Dorsal disc herniation l5-s1: treatment


  • 1Features of dorsal disc herniation l5 s1
    • 1.1The essence of pathology
    • 1.2Causes of the disease
    • 1.3Symptomatic manifestations
    • 1.4Therapeutic events
  • 2Dorsal hernia of the disc what it is
    • 2.1Dorsal hernia
    • 2.2Causes and risk factors
    • 2.3Symptoms
    • 2.4Treatment
  • 3Dorsal hernia of the disc: what is it, the classification and characteristics of the treatment
    • 3.1Dorsal disc hernia - what is it?
    • 3.2Causes of a herniated intervertebral disc
    • 3.3Classification of dorsal disc herniation
    • 3.4Symptoms of dorsal disc herniation in the cervical region
    • 3.5Clinic of a hernia in the lumbar spine
    • 3.6Diagnosis of intervertebral hernia
    • 3.7Treatment of dorsal disc herniation
    • 3.8Prophylaxis of intervertebral hernia
  • 4Symptoms and treatment of the dorsal hernia of the spine
    • 4.1Etiology of the disease
    • 4.2Symptomatology
    • 4.3Types of vertebral hernia
    • 4.4Conservative therapy and surgery
  • 5Diagnosis and treatment of the dorsal diffuse hernia of the L4 L5 disk
    • 5.1The main characterizing parameters
  • 6Dorsal hernia of the disc
    • 6.1Clinical manifestations of dorsal hernia
    • 6.2Diagnosis of the dorsal hernia
    • 6.3Treatment of dorsal hernia
  • 7Herniated disc l5 s1 what is it
    • 7.1Types of hernias
    • 7.2Symptoms
    • 7.3Methods of treatment
    • 7.4Healing Exercises
    • 7.5Operative treatment

Features of dorsal disc herniation l5 s1

Dorsal herniation of the intervertebral disc is a pathology in which there is a rupture of the fibrous rings of intervertebral discs, which leads to the release of its contents towards the nerve fibers and spinal the brain. If we talk about the dorsal hernia as such, then the question of what it is, the "lucky ones" are asked, in whom this education between the vertebral discs was diagnosed.

The appearance of intervertebral hernias is a very painful and complex pathological process that occurs in the case of disc dislocation. This process leads to the fact that the nearest nerve endings start to squeeze, which causes pain.

The essence of pathology

As experts note, the most common localization of the intervertebral hernia is the lumbosacral spine.

As the statistical data show, in medical practice the medial hernia of the disk l5 s1 was most often diagnosed. It accounts for 48% of all diagnosed cases of pathology.

In turn, the second most popular, or 46%, belongs to hernia discs l4 l5. As for the cervical, and thoracic, too, the appearance of hernias was recorded in only 6% of cases.

Medical practice has shown that there are various types of hernias, and the most common of them are the posterior dorsal, the hernia of the disc l5 s1, the median and, finally, the circular one.

Pathology can be differentiated by areas of protrusion. Thus, there are anterior, posterior and medial zones. The anterior dorsal hernia of the disk l5 is localized in the anterior part of the spine, which contributes to exfoliation of the longitudinal anterior ligament.

In turn, the posterior median hernia forms in the center of the terminal portion of the fibrous ring.

This type of disease is considered the most dangerous for the spine.


Similar neoplasms sometimes reach impressive sizes and in some cases can damage the back ligament.


If we talk about the circular hernia of the disc, it is formed during the period of intrauterine development or in case of infection.

If it happens that this new lesion will affect the spinal cord, then for the patient the case may end with a disability.

To solve this problem and cure such a hernia is possible only through surgery.

Another pathological condition that has to do with the displacement of intervertebral discs and is one of the types of dorsal hernia, is paraphoraminal hernia. In this situation, the displacement occurs in the foraminous cavity with spinal cord roots localized in it.

Causes of the disease

The reasons for the development of this new growth in the intervertebral discs are absolutely the same as for any other herniation in the spine. To help determine the exact factor that provoked the development of ailment, only the attending physician will be able to.

