Extrusion is a disease of intervertebral discs. Types of extrusion. Methods of treatment

Extrusion is one of the stages of development of the intervertebral hernia. And today many people face such a diagnosis. That's why patients are interested in information about the causes, symptoms and modern methods of treating this condition.

What is extrusion?

Quite a few patients today face such a diagnosis. And many people think that extrusion is a hernia. In fact, such a statement is not entirely true. After all, extrusion is, rather, the initial stage of the formation of a herniated intervertebral disc. What is observed with such a disease?

Surely many industry workers are familiar with this term. After all, in production, the extrusion method is the process of obtaining materials from the polymer, in which the melt is squeezed out through a special hole. In this case, you can draw some analogies.

In medical terminology, extrusion is a condition in which the fibrous ring of the disc is ruptured, and a fall of the pulpous nucleus outwards is observed. The latter thus goes to 3-4 millimeters (it hangs like a drop of water) and irritates the nerve roots.

Stages of formation of the intervertebral hernia

In order to understand what extrusion is and what its role in the formation of the intervertebral hernia, you should consider the whole process.

Hernial protrusion is formed in three stages. For the beginning there is a so-called prolapse, in which the substance of the intervertebral disc falls outside the functional segment, without breaking the fibrous ring. Due to lack of water and nutrients, the mobility of the pulpous core is significantly reduced.

In the future, there is a second stage, which in modern medicine is called protrusion. In this case, the intervertebral disc is displaced 3-4 mm (sometimes up to 15 mm) beyond the vertebrae.

Extrusion is the third stage of protrusion formation. At this stage, there is a rupture of the fibrous ring and the yield of the core material beyond the vertebra. In most cases, strong compression of the nerve roots is not observed, since the nucleus is restrained by the longitudinal ligament of the spine. If we are talking about extrusion in the lumbar and sacral areas, the disease can be more dangerous, as it often causes sciatic nerve compression.

Extrusion and its varieties

In modern medicine, there are several systems of classification of various vertebral diseases. For example, extrusion is often divided into types depending on the direction in which the pulpous nucleus falls.

For example, if the substance of the nucleus extends beyond the vertebral column, this form of the disease is called lateral. There is also dorsal extrusion of the disc, which is accompanied by protrusion towards the soft tissues of the back. Often, patients also face other diagnoses. For example, some people are interested in questions about what is central or paracentral extrusion of a disc. With this form of the disease, the substance of the core protrudes not outward, but inside the spine, which is extremely dangerous, since there is always a chance of squeezing the spinal cord. There is also the posterolateral form of the disease, in which protrusions are seen from behind and along the sides.

Sometimes a doctor diagnoses "subligmentary extrusion of the disc." What it is? In this case, the name does not speak about the direction of protrusion of the substance, but about the stage of the development of the disease. If at the initial stages the cartilaginous tissue of the nucleus is displaced, but still holds due to the posterior longitudinal ligament, then in this case, ligament damage and the formation of subglottic extrusion are observed.

The main reasons for the development of extrusion

In fact, there are many reasons for the development of such a disease. First of all, it should be noted that extrusion is a disease of old age. After all, in the process of aging, tissues gradually lose water, there is a violation of blood supply, etc. Thus, the intervertebral discs also become less elastic.

However, there are some other reasons. For example, extrusion often develops against a background of various degenerative diseases of the spinal column. For example, spondylosis, osteochondrosis or curvature of the spine quite often cause extrusion, and then hernia.

Of course, the list of causes can include injuries to muscles and ligaments. In addition, such a disease is often the result of prolonged and excessive physical exertion, especially when it comes to damage to the intervertebral discs in the lumbar and sacral parts, which are most often amenable to injury and take on the main load during movement.

What are the symptoms of the disease?

In fact, the extrusion of the disc is not always accompanied by some obvious and noticeable symptoms. Quite often, the disease is hidden. Pain and other signs appear only if the nucleus that has gone beyond the fibrous ring presses and irritates the nerve roots. And the clinical picture in this case depends on which part of the spine was affected.

With a problem in the cervical region, pain in the shoulders is observed. Often she gives in the elbows, forearms and fingers. Extrusion of the disc of the thoracic region may be accompanied by a violation of the work of some internal organs, as well as pain in the chest.

The most characteristic pattern is observed in the lesion of the lumbar region. Typically, patients complain of pain in the thigh or leg, as well as numbness or tingling in the lower limbs, toes. Extrusion of the sacrum can be accompanied by pain in the coccyx, pelvic region and genital organs.

Modern diagnostic methods

Of course, to begin with, a doctor's examination is necessary. Indications for further examination are the patient's history, clinical picture (presence and localization of pain, its intensity), some neurological disorders (eg, absence of knee or Achilles reflex, appearance of pain when examining the spinal column).

As a rule, magnetic resonance imaging or computed tomography is first assigned to confirm the presence of protrusion and to accurately determine its size and location. In some cases, a contrast study is performed in which a special substance is injected into the spinal canal. Such testing makes it possible to determine the structure of deposition (this is extrusion, protrusion or hernia).

Is conservative treatment possible?

Of course, extrusion of the disc in most cases can be cured with the help of conservative methods of medicine, especially if the protrusion does not exceed 5-7 mm. In this case, the doctor, most likely, will recommend correcting the diet and reduce physical exertion. For patients suffering from obesity, it is extremely important to normalize weight, as this will eliminate pressure on the spine and other joints.

Physiotherapy is also mandatory. The patient must regularly engage in special exercises that will help strengthen the muscular corset, which, again, will reduce tension in the spine.

As for medicines, in some cases, one can hardly do without them. With a strong pain syndrome appoint appropriate funds. In the presence of inflammation, patients tend to take non-steroid drugs. But with severe inflammation and intense pain syndrome, doctors can recommend steroids that are injected directly into the epidural space of the spinal cord.

Surgical methods of therapy

If extrusion exceeds 12 mm, ambulatory treatment is rarely prescribed, since conservative therapy can only worsen the situation. In such cases, as a rule, the possibilities of modern surgery are used.

Sometimes patients are prescribed a discectomy - a minimally invasive operation, in which all manipulations are performed using endoscopic instruments. In addition, laser correction of intervertebral discs is possible.

Possible complications during extrusion

Extrusion is a rather dangerous disease. Therefore, in no case should not abandon treatment or ignore the recommendations of doctors. After all, as the disease progresses, the pulpous nucleus will protrude outward, squeezing the roots, thereby increasing soreness and worsening the quality of life.

On the other hand, the lack of timely therapy is fraught with the development of an intervertebral hernia. And if conservative treatment is possible during extrusion, the hernia in almost every case requires surgical intervention.