HealthDiseases and Conditions

Protrusions of the lumbosacral spine. Treatment of protrusions of the lumbar region

The protrusion of the intervertebral discs, the symptoms, the treatment of which will be described later in this article, is a condition that is characterized by the bulging of the elements without breaking the fibrous rings. Violation is not considered an independent disease. Protrusion is one of the stages of osteochondrosis, and is also recognized by specialists as the initial stage of the formation of a hernia in the intervertebral disk. Let us consider this state in more detail. Special attention will be paid to the protrusion of the lumbosacral spine.

Frequency of occurrence

According to statistics, the protrusion develops in more than half of the population over forty. More often the pathology is revealed in men. The main risk group should include people engaged in physical work, as well as leading an inactive way of life, combined with sedentary work. In patients with advanced age, protrusions, due to the development of degenerative processes, often provoke the appearance of intervertebral hernia.


The most likely are the two areas in the body. A protrusion of the intervertebral disc of the lumbar spine is observed. There are five elements in the segment (L1-L5). About 80% of cases are protrusions of the lumbar spine L4-L5, and also L5-S1. The latter is a boundary element. In the region of the seven cervical vertebrae, the pathology is revealed in C3-C4, and also in C4-C5. In other elements of lesion are detected much less often. With regard to the thoracic region, then violations develop between D5-D6 and D6-D7 vertebrae.

Causes of pathology

A number of reasons cause the development of dystrophic changes in the fibrous ring and pulpous disk nucleus. These processes affect the structure of the elements. As a result, the elasticity decreases and the quality composition deteriorates. Due to the wear of the hyaline cartilage, the disk is flattened, and therefore the core extends beyond the boundaries of the fibrous ring while maintaining its integrity. These processes can be the result of the following:

  • Pathologies of the musculoskeletal system are congenital in nature (in children for example).
  • Osteoporosis.
  • Bruises, bumps and other injuries.
  • Changes in intervertebral discs of a degenerative nature.
  • Weighed down by heredity.
  • Kyphosis, scoliosis.
  • Weakness of the muscular corset.

As factors provoking protrusions of the lumbosacral spine, one should name:

  • Exchange disorders.
  • Excess weight, improper diet.
  • Hypodinamy (low mobility).
  • A number of infectious pathologies.
  • Chronic microtrauma.
  • Excessive physical activity.
  • Pathology of the organs of the nervous and endocrine systems.


The protrusions are divided according to the nature of the protrusion of the nucleus. In particular, the following types are distinguished:

  • Circular. In this case, the disk portion swells in a circle uniformly. Pathological disorder often provokes a pinching of the nerve roots. Characterized by chronic course.
  • Diffuse. In this case, protrusion occurs unevenly, in one direction or another. With diffuse protrusions of the lumbosacral spine, a break in the fibrous ring is often noted. In the absence of adequate and timely therapy, the condition is threatened with disability.

Depending on the direction in which the disk swells, the following types of protrusion are distinguished:

  • Lateral. In this case, protrusion occurs to the right or to the left of the spinal column. Most often provokes compression of blood vessels and nerves. At the initial stage, the condition may not be accompanied by any manifestations.
  • The central one. In this case, the protrusion of the intervertebral disc occurs toward the spinal cord. The main danger of this violation is the probability of contact with its roots.
  • Zadnelateral. In this case, the disk swells back first, then sideways relative to the spine. The condition may not be accompanied by severe symptoms.
  • Rear. In this case, the disc protrudes backward. The condition is accompanied by severe pain and a violation in the innervation of the organs in the small pelvis or chest (depending on the location of the lesion).

Clinical picture

Depending on the localization, the protrusions of the discs are distinguished:

  • The lumbar spine.
  • Thoracic area.
  • Neck department.

Signs of a violation in the thoracic region:

  • Soreness from the back under the ribs.
  • Tingling in the liver and heart.
  • Weakness of the musculature of the press.
  • Soreness in the area of scapula or chest.

How does the protrusion of the lumbosacral spine develop? Symptoms of the condition are as follows:

  • Limitation in the motion of the back.
  • Tingling, numbness and low back pain.
  • Shoots in the leg.
  • Weakened lower limbs.
  • Spread of pain to the toes, shins, thighs.
  • Sensitivity disorder in the pelvic organs.

