The word "foraminal" means the area where the nerve endings of the spinal cord are located. They begin in the spinal column itself. If in this space there was a deformation of the intervertebral disc, which resulted in a hernia, then this type of disease is called foraminal hernia.
That is, this is one of the types of hernias. It can be found not so often - from four to ten percent of all vertebral pathologies. Also, this species has its subspecies: posterior and lateral.
What causes this pathology?
A foraminal hernia usually occurs if a person exerts himself physically, stresses the area of the spinal column too much. The appearance of a hernia can also be caused by sports in the gym, when the main burden falls on the spine. Also, one of the reasons for the deterioration is any activity in which it is necessary to lift weights.
Foraminal hernia also occurs with existing spinal injuries. Any part of the spinal column can suffer, however, most often the neck and thoracic posterior part fall under the distribution. Especially often, foraminal hernias appear on the vertebral sections L2-5 (in any variation) and L5 - S1, since these places undergo the greatest load.
All bones in different parts of the human body have their names in the form of a letter from the Latin alphabet and serial number. When a doctor determines with a diagnosis, he uses just such a designation, since with its help you can clearly understand exactly where the protrusion occurred. For example, if the hernia is in L4 and L5, then the disk is damaged precisely between the fourth and fifth vertebra of the lower back. When a doctor says that a foraminal hernia formed in L3 and L4, he means damage to the intervertebral disc between the third and fourth lumbar vertebra. But the designation L5 and S1 means the presence of a hernia between the fifth vertebra of the lower back and the first vertebra of the sacral region.
What else can lead to the development of foraminal disc herniation? Various diseases and disorders in the body. For example, problems with the musculoskeletal system, weak muscles of the spinal corset, various infections that affect the cartilage body, and so on.
Species difference
In medicine, there is a special classification of such a pathology. Such hernias are usually divided into several types:
- A hernia that occurs at the very vertebral entrance is called medial.
- Pathology located inside the intervertebral foramen is referred to as intraforaminal.
- If the hernia is located at the vertebral exit, then it is called lateral.
- In the event of pathology outside the opening of the spine, this is an extraforaminal hernia.
Plus, the variety is divided into three parts of the spine: cervical, thoracic and lumbar.
The difference in the areas of pathology
Foraminal hernia of the spine can be divided into three other types, which are classified by the direction in which it is protruded. In this case, three varieties are distinguished:
- Dorsal foraminal hernia, where the cartilage is directed to the left side to the canal with the spinal cord. It is possible that with this development, the nerve root from the left side will be impaired. The left-sided foraminal hernia is most often found in the cervical and lumbar region of the spinal column. If the defeat of the nerve endings is serious, then the result will be paralysis (complete or partial).
- There is also a dorsal foraminal right-handed hernia, which protrudes, respectively, to the right, all to the same canal with the spinal cord. The consequences are the same as with the above pathology.
- And the third option is a paramedian-foraminal hernia. This is one of the most dangerous types of pathology of the spinal column, since when it occurs, the deformed cartilaginous tissue protrudes directly into the canal where the spinal cord is located. Then there is a compression of the spinal canal from two sides. Most often, such hernias arise due to severe scoliosis, severe osteochondrosis, or dysplasia. A paramedian-foraminal hernia of the disc can provoke severe deviations in a neurological plan in a person and ultimately lead to disability.
General symptoms
Common symptoms of all types of hernias are aching pain in the place where the cartilage protrusion occurred. The first stages usually do not go quite noticeably - they are sluggish, but with the repetition of strong loads on the back, sharp pains appear, after a while the back again comes into a state of rest and relaxation.
Further, the primary symptoms worsen, and the pain syndrome is accompanied by a malfunction of the internal organs, for example, the lungs or even the heart. There is a limitation in the mobility of the musculoskeletal system, which flows into the chronic stage.
Symptoms of a hernia in zone C6-7
Most often, additional symptoms are added to the general symptoms, depending on which particular disk was damaged. For example, in the presence of a right-sided foraminal hernia inside the C6 and C7 discs, the muscle tone of the right hand weakens, the hand and fingers are numb, but sometimes the entire limb is numb. There is also a constant pain at the site of the formation of the pathology. A person begins to suffer from migraines, his hearing is deteriorating, his memory and vision is falling.
