Herniated Schmorl of the lumbar spine. Causes, diagnosis, treatment, prevention

In order to understand what Shmorl's hernia is in the lumbar spine, one should understand the causes of its appearance and the problems that this seemingly harmless, at first glance, change in the structure of the cartilaginous tissue of the vertebrae.

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 does a Schmorl hernia form?

Amortization and mobility of the spine, thanks to the peculiarities of its structure, provides the 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 of uniform load distribution in the human spine is broken, then its individual motor segments begin to work for wear. Due to prolonged overvoltage in the fibrous ring, microcracks appear, 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 of the spine occur 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 usual intervertebral joint is that the nodes of the first of the listed pathologies do not go beyond the spinal segment 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 the 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 the Schmorl hernia in vertebral bodies do not allow to detect 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

Hernia of the lumbar spine, as well as other parts of it, as you probably already guessed, is caused by a decrease in bone density (this is possible with osteoporosis). But spine traumas, vertical loads, posture disorders or scoliosis can also provoke the appearance of this hernia, which is usually found only by chance, during an X-ray or computer tomography examination of the spine in connection with other complaints.

By the way, most of all it affects teenagers during the period of intensive growth of bones. In them, as a result of lagging 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 be the cause of hernia Schmorl. Osteochondrosis in medicine means a natural aging of the spine, that is, a 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 strongly disturbed, which causes uneven distribution of the load on the bone structures and ligaments. This leads to forced compaction of the bone on the border with the disc 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 pain in the back 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 anterior, central, lateral and posterior.

• Single lumbar hernia is more typical for people of elderly and mature age. 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 referred to as congenital pathologies.
• Multiple hernias Schmorl often associated with a 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, the described lumbar hernia usually does not cause pain, but can be the reason for the deterioration of the spine and the whole body as a whole.

The disc as a result of the appearance of a Schmorl hernia can almost completely fall into the spongy bone of the adjacent vertebra, which will lead to serious impairments 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 Schmorl's hernia?

Methods for treating Schmorl's hernia are chosen by an orthopedist or 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 physical therapy.

Great importance is attached to the therapeutic physical culture, which is carried out initially in the most gentle mode, for which swimming in the pool and gymnastics in the water are used. And then, after strengthening the back muscles, 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 sizes, prescribe 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".

Hernia is a conditionally safe condition

As you already understood from the article, the hernia of the lumbar spine is a condition that can not be classified as completely safe. After all, in fact, this process is a specific warning about the weakening of bone tissue and susceptibility to their fractures, which, you must agree, very seriously.

Therefore, the presence of Schmorl's hernia can be safely considered a prerequisite for other, already more severe and irreversible changes in the spine. So the advice of a doctor who has found out 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!