treatment of joints and spine
- Ankylosing spondylitis
- Flat feet
- Heel spur
Dorsal (dorsal) intervertebral disc protrusion
Learn more about the lower back, spine:
Causes of intervertebral disc prolapse
Rotation of the lumbosacral occurs through unilateral muscle contraction that follows the oblique direction of tension; the more the direction is skewed, the greater the effect of the rotation. Most extensor muscles and lateral flexors follow an oblique direction and rotate when their main component is neutralized by opposing muscle groups.
- The mobility of the spinal column is ensured by symphysis joints between the vertebral bodies, formed by a layer of hyaline cartilage on each vertebral body and the intervertebral disk between the layers.
- The first are distinguished by an uneven protrusion of the fibrous ring, and the second are accompanied by its uniform extrusion. Diffuse protrusions lead to inflammation of the nerve tissue, which can cause disability.
- He goes after the lumbar. It consists of five vertebrae. It is a triangular bone located between the pelvic bones. It has similar diseases with the lumbar region. Therefore, it is often called lumbosacral.
- Tailbone -5 vertebrae.
- Increased pain when bending the body forward, left and right.
Symptoms of dorsal protrusion
Radioisotope scanning of the skeleton – involves the introduction into the blood of a special substance that accumulates in the bone and cartilage tissue. The method allows to detect the presence of tumors and other pathological structures.
- Pain syndromes with posterior protrusion:
- Dorsal (dorsal) diffuse protrusion is a protrusion of the disc into the cavity of the spinal canal by up to 5 mm in several parts of the spinal column simultaneously (without breaking the fibrous ring). Pathology is very dangerous, as over time it leads to the formation of a hernia and compression of the nerve roots.
- The brain and spinal cord are two anatomical components of the central nervous system (CNS). This is the main reflex center and the pathway between the brain and the body. As noted earlier, the spinal cord usually ends, like a brain cone, within the lumbar spinal canal at the lower edge of the L2 vertebra, although there is a variability in most of the caudal lengthening.
- The group of the cross-spinous muscles, innervated by the dorsal branches of the spinal nerves, is located deeply towards the straightening muscle of the back and moves along the oblique (up and to the middle) from the transverse processes to the spinous processes. As a group, they act to stretch the spinal column. But shortening on the one hand, they cause rotation of the column in the contralateral direction. They are divided into 3 groups: the semi-bony muscle, the partitioned muscle and the rotator muscles of the waist. Lumbar rotator muscles are small, asymmetrical and changeable muscles that connect the upper back of the transverse process of the vertebra below to the anterolateral border of the vertebra membrane above.
The synovial joints between the upper and lower articular processes on the adjacent vertebrae are called faceted joints (also known as bowed process joints or Z-joints). They allow simple sliding movements. The movement of the lumbar spine is largely limited to flexing and stretching with a slight degree of rotation. The area between the superior articular process and the membrane is the interarticular surface. Immobility of the vertebra occurs if there is a violation of the inter-articular surface ossification.
Considering such serious consequences, it is extremely important to immediately consult a doctor at the first alarming symptoms in order not to be late with treatment.
The spinal column also has two physiological curves: lordosis and kyphosis. Divisions with lordosis curved forward – cervical and lumbar. The departments with kyphosis are curved backwards – thoracic and sacral.
The first stage of the diagnosis of dorsopathy is considered an external medical examination. During the collection of anamnesis, a qualified specialist determines the location of pain, the presence of pain depending on the position of the body, various pathologies of the spine, or previous injuries. Additional studies are needed in order to identify tumors, infectious processes in the body that declare themselves through back pain. Laboratory blood tests are performed.
- In the region of l5-s1, a uniform protrusion of the intervertebral disc is usually observed of about 7-10 mm. MRI in this case, there is a prolapse of the pulpos nucleus beyond the limits of the functional segment.
- Discography – the introduction of contrast in the intervertebral disc.
Lumbago – a sharp pain in the lumbar region. It is accompanied by a restriction of the mobility of the limbs, as well as a change in the structure of the spinal column. In order for a lumbago to appear in case of a prolapse of an intervertebral disk, strong compression of the nerves is necessary;
Dorsal intervertebral disc protrusion leads to nerve compression
In a cadaver study, 129 cadaver specimens of the spinal cord ended at L2 level in 60%, L1 in 30% and L3 in 10% of specimens. The characteristic growth rates of the spinal cord and spinal canal are the cause of these differences. Exceptions are also patients with congenital defects of the spine, known as spina bifida. In such patients, the cerebral cone may be displaced down to the middle or toward the lower lumbar spine.
Vascular network of the lumbosacral spine
- Intervertebral discs of the lumbar spine
- If the diagnosis of the disease occurred at its initial stage, then it will be possible to cope with the protrusions of the cervical spine with the help of traditional medical treatment. The main difficulty in carrying out an effective wellness course is that for the period of treatment the cervical section needs rest, which is not so easy to provide. In this regard, doctors may prescribe the wearing of a special collar and the use of traction traction methods.
- Osteochondrosis of the lumbosacral spine has its own characteristic symptoms – the patient at the time of the attack freezes in the position in which he was caught by the attack. Sometimes the patient may experience a burning sensation or, on the contrary, a cold in the lumbar region.
- These bends work as shock absorbers for the spine during sudden movements, when making jumps. And at the same time they contribute to the preservation of human balance when walking.
- During the inspection, a qualified specialist performs palpation (palpation) of the spine and paravertebral muscles. This is necessary to identify muscle tension and vertebrae. The most common method of investigation is the appointment of spine radiography in several projections.
Diagnosis of posterior protrusion
Circular-dorsal protrusion is the second most frequent. It is also most common in the lumbar spine. On a computer tomogram for pathology, there is a deformation of the disc in all directions, but with the greatest protrusion in the dorsal part. Also often noted is the contact of the formation with the nerve roots of the spinal cord.
