What is prolapse of an intervertebral disc, what are his symptoms and what he brings

The Prolapse of the disc between the vertebrae is the loss of part of the fibrous ring (compacted marginal portion of the cartilage). The cause of this condition are violations of the anatomical structure of the intervertebral disc when there is insufficient blood flow, impaired nutrient loads, excessive load on the spine.

the Narrowing gap in the segment of L5-S1 on x-ray

Causes of loss of the fibrous ring of vertebral disk

According to statistics, approximately 48% of the cases of prolapse occur in the between the lumbar and sacral spine (L5-S1). This segment operates a large pressure during physical activity and diseases of the vertebral column.

The Main causes of prolapse L5-S1:

• low back pain – decreased height of the intervertebral discs due to degenerative-dystrophic processes (disruption of the blood supply and nutrients);
• Trauma of the spine with damage to the integrity of the lumbar or sacral segments (a segment is a functional block of 2 vertebrae, intervertebral disc, muscles, vessels and nerves);
• Autoimmune disease (production of antibodies against its own tissues of the organism)
• Inflammatory damage (systemic lupus, rheumatoid arthritis)
• Other causes (infections, toxic substances).

Symptoms of prolapse in the lumbar-sacral spine

When defining a disc prolapse, the symptoms occur after compression of the formation surrounding tissues. They are formed depending on the direction of the loss of intervertebral disc and the severity of the disease.

Prolapsed intervertebral disc at the level L5-S1

The Main symptoms of disc prolapses of the spine at the level L5-S1:

• Periodic or constant pain in the sacrum or lower back;
• a Symptom of "cough push" – strengthening of pain in lower back when coughing
• Paresthesia (disturbance of skin sensation) generates a feeling of "pins and needles", burning sensation and cold.

When compression of the intervertebral disc of large nerves (e.g. sciatic) may limit mobility due to an impairment of innervation of the thigh muscles;

• disruption of the nervous sensitivity of the pelvic organs (lower back and pelvis receive nerve impulses from the lumbar and sacral divisions of the spinal cord), which is accompanied by frequent urination, impaired defecation, numbness in the genital area.

In most cases pain in this pathology is acute and often leads to limited mobility in the lower extremities. If the prolapse is pronounced slightly, there may be aching pain in the lumbar region, buttocks and hamstring. It increases when lifting or turning the body.

Acute pain syndrome in this pathology often leads to a forced position in which a person is unable to straighten his back. If a prolapse there are other changes of the spine (scoliosis, kyphosis), pain can occur in the thoracic region of the vertebral column.

Neurological symptoms of prolapse L5-S1:

• initially, there are Pain in the lower back or buttocks, gradually moving to the sacrum and posterior part of the thigh. In marked prolapse pain down to the heel.

Neurologist pain below the knee herniated disc in the lumbosacral spine indicates the existence of a person "radicular syndrome" (protrusion compresses the nerve root close to spinal cord);

• Localization of foci of numbness of the skin follows the development of pain syndrome. At the same time there is a violation of sweating, dryness and coldness of the skin;
• the Absence or reduction of the Achilles reflex on the affected side indicates a severe pathology with damage to the spine of the first sacral nerve.

The Essence of the reflex is that when struck with a hammer at the rear of the calcaneus in the normal foot is rejected, and the loss of sensitivity – remains in place;

• Weakness of foot flexion ability (people can't get up on toe) may indicate a damaged spinal roots S1;
• Paresis and paralysis of the limbs (partial or total limitation of movements) arise from a complete lesion of the nerve trunks of the lumbar and sacral nerves;
• Dorsal prolapse (prolapse of the intervertebral disc posteriorly) L5-S1 is often combined with constipation in the intestine due to violations of functionality;
• Symptom Lasegue – the disappearance of patellar and Achilles reflex occurs in the absence of impulses from the sacral nerves.

Types of prolapses of intervertebral disks in the segmentL5-S1

Most often in the transition zone between the lumbar and sacral spine occurs on the dorsal (back) localization of the protrusions as the load on the lower sections of the spinal column contributes to the deviation of its axis posteriorly.

Rear protrusion on an MRI

From other types of protrusions in the Sacro-lumbar spine can be distinguished:

• Anterolateral deposition are localized anterior to the anterior surface of the vertebral body with exfoliation of the anterior ligament or perforation;
• Posterolateral prolapse (paramediano) are back and side in the area of spinal canal;
• Median – posteriorly directed right in the center of the vertebral body. Pose a serious threat to spinal cord compression;
• Side (lateral) are localized on the side of the vertebral body. Often compress nerve roots passing through the gap between the vertebrae.

It Should be noted that the median prolapses at the level of L5-S1 can penetrate through the hard shell of the spinal cord in the sacrum, disrupt the functionality of many sacral nerves.

What complications can occur

The Danger of prolapse is that it compresses the anatomical structure that is situated near him.

Frequent complications of disc prolapses of the lumbar spine lumbosacral:

• spinal cord Compression occurs when excessive size of the diverticulum that compresses the nerve roots in the lumbosacral. This pathology leads to infringement of functions of pelvic organs (uncontrolled urination and defecation) and lower extremities (limitations to complete immobility when walking);
• spinal Stenosis is a lethal condition that is associated with impaired functions of vital organs (kidneys, liver).

In conclusion, we note that the prolapse of the disc between the vertebrae is a dangerous condition that is difficult to treat. If it is detected at late stages, often leads to severe complications involving disabilities.