Sequestered hernia: symptoms, treatment and prevention

Diseases of the spine are very dangerous. After all, they affect a vital structure - the spinal cord. One of such pathologies is the sequestered hernia. The disease affects the entire body negatively and can lead to a whole series of severe consequences.

Characteristics of the disease

What is a sequestered disk hernia? This is a pathology in which a pulpous core (jelly-like content) is squeezed through a rupture or crack in the disk sheath and completely separated from it.

Such a fragment begins to press on the adjacent spinal nerves. As a result, the patient has pain, numbness, a feeling of tingling in the area where the nerve is pinched. Sometimes a detached piece of disc is able to 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 extremities.

A severe condition is characterized by the development of horse tail syndrome. With such a course of the disease, the patient may lose control over the processes of defecation and urination. In addition, there is numbness in the legs and groin area. This form of ailment is an indication for immediate surgical intervention. Otherwise, irreversible damage to the nerve tissue is possible.

Separated fragment in some cases can collapse, and then suck in the bloodstream.

Sources of pathology

The destruction of the intervertebral disc is caused by excessive exertion of the near-vertebral muscles. This triggers the development of dystrophic processes. As a result, the fibrous ring is damaged.

The higher the load the disk experiences, the more likely the development of this hernia. In this regard, a sequestered hernia in the lumbar region is most often formed.

The predisposing factors to the appearance of ailment are such moments:

• Developmental defects;
• Osteochondrosis;
• Excessive weight;
• Deficiency in cartilage tissues of mineral substances;
• Work that exerts a strong load on the spine (loader, builder).

Most often the disease begins to develop against the background:

• Stress;
• Lifting of weights;
• Irregular slopes, squats;
• Supercooling.

Symptoms of ailment

Sequestered hernia in some cases can develop almost imperceptibly. In this case, the patient periodically has back pain. But people get used to such phenomena. The formation of sequestration is perceived by such a patient 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 development of pathology in the cervical section is evidenced by such signs:

• Frequent attacks of headaches;
• Periodically in the neck, arms numb;
• Pain syndrome in the neck area;
• Discomfort is of a constant intense nature;
• After loads of pain intensified;
• Muscular tissues on the upper limbs are gradually depleted;
• In the region of the shoulders, neck, arms appears weakness in the muscles;
• Changes gait;
• Gradually begins to develop limb paralysis.

If sequestration has developed between the thoracic vertebrae, then the patient has the following symptoms:

• Severe pain in the chest;
• Discomfort can be given in the scapula, abdomen, ribs;
• Pain intensifies even after minor loads;
• Paralysis of legs develops;
• Feeling of numbness can cover the chest, abdomen, back;
• Muscle tissue is gradually weakened, and sometimes complete atrophy is observed.

The pathology of the lumbosacral zone is indicated by such signs:

• In the lumbar zone there are intense painful attacks;
• Discomfort is permanent, strongly pronounced;
• The slightest load leads to increased pain;
• Discomfort can be given in the lower extremities, buttocks;
• Tendon reflexes are lost;
• Exhausted muscles;
• Toes, stops periodically numb;
• May malfunction process of urination or defecation;
• Weakness, impotence appear 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 should consult a neurologist. The doctor will listen to the patient's complaints, assess his neurological and physical status. If a hernia is suspected, an additional examination will be required.

Unfortunately, X-ray - in most cases, a little informative method of diagnosis. He is not able to show reliably the presence of fractures, bony proliferation, displacement of joints.

Sequential hernia of the spine is most accurately visualized by means of MRI. This study allows you to determine the position, size of pathology. In addition, MRI gives an idea of the state of muscles, ligaments, nerves.

Methods of treatment

To combat the disease is used:

• Conservative therapy;
• Operative intervention.

The decision on the necessary measures is taken only by the doctor. Very often, patients believe that it is only through surgical intervention that one can fight against a disease such as a hernia that is sequestered. Treatment conservative can be no less effective method. But all the prescriptions and recommendations of the doctor should be strictly observed.

