The normal functioning of the spine can be seriously hampered by a dangerous pathology - intervertebral hernia. The intervertebral disc becomes inflamed, deformed, displaced, or the fibrous ring is destroyed. A spinal hernia, depending on the stage of development, can be accompanied by severe pain and serious disturbances in the functioning of the spinal column. In many cases, the disease disconnects a person from a normal lifestyle. Pathology of the lumbosacral region is more common than that of the cervical and thoracic regions. A sedentary and sedentary lifestyle, spinal injuries, excessive body weight, osteochondrosis, heavy physical activity and congenital anomalies are the main causes of the disease.
The need for treatment of intervertebral hernia
If a formation is detected, medical intervention is a mandatory indication. A hernia provokes severe pain and serious consequences for the entire body. Treatment may not be required only if the hernia does not put pressure on the nerve roots and does not lead to complications. For disc degeneration and protrusion, conservative treatment is prescribed; for extrusion and sequestration, surgical intervention is preferred. In any case, a vertebral hernia cannot be left without attention. The disease entails many irreversible pathologies, including paralysis of the limbs and dysfunction of internal organs.
Establishing diagnosis
Diagnosis of intervertebral hernia is of key importance for choosing a treatment regimen and is carried out using the following methods:
- MRI of the spine. “Gold standard” for identifying pathological changes in muscles, ligaments and nerve structures.
- CT scan of the spine. Allows you to assess the condition of bones and soft tissues.
Ultrasound for intervertebral hernias is not the main way to diagnose spinal diseases. X-rays are prescribed only to determine the traumatic or non-traumatic nature of existing disorders.
Need for medical assistance
Regular back pain cannot be ignored. Often a painful syndrome can signal overwork, but herniated disc protrusions cannot be ruled out. You should be especially concerned about:
- pain radiating to the lower extremities, which intensifies during movement;
- painful sensations in the legs at rest, impaired sensitivity;
- increased muscular-tonic syndrome;
- discomfort, stiffness and limited movements, inability to move independently;
- loss of control over the processes of urination and defecation.
If the above signs appear, you need to visit a doctor urgently. Only a specialist neurosurgeon can make an accurate diagnosis after examination and diagnostic tests. Modern diagnostic equipment allows you to choose the right treatment method for diseases such as intervertebral hernia, as well as cervical osteochondrosis.
Causes of the disease
When body position changes, the intervertebral discs compress and push the ring out. If the discs are in a healthy state, no structural changes are observed. With the development of an intervertebral hernia, the nucleus pulposus of the disc is displaced and the fibrous ring is stretched (protrusion).
This is the first stage of development of an intervertebral hernia. If you do not see a doctor in time, further stress leads to rupture of the fibrous ring and prolapse of the nucleus. After this, the disease enters its destructive phase. Severe pain begins, sometimes neurological complications in the extremities are observed, and paralysis is possible.
Reasons influencing the development of pathology:
- typical back injuries;
- overweight;
- osteochondrosis;
- unsuccessful sudden movement;
- excessive stress on the spine;
- diseases associated with the destruction of bone or cartilage tissue;
- curved spine.
There are certain groups of people who have a doubled risk of developing an intervertebral herniation of any part of the spine, in particular the sacral region. This age category is from 25 to 50 years old, truck drivers who are forced to spend a lot of time behind the wheel, office workers who work for long periods at the computer.
The pressure on the spinal discs in a sitting position is much greater than when walking. With limited mobility, blood circulation in the muscular system becomes difficult, and this leads to loss of fluid reserves in the core.
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Do treatment methods depend on the type of hernia (thoracic, cervical, lumbar spine)
The method of getting rid of the disease depends not so much on the type of hernial protrusion, but on the stage of development of the formation and its consequences. Conservative treatment methods and surgical intervention are used. For pathology of the thoracic spine, the following is prescribed:
- Complex conservative treatment: — orthopedic regimen; - drug therapy; — physiotherapy; — massage, manual therapy; — cuff unloading of the spine.
- Surgery.
To relieve the symptoms of a herniated cervical spine, the following is used:
- drug treatment;
- massage;
- spinal traction;
- operation.
In the case of hernial formations in the lumbar region, medication therapy is also used, it is recommended to maintain a healthy lifestyle and reduce physical activity, therapeutic exercises and massages. If conservative methods do not help and the disease develops further, surgical intervention is prescribed.
Prevention
To reduce the chances of a hernia, you need to monitor your lifestyle.
What to do first:
- stop smoking;
- reduce the amount of alcohol to a minimum;
- do stretching exercises every day;
- undergo a course of massage or manual therapy once every six months;
- avoid stress;
- sleep at least 7-8 hours;
- balance your diet.
A herniated disc is one of the most serious back diseases. You should not start it even if there are no unpleasant sensations - in the most severe cases, the disease can lead to disability.