Only a doctor can determine the correct treatment for dorsal protrusion. With the help of drugs it is impossible to restore cartilage tissue. The best way to strengthen the intervertebral discs is physiotherapy.
- Sacralgia – pain in the sacrum, aggravated in the standing position. It is formed when the protrusion is localized in the L4-L5-S1 segments;
- The most common causes of dorsal protrusion:
- Spinal nerves and roots
- The discs form the main joint between the vertebrae. They carry the load during axial compression and allow movement between the vertebrae. Their size varies depending on the size of the adjacent vertebrae and is approximately one quarter of the length of the spinal column.
In order to quickly regain good health during protrusions, nonsteroidal medications are prescribed, which not only weaken the pain syndrome, but also eliminate inflammatory processes. Along with drug treatment, the patient must be prescribed sessions of wellness massage, manual procedures, physiotherapy and reflexology. During periods of remission, the patient should move as much as possible, walk a lot in a fast pace and regularly perform exercises of the physical therapy complex. (See also: LFK during protrusion of the cervical spine).
- Dorsal protrusion of the cervical spine is becoming an increasingly common disease. Given that it precedes the appearance of hernial formations, which are capable of severely undermining health, it is necessary to find out how the development of this disease occurs. First of all, we should remember how the intervertebral disk is arranged and what its main function is. The structure of the disk is very simple, since it consists of a fibrous ring and a pulp nucleus inside it, which is a thick substance. Thanks to this design, the individual vertebrae do not touch each other under the influence of daily loads, that is, the intervertebral disk simply performs the function of a natural shock absorber.
- It consists of 7 vertebrae and is the most mobile. It has in its structure two vertebrae, which are fundamentally different from all other human vertebrae – the atlas and the epistrophy. The first has no vertebral body. And the second has a bone growth, the so-called dentition. The presence of these two vertebrae allows a person to tilt and rotate the head in different directions.
MRI and CT are additional diagnostic methods. To determine the causes of nerve damage, electroneuromyography (ENMG) can be prescribed.
- Circular fooraminal protrusions in the lumbar region (L4-L5, L5-S1) are also very common. Usually on magnetic resonance tomograms, the size of the deposition does not exceed 5 mm, since the region is limited by the lateral canal (its size is about 5 mm).
- Spinal traction can be performed in a medical hospital. It is necessary to increase the gaps between the vertebrae, which eliminates the compression of nerve fibers.
- Koktsigalgiya manifested numbness and loss of sensitivity in the coccyx. The pains are aggravated by the act of defecation, and also in a standing position;
- Physical (spinal injuries);
- All the roots of the lumbar nerves originate from the vertebra T10 to L1, where the spinal cord ends up like a brain cone. The dorsal or posterior (somatosensory) root from the posterolateral side of the spinal cord and the ventral or anterior (somatomotor) root from the anterolateral side of the spinal cord are connected in the spinal canal to form the root of the spinal nerve. Then the roots pass down through the spinal canal, forming the horse’s tail, until they come out in the corresponding nerve (intervertebral) canal as a single pair of spinal nerves. Thus, the lumbar nerve roots extend from the spinal canal below the point where they appear.
- The vertebrae of the lumbar spine contact the anterolaterally with the dual lumbar arteries, which rise from the aorta, opposite the vertebral bodies L1-L4. Each pair passes anterolaterally around the side of the vertebral body to a place immediately adjacent to the intervertebral canal and leads to different branches. Periosteal and equatorial branches feed the vertebral bodies. The spinal branches of the lumbar arteries enter the intervertebral canal at each level. They are divided into smaller anterior and posterior branches that extend to the vertebral body and combinations of the arc of the vertebra, the meninges and the spinal cord, respectively.
Each disk consists of a gelatinous nucleus located in the center and slightly behind the mucous substance with inclusions of reticular and collagen fibers, surrounded by a fibrous ring, a membrane of connective tissue cartilage. The fibrous ring can be divided into extreme, middle and internal fibers. The anterior fibers are reinforced by a strong anterior longitudinal ligament (PPS). The posterior longitudinal ligament (LPS) can provide only weak reinforcement in the midline, especially in L4-5 and L5-S1, since it is a narrow construction attached to the ring. The front and middle fibers of the ring are especially numerous in the front and sides, but they are smaller in the back, where most of the fibers join the cartilage plate.
- One should always remember that protrusion of the cervical region is a serious and very dangerous disease. In no case do not need to practice self-treatment, as there is a high risk to significantly aggravate the situation.
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Osteochondrosis of the cervical spine is the most common disease of the cervical spine. Called the degenerative process in the intervertebral discs. If not treated in time, it becomes chronic with damage to the vertebral body, intervertebral joints and ligaments.
Taking into account the fact that dorsalgia is characterized by a chronic and progressive nature of the course, the main principle of its treatment is to apply therapeutic methods that are based on modern ideas about the mechanism of the occurrence of this pathological process.
According to statistics, circular-foraminal protrusion of intervertebral discs in 16% is directed in both directions. 62% of patients can be traced left-sided localization of education, and 22% – right-sided.
All about circular protrusion of the intervertebral disc
Thus, dorsal (posterior) intervertebral disc protrusion is a complex pathology. It requires an integrated approach to identifying the causes and methods of treatment of the disease. Particular care should be taken when falling out in the C5-C6-C7, L4-L5-S1 segments.
Cervicalgia – pain in the neck, which increases with flexion and extension of the head;
Causes of a uniform protrusion of intervertebral discs
Vascular (circulatory disorders in the spinal segments);
From the beginning of development, these roots continue independently to their respective channel, traversing the subarachnaidal space within the dural sac / arms. They pierce the dura mater before mixing with each other in the channel. In the side they move in the dural sleeve. There may be separate dural sleeves around the posterior and anterior roots for a given spinal nerve, or these two sleeves may be combined. Each root is washed by the CSF from a separate arachnoid envelope around it. The dural sleeves in the lumbar region are longer and move in a more posterior-lateral direction after exiting.
