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Hernia nuclei pulposi
February 6, 2012
The hernia nuclei pulposi is the state arising owing to pushing out of a pulpozny kernel through ruptures of a fibrous ring. The intervertebral disk divides vertebrae in a backbone of the person. Its function – ensuring depreciation of movements of vertebrae. Disk structure following: it consists of a pulpozny kernel (mass of jellylike character) and the fibrous ring consisting of fibers which shrouds it. The fibrous ring partly to bodies of vertebrae, nearby is fixed, partially it is fixed — to intervertebral sheaves, the lying row. On free sites of a fibrous ring sometimes there is stretching, and as a result, owing to too strong loading the kernel breaks off a fibrous ring, and intervertebral hernia is formed.
This illness is considered one of the most often met origins of a dorsodynia. The hernia nuclei pulposi most often arises at the person because of insufficient quantity of motive loads of a rachis, owing to too strong exercise stresses, and also in view of changes of age character. So, a protruded disk – the illness of people who lead a constant sedentary life or is too often lifted by heavy loads.
Most often hernias nuclei pulposi arise in lumbosacral department of a backbone. In more exceptional cases of a protruded disk arise in cervical department of a backbone, cases of emergence of hernias in chest department are very rare.
Hernia nuclei pulposi symptoms
Hernia of intervertebral disks – one of the heaviest displays of osteochondrosis of a backbone. As a rule, protrusion of hernia happens to the spinal canal. Owing to such pathology there is a squeezing of a spinal cord or a nervous root. In that case at the patient the pain radicular syndrome which is accompanied by paresis or paralyzes of legs, sensitivity disturbances is shown. Approximately the fifth part of patients with a hernia nuclei pulposi need surgical treatment of an illness.
In the presence of changes of degenerative character of an intervertebral disk in lumbosacral department there are certain symptoms of a hernia nuclei pulposi. In a zone of the struck disk there are pains which during loading become stronger. Pain often gives to a buttock, a hip and a shin from defeat. The patient feels a pricking, and also numbness in the field of an innervation of the struck roots, in legs periodically arises feelings of weakness, their sensitivity is broken. In development of a disease at the person functions of pelvic bodies can be broken owing to what manifestation of problems with defecation, an urination, a potentiality is possible. In perianogenitalny area numbness is shown.
In the presence of changes of degenerative character in cervical department of a backbone pain which gives to a hand, a shoulder is shown. The patient can periodically feel dizziness, it fixes jumps of arterial pressure. Often the headache, dizziness and supertension are observed at the same time, at the same time these phenomena are followed also by numbness of fingers of hands.
In the presence of changes of degenerative character in chest department of a backbone of people feels constant pain in the place of localization of hernia in the course of work in a forced pose. Often pain in chest department of a backbone is combined with a kyphoscoliosis or scoliosis.
Diagnosis of a hernia nuclei pulposi
To establish the diagnosis, doctors initially use the simplest methods: applies special tests to reveal illness symptoms, checks reflexes of sinews. Similar check allows to define, the rachis is how struck. However without use of hardware diagnosis it is rather difficult to define existence of intervertebral hernia at the patient.
The most widely applied diagnostic method of this pathology of a backbone is MRT (magnetic and resonant tomography). Also apply a computer tomography to receiving cross pictures of the vertebral channel. The X-ray analysis method in this case is urged to exclude existence of changes, tumors or infectious diseases. On the basis of results of inspection the doctor appoints optimum therapy.
The most careful inspection there shall pass those patients who complain of the dorsodynia which appeared under the following circumstances and answer such characteristics:
- recently the person had notable injuries of a back;
- at the patient body temperature is constantly increased;
- developing of pain is not connected with the movement;
- pain reminds blows current;
- the pains shown in spin give to legs, a stomach, generative organs;
- the dorsodynia is sharply shown after acceptance of food, in the course of sexual intercourse, during stay of the patient in a toilet;
- in the presence of constant dorsodynias problems with a menstrual cycle are shown;
- in a pose lying pain is more intensive, when walking it abates a little;
- pain has the increasing character, every day it amplifies;
- the patient feels weakness in legs, when walking this feeling becomes more expressed.
Treatment of a hernia nuclei pulposi
Often all symptoms of a hernia nuclei pulposi independently disappear approximately in six weeks after their emergence. After that the patient has a condition of remission.
Treatment by use of surgical intervention is applied only as a last resort that is if all methods of conservative therapy were bezdeystvenny, and the pain syndrome cannot be removed.
It is important to involve also in the course of treatment possibilities of physiotherapy exercises: the special complex of the sparing exercises is developed for patients with a hernia nuclei pulposi.