Dorsal median disc herniation can occur for reasons such as:

  • spinal cord injuries that occurred at an early age;
  • shock and mechanical damage;
  • obesity or overweight;
  • excessive loads;
  • congenital pathological muscle tone or provoked by excessive weight;
  • lack of physical activity;
  • Abuse of tobacco products;
  • various pathologies that contribute to the destruction of tissues, an example of such diseases can be tuberculosis;
  • other reasons.

As the main factor that increases the risk of developing such a disease, you can call osteochondrosis. Dorsal median disc hernia develops on the basis of osteochondrosis.

This can be a long sitting, which often happens in drivers and programmers. Thus, the uncomfortable position of the body and the not very good pose taken by a person during sleep can provoke the appearance of a dorsal median hernia.

Symptomatic manifestations

Depending on the area of ​​localization of the neoplasm, the signs of the pathological condition will differ. If we are talking about the cervical spine, then in this case the formation of the dorsal hernia will be indicated by the following symptoms:

  • uninterrupted migraine;
  • unpleasant sensations in the neck and upper limbs;
  • numbness of fingers;
  • noise in ears;
  • regular dizziness;
  • weakness in the hands;
  • partial loss of sensitivity in the limbs.

Dorsal lumbar hernia is characterized by the following symptoms:

  • pain in the lower back, the intensity of which increases over time;
  • the occurrence of unpleasant sensations, causing pain, in case of sneezing and prolonged coughing;
  • painful spasms in the pelvis and buttocks;
  • numbness of the lower extremities and a sense of weakness in them;
  • difficulties when a person needs to stand, or in case of being in the same position.

It should be noted that in the lesion of the lumbar region, a median paramedian hernia of the disc l5 s1, as well as l4 l5, is formed.

Therapeutic events

To begin with, it is necessary to understand and accept the fact that effective treatment of the indicated pathological state is possible only if you turn to a highly qualified medical specialist.

And it must be done as soon as possible.

If the qualification of the doctor turns out to be doubtful, then the foraminal disc herniation and therapeutic activities designated by such a specialist for its cure can lead to life-threatening complications.

Usually prescribed medication in combination with fizioprotsedurami.

As part of the treatment of the patient, painkillers and anti-inflammatory drugs will be prescribed to help relieve pain and inflammation.

If the painkillers do not allow you to achieve the desired effect, the doctor will resort to the use of Novocaine blockade.

In order to restore activity and eliminate spasms in the muscles, the patient is prescribed muscle relaxants.

They can be used as an adjunct to conservative therapy.

However, the therapeutic course may include manual therapy, which will achieve a positive effect in treatment and a speedy recovery.

When the form of displacement of the intervertebral disc on the segment l5 s1 is started, the treatment is performed only by a surgical method.


It is for this reason that it is very important for the patient to detect characteristic signs even at an early stage of pathology development.


Only this will get the most positive result of treatment and do without surgical intervention.

If you ignore the symptoms and do not seek medical help, the hernia will continue to increase and develop.

As a result of compression of the nerves, tetraparesis may develop, when all four limbs fail to function, as well as paraparesis - a condition in which the upper or lower limbs do not work.

In some cases, patients experienced disorders in the operation of the pelvic organs, in which incontinence of defecation products or urines occurred.

To exclude the likelihood of such a development of events and receive timely medical assistance, the first painful sensations in the back area are to make an appointment with a doctor and determine the cause of such symptoms.

A source:

Dorsal hernia of the disc what it is

Dorsal hernia of the disc is a severe variant of the development of the vertebral hernia. In this situation, the pulpous cartilage contents go to the side of the spinal canal. Therefore, in such a clinical picture, the risk of neurological complications is above all. Up to paralysis and leg paresis.

Dorsal hernia

Where dorsal disc hernias are formed and what it is is a matter of concern to patients. Intervertebral disks are cushioning structures between vertebrae, consisting of cartilaginous tissue.

They are needed to ensure normal mobility of the spine and not to allow the vertebrae to rub against each other. Such elastic gaps help us move, lift weights, simply walk, turn and tilt our back.

There are intervertebral disks from a soft pulpous core and a dense fibrous ring.

Dorsal diffuse hernia is called if the pulpous nucleus is outwardly backward, toward the spinal canal.


This is the hardest option, because in this area is the spinal cord and most of the nerve roots. The patient has the greatest number of neurological symptoms.


