Paramedicine protrusion – the initial stage of the walk limits

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Paramedicine disc protrusion – prolapse of the pulpous nucleus of the disc to the left or right side of the spinal segment. The incidence of pathology not more than 5% of all types of protrusions, but the characteristics of the localization of pathology causes serious clinical picture.

Right-sided localization of the pathology is observed less frequently than the left, due to the anatomical features of the structure of the vertebral segment with a more active development of muscular-ligamentous apparatus on the right side.

paramediano disc protrusion

diagram of the formation of the protrusion parmegianno
(protrusion of nucleus pulposus marked in purple)

Types and symptoms paramedicine protrusion

depending on the localization paramedicine protrusion distinguish the following types:

  • Neck;
  • Breast;
  • Lumbar.

Symptoms of pathology in various parts of the spine are slightly different but the main sign ParameterName bulging disc is the pain. It can be of several types:

  • Backache (lumbago) acute pain in the spine, which may be accompanied by forced posture and radiating pain in upper or lower extremities (depending on the localization of protrusions)
  • sub-Acute lumbodynia occurs when the infringement of one or more nerve roots (monoarticular, berdikulova, polyradicular) in the sacral or lumbar spine
  • Caudit (caudate) is a pain syndrome in the gluteal region and lower limbs, caused by infringement of the nerve plexus "horse's tail";
  • Cervicalgia – pain in the neck with protrusion of intervertebral disc in the neck
  • Torakalgiya – girdle pain in the costal arch due to the presence of protrusions in the thoracic spine.

In Addition to the pain syndrome paramediano protrusion with compression of the nerve roots of the spinal cord causes a number of specific syndromes:

  • Vertebral,
  • Compression.

How to manifest vertebral syndrome with medial-lateral bulging disc

Diagnostics paramedicine protrusion

Diagnosis of movement disorders

Vertebral syndrome is caused by violating the static-dynamic loads on the vertebral column.

It caused a whole set of changes:

  • flattening of the lordosis and the appearance of the deformation is formed due to the changed configuration of the spine (kyphosis, scoliosis, hyperlordosis, kyphoscoliosis);
  • the Imbalance of contractile muscle tissue in the area of damage (either local or General myopically);
  • Violating the dynamic functions of the spine with limitation of extension, flexion and lateral rotations of the body.

Kyphosis – the offset of the axis of the spine in the front or back of the plane.

scoliosis is a lateral displacement of the axis.

Hyperlordosis – excessive flexion physiological bulges in the cervical and lumbar.

Kyphoscoliosis – curvature of the axis of the spine in frontal and lateral planes.

Such changes in the spine are formed with long-term existence paramediano protrusion without qualified treatment.

Vertebral syndrome is a whole complex of reactions due to an ACL injury, pathology of the muscular and skeletal systems.

movement disorders in the mid-lateral prolapsed intervertebral disc

Movement disorders at the combination of the intervertebral discs in the lumbar spine is a frequent pathology. They arise due to:

  • Frequent irritation of the nerve trunks fallen disc in the background and then formed them inflammatory changes (sciatica);
  • Spasms of blood vessels innervated by the inflamed nerves (radiculoischemia);
  • of infringement of the nerve roots in the spinal cord with subsequent vascular changes (radiculoischemia).

When compression of the nerve roots L5-S1 there is a weakness in the muscle group of the extensor muscles of the foot. This person can not rely on the toes and heel bone because of the pain. If the loss of the intervertebral disc is localized at level L4-L5, there is a weakness of the extensors of the tibia and no knee reflex.

Movement disorders in the form of paresis (complete restriction of mobility) are observed, if paramedicine protrusion is localized in the segment of L5-S1.

Radiculoischemia at the level of L4-L5, L5-S1 is most acute in people who have extra lumbar artery (artery of Gottern), passing between the roots L5-S1. According to statistics it occurs in 30% of people.

A Bulging disc with impingement "horse's tail" is less common than medialdirection. However, if it occurs, to motor disorders with frequent urination and defecation. This pathology leads to disability.

Peculiarities of the clinical picture in the segment of L5-S1

The Frequency localization of disc prolapses in the area of L5-S1 about 45.3% of cases of all types paramediano protrusion. The same probability appears pathology in men and women.

Paramedicine protrusion in the segment of L5-S1 is often accompanied monoarticular pain syndrome with marked deformation of the spinal column in the form of kyphoscoliosis and kyphosis and severe limitation of walking. This pathology leads to weakness of the extensor of the first toe or of all the extensors of the foot.

Infringement of the S1 root pathology is found in 70% of cases. In 30% there is a compression of the L5. Joint their defeat (viridicornis syndrome) is observed in 3% of cases. Compression of other nerves, in combination with the infringement of the L5 and S1 nerve roots (polyradicular syndrome) was observed in 1.5% of cases paramediano protrusion.

Clinical symptoms of mono - and polyradicular syndrome with compression of the L5-S1:

  • severe pain in your lower back;
  • Weakness of the extensors of the foot and the first toe;
  • Reduced or absent patellar reflex (determined by neurologist);
  • Hypotension gastrocnemius leads to lameness.
diagnostics protrusion

Digital feeling (palpation) spinal column to identify compression syndrome

Principles of diagnosis paramediano protrusion

Paramediano protrusion, as with other types of slipped disc can be diagnosed based on clinical symptoms and the results of radiological methods of examination.

Under normal survey radiographs of the spine in frontal and lateral projections of the intervertebral disks do not appear in the picture, and the presence of pathology the doctor may suspect only on the basis of indirect signs.

In specialized neurosurgical departments are widespread myelography (x-ray examination of the spinal cord by injecting a contrast medium into the epidural space). The study allows to establish the location and degree of spinal cord compression.

In the absence of signs of spinal cord compression, but the existence of the patient has pain in the lower back and lower extremities, assigned a computer or magnetic resonance imaging.

For a more thorough diagnostic pathology doctors often apply a discography and pneumonology.

Discography – x-ray examination of the intervertebral disk after injection into it of a contrast agent.

Pneumonologia – x-ray after injection into the spinal canal of air.

Thus, paramedicine protrusion of the intervertebral disc is a complex pathology characterized by a great diversity of symptoms and clinical variants of the course. To identify a range of x-ray methods, but even the most careful examination does not guarantee effective treatment of pathology.