Modern methods of treatment of herniated cervical spine
Herniation of the cervical spine: a variety of symptoms and methods of treatment
Intervertebral disc herniation in the cervical spine is a fairly common condition that is often first diagnosed in middle-aged people.
The thickness of the disc between the vertebrae in this Department, as a rule, not large. Accordingly, the space between adjacent vertebrae, as the place for the passage of nerves, not also large, which allows even subtle and minor the size of the hernia cause compression of the nerve fibers, causing pain and other neurological disorders.
The variety of manifestations of herniated cervical?
Depending on localization of hernia symptoms can vary. Considering how nerve ending are affected hernia, place and nature of the manifestation of pain and other neurological symptoms can be divided into several groups.
When pressure on the fifth nerve root (located between the 4 and 5 vertebrae, following the roots lying, respectively, on a single vertebra) can cause muscle weakness, pain in the shoulder and, mainly, of the deltoid muscle. A change in the sensitivity this often does not happen.
The impact of the sixth nerve root often leads to weakness of muscles responsible for flexion at the elbow (mainly biceps) and extension of the wrist. In the area of the thumb is not uncommon soreness, tingling and numbness.
For lesions of the seventh nerve root characterized by the same symptoms in the triceps (muscle, whiling away is the back of the shoulder and is responsible for straightening the arm at the elbow) and the extensors of the fingers, as well as pain and paresthesia (numbness, tingling) in the lower part of the rear shoulder and middle finger.
With involvement of the eighth nerve root there is a weakness in the hands and the presence of pain and paresthesias in the little finger.
You can add that the symptoms are the most common, but taking into account the individual anatomical characteristics of a person, they can show different degrees of change in each case.
Options for the diagnosis of the disease
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The diagnosis of this pathology is based on the receipt of clinical data (complaints and inspection), as well as the conduct of special instrumental methods. The best method of diagnosing herniated discs is considered magnetic resonance imaging, which allows to obtain accurate images of any minute changes and is completely non-invasive (without invading the tissues of the body) method.
Computed tomography in combination with myelography is also very revealing. However, due to the fact that for carrying out this manipulation it is necessary to introduce a dye stuff into the cavity of the spinal canal, its purpose usually is auxiliary.
The use of imaging in isolation (without myelography) not allow in this case to obtain the necessary information.
As for the diagnostic method can be applied electromyography, the essence of which lies in the study of response to electrical stimulation of individual muscles. It often helps to discard the suspicion of other diseases that have similar symptoms with herniated discs.
A sample treatment plan for herniated cervical
Herniation of the cervical spine in the vast majority of patients responds well to conservative (non-surgical) therapy, which at its core aims to eliminate pain and related neurological disorders.
Pain result from pressure of a herniated disc on the nerve fibre in combination with inflammation of the surrounding tissues, therefore, justified the use of nonsteroidal anti-inflammatory drugs.
If necessary, the treatment may include steroids, diuretics, muscle relaxants, narcotic pain relievers, antidepressants and sleep AIDS.
In addition to drug therapy, there are a number of nonsurgical treatments that can help relieve the symptoms of the disease. These include:
- physical therapy, physiotherapy and gymnastics (performing a series of exercises, and use at the initial stage of heat, cold, ultrasound treatment helps to reduce muscle spasm and relax the spine);
- traction of the cervical (pull over the head may help reduce pressure on the nerve roots; it is not always effective, but simple method which in the case of effectiveness, allows to successfully use the patient at home);
- manual therapy (gives you the opportunity to relax tense muscles);
- osteopathy (some osteopathic manipulations and methods to restore normal joint mobility can be sufficiently effective);
- the use of the brace (or orthopedic cervical collar that provides additional relief and rest for the cervical spine);
- injection (injection into the space between the membranes of the spinal cord steroids or the introduction of drugs into the vicinity of the nerve effectively reduce inflammation and pain).
In cases of failure of conservative treatment proposed operation, the success of which according to different sources is 95 – 98%.
You can run the following types of transactions:
- anterior discectomy with fusion (this is done most often through a small hole in the skin of the anterior surface of the neck is removed intervertebral disc and fusion of vertebrae);
- anterior discectomy without fusion (similar to the previous procedure only after you eject the disc remaining space is still open, and the vertebrae are fused independently);
- back discectomy (runs from the back and applied in cases where the hernia is located posterolateral to the Department drive).
The probability of complications in the surgical treatment
Possible complications of surgery for hernia disk can include damage to the trachea, esophagus, blood vessel (1 case per 1000 operations).
About 1% of cases, the delay during the operation the recurrent laryngeal nerve can cause hoarseness, which usually goes away within two to three months. Sometimes the fusion (merger) may become insolvent, which leads to instability of the vertebrae and of the need for re-operation. Less than 1% of cases observed infectious complications.
Operation with front access are less traumatic, so can be run on the principle of «surgery of one day» (outpatient or conduct in the hospital for more than a day).
After the surgery in most cases is shown wearing an orthopedic cervical collar, as well as the temporal limitation of physical activity.