- These arteries give rise to ascending and descending branches, which communicate with the spinal branches of neighboring levels. The feeding arteries from the anterior spinal canal pass in front and feed most of the red spinal cord of the central vertebral body. Larger branches of the spinal branches continue as radicular or segmental cerebral arteries, distributed to the nerve roots and the spinal cord, respectively.
- The annular fibers are firmly attached to the vertebral bodies and are arranged in the form of thin plates. This circular arrangement allows you to limit the movement of the vertebrae, reinforced by the surrounding ligaments.
- If the protrusion has not passed into the last stage, then it will be possible to cure it. True, will have to try and make an effort. It is very important that an experienced specialist controls all changes, adjusting the course of treatment, then his results will be faster and more stable.
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Symptoms of circular prolapse of discs in the lumbar spine
Experts believe that osteochondrosis of the cervical spine is the most severe form of the disease.
- If we talk about the general objectives of the treatment of dorsalgia, they can be distributed as follows:
- In case of intervertebral disc prolapse and back pain, the primary diagnostic method at the outpatient stage is radiographic examination. It allows you to determine the presence of pathology indirectly.
- Circular disc protrusion is a uniform protrusion of intervertebral substance. The frequency of occurrence of this pathology is 3-5% of all types of protrusions.
- Thoracalgia – chest pains that resemble angina pectoris or myocardial infarction. Usually observed with severe dorsal bulging at the level of C5-C6-C7.
Infectious (inflammatory changes of the spine);
The cellular bodies of the motor nerve fibers are located in the ventral or anterior horns of the spinal cord, while the cellular bodies of the sensory nerve fibers are located in the dorsal root ganglion (spinal ganglion) at each lumbar and sacral level. Dorsal root ganglia (DKG) tends to be located within the nerve canal and, therefore, not strictly speaking, within the lumbar canal. However, at the lower lumbar (and sacral) level, DKG tends to be close to the nerve canal within the spinal canal, as found in 11-38% of cases at the L5 level and in 71% of S1. Dorsal root ganglia join the edges of the intervertebral canal.
Up to the age of 8 years, intervertebral discs have a good blood supply. After that, their nutrition depends on the distribution of tissue fluid along 2 routes: (1) bidirectional flow from the vertebral body to the disk and vice versa, and (2) propagation through the ring from blood vessels on its surface. As in adults, the discs are vascular-free structures, with the exception of their periphery.
Types of circular protrusions
Vertebral lumbar ligaments
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- They can be divided into two groups. The first is associated with a violation of the passage of nerve impulses due to the fact that the nerve roots are pinched. Symptoms are as follows: pains of different characteristics in the neck and neck. The pain can be given under the scapula, in the shoulder, in the arm. Often accompanied by weakness and numbness of the limb.
Actions aimed at identifying and eliminating factors that lead to dorsalgia;
With a mild degree of osteoporotic changes (rarefaction of the structure of the vertebrae), the presence of the disease can only be assumed by enhancing the clarity of the contours of the vertebrae and the deflection of their endplates.
Changes in the disc at the initial stages of protrusion formation (cross section)
A single clinical examination is rarely accompanied by a diagnosis of dorsal protrusion. Since the size of the loss is small, in the initial stages they do not lead to pronounced clinical signs of the disease.
Diagnosis of radiological signs
Allergic (damage to cartilage as a result of an allergic reaction);
Spinal nerve exit levels
How to treat a uniform prolapse of the intervertebral disc
The PPP covers the ventral surfaces of the lumbar vertebral bodies and disks. It closely joins the front annular fibers of the disc and expands as it descends along the spinal column. PPS maintains the stability of the joints and limits stretching.
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- The second group can be designated as vertebrobasilar insufficiency or “cervical artery syndrome”. Symptoms: headache, dizziness, reduced visual acuity, “front sight” before the eyes, tinnitus. Coordination and gait are disturbed, blood pressure is unstable.
- Elimination of pain;
- As bone density decreases, X-rays become more reliable. Due to external pressure, damage to the vertebral fixation plates may occur. In this case, the disks take the form of a biconcave lens, wedge, fish fins.
- This disease often occurs after 30 years. This is due to the predominant influence on his appearance of degenerative-dystrophic changes of the spine.
Suspected pathology at the level of C5-C6-C7 in the cervical region can be based on neurological symptoms:
Hereditary (anomalies of the spine).
The lumbar spinal nerves exit the spinal canal, passing from below to the legs of the corresponding vertebrae from the beginning of development. In the lumbar region, the first division of the spinal nerve occurs within the intervertebral canal, leading to the posterior and anterior (spinal and ventral) branches. The posterior branches pass behind the back, surrounding the articular processes at this level, and the anterior branches continue to the sides to supply the walls of the body and lower extremities.
Venous drainage runs parallel to the feeding of the arteries. Venous plexuses are formed by veins along the spinal column inside and outside the vertebral canal (internal / epidural and external vertebral venous plexuses). Both plexuses are sparse to the side, but dense in front and behind. Large basal-vertebral veins form within the vertebral bodies, appearing from a canal on the posterior surfaces of the vertebral bodies and flowing into the internal vertebral venous plexuses, which can form the large longitudinal sinuses. Intervertebral veins are connected to the veins from the spinal cord and venous plexuses, as they accompany the spinal nerves through the canal to descend into the segmental veins of the lumbosacral spine.
Causes of dorsalgia of the lumbosacral spine
Clinical manifestations of the disease
The ZPS is located within the spinal canal above the posterior surface of the vertebral bodies and disks. Its function is to limit the bending of the spinal column, except for the space in the lower L-section of the spine, where it is narrow and weak.
