What are intervertebral discs? These are natural pads that connect the vertebrae. They are essential for the he althy functioning of our spine. Inside the disks there is a special pressure that can keep them at a distance at the same time and at the same time connect them together. However, the intervertebral disc itself does not shrink. It is these areas that allow the spine to make smooth movements when walking. Any tilt or turn is under the control of the back of the spinal column.
What is a disc made of?
Any intervertebral disc has two components: the core, which is in a semi-liquid state, and the fibrous ring in the form of a dense mesh wall, consisting of twelve microplates. When a person bends over, the fibers that make up the plates stretch in diameter in opposite directions,this creates a strong tension and retention of the disc in the chain of the spinal column. The pressure between the vertebrae is created precisely due to the annulus fibrosus, so if it is damaged, the intervertebral disc located both above and below the annulus can suffer.
The back of the disc is framed by thinner plates, this effect is due to the fact that they are pressed against each other much more densely than on the front. It is thanks to the back plates that the vertebrae can diverge freely, for example, when leaning forward. True, their thin body is in danger of tearing the fibrous ring under strong tension.
The average height of the intervertebral discs is about seven millimeters, and the diameter of the vertebrae reaches four centimeters. A very fragile design at first glance. But with a change in the height of the intervertebral discs, protrusions can occur, since most often, with age, the border between the fibrous ring and the pulp of the nucleus is erased, from which the former breaks. In addition to protrusions, many suffer from varying degrees of hernia.
Interesting Spine Information
There are twenty-four intervertebral discs in the human spine, and without them only the occipital bone and the first vertebra belonging to the cervical region, the first and second vertebrae of the same department, as well as the coccyx (it is completely motionless) remained. The size of all disks is different, and when viewed from top to bottom, it increases in proportion. It depends on certain functions endowed with a disk in a particular zonespinal column.
Biochemical composition of disks
The intervertebral disc is a cartilage filled with water and collagen fibers, which in turn are immersed in a special gel with a complex name - proteoglycan. With age, as you know, the production of collagen by the body decreases, which is why degenerative processes begin to occur.
What are the advantages of having discs between the vertebrae?
First of all, they give the spine elasticity and at the same time act as a shock absorber during sudden movements, for example, when jumping or running. The fluid sacs between the discs in a standing position are squeezed more strongly than in a prone position, or in an inclination, from this the spine turns into a kind of spring, which instantly unbends. Thanks to the discs, the spine can have such a thin shape and at the same time have incredible strength. If they were not there, then the back would have to have very powerful muscles in order to bend and unbend the spinal column every time.
However, disks cannot save a person from protrusions and hernias, especially when standing all the time (meaning, for example, long standing work). When a person is forced to spend most of the day on his feet, the pressure on the lower spine will periodically increase, which in the end can lead to the destruction of his lower segments. Therefore, most often people begin to feel pain in the lower back.
What features does the L5 vertebra have?
Absolutely all intervertebral discs have their own designation. But it stands out especially against the backgroundthe place where the spine passes into the sacrum, since this zone most often suffers due to overload or improper exercise in the gym. The L5 disc differs from the rest in its shape - it looks like a kidney. Its lateral side is not protected at all, and the back side, on the contrary, is strengthened, which is why with strong deflections or with a pronounced lordosis, the side wall can gradually collapse. Turning the back will give a constant uneven load on this disc. Most often in such cases, a hernia of the lumbar intervertebral disc appears. This can be seen in the photo below.
But usually the complex of the intervertebral disc L5-S1 falls under the distribution, that is, there is an interaction with the first sacral.
Symptoms of a herniated L5-S1 damaged disc
First of all, pain in the lumbar region appears, especially when a person begins to lean forward or lifts heavy things. Sometimes the pain syndrome can immobilize a person for a while, or his subsequent movements will be very constrained. Any growing pain in the lower back is the main and first sign of a herniated disc in the spine.
Further, the pain may spread to the leg, affecting the thigh. Sometimes there is numbness of the leg, down to the ankle. If a person is in motion for a long time, or in a standing position, then a closing sensation appears in the body. There is a violation of sensitivity in the buttocks and lower back. When coughing, the pain begins to increase.
What types of hernias are there?
Modern medicine identifies several types of herniated discs. They are determined by the type of department of the spinal column. Herniation, or protrusion of the pulp of the disc - the nucleus beyond the fibrous ring, is divided into several categories:
- Cervical changes in the intervertebral discs. Most often, this type occurs in people engaged in sedentary work, so it can occur at a fairly young age of 25. Previously, a person can be tormented by a long and sluggish osteochondrosis.
- Degeneration of the cervicothoracic region. Here the problem is localized in the collar part and usually appears in people over forty years old. Mostly women suffer from such hernias. Pathology develops against the background of a curvature of posture and a violation of s alt metabolism in the body.
- Hernias in the thoracic spine are less common and are usually associated with trauma during a rough fall onto the back from a height.
- But hernias in the area between the sternum and lower back are quite common. Especially for people who just came into the world of weightlifting and immediately decided to move on to the main artillery without strengthening the muscular dorsal frame.
- The most popular type of pathology is lumbar hernia and protrusion of the intervertebral discs of the lumbar spine.
- Already mentioned hernia at the junction of the lower back and sacrum. Here, surgery is usually recommended in the form of removal of the intervertebral disc, since such a pathology cannot be treated.
- Hernias in the sacral region and in the coccyx are practically not diagnosed. But if they appear, it is solely due to serious injuries.