Symptoms of protrusion of the cervical spine:

  • Darkening in the eyes, dizziness.
  • Sore in the neck and neck.
  • Numbness in the upper limbs.
  • Tight mobility of the neck.
  • Spreading tenderness in the shoulder area, fingers and brush.
  • Weakness in the upper limbs.

General signs of the development of pathology

At first, the manifestations of a patient's disturbance are disturbed by painfulness on the background of increased physical activity, being in an uncomfortable position for a long time. When the protrusion of the lumbosacral spine or other area of the protrusion first appears, it is accompanied by vertebral (sciatica, lumbago, for example) and radicular (nerve compression) manifestations. In the course of progressing, the conditions of pain become more intense, acquire a aching, pulling character, can manifest themselves in the form of lumbago during sudden movements or during a cough. When tapping or palpation of the damaged area, there is an increase in tenderness, often giving up in the leg. Gradually, muscle weakness develops, marked dystrophy is noted.

Stages of formation

If the protrusion of the lumbar spine has not been performed in time, then the pathology intensively progresses. Manifestations take place in three stages:

  • Violations in the functioning of the nucleus. In this case, its position begins to change. There is a gradual destruction in the fibers of the fibrous ring with the formation of cracks in it.
  • Bulge of the nucleus for a small distance. It extends beyond the edges of the fibrous ring with preservation of its integrity and no more than three millimeters.
  • Further protrusion of the nucleus. The process is accompanied by compression of vessels close to the disk, nerve roots, pain syndrome, lumbago. At this stage, often breaks the fibrous ring. As a result, prolapse (hernia) in the intervertebral disc is formed.


Treatment of protrusion of the lumbar spine should be done in a timely and competent manner. Otherwise, the probability of complications is high. In particular, the mobility of the back or neck can be severely limited, the physiological flexure of the spine is impaired . In this regard, kyphosis or lordosis develops. Soreness can acquire a permanent chronic character. This, in turn, significantly reduces the performance of a person. A prolapse (hernia) and complete destruction of the disc is considered to be a serious complication. In this condition, surgical intervention is necessary. If the operation is not carried out on time, a person may remain disabled. With the protrusion of the lumbosacral zone, the risk of squeezing the nerve roots into the pelvis is high ("horse tail" syndrome). This, in turn, can lead to a sensitivity disorder in the organs of this zone, the emergence of inflammatory processes.


The main methods of research include:

  • Examination and assessment of the sensitivity of the zones of the extremities and back, the use of motor and neurological tests.
  • Radiography.
  • Collection of anamnestic data, including family ones.
  • CT or MRI. These studies can reveal the degree of atrophy of muscle fibers and assess the state of the vessels.
  • Electromyography. This procedure is used to examine the compression of rootlets.
  • Puncture of cerebrospinal fluid (in special cases).

In the course of differential diagnosis, it is necessary to exclude pathologies such as bone tuberculosis, Bekhterev's disease, circulatory disorders in some arteries, and oncology.

Treatment of protrusions of the lumbar region

The choice of a set of therapeutic measures depends mainly on the neglect of the process. In other words, the distance to which the intervertebral disc has shifted is of decisive importance in the choice of treatment. If it is up to 4 millimeters (and for the cervical region not more than 1 mm), then bed rest and therapy are recommended under stationary conditions. Conservative methods are aimed at arresting the pain syndrome, eliminating puffiness, inflammation. Treatment improves circulation, eliminates vascular spasm, and restores muscle function. For this, the following drugs are recommended:

  • NSAIDs. They include, in particular, such medications as "Xefokam", "Ortophen", "Ketoprofen", "Indomethacin", "Naproksen", "Movalis" and others.
  • Muscle relaxants. This category includes such means as "Diazepam", "Metaxalone", "Midokalm", "Orfenadrin". With the elimination of muscle spasm in many cases, the intensity of pain is significantly reduced.
  • Glucocorticosteroids. These drugs include "Methylprednisolone", "Flosteron", "Diprospan". This category of medicines is used in the ineffectiveness of NSAIDs and muscle relaxants as a second therapeutic line. The most effective method is the introduction of drugs into soft tissues.
  • Chondroprotectors (Aflutop, Structum and others), drugs that improve blood circulation (Aktovegil, Trental) are also recommended.

Similar articles





Trending Now






Copyright © 2018 Theme powered by WordPress.