Patients begin to ask the question of how to restore intervertebral discs after examinations. This is usually an MRI, which is ordered after treatment with acute back pain. In approximately 70% of cases, patients exhibit varying degrees of severity of degenerative changes in the cartilaginous tissues of the intervertebral discs.
Before restoring intervertebral discs, it is necessary to identify the potential cause of the development of this process. Osteochondrosis develops gradually and the first prerequisites for this are laid during the teenage transition period. Against the background of hormonal changes in the body, combined with uneven rapid growth of the skeleton and muscular frame of the body, there is a deficiency in nutrition of the cartilage tissue of the spinal column.
To understand this process, I advise you to gain basic information on the anatomy and physiology of the human spine. Let's start with the fact that this is a supporting structure, hollow inside and providing reliable protection for the spinal cord, which controls the vital functions of the entire human body.
The spine is not solid, it consists of individual vertebral bodies and intervertebral discs separating them. The vertebrae, together with the arcuate processes, form an oval foramen, which forms the basis of the spinal canal. The intervertebral disc has the unique ability to ensure uniform distribution of shock-absorbing load and protect the spinal cord and the radicular nerves extending from it from pressure from the vertebral bodies.
The disk consists of two parts. This is a dense but elastic outer shell - the fibrous ring. Inside it is a gelatinous (jelly-like) body - the nucleus pulposus. The intervertebral disc does not have its own vascular network. Its nutrition is carried out only when the paravertebral muscles surrounding the spinal column are fully functioning. Muscles contract and release a certain amount of fluid enriched with oxygen and nutrients. The annulus fibrosus of the intervertebral disc absorbs this fluid. When compressed, the intervertebral disc releases fluid with decay products, which is absorbed by the muscles and sent into the venous bed.
If this process of diffuse nutrition is disrupted, then degenerative dystrophic changes begin in the intervertebral disc:
- the surface of the fibrous ring becomes dehydrated and loses its elasticity;
- when such a disk is subjected to a standard shock-absorbing load, a network of small cracks forms on its surface;
- they are filled with deposits of calcium salts - this becomes an obstacle to the full absorption of fluid in the future;
- with total dehydration, the fibrous ring begins to take fluid from the structure of the nucleus pulposus;
- it decreases in size and the height of the intervertebral disc decreases - this is the stage of protrusion;
- when the volume of the corpus pulposum decreases, the ability of the intervertebral disc to evenly distribute the shock-absorbing load is lost;
- with a sudden movement or when performing unusual physical activity, the fibrous ring ruptures and part of the nucleus pulposus comes out through it - this is the stage of intervertebral hernia.
With total destruction of the intervertebral disc, the nucleus pulposus separates from the fibrous ring. It begins to move freely along the hard membranes in the spinal canal or along the spine. This stage is called sequestration. It is no longer possible to restore intervertebral discs. At all other stages of their destruction, it is possible to restore diffuse nutrition and start the process of regeneration of cartilage tissue using manual therapy methods.
If you have been diagnosed with degenerative dystrophic disease of the intervertebral discs (osteochondrosis or dorsopathy), we advise you to begin restoring cartilage tissue as quickly as possible. To receive a free individual consultation, you can make an appointment right now with a vertebrologist or neurologist in our manual therapy clinic. Experienced doctors will conduct an examination, get acquainted with the conclusions of the examinations performed and give individual recommendations for rehabilitation therapy.
