Herniated disc L5 S1: possible complications and ways of treatment

Hernia in the intervertebral disc is a protrusion or prolapse of its fragments into the vertebral canal. It develops due to osteochondrosis or trauma. The protrusion can provoke the compression of nerve fibers.

Anatomy

In the spine, individual elements are connected to each other by means of disks. These structures have a certain density and include an elastic core. It is located in the central part of the disk. The core is surrounded by strong rings formed by a connective tissue. Intervertebral discs give the pillar flexibility and strength. Some pathological conditions provoke the destruction of these elements. As a result, hernias are formed.

Prevalence

Most often, the disease appears in people 25-50 years old. In this case, the hernia develops rarely in the elderly. This is due to the fact that age changes in the elements reduce its mobility. In children protrusions are also formed quite rarely. As a rule, at an early age the pathology is congenital.

Causes of appearance

The main provoking factors include a variety of disruptions in the course of metabolic processes, infectious lesions, postural disorders, trauma, osteochondrosis. As a rule, the development of the intervertebral hernia is accompanied by an increase in the pressure inside the disc. This phenomenon can be provoked by various causes. In the presence of osteochondrosis, the appearance of a hernia can be caused by a rise in severity. Risk factors also include heightened body weight. With a lot of weight on the spinal column there is a lot of pressure. Disks and other elements experience increased load. Over time, they are subject to destruction. One of the first pathological conditions in this case is the herniated intervertebral disc l5 S1. The protrusion can also be formed with a sharp turn of the trunk to the side.

Localization

The lumbar spine is experiencing the greatest burden . Therefore, most often protrusion is formed precisely in this department. Rare are cases of the appearance of pathology in the cervical and thoracic segments.

Herniated disc l5 S1: description

In this segment protrusion is formed most often. Often the hernia of the disk l5 S1 also extends to nearby zones. This pathology indicates that the protrusion of the pulpous nucleus occurred (if this is the initial stage) between the fifth lumbar and the first sacral elements. It is in this area that the greatest burden is placed on the spinal column in the process of human movement. The hernia of the disc l5 S1 may be the result of trauma or a number of diseases. With persistent physical stress, the situation worsens.

Complications

The hernia of the disk l5 S1 can be in the advanced stage. This significantly complicates therapy and increases its duration. In the presence of unresolved factors and symptoms that increase pathology, a herniated intervertebral disc l5 S1 may be complicated by concomitant diseases. Of particular importance is the location of protrusion. Also, a hernia of the l5 S1 disc may be accompanied by a number of complications, which are due to the individual characteristics of the organism. Due to the impact of a strong axial load, the internal pressure on this area can increase. The paramedian hernia of the disk l5 S1 significantly complicates therapy. Over time, or under the influence of a complex of various factors, the destruction of the fibrous ring located between the discs may begin. In accordance with the stage of protrusion of the pulpous core, and also depending on the deviations from the anatomical norm of the surrounding tissue, the therapy will also differ.

Classification

In the region of the fifth lumbar and first sacral elements, the longitudinal anterior ligament is strongly strengthened. This ensures the protection of the structure of the intervertebral disc. In this regard, protrusion can break out in the opposite direction. The posterior longitudinal ligament is less elastic. Because of this, it is more prone to damage. As a result of the breakthrough, the dorsal hernia of the disc l5 S1 is formed. In this case, the protrusion can be of two types. In particular, there is a medial hernia of the disk l5 S1. In this case, protrusion occurred in the region of the midline. This type of diagnosis is made by a specialist if the herniation has penetrated into the intervertebral foramen. It begins to narrow, and the walls of the dural sac deform. Also define a paramedian hernia. In this case there is a curvature of the column as a scoliosis. The deformation occurs in the opposite direction from the protrusion.

