Spinal column diseases are very dangerous. After all, they affect the vital structure - the spinal cord. One of these pathologies is sequestered hernia. The disease negatively affects the entire body and can lead to a number of serious consequences.
Disease characteristics
What is sequestered disc herniation? This is a pathology in which the pulpous nucleus (jelly-like contents) is squeezed out through a gap or crack in the disk shell and is completely separated from it.
Such a fragment begins to put pressure on the adjacent spinal nerves. As a result, the patient has pain, numbness, tingling in the area where the nerve is pinched. Sometimes a detached piece of disk can penetrate the epidural space. In such situations, there is simply unbearable pain. It can be felt not only in the back, but also in the limbs.
A serious condition is characterized by the development of horse tail syndrome. With this course of the disease, the patient may lose control over the processes of defecation and urination. In addition, numbness appears in the legs and groin. This form of the disease is an indication for immediate surgical intervention. Otherwise, irreversible damage to the nerve tissue is possible.
The detached fragment in some cases can be destroyed, and then absorbed into the bloodstream.
Sources of pathology
The destruction of the intervertebral disc is caused by excessive tension of the paravertebral muscles. This triggers the development of dystrophic processes. As a result, the fibrous ring is damaged.
The higher the load the disc experiences, the greater the likelihood of developing this hernia. In this regard, most often a sequestered hernia is formed in the lumbar region.
Predisposing factors for the appearance of the disease are such moments:
- malformations;
- osteochondrosis;
- overweight;
- deficiency in the cartilaginous tissues of mineral substances;
- work that exerts a heavy load on the spine (loader, builder).
Most often, the disease begins to develop against the background of:
- stress
- lifting weights;
- incorrect bends, squats;
- hypothermia.
Symptoms of ailment
Sequestered hernia in some cases can develop almost imperceptibly. In this case, the patient periodically experiences back pain. But a person gets used to such phenomena. The formation of sequestration is perceived by such patients as another attack.
Symptoms of the disease depend on the location of the hernia. That is why it is necessary to consider them separately.
The following signs indicate the development of pathology in the cervical region:
- frequent bouts of headaches;
- periodically in the neck, arms numbness appears;
- pain in the neck;
- discomfort is constant and intense;
- after exertion, the pain intensifies;
- muscle tissue in the upper limbs is gradually depleted;
- in the area of ​​the shoulders, neck, arms, muscle weakness appears;
- gait changes;
- limb paralysis gradually begins to develop.
If sequestration has developed between the thoracic vertebrae, then the patient has the following symptoms:
- severe pain in the chest;
- discomfort may be given in the shoulder blades, abdomen, ribs;
- pain intensifies even after minor exertion;
- leg paralysis develops;
- a feeling of numbness can cover the chest, abdomen, back;
- muscle tissue is gradually weakened, sometimes complete atrophy is observed.
The pathology of the lumbosacral zone is indicated by such signs:
- in the lumbar region there are intense pain attacks;
- discomfort is constant, pronounced;
- the slightest load leads to increased pain;
- discomfort may be given in the lower extremities, buttocks;
- tendon reflexes are lost;
- leg muscles are exhausted;
- toes, feet periodically go numb;
- urination or bowel movement may be impaired;
- weakness, weakness appears in the legs;
- stiffness is felt in the lower back;
- sometimes paralysis of the legs develops.
Diagnosis of the disease
In the case of the above symptoms, the patient must consult a neurologist. The doctor will listen to the patient’s complaints, evaluate his neurological and physical status. If a hernia is suspected, an additional examination will be required.
Unfortunately, x-rays are in most cases a little informative diagnostic method. He is not able to show reliably the presence of fractures, bone growths, joint displacement.
Sequestered hernia of the spine is most accurately visualized using MRI. This study allows you to determine the position, size of the pathology. In addition, MRI gives an idea of ​​the state of muscles, ligaments, nerves.
Treatment methods
To combat the disease it is applied:
- conservative therapy;
- surgical intervention.
The decision on the necessary measures is taken only by the doctor. Very often, patients believe that only with the help of surgical intervention can it be possible to combat a disease such as sequestered hernia. Conservative treatment can become an equally effective method. But all prescriptions and recommendations of the doctor should be strictly observed.