In the beginning, this is only pain, and then - deterioration of mobility and sensitivity of the legs. Possible violations in the work of the pelvic organs.

Causes and risk factors

Dorsal disc hernias can occur for the following reasons:

  • Traumatic effects;
  • Excess body weight;
  • Excessive physical stress;
  • Sharp movements, lifting a large load with incorrect technique;
  • Genetically weak muscular tone;
  • Lack of motor activity;
  • Infectious diseases.

If the patient is predisposed to hernia and even constantly observed by a doctor, it is difficult to say where the rupture of the fibrous ring will be directed.

Usually this happens in the least dense and sheltered place.

The main factor in the development of protrusions, and then hernia - osteochondrosis, degenerative-dystrophic changes in the cartilaginous tissue of the intervertebral discs.

  • We advise you to read:What is a foraminal hernia?

The way of life of modern man has the appearance first of an osteochondrosis, and then a hernia.

We began to move a little, and a large percentage of the population constantly sits at work with a wrong posture. It is not surprising that the muscles supporting the back become weaker.

The load thus increases on them, as the body weight in such situation tends to grow.


Most often, the fibrous disc rings in the lower back are broken. Usually between L4 and L5 vertebrae, as well as L5 and S1. Sometimes occurs at the neck level, between C5 and C6.

In the thoracic region, such ruptures occur extremely rarely, because this is the least mobile and most protected area of ​​the spine. Associated diseases can be infectious inflammation, arthrosis and protrusion of discs.

If they accompany the hernia, treating it becomes even more difficult task.

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When the dorsal hernia manifests itself in the neck, the following symptoms can be seen:

  • Headache;
  • Sore upper limbs and neck, shoulders;
  • The sensitivity of the palms worsens;
  • Roaring in my ears;
  • The head is spinning;
  • It's getting dark before my eyes;
  • Weak upper limbs;
  • The pressure rises;
  • There may be pre-occlusive conditions.

All these symptoms of the neurological type begin to be excruciated because the hernia clamps the nerves and vessels of the neck. As a result, the brain begins to suffer from a lack of blood circulation, and the innervation of the hands worsens.

  • Also read: the head hurts because of illnesses of a backbone

Dorsal hernias of the waist are expressed somewhat differently:

  • Lumbar pain syndrome;
  • Sharp pains during sharp movements, sneezing, coughing and laughing;
  • Pain gives into the gluteal and femoral region;
  • The sensitivity of the legs deteriorates, there is a feeling of "running goosebumps
  • Feels weak in the legs;
  • It is difficult to maintain a static position for a long time, the pain worsens when the patient is standing.

Dorsal hernia of the intervertebral disc causes the greatest number of complications. Risky situation is that the released pulp tissue can begin to press on the spinal cord. As a rule, hernias of this type are quite large.


At first doctors usually try to use only conservative methods of treatment.The patient should be provided with rest and bed rest.

At the same time prescribed medications - non-steroidal anti-inflammatory drugs, such as Diclofenac or Ibuprofen.

Anesthetics will also help, including in the form of an injection blockade of the spine.

If the improvement has not occurred for a long time or there is a danger of a strong negative impact on the spinal cord, the doctors prescribe a surgical operation. The tissues out of the disk are removed. After surgery, a long rehabilitation period is envisaged.

After the acute period or rehabilitation after the operation is over, the patient should think about his way of life.

To prevent a recurrence of the dorsal hernia, you need to lose weight, strengthen the muscles.

So it means - to practice exercise physical therapy, change the diet, swim in the pool.

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A source:

Dorsal hernia of the disc: what is it, the classification and characteristics of the treatment

Pain in the spine is known to many people, not by hearsay. Especially often, discomfort occurs when the body tilts, flexing.

Pathologies of the vertebral department are more likely to be affected by people engaged in heavy physical labor, as well as performing monotonous movements for a long time (at a factory, a garment factory).

The disease that is common among men and women is the dorsal hernia of the disc. What it is? In most cases, people with a middle and old age experience this type of diagnosis.

Nevertheless, when performing heavy physical work, the dorsal hernia of the intervertebral disc can develop in young people. Treatment of this disease is very important to start immediately, as soon as the first signs appeared. In some cases, surgery is necessary.

Dorsal disc hernia - what is it?