Features of therapy

Especially difficult is affected by the posterior hernia of the disk l5 S1. It is much easier to conduct therapeutic measures with anterior protrusion. Often associated with pathology associated diseases. They significantly complicate the clinical picture and the subsequent treatment of the intervertebral hernia. Among the accompanying pathologies, antesponillolysthesis, retrospondylolisthesis, and uncoarthrosis are most often detected. In the list of pathologies, spondyloarthros can also be added. They are also often accompanied by a hernia of the disk l5 S1. Treatment in such cases will also be aimed at eliminating the symptoms of complicating pathologies. Among the previous diseases, osteochondrosis is most often diagnosed.

Importance of timely detection of pathology

In itself, protrusion is easily amenable to elimination. It is important to begin treatment of intervertebral hernia in a timely manner . In this regard, do not delay the visit to the doctor. However, often already started stages of the disease are diagnosed. This or that method of therapy is selected depending on the clinical picture, which is accompanied by a disc herniation l5 S1. Treatment can be both conservative and operative. Surgical method is used for long-term and serious complications.

Protrusion

This is one of the frequent complications of all, accompanied by a disc herniation l5 S1. Treatment in this case is complex. The protrusion is a condition against which a displacement of the pulpous nucleus is noted. In this case, the fibrous ring retains its integrity. The disc itself can move by 6 mm when protruding. The pathological condition can be of several types. In particular, they distinguish:

• Circular protrusions. In this case there is a uniform expansion and an increase in the intervertebral disc. Circular type of pathology is diagnosed more often than others.

• Median protrusion. It is sometimes confused with another kind of protrusion - the hernia of Schmorl. For this condition, it is characteristic to roll out towards the center of the spinal canal.

• Dorsal protrusions. This protrusion can be accompanied by a pinch of the elements of the nervous system.

• Diffuse protrusion. In this case, the damage to the disk is more than 40%.

• Foramen protrusion. In this case, protrusion occurs toward the intervertebral canal. In this case, infringement of the fifth root of the waist is noted.

• A paramedian protrusion. For this pathological condition is characterized by infringement of the first nerve root in the sacrum. The protrusion in this case is directed towards the center of the spinal canal.

• Joint protrusion. In this case, simultaneous lesion of two vertebral segments is diagnosed.

Sequestered education

This form is considered the most dangerous. It develops with untimely or incorrect treatment of extrusion. This is a stage in which it is difficult to normalize the vital activity of the spine without surgery. Against the backdrop of sequestered education, the nerve roots of the sacral and lumbar regions are infringed. Along with this, the lesion extends to fibers passing through the spinal canal. In the people this condition is called "horse tail syndrome".

Clinical picture

At the initial stages of the patient's illness, local pain begins to be disturbed, localized in the area of the lesion. Over time, they will spread to the buttock. Strengthening of the pain syndrome occurs with an increase in the load or during the movement. With a strong infringement of nerve fibers, pain will begin to be delivered to the hip part. The patient will feel a deterioration in the sensitivity in the area where the "squashed" nervous nerve root reacted. There is numbness in the foot or corresponding reflexes disappear. Such symptoms are especially characteristic of dorsal protrusion. Median stunting can squeeze especially important nerve fibers. This, in turn, often provokes violations in the activity of the pelvic organs. In the absence of treatment, paralysis of the legs may occur. To avoid such complications, specialists prescribe an operation.

Therapeutic events

Treatment of protrusion is carried out by two methods: conservative and operative. Traditional therapy includes the use of anti-inflammatory nonsteroid medicines. They include, for example, such means as "Naproxen" or "Ibuprofen". Also in the complex of conservative measures is physiotherapy. It is aimed at the release of pinched roots and stabilization of the spine. There are special sets of exercises recommended for patients. At first it can be squats and slow slopes. With exacerbation, a 2-day bed rest is recommended. Longer lie should not be, because it will be harder to recover. If there is no result after conservative measures, the operative method is used. Surgical intervention, as a rule, allows quickly and for a long period to get rid of pathology. However, a relapse is possible.