Disc prolapse
Disc prolapse is the displacement of the intervertebral disc by a distance not exceeding 2-3 mm. Disc prolapse is the initial stage in the formation of a herniated disc. Further displacement of the disc, which exceeds 4 mm or more, is already called protrusion.
Although disc prolapse is not a reason for hospitalization, it is impossible to leave a part of the spinal column in this state, since in the future the disc will move more. Therefore, disc prolapse requires immediate treatment.
Considering the term "disc prolapse", different authors give different characteristics to this condition. So, Russian scientists, among whom Golovatenko-Abramov K. V., And Magometov M. K., designate prolapse as a bulging of the intervertebral disc outside the vertebrae against the background of stretching of the fibrous ring. However, the ring does not break in this case. The authors consider prolapse and protrusion as identical conditions. They consider it possible to use these terms as synonyms.
Japanese scientists, including: Maeda M., Takashi I., Tarou K. and others, do not separately single out such a thing as disc prolapse. They propose to consider the stages of hernia formation from the moment the disc protrusion begins with or without rupture of the annulus fibrosus (without leaving the hernia beyond the annulus fibrosus). In this case, this condition is defined as disc protrusion.
Swedish scientists (Stromqvist B., Jonsson B. et al.) Consider disc prolapse as any dislocation of the nucleus pulposus to the posterior longitudinal ligament against the background of the absence of rupture of the annulus fibrosus, or with its rupture. At the same time, they call protrusion such a protrusion in which the rupture of the annulus fibrosus does not occur, or it is minimal.
To end the debate around these terms, the team of authors of the Department of Neurology of the RMA of Postgraduate Education (Professor V. N. Stok, Professor O. S. Levin and others), proposed any protrusion of the edge of the disc beyond the line of adjacent vertebrae, which exceeds 2-3 mm call it a herniated disc. Thus, prolapse can be considered as the initial stage of hernia formation without rupture of the annulus fibrosus.
Content:
- Causes of disc prolapse
- Disc prolapse symptoms
- Disc prolapse treatment
Causes of disc prolapse
The main reason for the formation of spinal disc prolapse is osteochondrosis. With this disease, degenerative-dystrophic changes occur in the spinal column, the disc loses moisture and ceases to be elastic. Gradually, the size of the disc decreases, which leads to increased pressure on the vertebrae. As a result, the disc is injured, as the spine is constantly undergoing physical stress. Parts of the disc begin to protrude beyond the vertebrae, forming a prolapse. In the future, a person develops an intervertebral hernia.
The average age at which a hernia is found in a person is 30 to 50 years. However, prolapse can begin to develop earlier, due to the early manifestation of osteochondrosis.
The reasons are:
- Anomalies of the development of the spinal column.
- Diseases of a dismetabolic nature (hyperthyroidism, diabetes mellitus).
- Spinal column injuries suffered at an early age.
- Skeletal abnormalities such as hip dysplasia.
Risk factors that contribute to the formation of disc prolapse include:
- Lifting weights;
- Spinal bruises;
- Frequent vibrations;
- Sudden movements, for example, during sports;
- Prolonged sitting (at risk of people working at a computer, motorists, etc.).
- Overweight;
- Kyphosis, lordosis and other types of curvature of the spine;
- Posture disorders;
- A long pastime in an uncomfortable position for a person.
If you do not start to control the prolapse of the spinal disc at the initial stages, then in the future a person will form a full-fledged hernia. In turn, this is a serious disease that often significantly impairs the patient's quality of life and requires surgical intervention.
Disc prolapse symptoms
Most often, the patient does not feel the symptoms of disc prolapse, since the initial stages of hernia development have a latent course.
Although, depending on the individual characteristics of the body, a person may present the following complaints:
- Recurrent pain in the part of the spine where there is a violation.
- The pains are dull, they are not constantly present. It is possible to increase pain under static and dynamic load. During the adoption of a horizontal position of the body, the pain completely disappears.
- A person seeks to protect the painful area from stress and excessive stress, limiting movement in it.
- In the area where the displacement of the disc occurred, muscle tension occurs.
As the hernia progresses, the pain increases, the mobility of the affected area is increasingly limited. In the future, complications of the disease develop, including: radicular syndrome, discogenic myelopathy, vertebral artery syndrome. Often, a prolapse of the disc, like a herniated disc, does not give itself away in any way until the stage of exacerbation begins.
Distinguish prolapse of the disc of the cervical, thoracic and lumbar spine. Depending on this, the symptoms of the disease differ, namely, the place of localization of pain.
Disc prolapse treatment
Treatment for disc prolapse should begin as soon as it is detected. The therapy is carried out on an outpatient basis and is reduced to drug correction. Spinal disc prolapse can and should be controlled in conjunction with the attending physician.
Therapy should be comprehensive. The patient is prescribed drugs to relieve pain. Preference is given to drugs from the NSAID group: Ibuprofen, Diclofenac, Ketoprofen, Naproxen, etc.
To reduce muscle tension and relieve increased tone from the back muscles, it is necessary to use muscle relaxant drugs, for example, Tolperisone hydrochloride. In parallel, the patient is prescribed vitamin and mineral complexes with an emphasis on vitamins of group B. Specialists often treat the early stages of a hernia of the spine using chondroprotectors, including: Teraflex, Chondroitin sulfate, Chondroxide, etc. Oral administration of drugs in the form of tablets and their local application in form of ointments.
It is equally important to undergo physiotherapy techniques, which at the initial stage of the development of the disease allow you to achieve the maximum effect. The restoration of the disc will be facilitated by traction therapy, due to which the distance between the vertebrae increases, which leads to a decrease in the load on the disc. It is possible to supplement the treatment with manual therapy methods, however, it should only be carried out by an experienced doctor.
It is important to remember about the complexes of physiotherapy exercises. Thanks to well-chosen exercises, it is possible to stretch the spine, strengthen the muscular frame, and improve the blood supply to the affected disc. However, in order to achieve the desired effect, it is necessary to exercise on a regular basis.
Thus, disc prolapse is a condition that requires treatment. With competent and timely correction, significant results can be achieved. As a rule, already a month after the start of treatment, the patient notices an improvement in his condition. The apogee of therapy is the reduction of disc prolapse in size due to resorption processes, and therefore, the prevention of the formation of intervertebral hernia.
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003, he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.