Information: Intervertebral disc replacement
- Duration of stay in the clinic:
2 days after prosthetic disc replacement in the cervical spine and 10 days in the lumbar spine - Inpatient rehabilitation:
14 days after cervical disc replacement and 21 days for lumbar disc replacement - Earliest time to fly home:
7 days after cervical disc replacement and 21 days for lumbar disc replacement - Recommended time to fly home:
14 days after cervical disc replacement and 21 days for lumbar disc replacement - Showering is possible:
7 days after prosthetic disc replacement in the cervical spine and 10 days in the lumbar spine - Duration of disability:
4 weeks after both surgeries - Removal of sutures:
after cervical disc replacement there are no stitches, 14 days after lumbar disc replacement - Driving a car is possible:
7 days after prosthetic disc replacement in the cervical spine and 28 days in the lumbar spine - Cost of the operation:
12,000 EUR regardless of department
medical request
When is intervertebral disc replacement necessary? © Spinal Kinetics
Lifestyle after spine surgery
After undergoing surgery with the implantation of a metal structure, a person will have to reconsider some of his habits and be more attentive to his health. So, he is recommended:
- engage in exercise therapy daily according to an individually drawn up plan;
- Healthy food;
- take measures to strengthen the immune system;
- do not perform heavy physical work;
- avoid serious weight gain.
As for sexual activity and pregnancy, sexual activity can often be resumed within 2–3 weeks after surgery. But you should choose positions for this so that your back does not strain. Pregnancy is allowed only one year after surgical treatment, but in some cases this period may increase.
Each spinal operation, during which fragments of the spine were partially or completely removed and replaced or fixed with metal structures, is a complex procedure. Of course, it has risks that can lead to deterioration of the patient’s condition and disability. But, fortunately, the modern level of development of neurosurgery makes it possible to reduce the number of such episodes to a minimum, especially if the surgical intervention is performed by an experienced neurosurgeon who thoroughly knows the techniques for installing metal structures. As a result, the patient gets rid of pain, gets the opportunity to move fully again and regains lost performance.
When is a complete spinal disc replacement necessary?
Total disc replacement is necessary for patients suffering from a pinched nerve in the lumbar spine due to degenerative disc disease.
For more than ten years, intervertebral disc prostheses have been in a constant state of development. After numerous modernization processes, artificial discs have become a significant and reliable alternative for the treatment of degenerative changes in the intervertebral discs.
Modern M6 intervertebral disc prostheses
are an excellent alternative to the previously known and successful operation for vertebral fusion.
Indications for spinal surgery with metal structures
Various metal structures are widely used in neurosurgery to stabilize a specific area of the spine. They are needed in many situations, including:
- injuries (dislocations, fractures);
- degenerative-dystrophic processes;
- congenital and acquired spinal defects, including scoliotic deformity;
- spinal neoplasms;
- pronounced vertebral listhesis;
- formation of false joints;
- unsuccessful spinal surgery.
All this negatively affects the quality of life and motor abilities of a person. Stabilizing metal structures can eliminate instability of the vertebrae and bring their position closer to normal.
Spinal surgeries using metal structures are prescribed in extreme cases when conservative treatment is unsuccessful. The installed structures are made of high-strength, biologically inert metals, therefore, as a rule, they are installed once and remain in the patient’s body forever. Only in isolated cases is it necessary to remove the metal structure due to the need for re-operation on a fixed spinal motion segment or the occurrence of unforeseen complications.
Advantages of intervertebral disc replacement compared to spinal fusion:
- Maintaining spinal mobility
- Fast recovery and recovery after surgery
- Long-term improvement in body biomechanics (flexibility and mobility)
- Opportunity to return to professional activities and sports in a short time
- No wear to adjacent spinal segments
- Implantation of an M6 disc prosthesis restores the natural mobility of the human spine
For several years, spinal fusion was the only treatment for pain in the lumbar spine.
This method was also used for fixation in various deformities. With each decade, the methods of achieving a bone block through spinal fusion have improved. Despite this, with spinal fusion there is a risk of degenerative changes in the vertebrae, as well as wear of the intervertebral discs (discopathy) in adjacent segments of the spine.
Spinal fusion is a safe and effective method, but has a negative impact on the dynamics and biomechanics of the human spine, which can limit the patient’s mobility.
Over the years, intervertebral disc replacements have been improved to the point that they are now a successful and reliable alternative for the treatment of intervertebral disc degeneration.
Modern M6 intervertebral disc prostheses are an excellent alternative to the already proven above-mentioned method of spinal fusion.