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- Like any living tissue, the pulpal nucleus requires fluids and nutrients to perform its work, but at the same time it does not have any incoming blood lines that enrich the cells of the body. The intervertebral disk absorbs all the necessary elements from the environment using the diffuse method, which works only during active flexions of the spinal column, since a pressure differential must be created for the absorption of nutrients during stress. (Learn how to cure cervical protrusion).
- Treatment of osteochondrosis of the cervical spine occurs in a complex. On the one hand, pain and inflammation are removed, and on the other hand, all the functions of the cervical region are restored. For this, both medical and physiotherapeutic methods are used simultaneously.
- Prevention of degenerative-dystrophic changes in the spinal tissues;
- Manual therapy for cervical protrusion
Diagnostic measures for dorsalgia
Other causes of circular protrusion:
Muscle cramps in the neck;
Dorsal protrusion is more often observed in the cervical (at the C5-C6 level) and lumbar (in the L3-L4, L4-L5, L5-S1 segments) sections of the spine.
- The supraspinous ligament connects the tips of the spinous processes of the adjacent vertebrae from L1-L3. The interspinous ligament connects the spinous processes from the root to the top of the adjacent processes. Sometimes they are described together as an interspinal / supraspinal ligament complex; they weakly maintain separation and bending of the spine.
- Usually, the appearance of dangerous changes occurs against the background of aging of the organism, but the biological age of a person does not always cause this phenomenon. With a sedentary lifestyle, aging of the vertebrae and discs occurs even in young people, especially if they suffer from excess weight. The fact is that poor blood circulation does not allow the body to actively distribute nutrients to the body, taking away waste from their cells from the cells.
- The drugs used are primarily non-steroidal inflammatory agents (ketonal, diclofenac
- Posterior prolapse of the intervertebral disc without breaking the fibrous ring is accompanied by a complex of symptoms:
- In the lumbar spinal canal, the anterior and posterior roots of this nerve (embedded in their dural sacs) intersect the intervertebral disc, which is located above the stem, under which the nerve goes. For example, the nerve roots L2 intersect the disc between the vertebrae L1 and L2 before reaching the corresponding canal, under the pedicle of the vertebra L2.
- The tubular spinal canal contains the spinal cord, its meninges, the roots of the spinal nerves and the blood vessels that feed the spinal cord, the meninges, the vertebrae, the joints, the muscles and the ligaments. Potential and real spaces wedge between the spinal cord, the meninges and the canals of the bone-ligamentous canal. The canal is surrounded by its pillar and formed by the immediate neighborhood of the spinal canal, which is lined up in series with each other. The bodies and discs of the vertebra make up the front wall (with the CPS lying folds above it), while the membranes and the yellow ligament limit the channel to the back. The sides of the spinal nerves and blood vessels pass through the intervertebral canal.
- Intergangular ligaments (MS) connect the interlayer spacing, joining the interspinal ligament in the middle and to the facet capsule on the sides, forming the back wall of the spinal canal. It has a wide attachment to the lower surface of the upper membrane and inserts on the front edge of the lower membrane. Usually, the ligament is tightly stretched, stretching to bend and contracting its elastin fibers in a neutral position or under tension. It maintains constant disc tension.
The main parts of the spine and their diseases
The vertebrae of the lumbar region, numbered L1-L5, have a vertical height smaller than their diameter horizontally. They consist of the following 3 functional parts:
Thus, the lack of motor activity in itself worsens the nutrition of the disk due to the disturbance of diffuse metabolism, and the lack of useful elements in the surrounding tissues further aggravates the situation. Because of this, the nucleus loses some of the fluid and cannot already be well absorbed, and this increases the load on the bone tissue, which cracks, deforms and eventually collapses.
- Very good help in the treatment of ointments and gels for external use – fastum gel, voltaren, finalgon and others. They can be purchased at any pharmacy without a prescription.
- Elimination of the causes that led to the development of pathological changes;
- Principles of treatment:
- Against the background of poor posture, circular dorsal protrusion may appear long after the onset of symptoms;
- Violation of the focus of the eye;
Pain syndrome is the first sign of spinal pathology. With dorsal protrusion, it is usually aching. Pathology occurs due to irritation of the nerve endings located in the ligaments, muscles and dura mater;
Innervation of the structures of the lumbosacral spine
Brain shells and related spaces
The inter-transverse ligament connects the transverse processes of the adjacent vertebrae and opposes the lateral bending of the trunk.
A vertebral body designed to carry weight;
Osteochondrosis of the cervical spine – symptoms:
As a result of the development of such degenerative processes, the fibrous ring becomes less elastic, its walls become very thin and the pulpous nucleus, under the influence of external loads, begins to strongly press on one of its walls (the weakest). As a result, the fibrous ring bulges laterally, which is called intervertebral disc protrusion.
Hernia of the cervical spine is a consequence of severe osteochondrosis.
Normalization of metabolic processes;
Osteoporosis of the bones (rarefaction of the structure) occurs against the background of a lack of calcium or its intense loss during bleeding.
Local pain when feeling the neck; Stiffness in the morning;
The lumbar spinal nerves produce one or more recurrent meningal branches, known as sinuvertebralnye nerves. These branches originate from the autonomic nervous system, paravertebral branches and the overlying muscles that are distal to the DKG. The sinuvertebral nerves re-enter the spinal canal and carry sensory and sympathetic efferent fibers. Similar to the spinal branches of the lumbar arteries, each nerve is divided into ascending and descending branches to power the periosteum, the ZPS and the outer annular membranes.
Cerebral membranes consist of 3 layers: the pia mater, the arachnoid mater and the dura mater. Together they enhance the protection of the spinal cord and roots. The dura mater is the most superficial and elastic layer. The pia mater and arachnoid, together called leptomeninks, are fragile. The spinal cord, roots and nerve roots are closely surrounded by the pia mater. The dura mater and the arachnoid membrane together form the free membrane (called the dural / fecal sac) around these structures, separated from the channel walls by the epidural space.
