the patient has undergone surgery, and conservative treatment does not bring the result necessary for normal functioning and ability to work.
In order to obtain disability, you must go through all stages of this process. This process involves studying the physiological state of a patient with a herniated disc, as well as studying aspects of his life.
Sequence of actions in the presence of a hernia to confirm disability and obtain disability:
- obtaining a certificate from the attending physician, which confirms the patient’s disability, from a neurosurgeon, neurologist;
- undergoing all medical measures to obtain both pictures of the disease;
- providing members of the medical and social examination with the necessary certificates, documents and examination results.
Read more about the procedure for obtaining disability in case of spinal hernia. In addition, the commission staff studies the social status of the patient. This is necessary in order to understand what kind of social assistance the patient received if he had the disease, as well as the patient’s income before the disease. The severity of the disease, the cause of its occurrence, and adherence to the doctor’s recommendations for treating the disease are considered.
The financial condition of the patient is significant for the commission's decision to assign the patient a disability . If there are additional incomes (dividends, other profits), then they will be forced to refuse to receive a disability subsidy.
The commission staff conducts a survey of the patient about his relatives, work activity, the ability to do simple work, life satisfaction and the ability to lead a limited lifestyle.
After going through all the procedures, the decision remains with the commission. You should know that disability must be confirmed annually . If there is progress in treating the disease, then the person can be recognized as legally competent.
Documents and criteria for group assignment
The applicant will be required to:
— referral for examination;
— passport and SNILS;
- medical card (or extract).
The results of all diagnostic measures taken before undergoing the MSE are required. If a rehabilitation course has already been completed, you cannot do without describing it. A certificate of disability is needed for those to whom the group was assigned earlier.
Social and material status (for example, income level before illness) is examined. The severity of the condition, its causes and whether medical recommendations were violated are taken into account.
In addition, experts can ask what kind of relationship the patient has with his relatives, how he is able to do simple work, what kind of life he leads, how satisfied he is with the quality of his life, etc. That is, objective and subjective components play a role.
Most often, disability is granted for a year with subsequent re-examination. If your health improves during this time, your incapacity status may be lifted.