Currently, pain has become the fifth vital sign.
Among the patients in outpatient clinics, more and more patients suffer from spinal pain. There are many reasons for spinal pain, one of the common and important reasons is herniated disc. The
intervertebral disc is located between the two vertebral bodies of the spine and consists of three parts: the nucleus pulposus, the fibrous annulus and the cartilage plate. Under the influence of external factors, the fibrous annulus of the intervertebral disc is ruptured, and the nucleus pulposus tissue protrudes (or protrudes) from the rupture, which causes the adjacent spinal nerve roots and spinal cord to be stimulated or compressed, and a series of clinical symptoms are produced. How does
respond? Today, I invited Hu Shuo , deputy chief physician of the Department of Orthopedics, the Tenth People's Hospital Affiliated to Tongji University, to give you a detailed explanation.
The condition of intervertebral disc herniation in modern people is intensified.
Daily intervertebral disc herniation mainly refers to lumbar disc herniation. Its clinical manifestations are mainly lumbar pain, often accompanied by a series of clinical symptoms such as numbness and pain in one or both lower limbs, which are accompanied by severe cases. There are abnormalities of lower extremity movement and urination. In fact, there are intervertebral discs between the cervical and thoracic vertebrae, which can also highlight . The clinical manifestations of cervical disc herniation mainly include neck and shoulder pain, one or both upper limb pain, numbness, etc. Although the incidence is not as high as that of the lumbar spine, the condition is serious. When compresses the cervical spinal cord, it can cause different degrees of upper and lower limbs. Paralysis, urinary dysfunction or even complete paralysis is life-threatening. Moreover, with the development of the Internet and the popularization of smart phones, swiping the screen and sitting in the office for a long time have become the daily lives of modern urban people. The age range of cervical disc herniation is becoming wider and wider, which seriously affects the quality of life of patients and brings a huge burden to the family and society. In addition to herniated disc, in fact, spinal stenosis, spinal tumors, bone hyperplasia, fractures, spinal instability, spondylolisthesis, etc. can all cause neck and shoulder pain. In addition, spinal osteoporosis, spinal infections, facet joint disorders, posterior spinal nerve compression, synovitis, chronic muscle and soft tissue damage, frozen shoulder, rheumatic immune diseases, diabetic, vascular, neuropathic pain, etc., also Will cause varying degrees of neck and shoulder pain.
Therefore, do not underestimate any pain in the neck and shoulders, it may indicate that your body is hiding other diseases. Once there is unexplained pain, you must go to a regular hospital to check it.
surgery is not the only treatment option
For patients with intervertebral disc herniation, many can be alleviated through regular conservative treatment, not all surgery.
Conservative treatment is mainly suitable for patients with mild symptoms, such as bulging, only neck symptoms and upper limb pain, who can relieve themselves after rest, and those without lower limb walking disorders; those who are younger, have the first attack or have a short course of symptoms, Mild; there is no prolapse of nucleus pulposus on imaging examination, no obvious compression of nerve root and spinal cord, and no obvious spinal stenosis.
But there is also a person with a herniated intervertebral disc that is heavier. The effect of conservative treatment on may not be good. At this time, surgery is often required for .
In the past, when people talked about surgery, they were very scared. They would rather endure the pain and continue to seek the so-called magical rejuvenation technique. However, “forbearance” cannot reduce or solve the pain, until the sequelae of nerve damage can make people despair. regret but too late.
Of course, surgery also has certain surgical indications. is generally suitable for non-surgical treatment for three months. Symptoms do not improve significantly, or even worsen, affecting work and life. ; patients with radiating nerve root pain; people with symptoms of spinal cord compression; a history of cervical spondylosis, which suddenly worsens in a short time , The symptoms continue to aggravate and the medication cannot be relieved.
The traditional open cervical spine surgery is mainly through an open neck incision, the anterior vertebral body, intervertebral disc, or posterior laminoplasty or laminectomy, the compression is completely decompressed, and internal fixation is performed for stability. Factors such as early pain, nerve and spinal cord, blood vessel, trachea, and esophagus injury risks after routine surgery are often the root causes of patients' fear of surgical treatment.
treatment should be "prescribe the right medicine"
With the advancement of medicine, the operation of the intervertebral disc has become more and more minimally invasive, and patients with intervertebral disc herniation do not need to worry about having a major operation anymore.
The so-called minimally invasive spine surgery technology refers to non-traditional surgical methods and specialMinimally invasive techniques and methods for diagnosis and treatment of spinal diseases with surgical instruments, instruments or other means. Its main feature is that it is less traumatic and has little impact on patients. It uses a minimally invasive way to solve the problems that need to be solved by conventional surgery.
mainly has the following technologies: microendoscope (disc mirror) removal of intervertebral disc, percutaneous endoscopic disc removal, microscopically assisted minimally invasive surgery technology, etc. The emergence of
minimally invasive surgery has greatly reduced the trauma caused by traditional surgery. As the technology matures, its surgical indications are becoming wider and wider.
However, it should be noted that in clinical work, the pathological state of each patient with neck and shoulder pain is not the same. For example, some people have only a single segment of intervertebral disc herniation, some people have multiple segments, some have posterior longitudinal ligament ossification, ligamentum flavum ossification, and some have cervical spinal canal developmental stenosis. Even if it is a simple disc herniation, due to the different directions of herniation, some patients have spinal cord compression, while others only have nerve root compression.
Therefore, this determines that the formulation of the surgical plan needs to be individualized, and a single technique and surgical method is not suitable for all patients. For severely compressed intervertebral disc herniation, routine surgery is still required to extensively decompress and reconstruct the cervical spine sequence.
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