Rheumatology
Rheumatology

Hernia of the cervical spine - symptoms, types of treatment

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Before we begin to consider the problem, I want to draw the attention of the respected Internet community to the correctness of pronouncing medical terms.

In the network, one can often read "intervertebral hernia of the cervical spine" - this is a completely illiterate expression, it means "a hernia between the spine".To do this, you need at least two people who have grown together with their backs. The same applies to "obezbalivayuschie" drugs.

The correct term is the intervertebral hernia, which indicates that the intervertebral disc has disintegrated and protrudes. Talking about the "intervertebral" hernia - it's like going to the library to pass a "proscribed" book.

Therefore, if you find a site with this name, then you better leave from there. Otherwise, the advice that you decide to accomplish can be expensive, and not so much for your wallet as for your health.

What is the intervertebral hernia, localized in the cervical region, how it manifests itself and how it is treated?

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Contents

  • 1 Hernia in the cervical spine - what is it?
  • 2 Symptoms of a hernia of the cervical spine
  • 3 Treatment of a hernia in the cervical spine
    • 3.1 Surgical treatment

Hernia in the cervical spine - what is it?

Hernia in the cervical spine

photo scheme

Intervertebral hernia of any part of the spine is called destruction of the fibrous ring or gelatinous nucleus of the cartilaginous intervertebral disc, in which these structures extend beyond the contour, forming protrusions in different directions( sideways, forward, backward, upward).

And the names of hernias are different: paramedian, lateral, foraminous. The most dangerous are hernia protrusions in the posterior direction, since they can cause compression of the spinal cord( see photo).

Hernia in the cervical spine develops due to the following conditions:

  • Injury. It can be a blow to the head about a low doorway, slipping in winter on ice, or the consequence of carrying a heavy load on the head, sudden movement or turning of the neck, practicing extreme sports;
  • Age of the patient. The gradual decrease in the elasticity of the discs due to their dehydration can lead to their increased brittleness. Otherwise, this cause is called "cervical osteochondrosis";
  • Osteoporosis. Violation of the articular surface of the vertebral bodies leads to the destruction of the cartilage lying between them. This often occurs in postmenopausal women;
  • Harmful habits, especially smoking. Without directly leading to a hernia, smoking causes disruption of blood circulation and diffuse nutrition of the cartilaginous tissue, leading to the fragility of the disc;
  • Overweight. More often it causes the formation of hernias in the lumbar region, and in the cervical region the reason is wearing heavy winter hats and hairstyles;
  • Weakness of the muscular corset of the neck. This leads to office work, lack of physical activity. Initially, the "instability" of the cervical region develops, and then there is the destruction of cartilage with the formation of single or multiple hernias.

Symptoms of a hernia of the cervical spine

Symptoms of a hernia of the cervical spine

With this lesion of the locomotor system of the spine, there are general symptoms that can appear with any localization of the lesion, and specific signs that depend on the specific location of the hernia.

It is on the symptoms of the second type that an experienced neurologist will be able to pre-diagnose with a high degree of probability without even resorting to such diagnostic methods as MRI.

Common Symptoms

First of all, these are various neck pains with a hernia. Their localization can be different. The nature of the pain - pulling, permanent due to chronic spasm of the muscles, which fell into the zone of innervation by those nerves that squeezed the hernia.

The neck muscles are in a state of chronic stress. There is a "vicious circle".Pain increases the spasm of muscle fiber, spasm prevents its normal nutrition, circulation and waste products. In turn, the accumulation of lactic acid in the muscle causes its secondary spasm.

These neck pains are capable of radiating to the nape, parietal-temporal areas, and being the cause of vertebrogenic cervicocrany.

The second type of pain is a sharp, shooting, like an electric shock, just like a lumbar "chamber".It has a neurological nature, and is not associated with muscle pain, but with a feeling born within the nerve fiber itself. The second name is the radicular symptomatology.

These severe pains are provoked if the patient has a "hernia of the neck", can have the following factors:

  • A sharp turn of the head. These patients carefully "carry" their head, and when they shout, they turn around with their whole body;
  • Coughing, sneezing, laughing.

Thus, if you avoid a sharp concussion of the neck, you can reduce the frequency and intensity of pain attacks.

In addition to the pain syndrome, there is often a crunch when moving around in the neck. It occurs much earlier than other symptoms, and indicates a decrease in the height of intervertebral discs and a violation of their configuration.

Muscle stiffness and tenderness in palpation in paravertebral( paravertebral points) is also nonspecific, a common sign of disc herniation in the cervical region, and a frequent symptom of osteochondrosis of the spine.

Particular symptoms depending on the location of

Most often, the hernia of the cervical spine begins at level C3.The most commonly affected levels are C5-C6, and also C6-C7, and lower, to the intervertebral disk between the seventh cervical and the first thoracic vertebra.

It should be remembered that there can be multiple hernias coming in succession, both on the one hand and in the "checkerboard" order. As a result, the symptoms of lesion of one and several segments develop. Typically, the signs of radicular irritation are:

  • Paresthesia, hypoesthesia, "crawling", other sensitive disorders;
  • Weakness in the muscles, peripheral paresis( incomplete paralysis), uncertainty in movements, muscle hypotrophy;
  • Vegetative-trophic disorders: reddening or blanching of the skin, increase and decrease of cutaneous temperature, "marbling" of the skin.

