What are intervertebral discs? These are natural pads connecting the vertebrae. They are necessary for the healthy functioning of our spine. Inside the discs there is a special pressure that can keep them at a distance at the same time and at the same time connect them together. However, the intervertebral disc itself is not compressed. It is these areas that allow the spine to make smooth movements when walking. Any tilts or turns are controlled by the back of the spinal column.
What does the disk consist of?
Any intervertebral disc has two components: a nucleus in a semi-liquid state, and a fibrous ring in the form of a dense mesh wall, consisting of twelve microplates. When a person bends, the fibers of which the plates are made are stretched in diameter in opposite directions, thereby creating strong tension and holding the disc in the chain of the spinal column. The pressure between the vertebrae is created precisely due to the fibrous ring, therefore, if it is damaged, the intervertebral disc located both above and below the ring may suffer.
The back of the disk is framed by thinner plates, this effect is due to the fact that they are pressed against each other much denser than on the front. Thanks to the back plates, the vertebrae can diverge freely, for example, when leaning forward. True, their subtle body is at risk of rupture of the fibrous ring under strong tension.
The average height of the intervertebral discs is about seven millimeters, and the diameter of the vertebrae reaches four centimeters. Very fragile design at first glance. But when the height of the intervertebral discs changes, protrusion can occur, since most often, with age, the border between the fibrous ring and the pulp of the nucleus is erased, from which the first breaks. In addition to protrusions, many suffer from varying degrees of hernias.
Interesting information about the spine
Twenty-four intervertebral discs are located in the human spine and only the occipital bone and the first vertebra belonging to the cervical region, the first and second vertebra of the same department, and the tailbone (it is completely motionless) were left without them. The size of all disks is different, and if you look from top to bottom, it increases in proportion. It depends on certain functions endowed with a disk in a particular area of the spinal column.
Biochemical composition of discs
The intervertebral disc is a cartilage filled with water and collagen fibers, which in turn are immersed in a special gel with a complex name - proteoglycan. With age, as you know, the production of collagen by the body decreases, which is why degenerative processes begin to occur.
What are the advantages of having discs between the vertebrae?
First of all, they give the spine elasticity and at the same time serve as a shock absorber during sudden movements, for example, when jumping or running. Bags with liquid between the disks when standing up are compressed more than in the prone position or in an inclination, this spine turns into a kind of spring, which instantly unbends. Thanks to the discs, the spine can have such a thin shape and at the same time possess incredible strength. If they were not there, then the back would have to have very powerful muscles in order to bend and unbend the spinal column each time.
However, discs cannot save a person from protrusions and hernias, especially when they are constantly in a standing position (meaning, for example, long standing work). When a person is forced to spend most of the day on his feet, then the pressure on the bottom of the spine will periodically increase, which in the end can lead to the destruction of its lower segments. Therefore, more often than not, people begin to feel back pain.
What features does the L5 vertebra have?
Absolutely all intervertebral discs have their own designation. But especially against the background, the place stands out where the spine passes into the sacrum, since this zone most often suffers due to overloads or incorrect exercises in the gym. The L5 disc differs from the rest in its shape - it looks like a kidney. Its lateral side is not protected at all, and the back side is strengthened, which is why with strong deflections or having a pronounced lordosis, the side wall can gradually collapse. Turns of the back will give a constant uneven load on the given disk. Most often in such cases, a hernia of the lumbar intervertebral disc appears. This can be seen in the photo below.
But usually, the complex of the intervertebral disc L5-S1 falls under the distribution, that is, there is an interaction with the first sacral.
Symptoms of a hernia of a damaged disc L5-S1
First of all, there is pain in the lumbar, especially when a person begins to lean forward or picks up heavy things. Sometimes the pain syndrome can immobilize a person for some time or his subsequent movements will be severely constrained. Any growing pain in the lower back is the main and first sign of the presence of a hernia of the intervertebral disc of the spine.
Further, the pain can spread to the leg, affecting the femoral part. Sometimes numbness of the leg occurs, up to the ankle. If a person is in motion for a long time, or in a standing position, then closing sensations appear in the body. There is a violation of sensitivity in the buttocks and lower back. When coughing, the pain begins to intensify.
What types of hernias are there?
Modern medicine distinguishes several types of hernias of the vertebral discs. They are determined by the type of spinal column. A hernia, or protrusion of the pulp of the disk - the nucleus beyond the fibrous ring, is divided into several categories:
Cervical changes in the intervertebral discs. Most often, this type is found in people engaged in sedentary work, so it can occur at a fairly young 25-year-old age. Previously, a person can be tormented by prolonged and sluggish osteochondrosis.
Cervicothoracic degeneration. Here the problem is localized in the collar and usually occurs in people over forty years old. Mostly women suffer from such hernias. Pathology develops against the background of a distortion of posture and a violation of salt metabolism in the body.
Hernias in the thoracic spine are less common, and their appearance is usually associated with trauma when grossly falling to the back from a height.
But hernias in the area between the sternum and lower back are quite common. Especially for people who just came into the world of weightlifting and immediately decided to switch to the main artillery without strengthening the muscular back frame.
The most popular type of pathology is lumbar hernia and protrusion of the lumbar intervertebral discs.
The already mentioned hernia at the junction of the lower back and sacrum. Surgery in the form of removal of the intervertebral disc is usually recommended here, since such a pathology is not amenable to treatment.
Hernias in the sacral section and in the coccyx are practically not diagnosed. But if they do, it is solely due to serious injuries.
