Foraminal herniated discs L4-L5, L5-S1 and other segments
And Protrusion defects in the intervertebral disc space become a cause of long-term disability and often contribute to the disability of the patient. One of the most unpleasant varieties of hernia orifices of the protrusions in the spinal column is a foraminal hernia.
If we consider the anatomical shape of the spine, it can detect the opening between the rear arcs of each two adjacent vertebrae. Opening length is about one and a half inches. Through this channel runs the spinal nerve root. It is these little weak spots in the spine, especially at the level of segments L4-L5, L5-S1, to allow prolobbirovatj graziosa education inside the spinal canal, compressing this nerve fibres.
What types of foraminal disc herniation exist?
Varieties of hernia orifices of these formations vary depending on side of lesion, level of vertebral segments and the relationship to the hole, through which comes the spinal root. Consequently, it could be a defect on the right or left of the spinal column. Most common left-sided foraminal hernia.
Any part of the spine may be affected, but the most frequent localization foraminal herniation occurs in the lumbar and sacrum segments L4-L5 and L5-S1.
In relation to the foraminal opening is 4 types of defects method is:
- Foraminal with the trend of prolobbirovat the inner edge of the intervertebral space or interforaminal hernia;
- with Foraminal protrusion to the outer edge of the intervertebral disc or extraordinally hernia;
- Foraminal hernial protrusion on the lateral edge of the hole with prolapse across the channel towards the exit thereof;
- medial Foraminal hernia, on the very edge at the entrance to the channel.
causes of intervertebral foraminal hernia
As for any other defects in the intervertebral disc space, the cause of the destruction of the fibrous ring and promoting protrusions inside the spinal canal becomes hard physical labor, improper pressure on specific areas of the spinal column. This can be cervical or thoracic spine, but most often foraminal hernia defect occurs in the lower back at the level of L4-L5 and L5-S1, where the load is much stronger during sharp turns of the body and when lifting heavy weights from the slope.
In Addition, metabolic disorders and injuries of the spine with a subluxation of the vertebrae have a significant impact on the state of the intervertebral disc space and the ability of the muscular frame to protect the spine.
What are the symptoms that accompany this pathology?
- Strong expressed pain
They make the patient take a forced posture. Any change of body position leads to an intensification of pain. Ordinary painkillers do not help. Only the use of narcotic analgesics temporarily soothes pain.
- Muscle weakness
It is caused by impaired innervation. Compression of the nerve roots contributes to the lack of effect of nerve impulses on maintenance of muscle tissue. If the reason was injury, it may be unbalanced muscle contraction that exacerbates the situation.
- Change in skin sensitivity, reducing typical reflexes and the inability to use the foot, when stepping on the heel or toe
Here, too, the reason is the violation of the nervous influences that should ensure the spinal cord through the relevant nerve trunks, flattened gryzunam protrusion.
diagnosed As degenerative changes in the spine?
An Experienced doctor-vertebrologist capable only of complaints and a forced position of the patient to assume the presence of serious pathology of the spine. After inspection and examination of the patient man, clearly describing the medical history of complaints and symptoms, you can put a preliminary diagnosis.
The Optimal method of determining the pathology foraminal openings with a clear localization in the segments L4-L5, L5-S1 will be the use of computed tomography or magnetic resonance imaging. MRI is the technique became the "gold standard" in the diagnosis of foraminal herniation of education.
What is a good method of MRI-diagnosis:
- excellent visualization of the intervertebral disc with protrusion detection andhernia orifices of the protrusions;
- evaluation of the cartilaginous tissue and the possibility of a long degeneration of the tissue elements;
- is quite informative in evaluating the status of soft tissues in the area of disc herniation;
- accuracy in the determination of the location of the lesion, which is especially important when combined with other types of hernia orifices of defects in the intervertebral disc space;
- no need for a diagnostic contrast;
- lack of x-ray radiation;
What are the possible remedial measures?
- Conservative treatment
In any treatment of intervertebral discs hernia orifices entities should start with conservative treatment methods. This impact should be as careful and comprehensive. In addition to drugs-analgesics should be used methods of physical and manual therapy. These methods will not give immediate effect but subject to any rules of treatment can help the patient.
remember that in inexperienced hands and with the underestimation of lesions of the spinal column, conservative methods can harm the patient. Need a strict accounting of indications and contraindications to chiropractic treatment methods.
- surgical treatment
For optimal effects are used as conventional methods of surgical treatment of typical access and endoscopic techniques. In the first case you can quite easily remove the medial foraminal hernia. In the second, using fiber optics, is introduced through the puncture needle to the affected hole. Through this needle under visual control is removed, the protrusion compresses the spinal root.
with this Method it is possible to operate almost all types of foraminal defects. In the case of lateral hernias of various segments of the spine, including L4-L5, L5-S1, sometimes you have to resort to the method of removal of the destroyed intervertebral articular surface. This leads to a scoliotic curvature and the partial preservation of the pain syndrome.
Given the rather high incidence of foraminal hernia orifices entities (4-10 %), patients and doctors should seriously consider this pathology. Timely diagnosis and correct therapeutic conduct tactical activities ensures the reduction of disability, pain and the possibility of recovery.