Why we need a spine is probably known to everyone. We know it helps keep you upright. That it is a kind of spring that distributes the load when the body moves in space. In addition, the ridge acts as a protective barrier for the spinal cord located in the spinal canal.
Theural sac of the spine: what is it?
Deformations in the spine affect the functioning of other body systems. Displacements, curvatures, and injuries negatively affect a person’s quality of life and therefore require emergency medical care. In the article we will tell you about the dural sac of the spine: what it is, why it is needed, we will talk about the structural features and characteristics of the injuries received.
Structure
To better understand what this shell is, let’s consider its structure. As mentioned above, this is a layer between the spine and the spinal cord to protect the latter from mechanical damage.
For the reasons listed above, it makes no sense to separate the DM from the ridge. They are inextricably linked. 32-34 consecutive fragments (vertebrae) are connected by joints and form the spinal shaft. The spinal canal is formed by openings in the vertebrae.
The spine separates three layers from the spinal cord:
- hard, which is the same bag;
- soft;
- arachnoid.
The spinal cord is surrounded by three layers
There is fluid inside the dural sac. It's called cerebrospinal fluid.
The structure and functions of the spinal cord itself are shown in the table below.
| Name | Structure | Functions |
| Gray matter | Cluster of nerve cells | Reflex response to various stimuli |
| White matter | Bundles of nerve fibers covered with myelin | Conducting signals from the brain to the organs and back |
| Posterior roots | Body and axons of sensory nerves | Perception of irritation and signaling of it to the spinal cord |
| Anterior roots | Motor nerve axons | Signal transmission to working parts |
The spinal cord is smaller than the DM. This allows the nerve endings to drift freely inside. The thecal sac can be called a hard case for the brain because it maintains an airtight seal.
In the spinal canal, it starts from the opening in the occipital region and stretches all the way to the third vertebra of the lumbosacral region. The dural sac is notable for its pyramid-shaped “protrusions” that surround each vertebra. Their function is surrounded by nerve endings. Inside the bag there are many fibrous bundles that strengthen its structure. Most of them are in the area of the posterior ligament.
The separation of the hard layer from the arachnoid layer is ensured by the subdural space, located from the skull to the sacrum. But still the connection between all layers is very tight. There are no nerve pain receptors in the brain itself, and damage to it should not cause pain. But if it is damaged, it means that the neighboring layer, where there is innervation, is automatically damaged, and pain is still felt - such is the strong interaction of the layers.
The dural sac (hard shell) is like a “cover” for the spinal cord
Judging by the description of its structure, it is easy to understand that it is difficult to isolate it from other membranes, such as the lungs, liver or other organs. It is even more difficult to separate the arachnoid and soft layers due to the very dense interaction between them.
Spinal cord device
The spinal cord is a long and tubular body consisting of nerve tissue and feeder cells. In the human body, this organ starts from the brain, where it enters the spinal canal. Its length in adult men is about 45 centimeters, in women - about 43 cm. It is located in the spinal canal, and its lower end reaches the level of the second lumbar vertebra. This end has a conical shape and is called the “medullary cone”.
The main function of the spinal cord is to transmit nerve signals from the brain throughout the body.
The spinal cord does not occupy the entire space of the spinal canal, so it cannot be damaged by the movement of the spine. It adapts to its curvature even in the case of pathological changes.
A characteristic feature of the design of the spinal cord is that it has a segmental structure. One pair of nerves emerges from each segment.
In the spinal cord, gray matter occupies its central part, and white matter is located along the periphery.
The spinal cord is surrounded by three sheaths of connective tissue:
- The hard shell (also known as the “dural sac” or dura mater). It is shiny and dense, located outside and does not touch the spinal canal. Between it and the canal wall there is loose connective tissue, as well as venous ligaments, which act as a kind of “cushion” for the spinal cord.
- Arachnoid arachnoid > Deformation of the dural sac
So, the dural sac is the outermost of the three meninges. It consists of two layers: connective tissue and the inner epithelial layer.
When it is damaged, a person does not experience pain - there are no nerve endings in it. However, since the dural sac is connected to other parts of the body, its deformation or displacement can lead to discomfort.
The cause of deformation of the dural sac is most often compression, which in turn occurs due to various pathologies of the spine, for example:
- osteochondrosis;
- intervertebral hernia;
- intervertebral disc protrusion;
- scoliosis;
- spondylosis;
- chondrosis;
- lordosis.