Contraindications to physical exercises
It is not always possible to carry out spinal rehabilitation therapy with the help of physical exercises. There are cases, for example, when a patient has a hernia with complications. In this case, any physical activity will provoke severe pain due to pinched nerve roots. In such cases, you need to be extremely careful and not allow heavy loads on the spinal column, but you shouldn’t sit too long. You need to move according to your capabilities, for example, walk for two or three hours every day. It is important to listen to your doctor, who knows the individual characteristics of his patient.
There are some contraindications to physical education
When visiting your doctor, it is best to ask what to do during exacerbations. NSAIDs and muscle relaxants can help relieve pain. You usually need to live in a comfortable rehabilitation mode for several months, depending on the condition. If it has improved, then you can add a little load, and so on until the painful spasms disappear forever.
Implantation of a prosthetic intervertebral disc does not have a negative impact on your mobility
Rice.
3: The artificial intervertebral disc can move in six dimensions of the natural mobility of the spine © Spinal Kinetics The natural intervertebral disc maintains the mobility of the spine in any angle and acts as a shock absorber. To avoid loss of natural mobility of the spine, the prosthesis must have the same property.
It is worth noting that only with the help of modern technologies for intervertebral disc replacement (M6 intervertebral disc prosthesis) has it become possible to preserve the natural dynamics of the human spine.
Lumbar disc prosthesis M6-L
designed to restore the anatomy and physiology of the intervertebral disc. In addition, it supports the natural biomechanics of the spine, providing a reliable and long-term solution to the problem.
Disability
The presence of a metal structure of any kind in the spine is not grounds for obtaining the status of a disabled citizen, since on the contrary it is aimed at restoring lost functions, pain and physical limitations.
A disability group can be assigned to a patient only if severe postoperative complications develop that significantly limit his physical capabilities. Therefore, this issue can only be considered if:
- frequent occurrence of long-term physical and neurological disorders that significantly limit the patient’s social, everyday and professional opportunities;
- long-term recovery process;
- cephalgic syndrome (regular headaches, migraines);
- critical movement disorders, in particular paresis, paralysis.
If the recovery process is delayed and unforeseen consequences of surgical intervention occur, the patient is referred for a medical and social examination (MSE). Here he must provide the results of instrumental studies, including ultrasound, REG, MRI. Based on them, the commission members will assess the patient’s health status, level of performance and make a decision on the need to assign disability.
In most situations, patients are assigned disability group 3, somewhat less often - 2. After recommission, it can be removed or transferred to a more severe one. Lifelong disability of the 1st group is given only if it is absolutely impossible to restore lost functions.
Artificial intervertebral disc?
Rice.
4 The prosthesis consists of two hinges, each of which consists of a plate with a friction unit insert. The surface of the plates follows the anatomical shape of the vertebral bodies, which reduces damage at the time of implantation and reliably stabilizes the endoprosthesis. © Spinal Kinetics Modern intervertebral disc implants contain a moving core that provides movement in all directions, similar to a natural biological disc.
This invention provides stable and reliable fixation of the vertebrae, which, in turn, prevents displacement in any direction. In addition, a more complete restoration of the anatomical structure of the spine and its functionality is achieved.
Factors that help speed up spinal rehabilitation and therapy
The role of rehabilitation treatment is to rehabilitate the discs between the vertebrae. It is carried out in stages; it is necessary to timely add load to the muscles, thereby training them. The more trained the muscle corset is, the less load is placed on the damaged vertebrae.
The following activities help in restoring the spine:
- massage sessions;
- Healing Fitness;
- physiotherapeutic procedures;
- healthy eating and sleep.
Physiotherapy and massage can speed up spinal recovery
Often, an inactive lifestyle and its unpleasant consequences, as well as poor nutrition, are the main causes of problems with cartilage. In this regard, salts accumulate in the body, blood vessels narrow, cartilage tissue is destroyed, metabolism deteriorates, and some other consequences arise.
One of the best recovery options is a regular walk. This is because it is called the cycle of alternating tension and relaxation. Using this method in rehabilitation means walking for about an hour every day.
