Intervertebral hernia — the last stage of the deformation of the intervertebral disc. This condition, according to statistics, occurs in about one person out of a thousand. Its development is facilitated by back injuries, excessive physical activity with weight lifting, diseases of the spine (in particular, osteochondrosis). Without treatment, the condition progresses rapidly and can cause disability in a generally healthy person. Therefore, modern methods of treatment of intervertebral hernia are aimed not only at restoring the health of the spine, but also at eliminating hernia complications.
- Conservative (non-surgical) methods of treatment of intervertebral hernia
- Surgical treatment of intervertebral hernia
Conservative (non-surgical) methods of treatment of intervertebral hernia
In modern vertebrology, the following areas of non-surgical treatment of herniated discs are used.
Drug therapy
Drugs are prescribed, as a rule, as an intensive care agent and are used in the acute period, when the tissues surrounding the hernia are inflamed and the nerve is injured. Drug therapy allows you to eliminate pain, reduce pressure on the spinal roots, remove inflammation and swelling in the affected area, and normalize muscle tone. Such drugs are used in a short-term course — for for 10-20 days. For long-term therapy, drugs with nootropic action (stimulating tissue metabolism and microcirculation), vitamins and mineral substances can be prescribed.
Physiotherapy
Physiotherapeutic methods are used after the acute manifestations of the disease have been removed. Massage techniques, acupuncture, electrophoresis, ultrasound therapy have shown the greatest effectiveness.
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Kinesiotherapy
Kinesiotherapy or movement therapy — method used to stabilize the results of treatment. In the course of therapy, special techniques can be used (active and passive movements, changing body position, tension of individual muscle groups and others) or special equipment (tables and racks for stretching muscles, to strengthen the ligamentous apparatus and to achieve other effects) .
Orthopedic treatment
To reduce the load on the spine, it is often recommended to wear special corsets or bandages. By helping to distribute weight throughout the spinal column, these orthotics relieve pressure on damaged discs and slow herniation progression.
It is important to know that conservative treatments are used in limited cases:
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With a hernia of minor size, which does not have a significant impact on the patient's ability to work.
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When a hernia protrudes «out» — in direction from the spinal canal to the tissues surrounding the spine.
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As an additional therapy in the rehabilitation period after surgical treatment.
Before choosing one or another method of therapy, an examination is mandatory. It should include X-ray of the spine, ENMG (electroneuromyography — a method that allows you to assess the degree of damage to the nerve endings) and other diagnostic measures, depending on the features of the clinical case.
Surgical methods of treatment of intervertebral hernia
Unfortunately, today there are no methods and means that would help to restore the structure and functions of the intervertebral disc. And if the hernia is large or it threatens the health of the patient in general, the only way to eliminate it — surgical operation.
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Depending on the location of the hernia, its size, reasons for its formation and other factors, the operation may be the following types of intervention:
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Discectomy. This is a surgical removal of a damaged disc; during the operation, bone growths, deformed ligaments and other pathological formations are also removed. A variation of discectomy is microdiscectomy — an operation performed under a powerful microscope.
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Nucleoplasty. This operation is performed on the nucleus of the vertebral disc — by removing a small amount of the gel-like nucleus, the doctor relieves the pressure on the fibrous ring that forms a hernia.
Vertebroplasty — restoration of the height of the vertebra, which puts pressure on the intervertebral disc. This type of intervention is recommended for a compression fracture of a vertebra, resulting in disc compression.
In addition to surgical treatment, medication, orthopedic therapy, recovery with the help of physiotherapy and exercise therapy, and treatment of complications of an intervertebral hernia (disturbances in the function of the intestines, bladder, parsthesia of the extremities and other conditions) are mandatory.
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