Each of these pathologies has its own causes of development, and, moreover, they can be congenital. However, if the diseases are acquired in adulthood, the reasons for this are most often:
- excessive physical activity;
- lack of physical activity, sedentary lifestyle;
- poor nutrition;
- alcohol and cigarette abuse;
- poor posture;
- wearing uncomfortable shoes (tight or high heels);
- stress and emotional stress;
- excess body weight;
- circulatory disorders due to diseases of internal organs.
A dural sac deformity is a disruption of the dura mater of the spinal cord due to pressure on it (for example, a protruding nucleus pulposus) or rupture (for example, due to strong loads on the spine or sudden movement).
The main causes of compression of the dural sac
The relationship between the spine and the dural sac is such that if we could take a separate picture of the spine and the dural sac separately, we would get the same image. Every deviation in the spinal column is reflected in the dura mater of the spinal cord. The most common causes of deformities are intervertebral hernias and degenerative changes associated with osteochondrosis. This pathology gradually destroys the structures of the vertebrae and spine, creating deformities.
The development of the disease begins with periodic back pain, which is usually ignored. But over time it progresses, affecting more and more bone fragments. Subsequently, intervertebral hernias and displacement of the vertebrae occur. Due to these changes, the dural sac is compressed. All this is accompanied by severe pain and, of course, the need for serious treatment. Therefore, it is extremely important not to ignore recurring back pain.
Compression of the dural sac occurs most often due to intervertebral hernia or osteochondrosis
The main causes of osteochondrosis are considered to be:
- passive lifestyle;
- poor nutrition;
- sedentary lifestyle;
- overweight;
- stress;
- tobacco abuse;
- excessive stress when playing sports;
- the habit of wearing tight high-heeled shoes;
- scoliotic posture.
Changing the position of the nerve roots
Most often, the roots in the zone of conflict with the disc are poorly visualized, which is especially typical for sequestered hernias or protrusions. In such cases, the expected location of its location can be determined by an imaginary trajectory connecting the “pre-hernial” and “post-hernial” images of the root. In other cases, a herniated disc displaces the root asymmetrically. With large sequestered hernias or protrusions and a pronounced adhesive process, the hernia and paradiscal tissues are not differentiated and look like a single conglomerate.
The following CT changes in the extrasaccal portion of the root are also identified:
- dislocation
- aggregation
- compression
- conglomeration
Clinical picture of spinal canal deformation
The symptoms of an intervertebral hernia caused by osteochondrosis and resulting in deformation of the dural sac differ depending on the location of the formation. It manifests itself with slight differences in different parts of the spine. But there is something common that unites the symptoms and can help in diagnosis - this is pain. In all parts of the ridge, the presence of a hernia is accompanied by severe pain.
With pathology in the cervical spine, the pain radiates to the arm or head. Additionally, dizziness, nausea, spots before the eyes, and tinnitus are observed.
Symptoms may vary depending on the area affected
If the lesion is in the thoracic region, pain in the chest or back is often perceived by a person as cardiac. And if in the lumbar region, then tingling and numbness of the toes are often added to the pain in the lower back. With exertion, the pain intensifies.
Symptoms of cervical spinal stenosis
Narrowing of the spinal canal cannot be asymptomatic. This is a severe pathology, which is always accompanied by pain in the neck on one or both sides, as well as neurological disorders.
Initially, pain can only occur when moving the neck or when the head takes a certain position. But as the causes of stenosis progress, pain appears more and more often and quickly becomes a constant companion of a person. Over time, they begin to radiate to the back of the head, shoulders, shoulder blades and arms.
In addition to pain, cervical stenosis may be accompanied by the following symptoms:
- headaches of varying intensity, up to migraines;
- Sensitivity disorders of the scalp, arms, and neck;
- feeling of numbness, crawling;
- weakness of the muscles of the arms and shoulders;
- dizziness, up to loss of consciousness due to infringement of the vertebral arteries and impaired blood supply to the brain (more often observed with a sharp tilt or turn of the head);
- increased muscle tone, which is a reflex response of the body to pain, which leads to increased pain and disruption of the nutrition of muscle fibers due to compression of their blood vessels.
In more severe cases, stenosis can lead to disruption of the functioning of all organs and parts of the body located below the level of damage. In such situations, you may experience:
- dysfunction of the pelvic organs (increased urge to urinate and defecate, urinary and fecal incontinence, erectile dysfunction, decreased libido);
- paresis (sensitivity disturbances) of the lower extremities;
- periodically occurring or constant feeling of “woolly legs”, gait disturbance, decreased stability, paralysis of the lower extremities;
- disorders of the respiratory system, which can be accompanied not only by difficulty breathing, shortness of breath, increased frequency, but also attacks of suffocation.
