All of a herniated disc

Intervertebral hernia is caused by rupture of the fibrous ring of the intervertebral disc (intervertebral disc - a padding Feminine pads - talk about wings   between individual vertebrae, which is composed of fibrous or connective ring within which lies the nucleus pulposus), through which the outside of the spine out of the nucleus pulposus of the disc. Since ruptured nucleus pulposus of the intervertebral disc compresses the surrounding tissue, and injured spinal nerves, ligaments, broken spinal mobility begins inflammation and swelling of the surrounding soft tissues.

Because of all these changes in the spine patient feels severe pain in the back, legs, weakness in the limbs, numbness in certain areas of the body. Sometimes, due to compression of the final structure of the spinal cord (cauda equina) may receive paralysis of the lower half of the body, breach of defecation and urination. This is a dangerous condition, which is an indication for surgery.

Intervertebral hernia may result from age-related disc injuries, diseases. Contributing factors include a sedentary lifestyle and overweight.

Intervertebral hernia diagnosis, doctors set neurologists, neurosurgeons, confirming its data X-ray examination.

Intervertebral hernia treatment can be conservative and surgical.

How to treat intervertebral hernia conservative

Conservative treatment starts with emergency aid to the patient, if he is concerned about severe pain. The patient is assigned to rest, cold on the back (removed tissue swelling), made in the course of procaine blockade disadvantaged spinal nerve, appointed painkillers physiotherapy and medication - painkillers as injections and medication inside. Assign NSAIDs (Voltaren, indomethacin, movalis Movalis - relieve symptoms of inflammation   and so forth), if desired - even stronger painkillers - opiates. Appointed as muscle relaxants - medicinal products, relaxing the muscles, since the disc herniation has a pronounced protective spasm of the back muscles, which increases pain.

After the pain removed, the patient explain how to move in order to reduce the likelihood of pain. Explain what traffic it will benefit, and what - to harm. Prescribe a course of medical gymnastics, massage, reflexology Reflexology - a policy of non-drug therapies , Manual therapy Chiropractic: the main thing - to choose the competent expert , Physiotherapy. Recommended spa treatment and weight loss.

Operative treatment of intervertebral hernia

Surgical treatment of a herniated disc - is a necessary measure resorted to in the event that, despite of conservative treatment, the patient continued to bother a lot of pain. The operation is also shown in the cauda equina syndrome, where there is paralysis and dysfunction of the pelvic organs (incontinence).

Surgical treatment is complete or partial removal of the intervertebral disc (discectomy). In some cases, brain surgeon first removes a small piece of the affected vertebra. This operation is called a laminectomy, it allows greater access to the operated intervertebral disc. Discectomy - operation is forced and carried out only if absolutely necessary. Today, neurosurgeons have learned to do more gentle operation - microdiscectomy, which is done with the help of special operating microscopes, without damaging surrounding tissue further.

In recent years, such an operation became increasingly done using endoscopic equipment where access to the operated tissues made several very small incisions. The entire operation is carried out by means of optical techniques, and the surgeon monitors and manages its tools through the screen.

Scalpel also increasingly replaced by laser or radio-wave equipment. So, today conducted operations aimed at eliminating the compression of the nucleus pulposus of the intervertebral disc and the operation to eliminate compression of the nerve roots.

Diagnosis of tuberculosis of the spine

Diagnosis of tuberculosis of the spine is quite complex, and often the disease is detected at later stages of development, when there were noticeable deformation and other problems with the spine. Symptoms of tuberculosis of the spine may be similar to the symptoms of these disorders, which the doctor must rule in the differential diagnosis:

• Tumors of the spinal cord;
• Infections caused by the bacteria Mycobacterium kansasii;
• Nocardiosis;
• Paracoccidioidomycosis;
• Septic arthritis Arthritis - a variety of forms and complications ;
• The swelling of the spinal cord;
• Actinomycosis;
• Blastomycosis;
• Brucellosis;
• Miliary tuberculosis;
• Multiple myeloma.

The tuberculin skin test at the 84-95% of patients with tuberculosis of the spine gives a positive result. In many cases, there is significantly increased erythrocyte sedimentation rate (100 mm / h).

For the diagnosis of tuberculosis of the spine can also be used biopsy, X-ray, computed tomography (CT) and magnetic resonance imaging (MRI). With biopsy sampling carried out the bone for microbiological studies, and, if necessary, carried out drainage of paraspinal abscesses, which are sometimes formed in patients with tuberculosis of the spine. A biopsy to diagnose a violation in 50-83% of cases.

With CT, you can better understand the state of the vertebrae and intervertebral discs, and to identify tuberculosis lesions, so this diagnostic procedure for suspected tuberculosis of the spine recently used more often than X-rays. CT also allows you to identify tuberculosis of the spine in the early stages of development.

MRI is recommended for the diagnosis of osteomyelitis, and infections affecting the intervertebral space, in addition, this procedure is most effective for the evaluation of patients who have tuberculosis of the spine spread to soft tissue. MRI can also reveal a pinched nerve Pinched nerve - what to do when severe pain? Which is frequently observed in patients with tuberculosis of the spine.

Treatment of tuberculosis of the spine

Before the advent of anti-TB drugs Pott's disease treated with prolonged immobilization - it was prescribed bed rest and / or wearing a brace. While mortality from tuberculosis was around spine 20% and the relapse occurred in 30% of cases.

Despite the fact that the efficiency with Corsets spinal tuberculosis is controversial, they still often used to prevent skeletal deformities.

However, the most important part of treatment for this disorder today is drug therapy. In most cases, patients are assigned to receive these drugs - isoniazid, rifampicin, pyrazinamide, ethambutol and streptomycin. If tuberculosis Tuberculosis - a full recovery is not guaranteed   spine caused by drug-resistant bacteria that can be assigned to other anti-TB drugs.

Specialists still no consensus regarding the optimal duration of treatment for tuberculosis of the spine. Although the results of several studies speak in favor of a course of therapy lasting from six to nine months, many doctors usually prescribe a course of treatment, which lasts from nine months to a year, and in some cases - even more. When choosing the length of treatment, doctors take into account the stage of the disease, the overall health of the patient, as well as how quickly after the start of medication he had TB symptoms disappear Symptoms of TB - how to recognize the disease .

Isoniazid - a powerful anti-TB drug, which is effective against bacillus Mycobacterium tuberculosis. He, like rifamycin, taking over the entire course of treatment. The most common side effects (occur in 10-20% of patients) are anorexia, nausea, vomiting, abdominal pain and weakness. In 1-10% of patients while taking this drug observed dizziness, drowsiness, slurred speech, and the gradual deterioration of liver tissue. Less than 1% of patients isoniazid causes anemia, thrombocytopenia, systemic lupus erythematosus, and convulsions.

Rifampicin is used in the treatment of spinal tuberculosis in combination with at least another anti-drug. It can cause side effects such as skin rashes, nausea, diarrhea, muscle cramps, pancreatitis, muscle weakness, swelling, headaches. Other anti-TB drugs usually cause similar side effects - usually they are mild or moderate, and tested a few weeks after the start of treatment, when the body gets used to the medication.

Contagious tuberculosis of the spine

Since the vast majority of cases of tuberculosis of the spine occurs in people with active TB of the lungs, they can spread the infection by airborne droplets, and the probability of infection by contact with such people is quite high. In rare cases, when the primary site of infection is in the spine, the probability of infection is much lower.