Spinal problems bother many people. Some, due to hard work, develop a condition such as intervertebral hernia of the lumbosacral spine.
Intervertebral hernia is often called severea condition in which the intervertebral disc is displaced from the plane of the spine. Most often, this condition develops as a result of excessive load falling on the spinal column.
Suffer from this disease mainly men aged 20 to 50 years.
The incidence of this disease is about 100 cases per 100,000 population per year.
Most of these hernias are due tophysical overload of the spine as a result of labor. Perhaps the manifestation of traumatic hernia after surgery on the spinal column or as a result of receiving a lesion. Rarely, but congenital hernia of the spine.
In older people, there are cases of hernia development on the background of the physiological weakness of the spinal ligaments.
The intervertebral hernia of the lumbosacral spine has the highest prevalence, as the lower back is the most vulnerable place for the development of this disease.
Under high load attributableon the spinal column, there is a gradual compression of the intervertebral disc. Because of this, the outer rim of the disc (outer fibrous ring) is most often broken, after which the contents of the intervertebral disc emerge.
Released pulpous nucleus may shift asinside the spinal canal, and to the side of it. In the first case, spinal cord infringement develops, which can lead to irreversible consequences. In the second case, the radicular syndrome may develop due to compression of the nerves emerging from the spinal cord. Aseptic inflammation develops in the place of compression, edema of surrounding tissues appears, which worsens the situation even more.
As a result, symptoms of radicular syndrome (pain, disturbances of sensitivity and function of the extremities) are characteristic of intervertebral hernia. Over time, mobility in the spinal column is impaired.
As can be seen, the place where the intervertebral hernia most often occurs is the lumbosacral region. Treatment should be scheduled immediately, as soon as the disc is diagnosed.
В любом случае следует немедленно начинать treatment of intervertebral hernia. The lumbosacral spine performs an extremely important function of the body - maintaining balance and overlying organs in an upright position. With the development of a hernia in the lumbar region, this function becomes much more difficult due to the intense pain that develops during compression of the nerves. The condition is aggravated by the inopportune nature of going to doctors.
When the first symptoms occur immediatelybegin treatment of intervertebral hernia. The lumbosacral spine responds well to non-drug methods such as the use of orthopedic mattresses, massage, the use of cold compresses. These methods have a purely symptomatic orientation (to alleviate the patient's condition) and can be used only for some time in order to avoid hernia complications. When the condition worsens, it is advisable to immediately make an appointment with a neurologist.
If nevertheless an intervertebral hernia has developed,to treat her, so as not to harm your body? To do this, use anti-inflammatory drugs from the group of non-steroidal drugs. The most widespread ointments, gels and creams. In their composition there are usually “Diclofenac” (“Rumakar”, “Dikloberl”), “Indomethacin” (“Metindol”, “Rumatsid”). The concentration of drugs in these drugs can relieve intense pain and inflammation (however, taking the same dose of drugs inside may not have the desired effect, as well as contribute to the development of gastric ulcers or 12 duodenal ulcer).
Perhaps a combination of nonsteroidal anti-inflammatory drugs with glucocorticoids.
Glucocorticoids are administered either orally orintravenously for the fastest effect. Drugs such as Prednisolone and Dexamethasone are used. Treatment with glucocorticoids should be prescribed only with the ineffectiveness of NSAIDs, as with long-term use of corticosteroids cause the body more harm than good.
In second place in terms of frequency of usethere is a physiotherapy treatment of intervertebral hernia. The lumbosacral spine is one of the most accessible parts of the musculoskeletal system for the use of various devices.
According to many experts, physiotherapy can contribute to a faster recovery than with the use of medicines.
Currently the most effective methodTreatment of intervertebral hernia is the use of multifunctional electrodes. The essence of this technique is the interruption of incoming pain impulses with the help of radio frequency waves.
Of the more well-known methods often usedelectrophoresis with analgesics, therapeutic baths, laser therapy. Electrophoresis and phonophoresis make it possible to deliver drugs directly to the spinal column. The effect is often noticeable after several treatments.
Relaxing hot baths in some cases may contribute to the spontaneous reposition of the hernia into place.
If there is deterioration, despite ongoing measures, then the intervertebral hernia has become complicated. How to treat it in this situation?
With the ineffectiveness of the used conservativetreatment or with the appearance of severe neurological symptoms (paralysis of the limb, urination and bowel disorders, paresis, paresthesia, intense pain, pain on the back of the lower extremities) should immediately begin surgical treatment.
Indications for emergency treatment are the infringement of the spinal cord, the compression of the vessels passing by.
The treatment is carried out mainly in specialized surgical departments (most often in neurosurgery).
Among the methods of treatment used are two main groups - endoscopic surgery and traditional microsurgery.
Depending on how the disease proceeds, they determine the tactics of operational access.
The treatment must be carried out under anesthesia and with the support of the main vital functions.
Before introducing microscopes into medical practice,if surgical treatment of an intervertebral hernia was indicated, the lumbosacral spine often underwent various postoperative complications (suppuration, relapses). A real revolution was the use of optical devices in the treatment of hernias. This made it possible to reduce the extensiveness of operative access, which significantly reduced the incidence of developing complications.
Most often intervertebral hernia sacralthe department is removed through a microscopic incision (laminectomy is performed). Under high magnification, it becomes possible to gently remove the hernial protrusion without damage to the adjacent tissues.
The revitalization of the patient comes already on the followingday. The patient is admitted to daily affairs after 10 days, and after a month he can already be engaged in physical labor without the risk of complications.
Данные операции по удалению межпозвоночной грыжи are a relatively new direction in neurosurgery. Most often they are carried out through the posterior lateral endoscopic approaches. The advantages of these methods are even greater safety in the creation of an operative wound (sometimes the usual puncture of the skin is done). However, this is also the main disadvantage - in this case, the possibilities of complete excision of the hernia and its removal from the puncture zone are limited. Hard-to-get hernia, or hernia, accompanied by compression of the spinal cord, with the help of such operations are not removed.
The patient can already on the day when the operation was performed, climb, walk. Work is allowed about a week after discharge from the hospital.
Over time, if the hernia begins to squeeze near the underlying tissue, complications may develop.
Если развилась обычная грыжа (межпозвоночная), the lumbo-sacral part does not completely lose its function, and a lesion of the spinal cord is not observed. Everything worsens when the hernia is displaced in the direction of the spinal canal.
The most dangerous of these is infringement.spinal cord. At the same time, the functions of urination and defecation are disturbed, which creates a threat to life (severe intoxication, ruptures of the bladder, intestines and urethra are possible). In addition, if the inflammation passes to the spinal cord, it is possible that the overlying parts may be damaged in violation of the functions of the internal organs, even fatal.
Another common complication of hernia is radicular syndrome. With long-term existence significantly worsens the condition.
More favorable complications are reduced sensitivity and paresthesia.
For the development of a hernia it takes some time (i.e., conditionally, it can be called a chronic disease). If you follow the basic recommendations, you can prevent its development.
To prevent recurrence, after removal of the intervertebral hernia, it is necessary to adequately distribute the load during physical work. Do not be overwhelmed, because it can end badly.
Also, for the prevention of hernias, it is recommended to conduct physical exercises and exercises that strengthen the muscular skeleton of the back (for example, deadlift with reasonable loads).
With long and hard work in order toPrevention is recommended to take a relaxing hot bath - they contribute to a small divergence of the vertebrae, which prevents the disc pinching between them.
Rehabilitation after a hernia, includes the avoidance of exercise, physical therapy, massage and manual therapy or acupuncture sessions.