Types of intervertebral disc herniation
There are the following types of intervertebral hernias: sequestered (in which the hernia is actually separated from the disc and is located in the cerebrospinal fluid), and non-sequestered (the connection with the disc is preserved).
According to the location of the hernia, they are divided into:
- medial (protrusion into the spinal canal);
- ventral (into the abdominal cavity);
- paramedian (very serious displacement inside the canal);
- mediolateral (in the lateral space);
- foramial, (at the point where the nerve root exits the spinal canal) very painful;
- extraforamial (outside the intervertebral canal).
There are several types of intervertebral hernias
Interestingly, a person feels back pain thanks to the cerebral cortex, where information comes through neurons. The spinal cord does not have receptors that are responsible for pain.
Main characterizing points
What is a dural sac? This is a closed, hermetically sealed sac that is formed by the tough membrane of the brain and contains the spinal cord ( the central part of the nervous system of animals, usually located in the head (anterior) part of the body and representing a compact accumulation of neurons and dendrites
). Due to the fact that the dural sac is deformed, a person may experience severe pain that can cause great discomfort.
Does the dural sac affect back pain? At the lumbar level, the spinal nerve is parallel to the dural sac, as a result of which the direction changes and at the same time bends around the vertebrae. Even during minor compression of the dural sac, a person can experience severe and constant pain. This causes diseases such as hernia and osteochondrosis. A deforming reaction begins.
A herniated disc occurs:
- non-sequestered;
- sequestered, which, in turn, is divided into ligating and non-ligating.
In the axial plane, intervertebral disc herniation occurs:
- ventral;
- medial;
- paramedian;
- mediolateral;
- foraminal;
- extraformal.
What is an intervertebral hernia? This is damage to the intervertebral disc, as a result of which the disc extends and moves beyond its own boundaries. Very often, a hernia occurs in the lumbar spine.
Symptoms of a hernia ( a disease in which internal organs come out (protrusion) from the cavity they normally occupy through a normally existing or pathologically formed hole in
) of the cervical spine can be:
- pain in the head, neck, pain in the arm;
- numbness in the fingers is felt;
- short-term dizziness;
- tinnitus occurs.
Symptoms of a lumbar hernia:
- pain in the waist, hip and buttocks;
- experiencing back pain that is felt when sneezing or coughing;
- aching pain in the legs and toes;
- numbness in the legs is felt;
- inability to stand or sit, pain when walking.
Symptoms of a thoracic hernia:
- heart pain;
- pain in the respiratory area.
There are 4 stages of hernia development:
- 1st - hernia size 1-2 mm; pain occurs in the lumbar, cervical, thoracic regions;
- 2nd - hernia size 4-5 mm; pain in the arm and leg;
- 3rd - the appearance of osteophytes, the root is susceptible to atrophy;
- 4th - atrophy of tissues that are located nearby; intense pain.
The risk of developing the disease is higher in the following cases:
- in people whose age ranges from 20 to 50 years;
- if there is heredity;
- if there were previous infectious diseases.
Relationship between intervertebral hernia and dural sac
If you look at the spinal column from a different angle, you can imagine a sequence of interconnected parts with a hole in the middle. The dural sac is a sheath that passes through these openings and contains the spinal cord. In the lower part of the column, the spinal nerve runs parallel to the DM and any deformation of the sac is reflected in the innervation of the lower back.
If you ignore back pain for a long time, then there is a risk of aggravating the hernia and even becoming disabled. First there will be a loss of sensitivity, and then paralysis will occur. Therefore, even rare pain in the back or neck cannot be ignored. And if they are accompanied by nausea, numbness of the limbs, dragging of the legs or other symptoms that significantly worsen the quality of life, urgent medical attention is needed.
Diagnostic methods
To diagnose destructive changes in the dural sac of the ridge, it is customary to use three methods.
- Magnetic resonance imaging (MRI).
- CT scan ().
- Ultrasound diagnostics (ultrasound).
The most effective methods for diagnosing deformation of the dural sac are CT and MRI
The principle of CT scanning is the computer analysis of X-ray images of the affected part of the body using a program. The technique is inferior to MRI in the accuracy of studying various deformations of the DM. Used less frequently. The advantage of this method is the speed of obtaining results and the low radiation dose. And if MRI is sensitive to random changes in the patient’s body during the examination, then CT wins in this regard.