Protruded disk treat, first of all, with use of conservative methods of therapy. So, treatment of a hernia nuclei pulposi assumes use of antiinflammatory nonsteroid drugs. For some patients with effective there can be an introduction of corticosteroids locally. Most often at treatment of hernias nuclei pulposi the specialist appoints administration of drugs diclofenac, indometacin, an ibuprofen. However it is necessary to consider that the people having digestive tract diseases need to appoint these drugs very carefully. Duration of the use of drugs of this group directly depends on that, the pain syndrome at the patient is how expressed. On purpose elimination of an acute pain it is possible to use also antiinflammatory drugs in the form of gels and ointments. However they can not always become full replacement to tablets.
In certain cases the patient with hernias nuclei pulposi the doctor can appoint carrying out blockade. For its implementation in the fabric close to a hernia nuclei pulposi, solution of lidocaine, novocaine or other anesthetics of solutions is entered.
It is important to consider that in the first days of an exacerbation of a disease it is impossible to do massage at all. It can provoke instability of a backbone and worsen a condition of the patient. Massage and physical procedures will optimum affect a condition of the patient if to apply them approximately on 4-6 week after herniation, that is during recovery.
Approximately on the sixth week the period of late recovery of the patient begins. The damaged intervertebral disk begins to heal, the backbone becomes stabler. In this period approximately for half a year it is necessary to exclude completely heavy exercise stresses, to apply periodic courses of massage and physical procedures.
The surgery the patient with a protruded disk is appointed in a case existence of disturbances of neurologic character, and also a pain syndrome which are steady against the drugs and methods applied at conservative treatment.
Earlier treatment of a hernia nuclei pulposi by a surgical method was carried out with use of a laminectomy. Today thanks to use of a surgical microscope it is possible to reduce considerably an injury which is necessary for access to fabrics. Thanks to a possibility of use of a microsurgical method to remove hernia it is possible through much smaller trepanation window. Also there is an opportunity to remove hernial protrusion by endoscopic removal.
The mikrodiskektomiya method, that is microsurgical removal of hernia is especially efficiently to get rid of a hernia nuclei pulposi. As noticeable advantages of use of this method doctors define existence of an opportunity to remove the intervertebral hernia located in any place and having any density. Operation will move with use of the general anesthesia, at the same time risk of complications minimum. After such operation of the patient about a week stays in a hospital.
First aid at a hernia nuclei pulposi
Formation of hernias nuclei pulposi happens very quickly, and at the same time the person feels severe pain. While there is herniation, the patient feels a crunch or click in spin, and severe pain is at once shown after that.
Pain in the first few days after herniation is especially intensive. So, the person can spend sleepless night, suffering from severe pain. Approximately for the fourth day pain to become a little less expressed. A protruded disk during the acute period of a course of a disease it is necessary to treat in a hospital. In the presence of similar symptoms to the address to the doctor it is necessary to render to the person suffering from pain, the help. The patient needs to be laid on a rigid plain surface. He can impose the corset fixing a waist. Such corset or a belt can be made of a cut of fabric or a sheet. Also to the place where pain is localized, it is possible to put heat – mustard plasters, a hot-water bottle.
Prevention of a hernia nuclei pulposi
In this case all measures of prevention which are applied to the prevention of osteochondrosis are actual. So, it is important to pay special attention to a condition of a muscular corset which is responsible for functioning of a backbone.
Load of intervertebral disks considerably increases in process of bending and extension of a rachis, that is at inclinations. Therefore, carrying out inclinations, it is necessary to tighten a belt, to strain muscles of buttocks and to round a back. It is important to create the correct gait: the back when walking has to be a straight line, the neck should not be extended forward. The back needs to be held directly and in a sitting position, at the same time legs have to touch a floor. During the sedentary work of a leg it is optimum to put on a special support so that hips appeared below knees.
The correct dream is important: the bed has to be equal and moderately rigid. An optimal variant — a qualitative orthopedic mattress.
It is important not to allow emergence of excess weight which is strong additional load of a backbone. Healthy food not only guarantees protection against obesity, but also promotes the correct course of exchange processes in a backbone. The diet has to contain a lot of protein, and also enough calcium which strengthens bones. Potassium provides an optimum water salt metabolism, vitamin C promotes strengthening of sinews and sheaves.
Considering a structure of the central kernel which consists only of proteic matters, existence in an organism of enough amino acids is very important. In a proteic matter moisture therefore protein synthesis will be provided by the amino acids which are contained in food of animal origin collects quickly and lost.
Preservatives make negative impact on a condition of a backbone. Also harmful acute products, salt, sugar, smoked products influence bone system.
As a preventive measure refusal of smoking is important, nicotine narrows vessels, and intervertebral disks have no good nutrition.
The most useful sport for prevention of a hernia nuclei pulposi – swimming, occupations by yoga, Pilates also approach.