The main diseases associated with spinal discs
The main pathologies associated with intervertebral discs are just protrusion of the pulp of the nucleus and they are divided into several types, depending on size. So, there are already distinguished above hernias, protrusions and prolapses. In order to accurately understand what the doctor is dealing with, it is necessary to take an x-ray of the part of the spine that the patient complains about.
With the help of a picture, the doctor can determine the size of the disk body that has gone beyond the vertebra into the external environment of the body. A hernia will be everything that is increased by more than five millimeters. If the pathology is less than this mark, then the diagnosis will be prolapse. Protrusion is a small deformation of the disk, with the body going beyond. In this case, the protrusion does not reach even three millimeters, and the fibrous ring can remain intact, but modified due to strong pressure. The most common disease in the latter species is protrusion of the cervical intervertebral discs.
Diagnostics
To determine the best treatment for intervertebral discs, the doctor determines the value of the output of the nucleus from the fibrous ring. And here, too, has its own classification, so if the gelatinous body protrudes within three millimeters, then this is called prolapse. And in the case of protrusion to a size of fifteen millimeters - this is the final rupture of the fibrous ring. By the way, there is such a definition as extrusion, which means that the fallen core (part of it) hangs down enough to finally come off.
Intervertebral hernias, protrusions and their location relative to the body
Regarding the body pathology can be:
- Median or median. They are located in the very center of the spinal disc and are guided by the back wall. For example, protrusion of the intervertebral discs of the cervical spine is most common among this category.
- Paramedian or lateral, respectively, are left or right, next to the foraminal openings.
- Ventral or anterior. They are closest to the inside of the skin and are the safest of all available.
- Well, the most dangerous are foraminal pathologies, since they are located exactly next to the nerve roots and can lead to paralysis of those areas of the body that are under the direction of the damaged nerve root. For example, such a disease can be dorsal protrusion of the intervertebral disc, with which you need to be extremely careful during treatment, since due to any incorrect movement or tilt, ring rupture can occur and the consequences may be irreversible.
In the case of delayed treatment with a hernia directed towards the spinal canal, part of the protruded pulpous nucleus can be separated with its subsequent exit to the canal itself, and this is already one hundred percent getting paralysis or meningitis.
By the way, it is worth knowing that even after getting into a traffic accident, or receiving serious injuries, a hernia and protrusion in the intervertebral disc for a long time may not show any signs. A year and a half, the disease can proceed without any special symptoms.
Treatment and prevention
Since the most dangerous disease of the vertebral discs is nevertheless a hernia, it is important to know what needs to be done for preventive purposes in order to prevent its occurrence, or the formation of protrusion. The best prevention will be a healthy lifestyle, including daily gymnastics for the whole body. In particular, this applies to those who are engaged in sedentary work in the office. It is best in such cases to do a little warm-up after a certain number of hours of sitting in one position. Indeed, for example, protrusion of the intervertebral discs of the cervical spine may appear not only due to the uneven load on the disc, but also from the uncomfortable position of the body.
Many people choose the evening visit to the pool as a preventive measure, since when swimming the muscles of the entire spine are involved, which means that the spinal frame is strengthened, which is very important for maintaining the spinal column in a healthy state. Particular attention should be paid to pain in certain parts of the back. Often there are cases when, due to the presence of osteochondrosis, which a person does not know about, protrusion of the lumbar intervertebral discs appears. It is best in these situations to immediately pass the diagnosis.
In the case when the disks are already flattened, a person should seek help from a doctor engaged in exercise therapy, who can help with the selection of a special complex for exercises on the spine and back. The most important thing in this matter is strengthening the muscular skeleton of the back, which will be able to take most of the load on itself.
What to do if the moment with prevention has already been missed and a person has a herniated disc? First of all, you should know that pain symptoms occur most often due to pinching of nerve endings, and such sharp pains lead to muscle spasms in the back and the condition worsens significantly.
Treatment in such a situation begins with a quiet life and reduced mobility of damaged disks. Most often they buy special corsets that fix the spine in one position. Cramps and pains are removed with the help of painkillers or blocking injections. But this treatment gives only relief in everyday life. During this time, a person must prepare his body completely new standards of existence. With the help of a doctor, you can determine which movements need to be performed with extreme caution, and which are available to him without restriction.
The use of electrophoresis techniques, ultrasounds, as well as massages, will perfectly help in the treatment. With reduced treatment with medication, physical activity is used to restore normal activity of the spine. A lot of different exercises are available in yoga. For example, there is a separate topic in yoga therapy, like the “Correct approach to the spine”, in which, together with the trainer, incredible results can be achieved. After all, with the correct performance of all physical activities, the disk can restore its function. These treatment methods apply both to protrusion of the intervertebral cervical discs, or pathologies in other departments, and to the treatment of hernias, although the latter cannot always be eliminated by the methods described above. Then the patient is recommended surgical intervention.
A visit to the surgeon occurs in the following cases:
- If a person has a malfunction of the genitourinary system (difficulty urinating and sexual dysfunction)
- Atrophy of the leg muscles.
- The absence of any positive dynamics in drug treatment for several months.
In especially severe cases, hernias cause serious disturbances in the functioning of the spinal cord, these are precisely the moments when the nucleus flows towards the spinal canal and, due to the risk of hearing loss, vision and limb mobility, most often resort to surgical interventions.
Sometimes not complete, but partial removal is performed. This operation is called discectomy. Most often, a discectomy is performed through a micro incision, so the damage to the surrounding tissues and the entire disc is much less.
With endoscopy, that is, the introduction of a microchamber into the spinal column, the surgeon can more accurately remove the affected area. But there is another method of surgical intervention - hydroplasty, in which a strong pressure of water leaches the affected nucleus, thereby removing the entire hernia.
But the ideal option would be, of course, timely diagnosis of the disease.