What is the difference between Schmorl's hernia and a hernia?understanding of most of us intervertebral hernia? Firstly, here we are talking not so much about the disease as about the X-ray term, which was first proposed by the German physician Christian Schmorl. In the picture, the scientist saw the pushing of the cartilaginous tissue of the endplate into the body of the lower or upper vertebra, directly into the cancellous bone. This pathology is attributed to the genetic nature of origin, because it is formed most often in early childhood against the background of the active release of growth hormone.
What is different from an ordinary intervertebral hernia
When a child grows up, his soft tissuesstretched out faster, and bony ones do not always keep up with the pace of development of muscle mass and ligaments, so their values may slightly lag behind. As a result of this process, voids are formed inside each vertebra. As time passes, the spinal vertebral plates are pressed into the spongy bodies, which in essence are these voids. Schmorl's hernia differs from the usual intervertebral formation:
- location;
- a pathological reaction in which neurovascular plexuses are not involved;
- lack of compression of the spinal substance and roots;
- the scarcity of clinical manifestations due to the formation of pathology involving only vertebral bodies and intervertebral discs;
- occurrence mainly in childhood and adolescence.
Is this disease dangerous?
Primarily detected on X-rayIn the picture, Schmorl's hernia can be considered a harbinger of intervertebral hernia formation in the future, because without appropriate therapy, as it progresses, it quickly thinns the vertebrae, making them unprotected and weak to physical factors (shock, long walk, weight gain). The result of this pathology may be a compression fracture of the spine.
Given that in the development of the diseaseintervertebral disk is involved, over time it falls into the hernial sac, and this significantly interferes with the depreciation functions of the spinal column. In severe cases, it is this factor that can lead to disability. In addition, the Schmorl hernia of the vertebrae of any of the departments (lumbar, thoracic, cervical) causes an increase in compression on the intervertebral joints. Young patients suffering from this disease are often diagnosed with degenerative changes in the joints, which indicate the initial stage of arthrosis.
Actually, such complications are dangerous.pathology, like Schmorl's hernia. Neglecting the need for therapy in the absence of clinical manifestations, the patient runs the risk of irreversible consequences. In most cases, such a problem is detected by random X-ray examination, which can be considered a great luck for patients.
Causes of pathology
Modern medicine is still difficult to explainwhy there is Schmorl's hernia in the lumbar, thoracic or cervical spine. But still, most experts agree on the causes of the disease, which may well be:
- Genetic predisposition of the patient.
- Features of the structure of the switching plates.
- The rapid growth of a child in early childhood oradolescence, which is accompanied by lagging bone growth with satisfactory growth rates of cartilage tissue. As a result, the emerging voids in the vertebrae are filled with cartilage.
- Calcium deficiency in the bone tissue or insufficient digestion of the microelement by the body.
- Violation of metabolic processes in the intervertebral disc.
- Excess physical exertion, leading to microtraumas of the spine (when playing professional sports).
- Pregnancy. During the period of gestation of the fetus, the woman increases the load on each section of the spinal column, but the thoracic and lumbar sections suffer the most.
Schmorl's hernia is a logical consequence.falls from a great height or a sharp weight increase. In the elderly, the cause of the development of pathology of the spine may be the deformation of bone and cartilage structures in the background of the progression of osteoporosis. By the way, this disease associated with a high risk of fractures is also found in middle-aged women during menopause.
In the lumbar spine of Schmorl's herniamay occur due to the deterioration of blood supply, which leads to loss of strength of the vertebrae, which are simply pressed through by intervertebral structures. Disturbance of the blood supply to the ridge occurs as a result of slouching, kyphosis, scoliosis, Scheuermann-Mau disease. But more often the lack of full-fledged motor activity and sedentary work leads to a similar problem.
Clinical picture
Symptoms of Schmorl's hernia are usually mild or absent altogether. To explain the paucity of the clinical manifestations of the disease can be the fact that this education:
- does not affect the nerve roots and blood vessels;
- does not provoke an inflammatory process;
- not accompanied by muscle spasm.
As stated at the beginning, this pathologyIt is rather a radiological sign and is diagnosed by chance. Patients rarely have pain, but even if an unpleasant symptom appears, it is of a local short-term nature. For example, discomfort can be felt during physical exertion and disappears during a period of rest, so patients often complain of a decrease in performance and motor activity.
In the lumbar region
Palpation of the affected vertebra areathe patient may feel slight soreness and muscle spasm. However, other neurological and vascular changes, as a rule, are completely absent. Therefore, the treatment of Schmorl's hernia of the lumbar spine is not symptomatic, i.e. aimed at eliminating the clinical manifestations of the disease.
Патология в нижнем сегменте позвоночного столба usually does not appear, rarely accompanied by muscle hypertonia and tension in the lumbar region, discomfort and poor flexibility of the back. In rare cases, Schmorl's hernia causes lower back pain radiating to the legs. The appearance of a symptom is often preceded by increased physical activity. By the way, such a symptom can sometimes indicate a complication of the disease. As the pathology progresses, the intervertebral disc may completely fall into the cancellous bone, which, in turn, will serve as a basis for dysfunction of the lumbar vertebrae. If we consider that the affected area is significantly weakened, the risk of compression fracture increases. Especially dangerous for patients with Schmorl's hernia is:
- significant lateral load on the spinal column;
- strong stab in the back;
- squeezing the ridge along the axis.