MRI makes it possible to make a more accurate diagnosis than CT. An additional advantage of magnetic resonance imaging is the ability to examine fibrous tissue, vessels and nerves. The technique is absolutely harmless - the only inconvenience is the need to keep the body still during tomography. The principle of operation is based on the fact that the tomograph reads energy fluctuations in the body and transmits the signal to a computer. And then, with the help of special programs, the signal is converted into an image.
The results make it possible to find out where the damage is, the condition of the spinal canal, and the presence of inflammation. MRI examines the following levels in the spine:
- cervical spine (vertebrae C3-C4, C4-C5, C5-C6, C6-C7);
- thoracic region (T4-T5, T5-T6, T6-T7, T7-T8, T8-T9, T9-T10);
- lumbar region and sacrum (L1-2, L2-3, L3-4, L4-5).
Ultrasound examination is inferior in accuracy to MRI and CT. For examination, you first need to contact a neurologist. After the examination, he writes out a referral for diagnostics.
Practical recommendations
To identify the disease, you need to contact a neurologist, who should conduct an examination and give a referral for X-rays and magnetic resonance imaging (MRI). MRI data show changes in the cervical (levels C3-4, C4-5, C5-6, C6-7 are examined); thoracic (examination of levels Th4-5, Th 5-6, Th 6-7, Th 7-8, Th 8-9, Th 9-10); lumbosacral (L1-2, L2-3, L3-4, L4-5) sections.
Treatment of intervertebral hernia can be performed in the following ways:
- Surgical intervention. May have pros and cons. The main advantage is the elimination of pain, which may subside within the next day. The disadvantages of surgery may be complications and relapse. During an inflammatory complication, a short course of antibiotics is prescribed.
- Physiotherapy.
- Massage.
- Manual therapy;
- Undergoing a procedure such as spinal traction. This procedure comes in two types: dry and water. The most popular is water traction of the spine. There are horizontal and vertical underwater traction. Vertical traction is carried out in a pool, the depth of which is at least 2 meters.
- Drug treatment (the course should be from 3 to 4 weeks).
- Regular exercise as prescribed by your doctor;
Folk remedies most commonly used:
- Using red clay.
- A mixture of honey, mumiyo and fir oil.
- Rubbing with horse fat.
- Using a special corset.
- Salt baths: dissolve 0.5 kg of sea salt in a bath at a water temperature of at least 37°C.
Stressful situations and overexertion should be eliminated. You should not self-medicate in any way, because the consequence of this disease can be disability, so you should contact experienced specialists who will help you choose treatment.
Each of us is worried about our health, and this is normal. If something suddenly starts to worry us, we immediately go to the Internet and look for information that suits us. For those who are faced with problems of the spine, today we want to talk about what it is - the dural sac of the spine.
Treatment of the disease
If a person regularly has back pain and suffers from numerous symptoms indicating deformation of the dural sac, he needs to urgently consult a neurologist. After receiving the results of all examinations, the patient is prescribed treatment.
Treatment of deformation of the dural sac and the root cause of the development of this pathology should be comprehensive
The treatment complex includes the following components.
- Taking medications. Medicines eliminate pain, help eliminate swelling, and stop inflammatory processes. For pain relief, take Diclofenac, Ibuprofen, Nimesulide or another drug prescribed by a doctor. In some cases, the intake is combined with drugs that reduce the tone of skeletal muscles. The period for taking medications is determined by the doctor - usually 5-10 days.
- Physiotherapy. To speed up the healing process, the patient may be prescribed electrophoresis with anesthesia, magnetic therapy, acupuncture, etc. The procedures performed weaken the symptoms, which has a beneficial effect on the course of the disease and the psychological state.
- Massotherapy. The purpose of the massage course is to restore normal muscle tone by relieving tension in the affected areas. At the same time, the full movement of blood and lymph in the body is restored, which definitely contributes to a speedy recovery.
- Manual therapy. In some cases, the help of a chiropractor is necessary. The technique consists of manually influencing the spine, due to which curved or deformed areas are installed in a naturally correct position. When the procedure is performed correctly, the patient feels significant relief. An additional bonus will be the restoration of full movement of body fluids (blood, lymph, intercellular) in previously blocked parts of the body.
- Physiotherapy. With the help of exercise therapy, you can strengthen muscles, help restore blood flow in the body, and improve the mobility of the spine. The main thing is not to overdo it with the load.
