And what are classified as the types of hernias of the spine
In recent times in doctors ' offices heard the diagnosis of herniated discs. It is therefore important to know what types of this pathology. Moreover, it is necessary for doctors, and patients.
Doctors, surgeons view of a spinal hernia prompt localization and extent of the surgery, as well as warn about possible complications during the operation and recovery period.
Therapists who are engaged in the conservative treatment of hernia is also important to identify location, stage of development, to first do no harm; to choose exactly what methods and in what volume should be used massage, manual therapy, stretching and exercise.
Patients know what type of hernia they discovered, learn how to spare the spine, where the problem is localized and will learn a set of proper movements, not to aggravate the disease.
Classification of disk herniation: from simple to complex
1. The simplest and most natural division according to the divisions of the spine in which they arise. Distinguish rezonance:
- cervical spine – 4%;
- thoracic – 31%;
- of the lumbar spine is 65%.
The Frequency of occurrence in a particular localization connected with the load carried by the corresponding segment of the spinal column, as well as with the degree of his mobility.
2. Hernias are also divided into primary and secondary.
Primary occur against the backdrop of a healthy spine under a heavy load or there is an injury.
Secondary are the result of degeneration of the intervertebral disc, desiccation and destruction of the meninges.
3. Sized, protruding beyond the intervertebral space release:
- protrusion – a bulging disc to 1-3 mm;
- prolapse – prolapsed disc – 3-6 mm;
- developed a hernia – 6-15 mm.
In connection with the confusion in the definition of medical terms, also according to this principle, distinguish between types:
- prolapse gap of 2-3 mm;
- disc protrusion – when he speaks from 4-5 mm to 15 mm;
- extrusion – teardrop dangling fragment.
It Should also be noted that the same size herniation has different clinical significance, if it is located in different parts of the spine:
- small in the cervical spine is herniated to 2 mm and in the lumbar – 4 mm;
- average – respectively 4 mm and 7 mm;
- large – up to 6 mm and to 9 mm;
- is huge – from 8 mm and 9 mm, respectively.
Some classifications, the authors believe that hernia can be considered that the protrusion of the circumference of the intervertebral disc, the percentage of which does not exceed 50%, and it can be:
- local (focal) – up to 25%;
- diffuse – 25-50%.
A Protrusion of more than 50% of the circumference is called a "bulging disc".
4. Anatomically doctors distinguish types of hernias:
- free – when the snippet of the contents of the intervertebral disc penetrates through the posterior longitudinal ligament that support the vertical position of the spine, but the connection to the drive is stored
- wandering – when the connection sticking out his fragment with the disk is lost, it is called sequestered, it is dangerous as the compression of the tissue of the spinal cord, and autoimmune inflammatory processes;
- moving – due to the extreme stresses or injuries of the spine with displacement, the result is the dislocation of the nucleus of the intervertebral disc, which at the termination of the load back into place, but there are times when he can engage in a pathological position.
5. Topographic localization of pathology gives grounds to divide herniated discs the following types:
- intra-cerebrospinal, when the protrusion is located in the spinal canal and may threaten its integrity; can be:
- zadnesredinny (dorsal midline) in the lumbar spine, they usually compress the spinal cord and nerve pathways "horse's tail";
- around the median (paramedicine/paramediano) – spinal cord compression likely one or both of the parties;
- lateral (dorsal-lateral) is the most common type, which is characterized by compression of the nerve roots on one or both sides;
- foraminal located in the intervertebral foramen, which on the one hand may compress the nerve roots emerging through this opening;
- side coming from the side of the disk, in which the symptoms are almost absent, except for the presence in the cervical spine – such location is a dangerous compression of the vertebral artery and nerve;
- front (ventral), has no clinical value because of lack of symptoms.
6. The direction of deposition of a fragment of the disc gives grounds to divide herniaon:
- anterolateral, located anterior to the vertebral body, violating the integrity of the anterior longitudinal ligament, and may cause pain type sympathalgias if you are interested in the sympathetic plexus, paravertebral running;
- posterolateral penetrating through the back half of the annulus fibrosus:
- median – the median line;
- paramediano – next to the middle line;
- lateral – on the sides from the middle line(on the sides of posterior longitudinal ligament).
7. By type of tissue that extend beyond the intervertebral space distinguish:
- tissue in the spinal canal of the spine or to the front and side of the paravertebral space acts as a pulpous nucleus that has penetrated outwards through the cracks in the fibrous ring or leaked into the tissue of the body, above - or underlying vertebra (schmorl's hernia);
- cartilage – fragments of intervertebral cartilage elasticity due to chronic inflammatory processes often of viral etiology, with stress on the spine is damaged, the cartilage is squeezed out, compressing the surrounding tissue;
- bone – usually in the elderly due to the development of spondylosis, bony growths of the edges of the vertebrae (osteophytes) begin to compress nerve roots and the larger size can even impact on the spinal cord and ponytail.
In conclusion, it should be noted that the pathologies of the intervertebral discs often revealed not one, but several different hernias, different types and localization. It is therefore important detailed diagnosis in order to clearly allocate them to a particular type, as with the definition of the view begins to develop the tactics of conducting the patient and treatment.