Effective methods of treating vertebral hernia
In the neurosurgical department of Dr. Zavalishin E.E. For the treatment of hernial protrusions, non-surgical (at the stage of degenerative changes and protrusion) and surgical methods are used. It is possible to prescribe an effective plan for eliminating the symptoms of pathology only after determining the type and stage of development of the disease. The clinic also diagnoses and treats brain tumors such as cavernoma.
Conservative methods that help alleviate the painful syndrome:
- medicines;
- physiotherapy and manual therapy;
- traditional therapy;
- physiotherapy.
In some cases, non-surgical methods are ineffective and surgery is prescribed to eliminate the intervertebral hernia.
Main services of Dr. Zavalishin’s clinic:
- consultation with a neurosurgeon
- treatment of spinal hernia
- brain surgery
- spine surgery
Pain intensity
If the patient suspects that he has a herniated lumbar disc, then appropriate treatment is prescribed only after confirmation of the symptoms. As mentioned above, the main symptom of the disease is pain. Most often he is of a dull nature. Increased discomfort can be observed after a person remains in one position for a long time. Temporary relief comes from changing the position of the body.
It is a mistake to assume that a lumbar disc herniation is a passing phenomenon and to delay treatment. Over time, the disease can become more progressive, causing multiple pinching of nerve endings.
Over time, the pain syndrome can be localized in the gluteal area or accompanied by lumbago in the lower back. This process is called sciatica.
Treatment with drugs
After diagnosis, the patient is recommended to diet and maintain a healthy lifestyle, exercise therapy in combination with taking medications. Massage, manual therapy, and acupuncture are also recommended. Only the attending physician can prescribe medications after examination and a complete examination. Types of drug therapy:
- etiotropic;
- symptomatic;
- pathogenetic.
The patient is prescribed medications:
- to relieve inflammatory processes in the form of injections;
- to relax muscles to tone them;
- chondroprotectors in the form of intramuscular injections to restore the fibrous ring;
- vitamin complexes to improve metabolism in the body.
A correctly drawn up conservative treatment plan and strict compliance by the patient with the doctor’s instructions, as a rule, gives a positive result without the need for surgical intervention.
What are drug blockades?
A spinal block is used to relieve pain symptoms. The effect after the procedure lasts about a month. Pain relief allows you to speed up the recovery process - engage in physical therapy without discomfort and take medications without interrupting your usual lifestyle.
The blockade should be carried out only by a neurologist or neurosurgeon with mandatory monitoring of the procedure on the monitor. Before the blockade, the doctor administers local anesthesia; the whole process takes about half an hour. The patient is administered single-component, two-component or multicomponent drugs. The analgesic effect is felt immediately. Blockade is not a treatment method. The manipulation is intended to relieve pain in combination with conservative treatment.
What are the methods of anterior abdominal wall plastic surgery?
Plastic methods can be tension or non-tension.
Tension is a type of plastic surgery performed using the patient’s own tissues. This method received this name because, in order to eliminate a hernia defect, the tissues must be “tightened” and sewn together. The resulting tension in the tissues can cause pain after surgery and result in a possible relapse. At the present stage of development of medicine, this method of closing hernias defects is significantly inferior to non-tension methods.
Tension-free plastic surgery involves the use of modern mesh prostheses to strengthen the anterior abdominal wall. The prosthesis is a polypropylene network, which, due to its flexibility, strength and high degree of tissue “germination”, has shown its reliability and safety when used in hernia repair. Mesh prostheses come in different sizes, from small ones with a diameter of 5 cm for umbilical hernias, to large ones of 50 x 50 cm for giant incisional hernias. Modern three-dimensional mesh systems make it possible not only to strengthen the hernia defect in the form of a “patch”, but to completely fill it, significantly reducing the risk of relapse. In some situations, a special mesh is installed, the surface of which is coated with a special composition that allows it to safely contact the abdominal organs and avoid the formation of adhesions between them.
The open hernia repair operation consists of several stages:
- Isolation of the hernial sac. A skin incision is made above the hernial protrusion, the hernial sac is freed from the surrounding subcutaneous fatty tissue. The “hernial orifice” is distinguished.
- The hernial sac is opened, the condition of the contents of the hernial sac is assessed, and if there are no complications, the contents are immersed in the abdominal cavity.
- The hernial sac is excised, stitched and plunged into the abdominal cavity.
- The integrity of the anterior abdominal wall is restored (plasty is performed).
Spinal hernia surgery
In case of rupture of the intervertebral disc, deterioration of the patency of the spinal canal, inflammation of the sciatic nerve or severe displacement of the disc, surgical intervention is performed:
If the disc is damaged, an implant is installed. Mostly, the operation gives a positive effect and guarantees a complete recovery. After surgery, the patient should be under the supervision of the attending physician.