Why are there relapses of hernias of the spine and how to prevent them?
In some cases, intervertebral hernia is recurrent, that is, the disease periodically becomes aggravated and once again brings suffering. What is the cause of relapse and how to deal with it?
the Most frequent reasons for recurrence of herniated discs
With any method of treatment of hernia is surgical or conservative, there is a possibility of relapse development. The frequency of occurrence for both methods are approximately the same and amounts to 0.4-4% of the total number of cases.
A Thorough analysis of the development of recurrent protrusion identified the main causes of this process:
- failure to comply with the physician's recommendations;
- hope for 100% effectiveness of drug therapy and reluctance of the patient to engage in therapy and other recovery methods;
- premature return to work and, as a consequence, continuous operation with axial load on the spine;
- equipment violation operation in the surgical intervention on the spine;
- individual characteristics of the patient's body, such as the tendency to develop keloids. In these patients after the operation marked overgrowth of scar tissue, which leads to relapse.
Peculiarities relapse in the surgical treatment
several studies have shown that the development of intervertebral hernia recurrence in postoperative period is associated with activation of degenerative process in the operated segment of the spine. Very often this process is seen with excessive access during primary operation.
Excessive trauma surrounding the spine and intervertebral disc tissue becomes the cause of instability in this spinal segment, which leads to re-traumatization of the disk. The strength of the provoking factor may be small – awkward movement, casual acceptance of the Seating position in the early postoperative period.
hernia recurrences after conservative treatment in terms of clinical manifestations (symptoms) is almost indistinguishable from primary onset of the disease. At the forefront of pain can be more intense, but usually at lower intensity and gradually increases in the absence of therapy. Disorders of the lower limbs and pelvic organs.
For recurrence in the postoperative period is characterized by the following:
- pain much stronger than when it first shows;
- notes the increased neurologic deficit as compared with the primary protrusion;
- postoperative exacerbation is characterized by higher severity of neurological deficit;
- high percentage of disability of patients with recurrent hernia.
At the moment the efforts of the majority of neurosurgical hospitals and institutes focused on finding methods of reducing the incidence of postoperative recurrence.
Treatment and rehabilitation
Principles of treatment of acute condition of spinal hernia do not differ from the principles of the relief initially emerged protrusion. They include:
- medication therapy (NSAIDs, protective agents, vitamins);
- therapeutic physical culture (physical therapy)
- manual therapy, etc.
The Lack of effect of conservative treatment – a reason for surgical treatment of recurrent hernias.
Much more difficult to treat the relapse of hernia of the operated spine. You must perform functional spondylograms, to determine the amount of the previous intervention with the help of magnetic resonance imaging or computed tomography.
The second operation includes decompression of neural structures by foraminotomy and radicalise; in some cases it is necessary to install steel structures, as the natural collateral circulation (protective-regenerative function) of an organism is not sufficient to restore function of the disc.
It Must be remembered that relapses hernias, developing later than 3 years after the operation, as a result of disease progression.
How to prevent the recurrence of a hernia of the spine
The Main method is the observance of all recommendations of the attending physician. The combination of medical treatment, exercise therapy, manual therapy, kinesiotherapy.
Of Immense importance is given to preventive measures: compliance with the protective regime in the postoperative period, reducing the load on the spine, strengthening the muscular system.
Despite all the successes of doctors in the problem of treatment of hernias of a backbone, in many ways, the incidence of exacerbation is determined by the patient passing out. waiting for instant healingsurgery or drugs. Treatment of hernia is daily, laborious work, and just working hard every day for months and years, you will be able to say: "I did IT, I CAN GO!" (V. I. Dikul).