Spinal hernia
The content of the article:
- The reasons
- Kinds
- Symptoms
- Possible complications
- Diagnostics
-
Treatment
- Surgery
- Conservative treatment
- Prevention
- Video
A spinal hernia is a pathological condition in which a patient has a protrusion of the contents of the spinal canal through a defect in the arches or vertebral bodies.
This is a congenital pathology, a rather rare malformation. According to studies, the anomaly is detected in about 0.1% of newborns (the latent form is noted in 15% of the population), in some of which the disease becomes the cause of disability. May be combined with other developmental anomalies.
Spinal hernia - congenital malformation
The reasons
The reasons for the development of pathology are not fully understood. The main factors contributing to the occurrence of a spinal hernia include:
- lack of vitamins (especially folic acid) in a woman's body before and during pregnancy;
- genetic predisposition;
- early pregnancy;
- alcohol and / or drug abuse by a woman during the period of bearing a child;
- intoxication of the body;
- infectious diseases in the expectant mother.
In adult patients, the existing pathology can manifest itself under the influence of the following provoking factors:
- lack of timely treatment of osteochondrosis;
- spinal injury;
- lifting weights;
- prolonged stay in an uncomfortable position (for example, during work);
- power sports;
- metabolic disorders (overweight);
- improper posture;
- infectious diseases.
Kinds
Depending on the localization, hernias of the following parts of the spine are distinguished:
- cervical;
- chest;
- lumbosacral (most common).
According to the contents of the hernial sac, the pathology is divided into several groups, which are presented in the table.
| Pathology type | Description |
| Meningocele | The spinal cord is correctly formed and functioning normally, only the spinal cord penetrates into the intervertebral defect |
| Myelomeningocele | The protrusion of the meninges and the substance of the spinal cord is observed, neurological symptoms develop |
| Meningoradiculocele | There is a protrusion of the meninges, roots of the spinal cord |
| Myelocystocele | Most dangerous form; the hernial sac consists of cerebrospinal fluid accumulated in the expanded central canal of the spinal cord, which is surrounded by the thinned substance of the spinal cord, its membranes and the posterior roots of the spinal nerves |
Symptoms
The course of the disease depends on the degree of damage to the spinal column and the volume of tissue that forms the hernial sac.
The easiest type of pathology is latent spina bifida. In this case, a slight deformation of one of the vertebrae is revealed, which, as a rule, does not cause any particular discomfort in a person. This form of pathology is often asymptomatic, however, such patients may also show signs of loss, in some cases, with this form of the disease, neurological symptoms appear. In some patients, clinical signs of pathology may appear in adulthood against the background of intense physical activity or other reasons.
A more serious defect occurs with spina bifida, in which a protrusion of fluid and meninges is visible. In the most severe cases, the pathological process involves the nerve roots and the spinal cord.
The photo shows that a spinal hernia is visualized as a round protrusion in the spine. On palpation, it has a soft consistency. The skin over the formation is usually shiny and thinned, have a reddish or cyanotic tint.
The patient may complain about:
- weakness in the upper and lower limbs;
- violation of all types of sensitivity (temperature, tactile, pain);
- dry skin;
- non-healing ulceration;
- cold extremities.
It can be observed:
- decreased limb reflexes (knee, plantar, grasping);
- muscle atrophy of the arms and legs;
- various forms of deformity of the lower extremities (clubfoot is often detected).
Symptoms also depend on the section in which the hernia developed.
| Spine | Manifestations |
| Cervical | Pathology affects the upper part of the spinal cord, which leads to a decrease in the motor activity of the upper and lower extremities. Also, the patient may experience disorders of the heart and lungs. |
| Pectoral | Disturbances from the respiratory system, heart, stomach, liver, spleen. |
| Lumbosacral | Disturbances in the work of the organs of the genitourinary system, gastrointestinal tract, as well as the lower extremities. Patients may experience problems with urination and defecation (including urinary and fecal incontinence). |
Possible complications
- Pyelonephritis, renal failure due to urinary disorders.
- Increased intracranial pressure due to fluid retention in the brain, which can lead to atrophy of areas of nervous tissue, the development of meningitis, encephalitis.
- Flexion contractures, paresis, paralysis.
- Infertility, erectile dysfunction in men.
- Pinched nerves, which leads to severe pain, decreased sensitivity, motor activity.
- Hydrocephalus.
- Decreased cognitive ability.
- Visual disturbances.
- Congestive pneumonia and pulmonary failure as a result of prolonged bed rest.
- Diseases of the internal organs.
- Disability. In severe cases, the patient needs constant home care, supportive treatment, and regular medical supervision.
Diagnostics
Modern diagnostic methods make it possible to identify fetal pathology even during intrauterine development. This usually happens during a screening ultrasound exam. In order to clarify the diagnosis, a laboratory determination of the level of alpha-fetoprotein and a number of other tests may be required.
The survey includes:
- collection of complaints and anamnesis, objective examination;
- neurological examination - allows you to assess motor activity, muscle tone of the upper and lower extremities;
- transillumination - a method that allows you to determine the nature of the contents of the hernial sac;
- computed and magnetic resonance imaging - allow you to identify concomitant lesions of the tissues of the brain and spinal cord, as well as get a detailed idea of the hernia;
- laboratory tests: general and biochemical blood test, general urinalysis, etc.
Treatment
Usually, the treatment of a spinal hernia involves its surgical removal, since conservative therapy is usually ineffective and is used only as an adjunct.
Surgery
During the operation, the defect in the spine is reconstructed, the opening is closed. Non-viable structures are removed from the hernial sac, healthy tissues of the spinal cord are returned to the spinal canal.
An operation to remove the hernial sac and eliminate the defect in the spine can be performed in the first weeks of a child's life. Surgical treatment is postponed if a mild form of pathology is detected (there is no need for an operation).
Spinal hernia treatment is only surgical
In hydrocephalus, a shunt may be placed to drain excess cerebrospinal fluid into the thoracic lymphatic duct.
After surgery, the patient needs rehabilitation, which allows:
- eliminate pain syndrome faster;
- prevent the development of possible complications (the addition of a secondary infection, thrombosis, etc.);
- restore normal muscle tone;
- correct posture and gait disorders;
- improve the general condition;
- minimize the risk of relapse.
Conservative treatment
In order to prevent the progression of pathology, as well as to improve the general condition of the patient, neurometabolic stimulants, vitamin therapy (vitamins A, E, C, group B) can be prescribed to him. Physiotherapeutic techniques (magnetotherapy, laser therapy), therapeutic exercises can be used.
Patients with disorders of the digestive system require adherence to a diet. It is recommended to include more fiber-rich foods in the diet to normalize intestinal motility.
Prevention
Prevention should be carried out in the prenatal period. To this end, a woman planning a pregnancy, as well as during it, should:
- to refuse from bad habits;
- abandon the uncontrolled use of medications;
- limit contact with aggressive chemicals (including household chemicals);
- not be exposed to ionizing radiation;
- reduce the risk of contracting a viral infection (do not be in crowded places during periods of seasonal increase in the incidence of ARVI).
Video
We offer for viewing a video on the topic of the article.
Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
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