Schmorl's hernia is a disease in which the intervertebral disc protrudes not in the horizontal plane, but in the vertical, and presses through the vertebral body. Its bone structure is destroyed and pressed vertically - up or down, the cartilage tissue of the disc fills the resulting cavity.
Diagnosis by MRI.
The pathology is often hereditary and develops mainly in adolescent children and the elderly due to degenerative processes in the structures of the spinal column.
General information about the disease
The intervertebral disc consists of an elastic core surrounded by a durable fibrous membrane. Under the influence of certain pathological factors, the shell becomes thinner and breaks, and the core begins to form a small cavity in the vertebral bone, simultaneously filling it. This disease is asymptomatic for a long time and is often detected accidentally during examination for one reason or another. Only with significant volumes of the formation does it begin to bulge beyond the boundaries of the vertebra, causing symptoms of compression of the nerve roots, similar to a classic intervertebral hernia.
Formations often occur in adolescents against the background of rapid skeletal growth. In this case, the most typical location is the thoracic region. Adults are more likely to experience Schmorl's hernias, which have formed in the lumbar spine due to increased load on the musculoskeletal system.
Make an appointment
Proper nutrition
Products recommended for cervical hernia include:
- dishes containing gelatin (jelly, pudding, aspic);
- fish (mackerel, salmon, herring);
- low-fat dairy products (sour cream, milk);
- fruits (berries, apples, pears);
- nuts (hazelnuts, walnuts, almonds);
- foods rich in fiber (cabbage, pumpkin, beans);
- dried fruits, raisins;
- porridge, bran;
- wholemeal bread.
Alcohol, spreads, margarine, tomatoes, white rice, flour products, sweets, and ice cream are prohibited. It is necessary to sharply limit the consumption of fatty, fried, spicy, smoked and pickled foods.
Causes
The reasons contributing to the appearance of Schmorl's hernia include:
- hereditary predisposition: often the pathology is congenital or develops in the first years of life;
- uneven growth, in which bones lag behind cartilage in development;
- intense physical activity and accompanying microtraumas of the spinal column (weight lifting, some sports, excess body weight, pregnancy);
- single intense physical activity: falling, lifting a heavy object in the wrong position;
- vertebral deformation due to osteoporosis or spondyloarthrosis (in old age);
- impaired blood supply to the spinal column;
- lack of microelements: calcium, vitamin D;
- metabolic disorders;
- postural disorders, scoliosis, thoracic kyphosis;
- osteochondrosis;
- sedentary lifestyle.
Consequences
Intervertebral discs are a kind of shock absorbers that help the vertebrae maintain a certain distance from each other. With the development of a Schmorl's hernia, hard cartilaginous tissue penetrates the vertebral body. People with minor impairments may not be aware of the existence of a pathology.
The spine weakens due to Schmorl's hernia, as a degenerative change occurs in the vertebrae, which leads to various curvatures. However, if the hernia continues to grow, it can involve nerve endings and the spinal cord in the pathological process and lead to the development of:
- disorders of posture, flexibility and mobility of the spinal column;
- early arthrosis of intervertebral joints (spondyloarthrosis);
- intervertebral hernia is a serious disease requiring surgical intervention.
- kyphosis (severe curvature of the spine in the thoracic region);
- compression fractures (especially in patients intensely involved in sports).
Symptoms
Schmorl's hernia is asymptomatic for a long time, since it does not extend beyond the contours of the vertebra. Regardless of the location of the protrusion, a person periodically notices slight pain in the affected area. They intensify when lifting weights, bending, turning the body, as well as staying in the same position for a long time. In a lying position, discomfort decreases.
The second typical symptom of Schmorl's hernia is a feeling of fatigue in the spine, which increases with prolonged stay in an upright position.
Significant pain occurs even with a significant increase in the size of the formation, as a result of which it can cause a typical picture of radiculopathy with pain and signs of irritation or compression of the nerve root: numbness of the limbs, paresthesia, decreased muscle strength and reflexes. With the development of pathology in the cervical spine, the growth of the protrusion can provoke headaches, dizziness and other signs of insufficient blood flow to the brain.
Forecast
The asymptomatic course of the disease does not have a negative impact on a person’s activity and well-being. Pain syndrome requires complex treatment, combining drug therapy and physiotherapy. This will stabilize the condition and lead to remission.
In the absence of therapy, the protrusion progresses, acquires large sizes, and begins to compress important structures of the spinal canal. This is dangerous by the development of complications up to complete paralysis, that is, immobilization of the patient.
Diagnostics
Diagnosis of Schmorl's hernia is not difficult. At the first visit, the neurologist interviews the patient, finding out details about the main complaints, the timing and circumstances of their occurrence. At the same time, data is collected on chronic diseases, past infections, and injuries. If we are talking about a child or teenager, the developmental characteristics of the body are taken into account.
After the interview, the doctor performs a neurological examination to assess the function of the central nervous system and peripheral nerves. The diagnosis is confirmed using modern techniques for visualizing internal structures. Depending on the situation, the following may be used:
- X-ray;
- computed tomography (CT);
- magnetic resonance imaging (MRI).
These examinations allow you to see characteristic changes in the bone tissue of one or more vertebrae and make an accurate diagnosis. If necessary, laboratory diagnostics are prescribed (general blood and urine tests, biochemical blood tests), instrumental and functional examinations, as well as consultations with specialists. They are necessary to exclude another cause of symptoms.
