Herniated Schmorl of the lumbar spine. Causes, diagnosis, treatment, prevention
To understand what the Schmorl's hernia islumbar spine, it is necessary to understand the causes of its occurrence and the problems that this unsanitary, at first glance, change in the structure of the cartilaginous tissue of the vertebrae provokes.
In the article, we will try to find out the circumstances that lead to the development of this pathology, as well as the ways of its treatment and prevention.
What is the intervertebral disc? How is the Schmorl hernia formed?
Amortization and mobility of the spine, thanksfeatures of its structure, provides an intervertebral disc. It consists of a pulpous core, which has a jelly-like consistency, and a fibrous ring that closes it.
If for some reason the system is violateduniform distribution of the load in the human spine, then its individual motor segments begin to work for wear. Due to prolonged overstrain, microcracks appear in the fibrous ring, and it can no longer hold the pulpous nucleus in the correct central position. As a result, different types of hernia are formed.
Most often degenerative changes in the spineoccur in the fourth and fifth intervertebral disc, since they are subjected to the greatest load. If this involves punching the disc in the vertebra, then this is the lumbar Schmorl's hernia. If the nucleus of the disc protrudes outward, squeezing the nerve roots at the same time, talk about the intervertebral hernia.
What is the difference between Schmorl's hernia and the usual intervertebral hernia?
The main difference between Schmorl's hernia and the usualintervertebral is that the nodules of the first of these pathologies do not go beyond the segment of the spine and do not appear in the lumen of the intervertebral canal. And this, in turn, does not cause pain from squeezing the nerve processes and spinal cord and does not lead to serious restriction in movements, as with the usual intervertebral hernia.
But in this situation there is a downside. Absolute painlessness and absence of other symptoms in Schmorl's hernia in vertebral bodies do not allow finding it on time, although this disease often proves to be a harbinger of kyphosis, development of protrusion of intervertebral discs, osteochondrosis or early intervertebral arthrosis.
In addition, the described pathology greatly increases the risk of compression fractures of the spine during heavy loads on it. Especially when it comes to its location in the anterior part of the vertebrae.
More on the causes of hernia Schmorlja
Herniated Schmorl of the lumbar spine, bothas well as other departments, as you probably already guessed, is caused by a decrease in bone density (this is possible with osteoporosis). But spine traumas, vertical loads, postural disorders or scoliosis can also provoke the appearance of this hernia, which is usually found only by chance, when performing an X-ray or computer tomography examination of the spine in connection with other complaints.
By the way, most of all it affects teenagers inperiod of intensive bone growth. In them, as a result of the lag in the synthesis of bone tissue, voids can form, into which the closure plate fails, and behind it the intervertebral disc. The risk group also includes athletes with a constant vertical load on the spine.
Osteochondrosis, Schmorl's hernia - can they be related?
Developing osteochondrosis can also bethe cause of hernia Schmorl. Osteochondrosis in medicine means the natural aging of the spine, that is, the degenerative-dystrophic process that occurs in its tissues. Naturally, the destruction of these tissues may entail the appearance of such a pathological change as the hernia of the lumbar spine of Shmorl or some other part of it.
The functions of the disks in this process are strongare violated, which causes uneven distribution of the load on the bone structures and ligaments. This leads to forced compaction of the bone at the border with the disk and the formation of marginal bone growths, which are called osteophytes. They appear compensatory, to increase the area of the vertebra and reduce the load on it. This process is characterized as spondylosis.
But osteophytes also lead to back pain,caused by irritation of the fibrous ring and ligament of the spine, which has a variety of nerve endings. As a result of these changes, the already complicated blood supply of the spinal structures is broken and venous congestion is formed. And in the intervertebral joints in such cases, develops osteoarthritis.
Varieties of hernia Schmorl
Depending on how the disc is affected and where the hernia is located, it is divided into single, multiple, as well as to the front, central, lateral and posterior.
- Single lumbar hernia in a greater degreeis typical for people of elderly and adulthood. True, in some cases, it can develop in young people, as a consequence of the individual features of the structure of the entire body or separately vertebrae. In such cases, diseases are usually attributed to congenital pathologies.
- Multiple hernias Schmorl often associated witha violation in the bone tissue of calcium metabolism and hormonal changes, which can also lead to a decrease in its quantity. The causes of this pathology include the development of osteoporosis. By the way, unlike a single hernia, multiple can manifest with an unclear pain syndrome, increasing in a standing or sitting position.
What can be dangerous hernia Schmorl?
As already mentioned, described lumbar hernia usually does not cause pain, but it can be a cause of deterioration of the spine and the whole body as a whole.
The disk as a result of the appearance of a Schmorl hernia is capablealmost completely fall into the spongy bone of the adjacent vertebra, which will lead to serious impairment of its cushioning function. In addition, it can cause bone sprouting, called osteophytes, as a result of which the nerve endings will still be squeezed, and as a result, the functions of the muscles or organs that they innervate are disrupted.
How to treat a Schmorl hernia?
Ways to treat Schmorl's hernia are selected by an orthopedistor the therapist. If it is small, then there is no need for medication. And to prevent possible complications, the patient is offered massage, medical gymnastics, manual and physiotherapy.
A great deal of importance is attached to the curativePhysical culture, which is carried out at first in the most sparing mode, for which swimming in the pool and gymnastics in water are used. And then, after strengthening the muscles of the back, reducing the load on the spine and improving its mobility, the intensity of exercise increases and allows the patient to return to previous physical activities.
With multiple hernias or their large sizeprescribe drugs-chondroprotectors. They prevent further changes in the spine, restoring the normal composition of its cartilaginous tissue. To such preparations carry "Alflutop", "Teraflex" and "Stopartrose".
Shmorl's hernia is a conditionally safe condition
As you already understood from the article, Schmorl's hernialumbar spine - a condition that can not be attributed to a completely safe. After all, in fact, this process is a specific warning about the weakness of bone tissue and susceptibility to their fractures, which, you must agree, very seriously.
Therefore, the presence of Schmorl's hernia can be safely considereda prerequisite for other, already more severe and irreversible changes in the spine. So the advice of a doctor who has discovered this pathology should be observed, and the procedures prescribed by him should not be ignored, even if you do not feel any pain or discomfort at the moment. Be healthy!