Hernias of absolutely any kind can cause great anxiety in a person who has encountered a similar phenomenon. They talk and write a lot about them, the consequences are considered irreversible, and the presence of the disease is martyred. However, is this information true and is it all dangerous? Is surgery always required? These are important questions that every patient seeks answers to. In our article, we will consider common types of the disease and methods for their treatment.
Essence of the disease
Any intervertebral hernia manifests itself as a displacement of the disk, in which a rupture of the fibrinous ring occurs. However, in the case of a median hernia, sequestration is shifted to the middle along the line of the spine, and not to the side, as with other pathologies. As a result, a neoplasm develops that can be removed by surgical intervention, although this is a very complex process that requires a professional approach. The fibrinous ring protrudes with this defect.
Median hernias are characterized by complications with their characteristic compression of the canals of the spinal cord, as well as their contents. This disease is particularly dangerous for people who lead a sedentary lifestyle or for those who have suffered spinal injuries.
In medical practice, cases of the formation of a number of hernias in a patient are known, which seriously complicates both the diagnostic process and the treatment itself for the patient.
Kinds
Three main types of hernias are distinguished depending on the protrusion of the sequestration:
- Circular, or better known as Schmorl's hernia.
- Posterolateral, which may appear on the left side of the spinal column or on the right. Known as dorsal hernia.
- Anterolateral.
The affected disc in the posterior median hernia is located mainly in the middle of the spinal column. This is a striking distinguishing feature of this type of disease. The posterior median hernia is the most complex manifestation of the pathology in question. It leads to compression of the cauda equina or spinal cord, as it penetrates into its canal. All this can result in paralysis, both of the organs of the internal department and of the limbs.
Another feature of the posterior median hernia is its location (lumbar, between 4 and 5 vertebrae). Since it is as close as possible to the spinal cord, the surgeon has a serious task - to find the exact location of the pathology, and then extract it. Any inaccuracy can lead to disastrous consequences.
Unfortunately, specifically this type of hernia requires urgent surgical intervention, because it has an effect on many organs. It is worth mentioning that many experts prefer to treat biases of this nature with conservative methods, rather than risking the patient’s health when it is surgically removed. Moreover, such tactics really work, which means that not every person suffering from such a disease has to undergo surgery.
This type of protrusion has its own divisions:
- hidden;
- medial;
- diffuse;
- median paramedian;
- foraminal;
- paramedial.
The most dangerous hernia is rightly considered a median-paramedian hernia. It is this kind of ailment that poses a threat to the patient and is fraught with complex consequences.
Often with a median-paramedian hernia, the disc of which is undergoing displacement, is at I4-I5 level. This increases the likelihood of developing stenosis in the spinal canal. Unfortunately, such a shift sometimes even leads to paralysis of the patient, if you do not provide him with the necessary help in time and do not carry out certain procedures. At risk are men after forty years, in women this ailment is extremely rare.
A feature of the dorsal median hernia is that the displaced sequestration affects the roots of the nerve, that is, it is pinched. Patients experience constant pain, while their gait changes. The disk itself shifts to the intervertebral lumen. Dorsal median hernia can occur in various parts of the spinal column, up to the cervical. It may be the result of sleep in an uncomfortable position or even travel in public transport.
Etiology of the phenomenon
No matter how trite it may sound, but the main cause of the pathology is an unhealthy lifestyle. This disease is often the result of a sedentary lifestyle, lack of certain vitamins and nutritional components, as well as excessive back loads.
The lack of mobility reduces the diffusion of the body, and after all, it plays a huge role in the absorption of nutrients by the intestines. Physical activity will help to avoid this phenomenon. However, we must not forget that excessive overvoltage is also fraught with dangerous consequences, so the main thing is not to overdo it. Useful walking, exercise, jogging, visiting fitness rooms, yoga or dancing, and so on.
If the intervertebral disc does not receive the necessary nutrition, then it begins to lose all its properties and literally collapses.