What it is?
Schmorl's hernias are changes in the structure of the spine that appear due to the pressing of a disc into a vertebra and are usually asymptomatic. Patients with this pathology complain of pain caused by a violation of the statics of the spinal column. Over time, this disorder leads to degenerative changes and dysfunction of the intervertebral disc.
In Schmorl's hernia, the intervertebral disc is pressed into the vertebral body
Clinical picture
Normally, each vertebra has an additional layer of hyaline cartilage , which protects bone tissue from various injuries and deformations. In medicine, this layer is called the endplate. If there are no deviations, the endplate has clear edges, is smooth and not deformed.
If the vertebral spongy body becomes weaker and softer than the cartilage of the intervertebral disc, the latter can push through the bone tissue. This will entail protrusion of the cartilage (the formation of a “triangle”, the apex of which faces the inside of the vertebra, and the base faces the intervertebral disc). This pressing is called “Schmorl’s hernia.”
Classification
| According to the location of Schmorl's hernia, there can be: | According to the number of Schmorl's hernias there can be: |
|
|
Prevalence and significance
Schmorl's hernia occurs in all countries and regions and, as a rule, is hereditary. Most often, the disease is diagnosed in tall people (from 170 and 180 cm in women and men, respectively) and teenage boys.
Treatment of Schmorl's hernia
Treatment is based on a combination of methods of unloading the spine, strengthening the muscle corset, drug support and physiotherapy. An integrated approach allows not only to relieve the patient from pain and discomfort, but also to eliminate the consequences of compression of the roots.
Drug treatment is prescribed if the patient has pain and other signs of damage to nerve fibers. Depending on the situation, the following are used:
- nonsteroidal anti-inflammatory drugs (NSAIDs), necessary to relieve inflammation and pain (diclofenac, nimesulide, meloxicam, ibuprofen, etc.); Both local and tablet forms are used, as well as injections;
- muscle relaxants (baclofen, mydocalm): aimed at relieving reflex muscle spasms that occur in response to irritation;
- chondroprotectors (chondroitin, glucosamine and drugs based on them): necessary for concomitant osteochondrosis, promote the regeneration of cartilage tissue;
- B vitamins (milgamma): stimulate the restoration of nervous tissue;
- calcium and vitamin D supplements: necessary if there are signs of osteoporosis.
The type of drugs, their combinations, dosages, and regimen are determined by the doctor in accordance with the specific clinical situation.
Physiotherapy is aimed at improving blood supply to affected areas and eliminating inflammation. Depending on the indications and concomitant diseases, the following are prescribed:
- electrophoresis: delivery of drugs to the site of inflammation by electrical impulses;
- phonophoresis: administration of drugs into the pathological focus using ultrasonic waves;
- magnetic therapy: stimulation of blood circulation in the affected area using electromagnetic waves;
- electrical stimulation: improving blood circulation and metabolism through stimulation with weak electrical discharges
To enhance the effect of therapy, auxiliary techniques are used:
- massage: improves blood circulation, prevents stagnation of lymph in the affected areas;
- physical therapy: training is aimed at strengthening the back muscles and forming a natural corset, as well as stretching the spine;
- underwater and classic traction: helps unload the spinal column;
- manual therapy: helps remove muscle blocks, improve blood circulation, reduces the load on the spine;
- acupuncture: relieves muscle and vascular spasms, reduces pain.
When hernias are large and conservative therapy is ineffective, doctors resort to surgical treatment. Operations are indicated for severe pain, severe pinching of a nerve root, as well as for a fracture of the affected vertebra.
In this case, the following is carried out:
- percutaneous fluoroscopic vertebroplasty: a procedure for restoring vertebral bone tissue;
- removal of fragments with the subsequent installation of prostheses or the introduction of special fillers to eliminate compression of the spinal cord or roots.
Specific treatment methods are selected depending on the size and location of hernias, as well as their number.
Make an appointment
Prevention
Preventive measures are relevant both for patients who have already started treatment, and for those who do not want to allow its formation. These include:
- eliminating physical inactivity, regular exercise and walking;
- reducing the load on the spine by normalizing body weight;
- proper nutrition with a sufficient amount of nutrients, vitamins, microelements (especially calcium and vitamin D);
- eliminating situations that require heavy lifting;
- compliance with the work and rest regime;
- a full night's sleep.
Treatment at the Health Energy Clinic
Neurologists at the Energy of Health clinic offer a full range of services for the diagnosis and treatment of Schmorl’s hernias of any size and location:
- thorough diagnosis excluding other possible diseases;
- individual selection of drug treatment using effective combinations of drugs;
- massage, physical therapy, physiotherapy to quickly achieve results;
- services of an osteopath and chiropractor;
- selection and organization of sanatorium-resort treatment.
Advantages of the clinic
Multidisciplinary medical is:
- experienced staff;
- comfortable conditions;
- affordable prices;
- high-precision diagnostic equipment;
- all types of laboratory tests;
- individual approach to the selection of therapy;
- auxiliary treatment methods: exercise therapy, massage, manual therapy, acupuncture;
- own day hospital;
- organization of rehabilitation and sanatorium-resort treatment;
- issuance of certificates, conclusions, certificates of incapacity for work.
A Schmorl's hernia may not manifest itself for a long time, but sooner or later the formation will make itself felt. Don’t delay contacting a neurologist; sign up for an examination at Health Energy.