Paramedian disc protrusion
Paramedian disc protrusion is the protrusion of the nucleus pulposus to the left or to the right. This condition is not common and in the structure of all protrusions is no more than 5%, but the clinical signs of paramedian protrusion are quite pronounced. Mostly in patients, right-sided paramedian protrusion is detected, which is due to the anatomical features of the spinal column (the muscular frame, as a rule, is more developed on the right).
Paramedian protrusion can be localized in any part of the spine: in the cervical, thoracic and lumbar. Especially often, pathology is found between the last lumbar and first sacral vertebra.
Content:
- Symptoms of paramedian protrusion
- Causes of paramedian disc protrusion
- Treatment of paramedian protrusion
Symptoms of paramedian protrusion
Since the paramedian protrusion protrudes into the canal of the spinal column and squeezes the nerve endings located there, this condition is always accompanied by pain. Symptoms of paramedian protrusion are as follows:
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Acute pain in the spine of the lumbago type, which is localized in the affected area. They can be triggered by lifting weights, staying in an uncomfortable position for a long time, etc. Often pain radiates to the lower extremities and to the groin region (provided that there is a protrusion in the lumbar spine).
- There may be severe pain in the buttocks and lower extremities, which are manifested in the syndrome of "cauda equina". This syndrome develops when the lumbar zone is affected.
- Thoracalgia - shingles type pains that are localized in the ribs. They arise during the formation of protrusion in the thoracic spine.
- Cervicalgia - painful sensations in the neck, caused by the formation of protrusion in the cervical spine.
- Muscular-tonic tension will always be present in the area where the protrusion is located. This condition causes increased pain, contributes to limitation of movement, and sometimes it can be so severe that it leads to a distortion of the spine.
The main danger of paramedian protrusion is that it can provoke the development of radicular syndrome. It is accompanied by acute pain, which patients compare with a lumbago, and then there is a deterioration in sensitivity, muscle weakness and atrophy. Without the provision of medical assistance, tendon reflexes will fade away, and trophic disorders will develop.
Causes of paramedian disc protrusion
The main reason for the formation of paramedian protrusion is osteochondrosis of the spinal column. This disease, which has a long course, leads to degenerative-dystrophic processes occurring in the disc. As a result, it loses moisture, becomes inelastic, does not withstand the load that the vertebrae put on it, and goes beyond them. Thus, a paramedian disc protrusion is formed.
Separately, the following factors can be distinguished that affect the early onset of the formation of osteochondrosis:
- Congenital malformations of the spine, including such pathologies as: wedge-shaped vertebrae, fusion of the vertebrae, etc.
- General diseases of the body associated with dysmetabolic disorders. First of all, we are talking about diabetes mellitus and hypothyroidism.
- Spinal column injuries. Bruises, fractures, and compression can affect the condition of the disc.
- Uneven load on the spine, which is caused by dysplasia of the hip joints.
- Frequent overstrain of the spine associated with heavy lifting, professional costs (work in conditions of increased vibration or in a static position).
- Being overweight.
- Diseases of the spinal column: scoliosis, lordosis, kyphosis, etc.
The simultaneous combination of several risk factors at once is especially dangerous. In this case, paramedian protrusions can be found in people under the age of 30.
Treatment of paramedian protrusion
Treatment of paramedian protrusion is reduced to conservative therapy, which must be comprehensive.
As for taking medications, the patient is prescribed non-steroidal anti-inflammatory drugs (Diclofenac, Ketoprofen, Nurofen, etc.). They help relieve pain and reduce inflammation in the affected area. It is imperative to relieve muscle tension, which contributes to the intensification of painful sensations. For this, muscle relaxants are used (Baclofen, Mydocalm, Sirdalud, etc.). In parallel, the patient is prescribed B vitamins, decongestants, if necessary.
If the pain is very intense, then local administration of corticosteroids and anesthetics is practiced. Such blockades are very effective, but not long in time.
In addition, the patient is sent to undergo physiotherapeutic procedures (electrophoresis, UHF, phonophoresis, reflexotherapy, mud therapy, etc.). Other methods of treating paramedial protrusion are traction of the spinal column, massage, therapeutic gymnastics. Swimming, exercise bike classes, water aerobics are very useful.
With the development of complications, as well as with the transition of protrusion into a hernia, it is possible that surgical intervention will be required. Operations are used when it is impossible to eliminate the pain syndrome for 8-16 weeks. As a rule, minimally invasive techniques are used for disc protrusion with minimal trauma to the patient.
With regard to the prognosis, with early detection of paramedian protrusion, it is most often favorable. However, a person must understand that he will need to maintain the health of his spine for the rest of his life. Otherwise, a recurrence of protrusion and its further transition into an intervertebral hernia is possible.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".