If there is not enough time for a walk, then simple yoga exercises can help the patient out. It is very important not to strain during the first period, because the patient’s task is to improve blood circulation, but not to train muscles. Thus, various stretches, light twists, backbends, etc. may be suitable. After all, everyone chooses a set of exercises for themselves so that they give them relaxation, relieve fatigue, etc. It is recommended to do approaches as often as possible with as many executions as a person considers suitable for himself.
Advantages of an artificial intervertebral disc
The M6-L lumbar disc prosthesis fully matches the structure of the intervertebral disc. A similar result could be achieved with the help of an ultra-modern design that performs the functions of the fibrous ring, as well as the nucleus pulposus. Experience with endoprostheses of this type shows only positive results.
Many patients have already been able to verify the quality of this method, offered in famous clinics in Germany: it is a reliable and safe intervention that relieves patients with lumbar disc degeneration from pain and gives longer-term results than the established method of spinal fusion.
You can find out if this method can help you or a family member by clicking on the link below.
medical request
Possible consequences and complications
In the first time after surgery, an increased temperature may be observed, as well as a sensation of the presence of a foreign object. This is often accompanied by pain of varying intensity and swelling of the soft tissues. This is not a sign of the development of complications and is a natural reaction of the body to surgical intervention.
Complications of the intervention may include:
- infectious-inflammatory process;
- muscle atrophy;
- degenerative changes in adjacent spinal motion segments;
- recurrence of segmental instability;
- spinal canal stenosis;
- paresis, paralysis;
- implant rejection.
The most striking sign of the development of complications is pain that does not decrease over time. Also, the undesirable consequences of spinal surgery with a metal structure may be indicated by the appearance of crunches and clicks in the back when moving.
What are chondroprotectors?
To understand the history of the development of these drugs, let’s get acquainted with them in general. This is a group of drugs whose active ingredients are part of the synovial fluid of the joints.
These include:
• Chondroitin sulfate is a natural component of the intercellular substance of elastic (hyaline) cartilage. It activates the regeneration of chondrocytes (cartilage cells) and suppresses the activity of enzymes that contribute to their destruction. • Glucosamine sulfate is a monosaccharide, a precursor of chondroitin. It stimulates the synthesis of complex proteoglycan proteins, which form the intermediate substance of connective tissue. • Glucosamine hydrochloride. It has a similar effect to sulfate, but is more stable and bioavailable. • Hyaluronan is a preparation of hyaluronic acid, which is part of proteoglycans. It increases the viscosity of synovial fluid and the elasticity of cartilage.
Sometimes chondroprotectors also include piascledin (a herbal preparation that stimulates the regeneration of cartilage tissue) and alflutop (a marine fish extract that activates the synthesis of hyaluronic acid).
Diagnosis of sequestered hernia
This pathology is diagnosed and treated by several specialists. Vertebrologists deal with pathology of the spinal column. Innervation disorders that arise as a result of the development of a hernia are identified by neurologists. Surgical interventions on the spinal cord are performed by neurosurgeons. The best results can be achieved through the coordinated work of all doctors.
Diagnosis begins with a detailed examination of the patient. It allows you to identify the level of damage to the spinal column and the depth of damage. Then they move on to additional diagnostic methods. The gold standard for making a diagnosis is magnetic resonance imaging (MRI).
MRI allows you to visualize in detail each vertebra, intervertebral discs and ligaments of the spinal column. In this way, it is possible to detect a sequester, determine its type and location.
Less informative, but more accessible is CT - computed tomography. It also shows soft tissue, but with a lesser degree of visualization of structures. Another diagnostic method is radiography of the spinal column. It does not show soft tissue, but allows you to assess the integrity of bone structures and their position relative to each other. X-rays are performed in conjunction with MRI or CT.
Laboratory tests will not help make a diagnosis. They are necessary if surgical treatment is chosen. A general and biochemical blood test, a coagulogram and a urine test are the standard list of preoperative preparations.
What types of intervertebral hernias are most difficult to treat?