Drug therapy
It should be recalled once again that treatment of sequestered hernia without surgery is possible only on the recommendation of a doctor. Fighting such a pathology yourself is strictly prohibited. Indeed, in most cases this is the path to disability.
Conservative treatment implies keeping the sequestration from complete loss until the tissue of this fragment is completely dead. This will allow the formation of bone growths, covering the formed holes.
To improve the patient's condition, medication is prescribed:
- Anti-inflammatory drugs. Such drugs relieve pain, reduce the severity of the inflammatory process. The patient may be recommended medications: “Ibuprofen”, “Diclofenac”, “Nimesil”.
- Diuretic drugs. Such drugs are prescribed in short courses. They perfectly relieve swelling caused by tissue compression. The following drugs may be included in therapy: Furosemide, Hypothiazide.
- Muscle relaxants. These funds eliminate muscle cramps. One of the effective muscle relaxants prescribed for this ailment is the drug "Midokalm".
- Vitamins of group B. They are prescribed to improve the conductivity of pulses. These are the following medications: Thiamine, Pyridoxine.
- Chondroprotectors. These are medicines that provide improved nutrition for cartilage. The most commonly prescribed medicine is Chondroitin Sulfate.
- Anticonvulsants. This group of drugs is able to eliminate neuropathic pain. The following drugs are recommended for patients: Carbamazepine, Finlepsin, Convulsofin.
- Other medicines. To improve tissue trophism, stimulate microcirculation, medications may be included in the treatment: Actovegin, Trental.
If necessary, resort to the help of novocaine blockades.
Additional methods of conservative therapy
Sequestered hernia is treated without surgery, not only with drugs.
The patient is prescribed a number of physiotherapeutic procedures to improve health:
- diadynamic currents;
- magnetotherapy;
- traction;
- ultrasound;
- Darsonval currents.
In addition, the patient is recommended physical therapy exercises, a massage course is prescribed.
With a positive trend, improvements are noticed already at 2-3 weeks of conservative therapy.
When surgery is required
But, unfortunately, there are situations when sequestered hernia cannot be treated conservatively. Surgery is the only way to restore health.
The need for surgery arises in such cases:
- The course of the disease is characterized by a sharp deterioration. There may be periods of improvement. They are rapidly replaced by deterioration.
- The size of the sequestration is quite large (more than 10 mm).
- There is a strong weakening in the nerve root zone of muscle tissue.
- Constantly numb limbs.
- Conservative therapy for six months did not give a positive trend.
- There is a progression of pathology, despite the observance of all doctor's prescriptions.
- The patient is diagnosed with autoimmune ailments.
Surgical intervention
As noted above, conservative treatment of sequestered hernia does not always give positive results.
The operation can be carried out in several ways:
- Microdisectomy. With the help of microsurgery, sequestered hernia is removed. This allows you to save the patient from the pressure exerted by this fragment on the roots of the brain.
- Endoscopic removal.
- Percutaneous nucleoplasty. During the operation, sclerosis of the disk is performed using a cold plasma and an electrode.
- Removing a prosthetics disc. Replace the damaged prosthesis with the bone of the patient himself or with a titanium prosthesis.
- Cartilage autotransplantation. The necessary tissues are taken from the patient and propagated in vitro. After 3-4 months, such cartilage is transplanted to the patient.
- The part of the vertebra that causes compression of the spinal cord is removed. These are operations: laminotomy, foraminotomy.
Rehabilitation and prevention
If a sequestered hernia has been operated on, the patient must follow certain rules recommended by the doctor.
During rehabilitation, it is important:
- do not lift weights;
- take all the drugs prescribed by the doctor;
- avoid strong physical exertion.
When the body recovers from surgery, the patient should proceed to the prevention of repeated hernia formation.
To protect against relapse, it is recommended:
- regularly engage in therapeutic exercises;
- follow a special diet;
- go to the pool (swimming is very useful with a similar ailment);
- monitor your posture;
- periodically treated in a sanatorium.
Strict adherence to all medical recommendations will defeat the pathology and protect against its repeated manifestations.