Main disc diseases
The main pathologies associated with intervertebral discs are just protrusions of the pulp of the nucleus and they are divided into several types, depending on the size. So, the hernias, protrusions and prolapses already described above are distinguished. To understand exactly what the doctor is dealing with, it is necessary to take an x-ray of the part of the spine that the patient complains about.
With the help of a picture, the doctor can determine the size of the disc body that has gone beyond the vertebra into the external environment of the body. A hernia will be everything that is increased by more than five millimeters. If the pathology is less than this mark, then the diagnosis will be prolapse. Protrusion is a slight deformation of the disc, with the body going beyond. In this case, the protrusion does not reach even three millimeters, and the fibrous ring can remain intact, but modified due to strong pressure. The most common disease in the latter species is protrusion of the intervertebral discs of the cervical region.
Diagnosis
To determine the best treatment for intervertebral discs, the doctor determines the value of the exit of the nucleus from the fibrous ring. And here, too, there is a classification, so if the gelatinous body protrudes within three millimeters, then this is called prolapse. And in the case of a protrusion up to a size of fifteen millimeters, this isfinal rupture of the annulus. By the way, there is such a definition as extrusion, which means that the fallen core (part of it) hangs down enough to finally come off.
Intervertebral hernias, protrusions and their location relative to the body
Regarding the body pathology can be:
- Median or median. They are located in the very center of the spinal disc and are oriented towards the back wall. For example, protrusions of the intervertebral discs of the cervical spine are the most common among this category.
- Paramedian or lateral, respectively, located on the left or right, next to the foramen.
- Ventral or anterior. They are closest to the inside of the skin and are the safest available.
- Well, the most dangerous are foraminal pathologies, as they are located exactly next to the nerve roots and can lead to paralysis of those areas of the body that are under the direction of the damaged nerve root. For example, such a disease can be a dorsal protrusion of the intervertebral disc, with which you need to be extremely careful during treatment, because due to any wrong movement or tilt, the ring can break and the consequences can be irreversible.
In case of delay in treatment with a hernia directed towards the spinal canal, a part of the protruding nucleus pulposus may separate, followed by its release into the canal itself, and this is one hundred percentgetting paralysis or meningitis.
By the way, you should know that even after getting into a traffic accident or getting serious injuries, a hernia and protrusion in the intervertebral disc may not show any signs for a long time. A year and a half, the disease can proceed without any special symptoms.
Treatment and prevention
Since the most dangerous disease of the vertebral discs is still a hernia, it is important to know what needs to be done for preventive purposes in order to prevent its occurrence, or the formation of a protrusion. The best prevention is a he althy lifestyle, including daily exercises for the whole body. In particular, this applies to those who are engaged in sedentary work in the office. It is best in such cases to do a little warm-up after a certain number of hours of sitting in one position. After all, for example, protrusion of the intervertebral discs of the cervical region may appear not only due to uneven load on the disc, but also from an uncomfortable position of the body.
Many choose an evening visit to the pool as a preventive measure, since swimming involves the muscles of the entire spine, which means that the spinal frame is strengthened, which is very important for maintaining a he althy spinal column. Particular attention should be paid to pain in certain parts of the back. Often there are cases when, due to the presence of osteochondrosis, which a person does not know about, there is a protrusion of the intervertebral discs of the lumbardepartment. It is best in such situations to immediately undergo a diagnosis.
In the case when the discs are already flattened, a person should seek the help of a doctor involved in exercise therapy, who can help with the selection of a special complex for exercises on the spine and back. The most important thing in this matter is strengthening the muscular frame of the back, which can take most of the load on itself.
What to do if the moment with prevention has already been missed and a person has a herniated disc? First of all, you should know that pain symptoms most often occur due to pinched nerve endings, and such sharp pains lead to muscle spasms in the back and the condition worsens significantly.
Treatment in such a situation begins with a quiet life and a decrease in the mobility of damaged discs. Most often they buy special corsets that fix the spine in one position. Spasms and pains are removed with the help of painkillers or injections-blockers. But this treatment only provides relief in everyday life. During this time, a person must prepare his body for completely new standards of existence. With the help of a doctor, you can determine which movements need to be performed with extreme caution, and which are available to him without restrictions.
The use of electrophoresis, ultrasound, and massages will perfectly help in the treatment. When drug treatment is reduced, physical activity is used to restore normal spinal activity. There are a lot of different exercises inyoga. For example, there is a separate topic in yoga therapy, like the "Correct approach to the spine", in which, together with a trainer, you can achieve incredible results. Indeed, with the correct performance of all physical activities, the disk can restore its function. These methods of treatment apply both to protrusions of the intervertebral cervical discs, or pathologies in other departments, and to the treatment of hernias, although the latter cannot always be eliminated by the methods described above. Then the patient is recommended surgery.
The surgeon is contacted in the following cases:
- If a person has disorders in the genitourinary system (difficulties with urination and sexual dysfunction)
- Atrophy of the leg muscles.
- Absence of any positive dynamics in medical treatment for several months.
In especially severe cases of hernia, there are serious disturbances in the functioning of the spinal cord, these are precisely the moments when the nucleus flows towards the spinal canal and, due to the danger of loss of hearing, vision and mobility of the limbs, they most often resort to surgical interventions.
Sometimes not complete, but partial removal is performed. This operation is called a discectomy. Most often, discectomy is performed through a micro-incision, so damage to the surrounding tissues and the entire disc is much less.
With endoscopy, that is, the introduction of a micro-camera inside the spinal column, the surgeon can more accurately remove the affected area. But there is another way of surgicalintervention - hydroplasty, in which a strong pressure of water washes out the affected core, thereby removing the entire hernia.
But the ideal option would be, of course, timely diagnosis of the disease.
