Intervertebral disc herniation is a type of disease that everyone often hears about today, such as lumbar disc herniation, cervical disc herniation, etc. Intervertebral disc herniation will always use pain to remind you of its existence, back pain, lower limb radiating pain, numbness and weakness Wait, severe or even loss of athletic ability.
Among them, the intervertebral disc herniation is divided into four stages: intervertebral disc bulge , intervertebral disc herniation, intervertebral disc herniation, and intervertebral disc free. Different stages correspond to different pain levels, treatment difficulties, and rehabilitation methods.
is divided into central type, lateral type, and paracentral type according to the position of intervertebral disc herniation, and the corresponding symptoms are also different.
Brief introduction of intervertebral disc herniation
intervertebral discs
First of all, we must briefly introduce the lower intervertebral disc. Between our vertebral bodies, there is a part of the soft tissue structure used to move the spine, which is the intervertebral disc.
intervertebral discs increase the flexibility of our spine, allowing us to perform more curved movements such as bending the waist, backing up, etc., but it also brings problems-intervertebral disc herniation. The
intervertebral disc is composed of the outer fibrous ring and the nucleus pulposus in the center. The nucleus pulposus is an elastic milky white translucent colloid, located between the two cartilage plates and the annulus fibrosis. It is an elastic jelly substance composed of a crisscross fibrous network structure, namely chondrocytes and proteoglycan mucus-like matrix.
When the nucleus pulposus is subjected to external force, the force will be dispersed to the annulus fibrosus, reducing the damage of the force to the nucleus pulposus. On average, the intervertebral disc is stressed about 4 to 5 million times per year.
However, the lifespan of the intervertebral disc is not long, and the common age of intervertebral disc herniation is 30 to 40 years old. Due to external force or degenerative disease , the intervertebral disc gradually herniated.
intervertebral disc herniation
When the soft tissue structure in the spine is ruptured under the action of external force or degenerative disease (especially the nucleus pulposus), the nucleus pulposus tissue protrudes from the rupture into the spinal canal. Caused a herniated disc.
Simple intervertebral disc herniation does not affect our lives. Intervertebral disc herniation will make the flexibility of the spine worse. The surgical treatment of intervertebral disc herniation is to remove the nucleus pulposus and fix the vertebral body so that it cannot move. The human body has a large number of vertebral body segments, and a single intervertebral disc cannot move, which does not greatly affect the flexibility of the spine.
intervertebral disc surgery nail
The most serious problem with herniated disc is the exposed nucleus pulposus compressing the spinal cord and spinal nerves.
According to the degree of disc herniation, it is divided into four states: disc bulging, herniation, prolapse, and free.
Four states of intervertebral disc herniation
Disc bulge
The annulus fibrosis is loose but intact, and the nucleus pulposus shrinks, which is manifested as the fibrous annulus evenly beyond the edge of the vertebral endplate.
The imaging of intervertebral disc bulging is defined as herniated part> 25% of the edge of the disc, or the angle between the two sides of the herniated and the center of the nucleus pulposus> 90°. Instability of joints, secondary changes in articular processes, recurring low back pain, rarely radicular symptoms. If it is combined with developmental spinal stenosis, it is manifested as spinal stenosis, and spinal canal decompression should be performed.
herniated disc (Disc protrusion)
is that the nucleus pulposus protrudes into the annulus fibrosus but the posterior longitudinal ligament is not ruptured, and it is manifested as the limited protrusion of the intervertebral disc into the spinal canal.
The imaging definition of intervertebral disc herniation is that the herniated part is less than 25% of the disc edge, and the base> the diameter of the herniated part; the angle between the two sides of the herniated disc and the center of the nucleus is <90°>
clinical manifestations
The patient presented with typical radiculopathy symptoms and signs. This type can be relieved by conservative methods such as traction, bed rest, and focal injection, but due to the poor healing ability of the broken annulus, the recurrence rate is higher.
intervertebral disc prolapse (Disc extrusion)
the annulus fibrosus and posterior longitudinal ligament are completely ruptured, and the nucleus pulposus protrudes into the spinal canal.
The imaging of intervertebral disc herniation is defined as the base of the herniated disc (A) clinical manifestations Lumbar disc herniation has obvious symptoms and signs, and it is difficult to heal by conservative treatment. The effect is relatively poor, most of which require minimally invasive intervention or surgical treatment. Disc Sequestration (Disc Sequestration) The protruding nucleus pulposus is not connected to the corresponding intervertebral disc, and can be free to the upper or lower segment of the diseased disc, intervertebral foramen, etc. in the spinal canal. Free intervertebral disc refers to the complete prolapse of the nucleus pulposus not connected to the intervertebral disc, free in the spinal canal Clinical manifestations Persistent nerve root symptoms or spinal stenosis symptoms, a small number of cauda equina syndrome (perineum loss) Surgical treatment is often required. This is one of the pathological types of lumbar disc herniation. Three forms of intervertebral disc herniation (1) Central type is mainly manifested by cervical spinal cord compression. In the past, this type of herniation was considered to be rare. With the development of diagnostic technology, especially after the advent of MRI technology, central disc herniation is no longer rare. Due to spinal cord compression, incomplete or complete paralysis of the limbs and abnormal urine and feces may occur; at the same time, the tendon reflexes of the limbs are hyperactive. Pathological reflex signs can be positive, and the sensory decreases or disappears according to the different protruding planes. (2) Lateral is mainly radicular pain. The main symptoms are pain, restricted mobility, pain and numbness in one upper limb. During the intermittent period, the patient can be asymptomatic. On physical examination, it was found that the affected area was often in a rigid position and restricted movement. may have tenderness, and the pain radiates to the limbs. Stretching the affected upper limb can cause pain. Sensory disturbances have different manifestations due to the different planes of the disc herniation. (3) Paracentral type in addition to lateral symptoms and signs, there are still different degrees of unilateral spinal cord compression symptoms, that is, Brown-Sequard syndrome. Often due to severe radicular pain, spinal cord compression is masked. Clinical treatment of intervertebral disc herniation rest According to the severity of the disease, you can choose absolute bed rest, general rest or restricted activity. The former is mainly used for patients in the acute phase, or those whose condition suddenly worsens. medications includes oral sedatives, topical analgesic and anti-inflammatory ointments, chondroprotective agents such as glucosamine sulfate and chondroitin sulfate, physiotherapy, blood circulation and stasis-removing drugs and other effective treatment measures, mainly used to eliminate inflammation and relieve pain. massage massage can relieve muscle spasms and reduce the pressure in the intervertebral disc. But be aware that violent massage can lead to aggravation of the condition. traction treatment can increase the width of the intervertebral space, reduce the pressure of the intervertebral disc, reinstate the herniated part of the intervertebral disc, and reduce the stimulation and compression of the nerve root. It needs to be carried out under the guidance of a professional doctor. surgical treatment for recurrent attacks, non-surgical treatment ineffective, or symptoms of spinal cord compression, surgical treatment should be performed as soon as possible. At present, the main focus is to remove the nucleus pulposus and replace the artificial disc. Source: Spine Health Alliance [Copyright Statement] This platform is a non-profit learning platform, reprinted for the purpose of conveying more learning information, and the author and source have been indicated. If you don’t want to be disseminated, teachers can contact us to delete
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