Home > Blog > Algology > Intervertebral disc protrusion

 

An intervertebral hernia is the displacement of the pulpous nucleus of the intervertebral disc with rupture of the fibrous ring. The most common are herniated discs of the lumbosacral spine (150 cases per 100,000 population per year), hernias at the cervical level are much less common, the most rare are thoracic disc protrusions. In 50% of cases, hernias are localised at the level of L5-S1 of the lumbosacral, in 44-46% they are at the level of L4-L5, the rest are at other levels.

The following stages of hernia development are distinguished:

  • Prolapse – bulging up to 2-3 mm;
  • Protrusion – protrusion up to 4-6 mm without breaking through the fibrous ring;
  • Extrusion (prolapse) – rupture of the fibrous ring with the migration of the pulpous nucleus into the spinal canal.

The main factors of development 

Protrusion of intervertebral discs occurs due to pathological processes in the spinal column of a degenerative nature. As a rule, stenosis occurs (reduction of space), which can be central (narrowing of the spinal canal) or foraminal (narrowing of the intervertebral foramen). Factors that can provoke protrusion:

  • sedentary work;
  • weight lifting in non-physiological positions;
  • violation of posture;
  • prolonged vibration;
  • malnutrition;
  • decreased protective functions of immune system;
  • genetic predisposition;
  • increased physical activity (athletes);
  • severe hypothermia;
  • development of physical inactivity;
  • prolonged staying in an uncomfortable body position.

Signs of the disease

Common symptoms of the disease:

  • pain in the affected area;
  • sensitivity disorders (increased or decreased);
  • muscle atrophy of the limb on the side of the lesion;
  • headaches (with a protrusion in the cervical spine);
  • dizziness, ringing in the ears (cervical spine);
  • numbness and discomfort in the upper and lower extremities;
  • pressure surges;
  • sleep disturbance;
  • disorders of the central nervous system;
  • behavioural disorders – excessive tearfulness, nervousness and irritability;
  • constant feeling of tiredness, drowsiness.

Treatment of protrusion of the disc is a long process, requiring the implementation of a set of therapeutic measures, often ending with a surgical operation.

Therapeutic methods

The treatment of protrusion is complex. Medications are selected individually, depending on the stage of development of the pathological process and the degree of intensity of the clinical picture. To normalise the condition of the spine and its departments, the patient is prescribed a course of physiotherapy and massages, an obligatory measure is to perform physiotherapy exercises.

Drug treatment of protrusion of the discs and neck is aimed at alleviating the patient’s condition. To stop the pain, painkillers and anti-inflammatory drugs are prescribed in tablets, injections, topical remedies are used – creams, ointments. Physiotherapy is carried out to improve blood circulation and normalise metabolism. It is possible to carry out a set of physiotherapy only after stopping an exacerbation.

Drug therapy, massages and physiotherapy do not always give a positive result.

However, in such cases, it is not always necessary to resort to surgical intervention.

To date, a breakthrough has been made in the treatment of pain syndromes, in particular associated with herniated discs, which can significantly improve the quality of human life and often avoid surgery.

The medical centre “MedClinic” practices advanced, minimally invasive, unparalleled in Ukraine, methods of treatment of pain syndromes.

These include:

  • selective transforaminal radicular blockades;
  • interlaminar (epidural blockade);
  • caudal epidural blockade for pelvic pain;
  • radiofrequency ablation of the medial root branch (facet syndrome);
  • radiofrequency neuromodulation of the spinal roots;
  • block /neuromodulation /ablation of the solar plexus;
  • block /neuromodulation /ablation of ganglion impar (coxalgia);
  • block of ganglion stellate;
  • block of triggering points.

The advantages of these techniques:

  • performed on an outpatient basis under local anesthesia;
  • duration of the procedure is 15-30 minutes;
  • duration of being under medical supervision – up to 1 hour;
  • there are practically no restrictions in the post-procedural period;
  • minimal risk of complications;
  • effective and safe;
  • have a high level of evidence;
  • there are practically no contraindications;
  • can be performed in combination with other treatment methods, provide a faster and more stable treatment result.

In some cases, taking into account the clinical picture and the data of instrumental examination methods, a surgical operation is immediately prescribed.

To date, the following modern minimally invasive techniques are used:

Thermodiscoplasty – the essence of this method is using the laser on the disk to evaporate its pulpous nucleus so that it decreases in size, and the disk stands at its desired location. The operation is performed on an outpatient basis, the patient leaves the hospital on the same day.

– Microdiscectomy – removal of a hernia from a mini-incision using a modern microscope. The operation time was significantly reduced in comparison with the traditional operation (up to 30 minutes), there is minimal surgical trauma, and a short recovery period (the patient is discharged from the hospital the day after the operation).

All the above treatment methods and surgical interventions are performed at the MedClinic Medical Center by doctors – algologists, neurosurgeons and traumatologists, who have hundreds of successful procedures and operations behind them.

MRI of the lumbar region of a patient who asked for help at our medical centre – disc herniation L5-S1, haemangioma L3, L4.