- Surgical intervention. It must be noted that the operation is not indicated for everyone suffering from a hernia or other damage to the dura mater of the spinal cord. Moreover, relapses and complications are often possible. There must be direct indications for surgery. These include: paralysis or paresis of the sphincter of the rectum or bladder, radicular pain with sequestration and protrusion of the hernia more than 7 mm. All other cases do not require emergency surgery. In case of complications and inflammatory processes after surgery, a course of antibiotics is prescribed. Indications or contraindications are determined by the attending physician.
- Spine stretching. The purpose of this procedure is to mechanically stretch the spine to release pinched nerve endings and reduce intervertebral hernias. There are vertical and horizontal stretching. Also divided into dry and underwater. The best effect is achieved by underwater horizontal stretching due to deeper muscle relaxation. Drying is done using weights or special units. For example, the prophylactic Evminov. It is forbidden to do this procedure yourself, because there is a high risk of harm. Possible micro-tears of muscle tissue, aggravation of the hernia bulging, and divergence of the vertebrae beyond measure.
Preventor Evminova
As you can see, there are many ways to help a patient with deformation of the dura mater. Each has contraindications and side effects. Therefore, it is strictly forbidden to engage in self-diagnosis and self-medication, and if there are signs of pathologies of the locomotor system, you should contact a specialist. The faster the better.
Procedures and treatment are prescribed by the attending physician, basing his decision on the results of examinations and tests, as well as the individual characteristics of the body. Given the complexity of the disease, almost all cases require separate, individual consideration.
ethnoscience
For pathologies during the development of which the structure of the hard shell is disrupted, folk remedies are sometimes used. It should be noted right away that the main goal of treatment is to eliminate the deformity as much as possible. And for this purpose, folk remedies act only as an additional resource. Unfortunately, using baths, ointments, and decoctions will not eliminate the hernia.
Alternative treatment can become an aid in the fight against pathologies
But as a means to alleviate suffering, you can use:
- ointment made from mumiyo, honey and fir oil;
- support corset;
- rubbing with horse fat;
- salt bath 500 g of salt are dissolved in a bath whose water temperature is similar to body temperature;
- applying red clay cakes. Possible allergic reaction! Need additional advice.
Other traditional medicine methods
Prevention
In order to complicate or even make it impossible to develop diseases associated with deformations of the dural sac, it is necessary to adhere to certain rules. It is ideal when parents take care of this and teach their children to do morning exercises from a very young age. They convinced me to give up tobacco and alcohol, showed me an example of an active and healthy lifestyle, and taught me how to calmly react to stressful situations. To this you need to add the habit of eating right, avoiding fried and smoked foods. And as a result, we will receive not only the prevention of diseases of the musculoskeletal system, but also a powerful foundation for health and a long, fulfilling life.
It is also necessary to independently pay attention to various deviations in the functioning of the spine. If pain periodically occurs or curvature in the back, spasms, or convulsions are observed for no apparent reason, contact a specialist.
Very often, diseases are “layered”, and the later you seek help, the more difficult it becomes to determine the causes of the disease. For prevention, you can use special exercises developed by instructors. If you have an existing pathology, consult your doctor about the compatibility of certain exercises with your case.
An excellent way to prevent diseases of the musculoskeletal system is a massage course. This improves the movement of fluids (blood, lymph, intercellular) in the body. Additionally, the relaxing effect promotes psychological relief. You can go to the pool 1-2 times a week. This will strengthen the muscles and help relieve psycho-emotional stress.
It is very important to prevent diseases of the locomotor system
You also need to pay attention to the position in which a person sleeps. If, after waking up, you feel tired or have stiff muscles, it is recommended to change it: ideally sleep on your back or in the fetal position.
Diseases associated with damage to the dural sac are very painful. They significantly worsen the quality of life. To avoid serious consequences, if you have any suspicions, seek help.
conclusions
To summarize, let's look at a few key points. The thecal sac is a hard sheath located inside the spine that protects the spinal cord from damage.
Any deformation of this “case” causes a change in the functioning of other membranes of the ridge and, as a rule, is accompanied by severe pain. The worst-case scenario is the development of an intervertebral hernia.
The hernia and pain will not go away without treatment. Without timely treatment, the pathology will enter the chronic stage, and then the recovery period will increase significantly.
Therefore, it is important to understand that even minor pain is a reason to consult a doctor.
Exercise, swimming, massage and other preventive measures will help avoid diseases. But if the disease has already actively developed, it is necessary to follow the recommendations of the attending physician without self-diagnosis and self-medication.
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