Doctors subdivide all the causes of the development of median hernia into several main groups:
- various kinds of addiction (for example, cigarettes);
- excessive loads on the spine;
- sedentary lifestyle;
- damage to the spinal column;
- car injuries;
- pinched nerves;
- osteochondrosis;
- congenital inferiority of the joints.
Symptomatic manifestations
The following symptoms at the onset of the disease are characteristic of a median disc herniation:
- noticeable neoplasm in the spine;
- feeling of mild pain;
- lumbar pain.
In the course of the development of the neoplasm, the symptoms also change:
- pain intensifies;
- posture is disturbed;
- with flexion and extension of the back pain pierces;
- limb sensitivity is impaired;
- the skin turns pale.
All these symptoms have the property of intensifying equivalent to the development of the median hernia itself. The patient should avoid provisions or actions that exacerbate his condition.
Treatment methods
Both the patient and the doctor treating him are interested exclusively in a conservative treatment method. This is an attempt to avoid radical measures, as they are very dangerous to health. This approach is quite productive. It is aimed at relaxing the back muscles, as well as at reducing the formation itself.
The set of measures includes several points:
- physiotherapy;
- physiotherapy;
- medications;
- massage.
In order to cope with pain, the patient will be prescribed a complex of painkillers.
Operation avoidance
To avoid surgical intervention, the necessary preventive measures should be observed:
- Timely visit a neurologist.
- If you suspect a pathology, an urgent diagnosis is required.
- When treating, follow all doctor's recommendations.
- Attentive to health during the rehabilitation period.
Even if, after the treatment, the patient's condition has not stabilized, there is no need to despair. The specialist will prescribe additional procedures that should bring the disease to remission, which will avoid surgery. It should be remembered that self-medication does not bring any positive results.
Operation
If conservative methods of therapy are unsuccessful, and the patient's condition only worsens, a decision is made for the operation. This should not be feared, since complications are extremely rare. Most of those who survived the surgery undergo a rehabilitation period and continue a normal lifestyle.
The operation consists in removing the median hernia and introducing an artificial implant in its place to preserve the structure of the spine.
To exclude relapse, it is necessary to follow all the instructions of a specialist.
Complications
Almost any defect after the operation does not give complications. However, this can not be said about the posterior medial hernia. The complexity of its removal lies in its location - it literally interacts with the spinal cord. Since the distance between the spinal discs and the tumor itself is practically absent, surgical intervention can harm the patient's health. The most common complication is myelopathic syndrome. Sometimes disturbances in the nervous system resonate with the malfunctioning of internal organs.
A number of dangerous signs that the patient and the attending physician should consider:
- sheath deformity, which protects the spinal cord;
- pain during urination;
- renal failure;
- acute pain in the lumbar region;
- manifestation of paralysis or its first symptoms.
Rehabilitation
After the operation, a certain period must pass before the patient can again lead a full-fledged lifestyle.
- In the first 2-3 weeks it is necessary to learn how to move so that there is no pressure on the operated area.
- Even if it seems to the patient that he is feeling well enough, doctors strongly do not recommend overloading himself.
- After a certain period, depending on the condition of the recovering person, he is allowed to walk (no more than 90 minutes), but he should not sit down yet.
- After the rehabilitation period (about 8 weeks), the patient is allowed to perform some exercises. This is done to restore blood circulation.
- Three months later, you can engage in full-fledged sets of exercises, such as push-ups, squats, wave arms and legs. Neat flexion and extension of the back are permitted.
Contraindications during the rehabilitation period
After getting rid of the median hernia, one should not forget about its likely consequences, therefore, there are certain precautions:
- Do not lift weights.
- It is necessary to exclude all bad habits.
- Exercises on the back are contraindicated.
- Sharp bends and bends of the back should be avoided.
- Sitting positions should be avoided (it is recommended to stay in a standing or lying position).
Conclusion and Conclusions
Median hernia is dangerous for its complications, but this is not a sentence at all. If you consult a specialist in a timely manner and conduct competent conservative treatment, you can avoid surgery. Even if surgery has been prescribed, you should not be afraid. In most cases, operations are successful. To prevent relapse, all doctor's recommendations should be strictly observed during the rehabilitation period.