The iliopsoas originates from the transverse process of L5 and is connected by the posterior part of the inner lip of the iliac crest. It helps the lateral lumbosacral ligament and the ligaments mentioned above stabilize the lumbosacral joint.
The vertebral (nerve) vault, designed to protect the nerve elements;
Usually the appearance of dorsal protrusion of the intervertebral discs of the neck occurs against the background of a damaged posture, since an abnormal body position increases the load on individual vertebrae.
When the jelly-like central part of the intervertebral disc breaks the membrane through the affected area. For clarity, some doctors explain to their patients the process of the disease, comparing it with squeezing jam from a bitten donut.
Actions aimed at reducing or restoring impaired spinal function, with the aim of restoring the ability to work of patients with dorsalgia.
Stopping the progression of pathology;
Due to the presence of anatomical lordosis in the lumbar and cervical spine, circular disc protrusion is localized most often in these places. Particularly dangerous is the location in the L5-S1 segment, through which the nerve plexuses, which are responsible for the functioning of the pelvic organs and lower extremities, exit from the spinal cord.
Numbness and tingling of the tips of the fingers.
Headaches and dizziness are a standard sign of localization of the disease in the cervical spine (levels C5-C6-C7);
PPS is richly innervated by nerve fibers from the sympathetic system. The sinuvertebral nerves are also sensory to the meninges and the walls of the vertebral venous plexuses. They supply vasomotor fibers that regulate blood flow in the arteries and internal vertebral venous plexuses.Spinal hard shellLumbar muscles
Dorsal protrusion of the cervical spine
Bone processes (spinous and transverse), whose function is to increase the effectiveness of muscle activity.
Injuries to the spinal column also cause deformation of the intervertebral discs.
When a patient has a hernia of the cervical spine, doctors begin treatment with traditional non-surgical methods. This is the use of drugs, physiotherapy, exercise therapy. If conservative methods did not help, then surgical treatment is usually prescribed.
Drug treatment of lumbosacral spine dorsalgia:
Strengthening vertebral structures;
Circular prolapse of discs in the lumbar spine (L5-S1) in 10-12 mm is often accompanied by severe clinical symptoms:
How pathologies are formed
Medical diagnostic methods of intervertebral disc bulging:
Impaired blood supply in pathology is manifested by a change in the color of the skin.
The sinuvertebral nerves extend to communicate with branches from the radicular levels above and below the entry level, as well as the contralateral side, making it difficult to localize pain from these nerves.
Because of what are formed protrusions
- The dura mater consists of rigid longitudinal bundles of collagen fibers woven into round elastic fibers. The outer surface is rough and mixed with loose connective tissue in the epidural space. The inner surface, turned to the subdural space, is smooth and covered with a layer of mesothelium. From below, the dural sac ends in the sacral canal, usually in S2-S3 (sometimes S1).
- Four functional muscle groups control the lumbar spine, they can be divided into extensor muscles, flexors, lateral flexors, and rotators. The synergistic effect of the muscles of the left and right side muscle groups is realized during flexion and stretching of the L-spine.
- The bodies of the vertebrae of the lumbar spine differ from the thoracic vertebrae by the lack of costal edges. The vertebral bodies of the lumbar spine (vertebrae) are the heaviest components interconnected by intervertebral discs. The size of the vertebral body increases from L1 to L5, which indicates an increase in the load carried by each lower lumbar vertebra. It is important that the vertebra L5 has the heaviest body, the smallest spinous process and the thickest transverse process.
Symptoms of protrusions of the cervical spine
Another reason are diseases that are accompanied by degenerative-dystrophic processes: kyphosis, osteochondrosis, lordosis, and others.
For the diagnosis of lesions of the cervical spine, it is usually used MRI of the cervical spine. This examination most accurately shows all abnormalities in the structure of the spinal column, including the pinching of the nerve endings.
- For therapeutic purposes, warming gels, ointments, and patches (pepper plaster, sabelnik, finalgon) are prescribed;
- Prevention of neurological disorders.
- Pain in the lower back and lower limbs;
Magnetic resonance imaging (MRI) is the most popular method for diagnosing spinal pathology. It allows you to assess the degree of damage, measure the size of the epidural space.
Dorsal protrusion of the cervical spine (in the C5-C6-C7 segment) is transformed over time into a hernia. It is dangerous to impaired blood supply in the brain. Through the transverse processes of the cervical vertebrae passes the vertebral artery. It provides blood supply to about 25 structures of the brain. With the rear bulge likely compression of the vessel.
- Anatomically, the ventral and dorsal (anterior and posterior) branches originate from the spinal nerve, just as it leaves the canal. The abdominal main branch is involved in the formation of the lumbosacral plexus and also provides several nerve endings for the adjacent superficial fibrous ring of intervertebral discs. Otherwise, disks are considered non-innervated structures.
- The dura mater continues caudally, like a fibrous filament, called an outer terminal filament or coccygeal ligament, which is mixed with the RFS above the coccyx. The dural pouch sends sleeve-like projections into the intervertebral canal, where the dura mater is mixed with the epineurium of the spinal nerves. The bands of connective tissue in the canal rest on the dural sleeves so that they can protect the roots of the spinal nerves from stretching while the L-spine is moving. In addition to these fixatives, the dura mater is attached in places to the LTP.
The surface of the intervertebral disc of an adult vertebra contains a ring of cortical bone, which has a secondary name epiphyseal ring. This ring acts as a growth zone in young, bonding the addition of ring fibers in adults. A plate of hyaline cartilage lies within the boundaries of this epiphyseal ring.
