It would seem that nature provided everything spine inherent flexibility to movements and strength, because it is the channel through which the spinal cord passes. But though the body of the vertebrae and are connected to a very stable and mobile intervertebral disc, with age or due to reasons outside its firmness and elasticity decreases - there is so-called aging of the tissues of the disc. Interesting fact: among the surveyed people aged 30 years a third of the cases identified by MRI, it is the deterioration of the disc.
Than it can threaten us, the employee of Hospital №83, Moscow, neurosurgeon of higher category, PhD, a specialist in spine surgery Oleg Durov (www.doctordurov.ru)
How common is this disease? It is equally common across the globe, or have any features?
- Diseases of the musculoskeletal system, which include osteochondrosis, are among the most common diseases around the globe. Osteochondrosis, or figuratively, "the aging spine," manifests the formation of intervertebral hernia, listezov (displacement of the vertebrae), stenosis (narrowing of the spinal canal), spondylarthrosis and spondylosis (swelling of the joints and vertebrae, respectively). The most common problem is the formation of hernias of intervertebral lumbar spine, this primarily and will talk below.
The reasons for the emergence of a plurality of disc herniation, the most common name.
- Usually there are 3 of the most common causes of the disease:
First. Physical inactivity, ie lack of adequate motor load.
II. Overvoltage spine: repetitive movements when performing any work, repeated for a long time, such as at the movers or the inadequate single load (for example, the rise of the cabinet).
The third - a genetic predisposition to diseases of the spine associated with the weakness of the connective tissue. In this group of people a spinal disorder is often associated with varicose veins and hemorrhoids.
What are the first symptoms of the disease? What you should pay attention to?
- The very first sign of development of osteochondrosis is the emergence of back pain. However, on their own pain in the spine are not necessarily a sign of illness. Sometimes, for example, after intensive work in the garden or the garden, there are pains in the lower back that may be due to overloading of vertebral joints, deep back muscles and ligaments. But after a day or two the pain completely disappear. In this case, about any disease of the question. However, when the background of overall health, with no load appears aching pain or neck, which holds one or two weeks and passes only after receiving anesthetic drugs, this may be the first sign of disease.
Which doctors treat the disease? And when you need to refer to a neurosurgeon at what stage of the disease?
- Usually, spinal disorders neurologists are engaged and successfully cope with it. However, about 5% of cases, it is necessary to resort to surgery. Surgical treatment is necessary in case of violation of pelvic functions: the delay or frequent urination, constipation, against the backdrop of intense pain in the spine and leg, in the case of weakness in the foot, even in the absence of pain, and finally the ineffectiveness of non-surgical methods of treatment for 2 months.
What is the "muscular corset"? And how realistic exercises to strengthen it?
- Well-developed muscular system, that is, abdominal muscles and back muscles, a person needs to work properly spine. It is best to shape it in the gym under the supervision of an instructor. But you can yourself, using special literary benefit. In addition, it is necessary to correctly perform the motion associated with the load on the spine. Unfortunately this never taught, but such a skill is necessary for the proper use of your spine so that it can last for many years without problems.
It is believed that the most common herniated lumbar spine, and what is the reason?
- In more than 85% of all hernias of intervertebral hernia of the lumbar found. This is due to a greater load on the lumbar region, and in addition, this department is no rib in the thoracic support. Further, the frequency of occurrence are the cervical intervertebral hernia, and in last place, about 1% of cases - the thoracic hernia.
What kind of research would be sufficient for the correct diagnosis?
- The principle of treatment of intervertebral hernia in any region of the spine is the same: first, the patient is treated conservatively, ie without surgery in the clinic under the supervision of a neurologist. If this does not work, then it goes to the hospital just to conservative therapy. If this does not work, then the surgery.
Many patients believe that "more research and analysis, the better" - this is such a case?
- For the correct diagnosis in addition to clinical examination by a doctor, you must perform an MRI of the spine of the patient. It is desirable that the device has characteristic MRI magnetic field strength of at least 1, 5 Tesla. In this case, the MRI pictures are of good quality.
What is being done during the surgery? How the surgeon can help the patient?
- During the operation, the neurosurgeon removes the so-called fallen part of the disc (sequestration) from the spine, eliminating its compression. Furthermore, it degenerated removed (non-functioning) of the cartilage disc. Incomplete removal of the disk is one cause of relapse (re) disc herniation. Deleting a single disk does not affect a person's ability to bend in the postoperative period.
Are there any new treatments and new methods of operation?
- Constantly there are new methods of treatment of intervertebral hernia. This applies mainly to the early stages of the disease, when conservative therapy is not effective, and microsurgical operation carried out prematurely. In such cases, various operations are carried out through a puncture, without a cut, for example, laser vaporization, etc.
There are additional methods of treatment: manual therapy, physiotherapy and so on. D. How effective are they?
- Manual therapy, physiotherapy relate to the conservative methods of treatment and are usually used in the early stages of treatment. I would like to warn perform manual therapy without MRI. With the development of sequestration hernia manipulative therapy may lead to increased herniation, increased pain and the development of adverse effects.
- There are many types of massage, there are exotic, there is a stretching and so on. D. Something you can recommend?
In the early stages are suitable almost all treatments, including massages. On pulling the situation is more complicated: you need to very carefully use this method to prevent damage to the intervertebral disc. The optimal traction is in the water.
It is believed that a person with a bad back, relax only hard bed, right?
- The bed should be neither hard nor soft. For a sample of stiffness for a person weighing about 75 kg, you can take a foam mattress 8 cm height of lying on a hard floor. But this is only the sample, because this bed a couple of weeks promnetsya and sleep will be very tough.
What can you advise as prevention?
- Definitely, walking. The proverb "Movement - Life" is the best suited to the spine, as it occurs when walking the correct operation of the intervertebral discs and vertebral joints, their food and the removal of waste substances. Similar walking outdoors is much more useful prophylactic use of various drugs. Good unloads the spine swim, but running is not recommended because of the large impact load on the wheels.
Treatment and prevention
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