Below are the most known symptoms of the defeat of the cervical spine at various levels:

  • Hernia C3 and C4 : develops pain in the neck and shoulder, partial paresis of the diaphragm with the development of respiratory failure;
  • Hernia C5-C6 ( corresponds to the root of C6): pain and sensitivity in the neck, shoulder, side of the shoulder, radial surface on the forearm, up to the thumb and index finger. In these same departments there may be paresthesia. Paresis of the biceps can occur, as a result of which there is a weakness when the arm is bent at the elbow and the weight rises. The flexor-ulnar tendon reflex falls;
  • Hernia C6-C7 ( corresponds to the root of C7): The pain in the neck is also disturbing, but unlike the previous location, there is a decrease in sensitivity in the area of ​​the index and ring fingers. There is an extensor - elbow reflex( from the triceps).There is a weakness when trying to straighten a hand at the elbow, affects the triceps brachial muscle, and also the elbow extensor of the wrist. Sometimes there is an atrophy of the tenar, or the muscles of the elevation of the thumb( a "fleshy" place on the palm);
  • Hernia C7-Th1 .Corresponds to the last cervical segment of C8.It is manifested by pain, paresthesias, decreased sensitivity in the little finger, the elbow half of the ring finger( closer to the little finger).There is weakness in the extensors of the wrist and the muscles of the wrist.

It must be known that sometimes there is such a pronounced narrowing of the neighboring intervertebral foramen caused by many hernias that there is compression not only of the nerve roots corresponding to the segments, but also the radicular artery that flows into the anterior spinal artery.

This leads to a deficiency in the blood circulation of the spinal cord, which can be so pronounced that the spinal cord symptoms, or transient ischemic attacks, may eventually attach to the above-described symptoms of radicular compression.

In addition, the hernia can directly narrow the lumen of the central canal and lead in rare cases to compression of the spinal cord.

It should be remembered that the corresponding symptoms can be caused not by the hernia of the spine, but by damage to the peripheral nerves, for example, the median and radial( segment C8), or the suprascapal nerve in the C6 segment.

Treatment of a hernia in the cervical spine

Treatment of a hernia of the neck

Treatment of osteochondrosis of the cervical spine is the best way of preventive treatment and hernia. Everyone knows these methods, we list them.

To non-medicinal methods include:

  • sleep prevention, the purchase of an orthopedic mattress and pillow, or a platen for sleep;
  • acupuncture, application of applicators Lyapko, Kuznetsova;
  • curative gymnastics, swimming;
  • treatment and prophylactic massage;
  • manual therapy;
  • balneotherapy, mud therapy;
  • physiotherapy procedures.

To medicinal methods include:

  • Introduction of non-steroidal anti-inflammatory drugs( NSAIDs) during exacerbation( Ketonal, Movalis, Xefokam, Tselebrex, Ibuklin) with exacerbation. In the treatment of a hernia in the cervical spine, these drugs help reduce pain and inflammation. They are used both intramuscularly and in tablet form. Together with them, prophylactic omeprazole should be taken to reduce the risk of stomach ulcers;
  • Muscle relaxants of central action - tolperisone and tizanidine, or "Midokalm" and "Sirdalud".Intramuscularly applied courses to reduce the tone of skeletal muscles. This leads to the breaking of the "vicious circle", improving the blood supply of the neck muscles, reducing the severity of the pain syndrome;
  • Multivitamins of the "B" group. This is "Milgamma", "Milgamma-compositum".They increase the sensitivity, eliminate paresthesias and normalize nervous trophism. It is advisable to take them by courses, in the form of intramuscular injections;
  • Chondroprotectors. They promote the normalization of the metabolism of the cartilaginous tissue. With the formed hernias, their administration is meaningless, shown only when there are no protrusions and hernias yet. They are used both in the form of combined preparations with NSAIDs( for example, "Teraflex Advance"), and in pure form, for example, "Alflutop".

Surgical treatment of

Treatment of a hernia in the cervical spine

In the event that conservative treatment of a hernia in the cervical spine has proved ineffective, then surgery is necessary. What indications are there for prompt intervention?

  • Strengthening of the pain syndrome, which does not stop;
  • Progression of muscle weakness, paralysis and paresis;
  • The appearance of spinal symptoms associated with compression of the spinal cord.

Surgery of the hernia of the cervical spine most often reduces to performing microdiscectomy from a small access. A large cut is not required. In addition to removing the disc, the second stage is to stabilize between adjacent vertebrae.

This is due to the fact that the mobility in the cervical region is great. In addition, this achieves a normal spacing between the vertebrae, and the restoration of the intervertebral( intervertebral) blood flow. To do this, we use our own bone autograft, which is taken from the pelvic bone of the patient, which is inserted between adjacent vertebrae, and after a few months fuses with them.

Thus, the price for the treatment of pain and paralysis is a slight restriction in the neck.

A more modern technique for is the installation of a cage, or a mesh containing the patient's bone crumb. This cage with time also sprouts with bone tissue, immobilizing two adjacent vertebrae.

The most modern method is the installation of an artificial intervertebral disc, which completely replaces the remote, retaining elasticity and mobility in the operation area. An artificial disc has the same mobility and damping properties as human cartilage.

Similar endoprosthetics of the cervical disc can be done for 35 - 40 thousand dollars abroad.

In conclusion, we can say that the hernia of the cervical spine, the symptoms and treatment of which we have considered, does not occur suddenly. And always, to some extent, the patient is wasted precious time.

Timely diagnosis and treatment of a hernia in the cervical spine, already at the stage of minimal changes, will allow patients to dispense with surgery in a large number of cases.

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