Modern methods of protrusion treatment
The vertebrae of the cervical region are very different from the joints in other parts of the spinal column. They are small in size and are generally more fragile, although they are forced to perform a lot of movements and are more stressed during the day. The diameter of the spinal canal in the cervical spine is very small and the protrusion of the fibrous ring in its cavity instantly causes a number of dangerous symptoms. The most characteristic of them will be: pain in the neck and head, disorientation of orientation in space, chronic fatigue and so on.
Behind the cervical region follows the thoracic spine. It is the largest and includes 12 vertebrae. To which are attached the ribs that form the chest. In its normal state, it looks like the letter “C”, just facing backwards.
Anti-inflammatory drugs (Nise, Voltaren Emulgel, hydrocortisone ointment);
The choice of the main method of treatment also depends on the patient’s well-being, the presence of other diseases.
Numbness of the gluteal region and back;
Functional radiographs (made in the state of flexion and extension).
Graphical diagram of the irradiation of pain with a lesion of the disk in the cervical region
Macroscopic anatomy of the lumbosacral spine
The dorsal main branch is divided into middle, intermediate and lateral branches immediately after it gives the facet branch of the face to the dorsal part of the joint immediately above. The intermediate and lateral branches move to the sides on the transverse process and feed the rectifying spinal muscles. Each middle branch of the posterior main branch is involved in the innervation of 3 facet joints: one branch excites the facet joint above the level, the second branch innervates at this level, and the third branch descends caudally to the level below.
- The extensor muscles are located in 3 layers. The largest group of internal muscles of the back and the main extensor muscle is the muscle that straightens the spine (or sacro-vertebral muscle). In the lower L-part of the spine, the spine straightening muscle acts as a single muscle. In the upper lumbar region, it is divided into 3 vertical columns of muscles (iliopus muscle, longest muscle, spinal muscle). Located in the posterior lateral direction from the spinal column, they have a common origin from the thick tendon, which is attached to the sacrum, lumbar spinous processes and the iliac crest. Ilio-costal muscle is the most lateral, and the spinous muscle (the smallest) is the most median. The longest muscle (the largest) is inserted into the base of the skull, while the iliopus muscle enters at the corners of the ribs and transverse processes of the lower cervical vertebra. Since these muscles rise along the spinal column, they are divided into places depending on where the muscle joins above.
- Each vertebral arch consists of 2 legs, 2 membranes and 7 different bone processes (1 spinal, 4 articular, 2 transverse), connected by faceted joints and ligaments.
- Depending on which side of the intervertebral disc bulging occurred, there are dorsal protrusions of the cervical discs on:
This is the norm of the so-called physiological bending – kyphosis of the thoracic spine. But very often doctors meet with such a pathological bend as scoliosis of the thoracic spine. This is the lateral curvature of the spinal column, which normally a person should not have.
NSAIDs (nonsteroidal anti-inflammatory drugs) in injections or tablets;
Anti-inflammatory drugs (NSAIDs) are prescribed as the main means in the treatment of spinal diseases. Along with the anti-inflammatory effect, they are good analgesics (painkillers). When using them, it should be borne in mind that NSAIDs have a negative effect on the gastrointestinal tract. They provoke the occurrence of gastric ulcer and the formation of cracks in the gastrointestinal tract.
Violation of the motor functions of the legs due to spasm of muscle tissue;
If the cervical spine is diagnosed if a protrusion is suspected in the C5-C6-C7 segment, the doctor will be able to assess the mobility of the vertebrae.
The localization of dorsal protrusion at the C5-C6 level is due to the increased mobility of this segment of the cervical spine. This happens when a person spends a long time at the computer and the neck is subjected to a heavy load.
Anomalies of the lumbar spinal column
The epidural (epidural / extradural) space ends at the bottom of the sacral opening, where it is compacted by the posterior sacrococcygeal ligament. The roots of the nerve cross the space, as they continue in the intervertebral canal. The entire space is occupied by loose connective tissue with variable fat content, providing a seal around the dural sac and spinal cord, and acting as a form to keep the thin internal vertebral plexus of the veins open. The vertebral venous plexus is inserted into the epidural loose connective tissue, sometimes transmitting a large amount of blood.
A bundle-growing 3-layer muscle, a group of lateral-spinous muscles, lies deep in the muscle, straightening the spine, and originates from the teat processes in the lumbar spine. In the sacrum, it comes from the lamella region in the middle of the posterior sacral foramen, from the muscular source on the muscle, straightening the spine, and the median surface of the upper posterior spine (VZO). Each bundle is directed in the upper median direction to the lower and middle edges of the membrane and to the adjacent spinous processes. The surface layer joins from 3-4 levels above, the intermediate layer joins 2 levels above and the deep layer joins 1 level above. The group of the cross-spinous muscles acts as extensor and as a rotating muscle of the L-section of the spine.
A foot, strong and directed back, connects the arch with the posterolateral body. It is attached to the cranial part of the body and acts as a protective coating for the contents of the horse’s tail. The concavities in the cranial and tail surfaces of the leg are called vertebral notches.
The main symptoms in making this diagnosis for the patient are: forward mixing of the abdomen and raised shoulders and shoulder blades. Scoliosis can be congenital or acquired. If everything is clear with the innate, then you can be saved from the acquired. It is only necessary to observe the correct posture.
Physical therapy is the main normalizing factor aimed at eliminating the causes of pathology. It strengthens the muscular corset, which will prevent the intervertebral disc prolapse.
X-ray tomography – a layer-by-layer examination of the spinal cord with x-rays.
With the protrusion of the intervertebral disc in the cervical region pains are formed with irradiation to the upper limbs. Lumbar localization is accompanied by aching pain in the lower back and legs. These manifestations are caused by irritation of the nerve receptors of the musculoskeletal system by protrusion of the pulpal nucleus.