Revealed pathology in the lower back requiresserious and responsible treatment. Education can form on any segment of the spine. In the lumbar region there are five vertebrae. In comparison with the vertebrae of other departments, these have the largest size. This is due to physiological features: it is on the lower back that the maximum weight load falls. The doctor establishes the X-ray diagnosis based on the location of the hernia at the vertebral level L1, L2, L3, L4 or L5.
Thoracic affection
Schmorl's hernia in the thoracic spine mayform at any level, but in this part of the spinal column pathology is much less common than in the lower back or in the neck. Most often, it develops within the vertebrae of Th8-Th12 and is asymptomatic, since only bone tissue is affected, and the nerve roots are not affected absolutely.
At first, the pain syndrome may be completely absent, but as the hernial formation grows, the patient may notice increased fatigue of the whole body, tension in the thoracic region.
Лечение грыжи Шморля сводится к устранению secondary signs of pathology - violations of the internal organs. With the increase of its size often there is a rapid heartbeat, shortness of breath. After some time, back pains join, which become noticeable during any physical activity and decrease, as soon as the patient relaxes, will assume a lying position. The pain can be given to the hands, manifesting numbness and tingling in the shoulder, elbow.
Schmorl's hernia in the cervical spine
In this area of the spinal column pathologyoften develops due to the softness of the cervical vertebrae. With a small size, education in the cervical region may not appear, but as soon as the pathology begins to progress, the patient will develop weakness, decrease working capacity, and the pain in the neck-shoulder collar will become permanent. Most often, the development of the disease is due to a change in the size of the hernia or the addition of additional complications associated with impaired cerebral circulation. Patients with Schmorl's hernia in the cervical region often complain of severe headache and drowsiness.
How to recognize the disease
Primary diagnosis of Schmorl's hernia is based on the principles:
- a detailed description of complaints by the patient - the presence of pain, its exact or approximate localization, the relationship of symptoms with physical exertion or staying at rest;
- medical history - it is important to find out if one of the close relatives of the hernia suffers, whether the patient had previous spinal injuries, etc .;
- visual examination and palpation along the ridge - the doctor assesses the condition of the spinal column, including possible curvature or swelling of the soft tissues.
To mandatory examination methods forSuspected of this disease of the spine include radiography. By the way, this is a fundamental method for making a diagnosis. A more informative alternative to it is MRI, CT. A vertebrologist can also refer a patient to an orthopedist and a neurologist for advice.
Schmorl hernia treatment
Spine with identified usurative defectsrequires complex therapy taking into account the gender, age of the patient, the characteristics of his professional activity, the severity of the pathological process. The course of concomitant chronic diseases is also taken into account. Starting treatment for Schmorl's hernia of the thoracic or lumbar spine, the doctor sets the following tasks:
- Eliminate pain (if any).
- Run metabolic processes in the bone tissue.
- Improve blood circulation in the muscles of the back.
- To restore the flexibility of the spinal column.
- Eliminate muscle spasm by taking muscle relaxants.
- Prevent the development of complications.
In the predominant number of cases, therapydiseases of the spine is carried out conservatively. The goal of treating Schmorl's hernia of the lumbar is to strengthen the musculoskeletal system, which can be achieved with a number of recommendations and medical prescriptions.
Special medicines thatintended for the treatment of this disease of the spine, does not exist. However, symptoms can be controlled with anti-inflammatory and pain medication. With Schmorl's hernia, patients are prescribed:
- Dicloberl;
- "Nimesil";
- Movalis
- Diclofenac;
- Ibuprofen;
- "Dolar".
In addition to these drugs, sometimes usedmeans for strengthening the bone skeleton. These include calcium-containing agents (for example, "Calcitonin", "Alostin", "Miacalcic"), fish oil. It is important to consider that medications that strengthen bone tissue can adversely affect the work of the kidneys, so before treating Schmorl's hernia of the lumbar region, you should make sure that there are no contraindications, consult with your doctor.
With a hernia of this type, surgical treatment is notcarried out, but in the case of a complication, which is a direct indication for surgery, the final decision on the operation is made by the patient. If Schmorl's hernia was transformed into an intervertebral hernia or a compression fracture of the spine occurred, as a result of which the patient's condition worsened significantly, surgery will be the only way to prevent disability.
Additional measures of therapy and prevention
In addition to drug treatment, importantvalue for the patient is a balanced and balanced diet. A diet aimed at strengthening bone tissue should consist of protein products. It is necessary to consume fermented milk drinks, milk, low-fat varieties of meat and fish, tofu cheese. In this case, the intake of salt into the body must be minimized. In diseases of the spine, including Schmorl's hernia, you should keep your weight under control, since excess body weight is an additional burden on the vertebral back. In addition, for the patient it is important:
- Do not engage in sports involving riding a motorcycle, diving, lifting and carrying heavy loads.
- Regularly perform supportive exercises from the physiotherapy complex. This method allows you to strengthen the muscles of the back and improve its flexibility.
- Take a course of therapeutic massage. With each session, the patient will be able to feel better, as the massage normalizes blood circulation and pain, relieving spasm of the back muscles.
- To lead a healthy lifestyle that does not allow smoking and drinking alcohol. Bad habits lead to impaired blood circulation and tissue trophism.
Treatment of Schmorl's hernia with folk remediesIt is ineffective, but in some cases, doctors recommend supplementing drug therapy with the use of natural compounds for muscle relaxation and eliminating uncomfortable sensations in the affected spine.