Medication Therapy

It should be reiterated that treatment of sequestered hernia without surgery is possible only on the advice of a doctor. It is strictly forbidden to fight with such pathology. After all, in most cases this is the path to disability.

Conservative treatment means keeping the sequester from full loss until the tissues of this fragment are completely dead. This will allow the formation of bone growths that cover the formed holes.

To improve the patient's condition, medication is prescribed:

1. Anti-inflammatory drugs. Such drugs relieve the pain, reduce the severity of the inflammatory process. The patient may be recommended medication: Ibuprofen, Diclofenac, Nimesil.
2. Diuretic drugs. Such drugs are prescribed in short courses. They excellently relieve swelling, provoked by squeezing the tissues. Such drugs can be included in the therapy: Furosemide, Hypothiazide.
3. Muscle relaxants. These remedies eliminate muscle spasms. One of the effective muscle relaxants, prescribed for this disease, is the drug "Midokalm".
4. Vitamins of group B. They are appointed to improve the conductivity of impulses. These are the following medicines: "Thiamin", "Pyridoxine".
5. Chondroprotectors. These are medicines that provide improved nutrition to cartilage tissues. The most commonly prescribed medication is Chondroitin Sulphate.
6. Anticonvulsants. This group of drugs can eliminate neuropathic pain. Patients are recommended such means: "Carbamazepine", "Finlepsin", "Convulsofin".
7. Other medicines. To improve the trophism of tissues, stimulate microcirculation, treatment may include drugs: Actovegin, Trental.

If necessary, resort to the help of Novocaine blockades.

Additional methods of conservative therapy

It is treated sequestered hernia without surgery, not only with medicines.

The patient is assigned a number of physiotherapeutic procedures that allow to improve well-being:

• Diadynamic currents ;
• Magnetotherapy;
• Traction;
• ultrasound;
• Currents of Darsonval.

In addition, the patient is recommended to practice physical therapy, prescribe a course of massage.

With positive dynamics, improvements are seen already in the 2-3 week of conservative therapy.

When an operation is required

But, unfortunately, there are situations when a sequestered hernia can not be treated conservatively. Operation is the only way to restore health.

The need for surgical intervention arises in such cases:

1. The progression of the disease is characterized by a sharp deterioration. There may be periods of improvement. They are rapidly replaced by deterioration.
2. The size of the sequester is quite large (more than 10 mm).
3. There is a strong weakening in the nerve-root zone of muscle tissue.
4. The limbs are constantly numb.
5. Conservative therapy, conducted during six months, did not give positive dynamics.
6. There is progression of pathology, despite compliance with all prescriptions of the doctor.
7. The patient is diagnosed with autoimmune diseases.

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:

1. Microdiscectomy. With the help of microsurgery, a sequestered hernia is removed. This allows to relieve the patient of the pressure exerted by this fragment on the roots of the brain.
2. Endoscopic removal.
3. Percutaneous nucleoplasty. During the operation, the disk is sclerized using a cold plasma and an electrode.
4. Removal of the disc with prosthetics. Replace the damaged prosthesis with the bone of the patient or with a titanium prosthesis.
5. Autotransplantation of cartilage. The necessary tissues are taken from the patient and multiply them in a test tube. After 3-4 months, this cartilage is transplanted to the patient.
6. Remove a part of the vertebra that presses the spinal cord. These are operations: laminotomy, foraminotomy.

Rehabilitation and prevention

If the sequestered hernia has been operated, then the patient must follow certain rules recommended by the doctor.

During rehabilitation it is important:

• Do not lift weights;
• Take all medications prescribed by the doctor;
• Avoid strong physical exertion.

When the body recovers from surgery, the patient must pass to the prevention of repeated hernia formations.

To protect against relapse of pathology, it is recommended:

• Regularly engage in therapeutic gymnastics;
• Observe a special diet;
• Go to the pool (swimming is very useful for such a disease);
• Watch your posture;
• Periodically to be treated in a sanatorium.

Strict observance of all medical recommendations will help to defeat pathology and protect against its repeated manifestations.