As a rule, there are 5 human lumbar vertebrae. However, approximately 4-21% of the population as a whole and 10% of adults with symptomatic degenerative conditions of the lower back have a transitional lumbosacral vertebra (PCPD). These anomalies are mainly damage to symmetric or asymmetric segmentation. In these cases, the last lumbar vertebra contains an elongated transverse process, with varying degrees of connection with the “first” sacral segment. It is now recommended to use the term PPKP instead of the definitions of “sacral L5” or “lumbar S1”. PPKP is classified by simple radiographs on the system of Castelvi. A Ferguson lumbosacral joint review and anteroposterior (PZ) lumbar-thoracic joint review are recommended.
Many small segmental muscles make up the deepest layer of extensor muscles of the lumbar spine. They can be divided into 2 groups, both innervated by the posterior branches of the spinal nerve. The muscles that lift the ribs are usually not present in the lumbar spine. The second group contains the interstitial and interdigital muscles. The interstitial muscles consist of short tufts attached between the spinous processes of the adjacent vertebra. The transverse muscles consist of 2-3 processes of muscles that pass between adjacent transverse processes. They stabilize the posture and increase the effectiveness of large muscle groups.
Under each vertebra of the lumbar spine, a pair of intervertebral (nerve) canals can be detected with the same numerical definition, so the L1 nerve canal is located just below the L1 vertebra. Each canal is bounded above and below by the leg, in front by the intervertebral disk and vertebral body, and behind by the facet joints. The root of the spinal nerve, repeated meningeal nerves and radicular blood vessels with the same numbering pass through each canal. On each side are the five roots of the lumbosacral spinal nerves.
Another disease, osteochondrosis of the thoracic spine – is much less common than in other departments. This is due to the fact that the chest section is practically immobile. Therefore, it almost does not create the conditions for the trauma of intervertebral discs. But still, the disease sometimes affects the chest section. And this is most often associated with damage to the lower vertebrae of the thoracic region. The so-called cervicothoracic osteochondrosis.
The spinal column is what keeps the whole human skeleton. It consists of three dozen vertebrae (32-34), which are connected by cartilage, ligaments and joints. Some vertebrae in the adult state may grow together (coccyx).
With severe pain to relieve the patient’s condition, it is necessary to remove the load from the affected vertebral-disc segments. To do this, special attention in the treatment of pathology should be paid to myopically (strengthening of the muscular system around the area of damage). To do this, in the hospital can be used muscle infiltration with 0.5% novocaine solution or application to the lesion of Dimexidum in combination with 2-5% novocaine solution.
In fairness it should be noted that this symptom is observed only in 3-5% of cases. In other situations, a uniform protrusion of the intervertebral discs does not manifest itself with pronounced clinical symptoms. Individual tingling in the back area people blame for daytime fatigue, so the loss of intervertebral discs only progresses with time.
Spondylourography – is a combination of conventional radiography of the spine with contrasting urinary tract.
Dorsal disc protrusion is classified into:
No standard method has been established for vertebral numbering based solely on swept magnetic resonance imaging (MRI) of the lumbar spine. The ilio-lumbar ligament (PVPS) is easily recognized on an axial MRI of the L-spine and always arises from the L5 vertebra (based on anatomical studies and MRI). Therefore, by defining L5, therapists can increase their confidence in correctly establishing the levels of the lumbar region.
The pia mater and the arachnoid are thin membranes consisting of loose connective tissue and separated from each other by the subarachnoid space. The layer of mesothelium covers the entire leptomeningeal surface washed by the cerebrospinal fluid (CSF).
Anterior flexor muscles
Wide and strong membranes are plates that extend in the posterior-internal direction from the leg. Spinous processes of oblong shape are directed backwards from the junction of membranes.
If you suspect osteochondrosis of the thoracic spine, the symptoms should be something like this: pain between the shoulder blades, in the places where the ribs attach to the spine. Pain syndrome increases with deep breathing, may take the form of angina, renal or hepatic colic. Therefore, patients are often hospitalized with erroneous diagnoses. An X-ray image usually helps to clarify the diagnosis.
Doctors divide the spine into five sections. Spine:
The clinical signs of dorsalgia can manifest themselves in different ways, since they are directly dependent on the causes and localization of the pathological process.
Often, mild symptoms of protrusion are ignored, and this very dangerous disease continues to develop. For often occurring or incessant for several days, pain in the back should consult a specialist.
Myelography is a method for studying the spinal canal by introducing a contrast agent into the spinal canal.
Congenital abnormalities of the vertebrae consist of a set of spinal defects. Most are not clinically significant, but they can cause compression of the spinal cord and nerves or can cause instability.
The arachnoid covers the entire dural sac and extends into the dural sleeves. It also sends trabeculae through the subarachnoid space to the pia mater, facilitating the mixing of CSF. Along the posterior midline, the trabeculae form a distinct subarachnoid septum. Bottom she lines the dural sac within the sacral canal and ends after the completion of the sac at the level of vertebra S2.
The flexors of the L-spine are divided into the ileo-pectoral (external) group and the femoral-spinal (internal) group. The ileo-pectoral group consists of the muscles of the abdominal wall: the rectus abdominis, the external abdominal oblique muscles, the internal abdominal obliques and the transverse abdominal muscles. The femoral-spinal group consists of a large psoas muscle and ileal muscles. The psoas major muscle comes from several areas: from the front surface and the lower border of the transverse processes of L1-L5, from the bodies and disks T12-L5. It is attached to the lesser spit of the femur and innervated by the straight fibers of the lumbar plexus. Its main action is the flexion of the hip and torso.
The 2 upper (in the posterior-internal direction) and lower (in the anterolateral direction) articular process, labeled VSO and NSO, respectively, extend cranially and caudally from the place where the legs and membranes are connected. Circular joints are in the parasagittal plane. When viewed in dimetric projection, the outlines of the faces and inter-articular surfaces are similar to the neck of a Scottish terrier.
