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Disc hernia


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Disc hernia is a pathology where a portion of gelatinous mass (pulpous nucleus) moves from the intervertebral fossa, “swelling” the disc, or it pierces and even breaks the outer covering (fibrous nucleus) of the disc.

 

What is the disc hernia?

The disc hernia represents one of the most frequent and painful diseases of the vertebral spine. The intervertebral disc may herniate while executing abrupt, wrong movements, physical effort, with incorrect body mechanics, but in most cases, it herniates following a long wear process, caused by the incorrect posture, multiple mini-trauma, prolonged incorrect position, exposure to cold and draft, prolonged orthostatism, shocks, stress, physical effort (causes of disc hernia).

The context in which the disc disease occurs consists in an unbalanced and insufficiently exercised muscle system.

Occurrence of disc hernia

The disc hernia may have an abrupt start, joined by intense pain and functional impossibility, or insidious start, occurring gradually.

At the beginning, it may be asymptomatic; while it progresses, tolerable pain occurs, developing in unbearable pains

Disc hernia stages

H.D. Saunders describes four stages of disc hernia evolution: :

1. It represents the incipient stage when the nuclear material moves by pushing or penetrating the first few fibers of the fibrous nucleus. Clinically, discomfort occurs, or slight pains, which disappear while resting.

2. Deeper movement of the pulpy nucleus, pushing the fibrous ring. The intervertebral disc “wells” without entering the intervertebral hole, through which the spinal nerves come out.

Clinically, it is characterized by bearable pains, restriction in movements. Short pain is felt, “breathtaking”, as if something was “pinching” the nerve.

3. The pulpy nucleus presses more, being able to deform, pierce through or break the fibrous ring. Thus, the prominent disc potion reaches the internal vertebral hole, where it presses the nervous root. Clinically, the pains are very acute or with wide distribution range, on the trajectory of the compressed nerve. There appear clear neurologic signs.

4.The nucleus migrates outside the disc, the migrated portion being able to flow at the level of the sub-adjacent vertebra. Clinically, very big pains occur, large distribution area, pains on the trajectory of the compressed nerve, clear neurological signs, being able to affect the functionality of certain internal organs.

 

Clinical signs of disc hernia:

  • pain
  • modification of the body posture;
  • motor modifications;
  • sensorial modifications;
  • reflex modifications.
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