4 stages of treatment for intervertebral hernia
What is the danger
Destruction of the intervertebral disc goes unnoticed for a long time. The disc is not innervated and has no blood supply in adults. If the sequester does not affect any structures of the spinal cord, it does not pose a danger. The main problem is that there is no free space in the spinal canal. One way or another, some brain structures remain compressed by part of the disc.
The sequester can put pressure on the nerve roots. This stops the transmission of impulses along the nerve fibers. This leads to disruption of the functioning of those organs and parts of the body that were innervated by these fibers. This can cause paresis or even paralysis of the upper or lower limbs.
A sequestered cervical hernia can lead to compression of the vertebral arteries. These arteries supply brain tissue. Poor blood supply to the brain leads to headaches and fainting. Squestered hernias of the lumbosacral region are especially dangerous. They can cause the so-called “cauda equina syndrome”. In this case, the fibers innervating the lower limbs, pelvic organs, and perineum are affected.
Stages of development of a sequestered hernia
In severe cases, a sequestered hernia leads not only to paresis of the lower extremities, but also to disruption of the functioning of the pelvic organs. Urinary retention caused by compression of the cauda equina provokes the development of an infectious process in the bladder. Its complication can be pyelonephritis, an infection of the renal pelvis.
Constipation due to impaired innervation leads to intestinal obstruction and intoxication. The reverse process - urinary and fecal incontinence - is also possible with the described pathology. This significantly complicates social functioning and leads to disability.
Treatment methods
If a patient has worn out intervertebral discs, treatment in most cases is preventative. This means that pathology therapy is aimed primarily at relieving acute symptoms, pain, as well as restoring normal mobility and preventing further progression.
Features of treatment
Drugs
Drug therapy is carried out according to the treatment regimen for acute osteochondrosis and is advisable only if the pain syndrome is severe. The complex treatment regimen usually includes the following groups of drugs:
- non-steroidal anti-inflammatory drugs in the form of solutions for intramuscular administration (Movalis, Meloxicam, Nimesulide, Diclofenac);
"Diclofenac" - local anesthetics in the form of paravertebral or vagosympathetic point blockades (novocaine, lidocaine);
- microcirculation correctors to restore normal blood supply to worn-out discs and improve their nutrition (Trental, Actovegin);
- vitamins and vitamin-like products for the prevention of further degeneration of cartilage tissue (“Calcemin”, “Calcium gluconate”, “Magne B6”, “Milgamma”);
- chondroprotectors (“Dona”, “Teraflex”).
"Teraflex"
In some cases, the patient may be recommended a course of treatment with immunomodulators, but only a doctor should decide on the advisability of such therapy.
Types of sequestered hernia
Sequestered spinal hernias are divided into types in relation to the plane of the spinal column. Thus, they distinguish:
- dorsal (posterior)
– protrude into the lumen of the spinal canal, are most common, are subject to conservative and surgical treatment; - median
- rarely found, mainly between the lumbar and sacral vertebrae, causing concern only in case of intense increase in size; - paramedian
- in this case, the hernia protrudes in the projection of the nerve root and touches it, they are the most painful and quickly lead to complications.
Detailed qualifications in our article “Types of spinal hernias”.
Causes
Damage to the intervertebral discs, their erasure, occurs as a result of the following reasons:
- Scoliosis, kyphosis or lordosis.
- Abnormal pelvic structure, flat feet.
- Narrow shoulder girdle.
- Spinal injuries.
- Metabolic disorders.
- Osteoporosis.
- Gastrointestinal diseases.
- Genetic predisposition.
- Diseases of the cardiovascular system.
These reasons are important both individually and in combination with each other, since together they can have a permanent effect on the body. The presence of these factors does not mean that the disease will necessarily develop and progress, but people suffering from the listed diseases and pathologies are at risk and should be especially attentive to their health.
The development of pathology is accelerated due to poor nutrition, lack of vitamins in the body and due to regular increased stress. Hypothermia can trigger inflammation of the intervertebral disc.