Dorsal protrusions of the cervical spine are the most dangerous variety, since the bone formation is squeezed into the cavity of the spinal canal, squeezes the artery passing there and presses on the spinal cord tissue. If the artery is severely constricted, it will trigger a stroke in the brain. (See also: signs of protrusion of the cervical spine).
Treatment of osteochondrosis of the thoracic spine is conservative. The operation is needed extremely rarely and only when the hernia squeezes the spinal cord.
Cervical – has 7 vertebrae.
This pathology is often detected randomly with MRI (magnetic resonance imaging) of the spine. On x-rays to see it in the initial stages is very problematic.
Echospondylography is an ultrasound examination of the spine, which is used to detect abnormalities in the structure of the spinal column.
A certain type of transitional lumbosacral vertebra (PPKP) was first described by Bertolotti in 1917. With this syndrome, a large transverse apophysis on one or both sides of the transitional lumbar vertebra articulates with the sacrum or the iliac bone. The next arch or transverse apophysis of the vertebra usually has lumbar and sacral features, most often originating from L5, but they can also occur in L6. In most cases, patients with Bertolotti syndrome have no symptoms, and little is known about the biomechanical effects of such an abnormal vertebra and its association with back pain.
The pia mater maintains the vasculature and nerves in the subarachnoid space. She deeply holds the spinal cord. The pia mater forms a separate sheath for each root and nerve root in the same direction as the canal, mixing with epineurium. The caudal pia mater continues as a thin inner end filament; after reaching the lower end of the dural sac, the thread is covered by the outer end of the thread and continues until the tailbone.
Lateral flexor muscles
Between the upper and lower articular processes, two long, thin and strong transverse processes are laterally protruded. They have an upper tubercle at the junction with the superior articular process (the nipple process) and a lower tubercle at the base of the process (ancillary process). These bony protrusions are the attachment points of the deep back muscles.
In turn, dorsal protrusions are divided into:
It has the largest vertebrae, as it accounts for the lion’s share of human mass. Yes, and all the main burden falls on him. Therefore, osteochondrosis of the lumbar spine is a very common disease. Doctors diagnose it practically in every person. Many do not pay for back pain, they say, it all happens. They’ll smear with any kind of voltaren gel or chondroxide ointment and forget about the pain.
Thoracic region – consists of 12 vertebrae, a feeling of discomfort in the affected parts of the spinal column;
Circular protrusion in size can reach up to 12 mm, but the difference between different areas does not exceed 1 millimeter. Depending on the characteristics of its structure, the following types are distinguished:
Epidurography is the study of the spinal canal by introducing a contrast agent into the epidural space.
Diffuse protrusion is an uneven prolapse of intervertebral discs at several levels of the spine.
PFST has often been discussed by specialists as a possible etiology of back pain. One systematic review and some authors have concluded that the level of PCPP is the same in cases with and without pain, being detected only by chance during scanning. Other authors report more frequent cases of back pain in the population, ranging from 16% to 30%, and more frequent cases of disc degeneration above the PCD and a hernia that occurs at a younger age.
Real lateral flexion is usually a combination of lateral flexion and
The lumbosacral spine has an anterior, middle, and posterior column suitable for cracks in the lumbosacral spine.
But do not forget that this disease can lead to such complications as a hernia of the lumbar spine. And it leads to a loss of mobility or even to even temporary, but paralysis of the lower extremities. And you need it? In men, it can lead to a violation of sexual functions, regardless of age. And if you have been diagnosed with osteochondrosis of the lumbar spine, treatment should be started immediately.
Lumbar region – 5 vertebrae.
The presence of severe pain in the problem areas of the back;
Venospondilografiya – a method of visualization of the venous systems of the spine. Its essence lies in the introduction of a contrast agent into the veins near the area of compression of the spinal cord by protrusion or hernia.
Circular protrusion is a uniform exit of the intervertebral disc beyond the limits of the functional segment. This pathology is the most dangerous. If it is localized in the lumbar segment, it leads to lumbago, sacralgia and coccygalgia.
In the study of Deport et al., The frequency of PEP was shown in 30% of people with back pain. A review of the literature makes it obvious that with PPKP, the symptoms are not obligatory, but people with PPKP, who do have symptoms, tend to have a certain pathology. For the general entities associated with the transitional vertebra, the following was proved: the internal destruction of the disc is at a higher level, the contralateral facet pain and the pain of articulation with the transverse process. The transitional vertebra may be more significant in younger people, since normal age-related changes equalize disc degeneration in groups to middle age, and in people with PCPD, spondylosis does not occur more frequently.
Vertebral joints of the lumbosacral spine
The first treatment is pain relief. This is mainly used for this drug treatment: analgesics, chondroprotectors. To relieve increased muscle tone, muscle relaxants are prescribed. With success applied traditional medicine. Physiotherapy with exercise therapy is also doing its work. The treatment of a hernia of the lumbar spine is exactly the same. Well, unless, that at some complications and operational methods can be added.
Sacral – 3-5 vertebra.
Increased pain with a deep breath;
The use of vendilospondilografiya based on the fact that any damage to the spinal cord is accompanied by compression of the nerve trunks.
The localization of the protrusion in the cervical region (C5-C6-C7) forms thorakalgia, cervicalgia and soreness in the intercostal spaces.
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The spinal subarachnoid space is extensive in the lumbar spine, below the L2 level it is called the lumbar cistern. Its CSF content (20-35 ml) is only part of the total volume of CSF (120-150 ml). The lower third of the arachnoid sac contains only the inner terminal thread and the horse’s tail, which contains the roots of the lumbar, sacral and coccygeal nerves. They hang like a horse’s tail, forming the lower part of the spinal cord (brain cone), leaving the spinal canal below the lower third of the arachnoid sac.