Symptoms of a hernia in zone L4-5
When the L4 and L5 discs are deformed, then in addition to the general symptoms described above, a person begins to feel constant weakness in the legs, and if it is also a left-sided foraminal hernia of the disc, then the left leg suffers the most and may even completely lose sensitivity. Periodic lumbar pains develop into permanent. Tingling is also felt in the legs. In the internal cavity of the body there is a disruption of the organs located in the lower abdominal cavity and in the pelvis.
Most often, foraminal hernias are found in the area of the discs L5-S1 and L3-4. Here the symptoms are more pronounced with severe pain and severe forms of neuralgic abnormalities. It is difficult to treat such pathologies, since the initial symptoms are not noticeable, and when neglected, the improvements come after a very long treatment.
How to diagnose a foraminal hernia?
If the patient goes to the hospital, the examination will be carried out by a vertebrologist who makes a preliminary diagnosis based on complaints and reflex responses of the patient. Accurate information will become known only after tomography (computed, or magnetic resonance).
Smart modern equipment makes an accurate analysis of the state of cartilage tissue and finds places affected by pathology, in particular - nerve endings and other vessels. It is important to determine to what extent a degenerative change in damaged joints has occurred. Actually, success in treatment can be achieved only due to the correct diagnosis.
What are the treatment options?
In total, two options can be distinguished:
- medical therapy with the introduction of gymnastics, yoga, exercise therapy and more;
- operation.
The latter method is usually suitable for advanced stages, when the difficult situation of the body does not accept therapeutic procedures that make life easier for the patient.
Conservative therapy. Stages
Therapy can be used only in the initial stages of the development of pathology. It includes a comprehensive solution to the problem:
- First of all, the patient should get rid of pain, as well as cure the inflammation in the neurotissue that appeared as a result of compression. For this, treatment with the help of medications is used. Usually, doctors prescribe Ketorol or Nalgesin as anti-inflammatory drugs, since they do not contain steroids. Most people take Analgin or Spazmalgon as painkillers, and Ditylin and Midokalm are popular among muscle relaxants.
- The second part of therapy is physiotherapy. This includes massage and manual techniques. In addition, electrophoresis, magnetotherapy and, of course, therapeutic baths are recommended.
- The third step will be to consolidate the result by strengthening the muscles of the spinal corset. This is where therapeutic gymnastics and wearing a bandage come into play. Yoga, as well as walking and swimming, without using the technique of breaststroke, will prevent a possible relapse. Acupuncture helps strengthen the muscles to reduce the load on the affected area, and stretching the spine reduces the protrusion of the cartilage.
Operation
When the patient does not feel improvement when performing the above prescribed therapy, tough methods - operations come into play. Ineffective drug treatment, sometimes, can even further trigger the disease, so it is important to immediately determine the degree of damage. Usually, operations are prescribed if the disc protrudes toward the spinal cord by more than nine millimeters, as well as in the presence of severe pain syndromes and loss of mobility of the limbs.
Surgical intervention can be performed in several variations:
- When the surgeon removes the entire disk with the lesion.
- An implant is placed instead of a disc with a hernia.
- Removal of some parts of the vertebrae that carry out pressure on the nerve roots.
The rehabilitation period after such operations in all patients may be different, it all depends on the general health of the patient and his individual development of the body. Usually, if a person fulfills all further prescriptions of a doctor, then he pours into his former active life after about one and a half, and sometimes two years.
Prevention
On the advice of rheumatologists, in order to avoid new formations and deformations, a person should monitor the physical exertion that he gives his body. Moreover, both during rehabilitation and after it throughout life. Of course, he will need to abandon all existing bad habits and begin to monitor his diet, at least switch to healthy foods in a healthy diet.
In order for the body to recover faster, the patient must nourish him with vitamins and minerals. Of course, you should not completely limit yourself in physical activity, but playing sports should be in a moderate mode. Be sure to perform exercises to strengthen the muscular corset of the back, because this is the only way to remove the load from the cartilage. And do not forget about yoga - a panacea for the treatment and maintenance of a healthy look of the back.