The vertebral column is a skeleton skeleton, consisting of 33 (sometimes - 34) articulated structures. They are attached to the ribs, bones of the pelvis and the shoulder girdle. All vertebrae are interconnected by means of discs consisting of fibrous tissue and pulpous core.

The main function of these joints is depreciation. The fact is that while performing any movements (walking, tilting) and lifting weights, the vertebrae converge with each other. If the discs are damaged, bone tissue may also be affected.

The displacement of articulations causes pain syndrome due to compression of the nervous structures. One of the most common diseases is the dorsal hernia of the disc. "What is it?" - ask patients who are diagnosed with this diagnosis.


This pathology develops when the fibrous tissue breaks, due to which a disc is formed. As a result, the joint changes its shape, that is, it protrudes forward (shifts). As a result, the disc tissue enters the area of ​​the intervertebral canal.


For this reason, compression of the nerve structures occurs. With a pronounced displacement of the joints, bone tissue can come into contact and be damaged.

Causes of a herniated intervertebral disc

To understand what a dorsal hernia of the intervertebral disc is, you need to know the reasons for its occurrence. The disease, against which often develops a rupture of the fibrous articulation ring, is osteochondrosis. There are following causes of intervertebral hernia:

  1. Excessive strain on the back.
  2. Injuries of the spine.
  3. Excess body weight.
  4. Pathologies of muscle tissue, in which there is a decrease in the tone of skeletal muscle.
  5. Endocrine diseases.
  6. Bad habits. To a large extent this applies to smoking.
  7. Degenerative diseases, in which the destruction of bone tissue. They include such pathologies as tuberculosis and syphilis.
  8. Systemic diseases (rheumatoid arthritis, SLE).

Most often the hernia develops due to a combination of damaging factors and a violation of the bone structure. Practically all patients with this disease suffer from osteochondrosis for a long time.

Classification of dorsal disc herniation

The most common is the dorsal hernia of the disc.

What is it and what is its difference? The term "dorsal" means that the hernial protrusion is directed from behind, that is, towards the vertebral canal.

In this place is the spinal cord. Depending on the location, the following types of dorsal hernias are distinguished:

  1. Diffuse damage. It is characterized by the fact that it is impossible to establish the exact localization of deformation. Damage covers the entire intervertebral disc.
  2. Medial hernia. In this type of damage, the protrusion of fibrous tissue is directed into the middle of the spinal canal.
  3. Paramedic hernia. It differs in that the protrusion is directed towards one of the sides of the spinal canal.
  4. Foraminal hernia. The protrusion of fibrous tissue fills the canal in which the nerve root is located. In this case, it is compressed and the development of severe pain syndrome.
  5. Dorsal medial-paramedial hernia of the disc is characterized by the fact that the damage is directed from the center (spinal cord) to one of the sides of the spinal canal. That is, the hernia is at an angle. In this case, pain and curvature of the spine are observed.

Symptoms of dorsal disc herniation in the cervical region

In the cervical spine, the dorsal hernia of the C5-C6 disc is most common. In this case, the clinical picture may resemble chronic cerebral circulatory insufficiency (dyscirculatory encephalopathy).

There are symptoms such as headache, high blood pressure, tinnitus. Sometimes it is possible to develop paresis and even paralysis of the extremities. Unpleasant sensations are observed in the neck, extend into the shoulder, under the shoulder blade.

Dizziness and general weakness are common. In addition, the symptoms of cervical hernia include memory loss, performance, visual acuity, sleep disturbance.

Painful sensations arise after bending the head, a long stay in one position.

Clinic of a hernia in the lumbar spine

In addition to the cervical region, protrusion of fibrous tissue often occurs in the lumbar region. In this case, the dorsal diffuse hernia of the L4-L5 disc develops. This pathology is dangerous in that there can be a lesion of the spinal cord.

In this case paresis or paralysis of the entire pelvic girdle occurs. The patient is unable to move. The ability to control the bladder and sphincter of the rectum is also impaired.

These symptoms occur when the disc is destroyed in the medial department. If the lesion is slightly deflected from the center of the spinal cord, the spine is curved. With diffuse lesions, the intervertebral disc can completely collapse.

Therefore, in this case, surgical treatment is often necessary.

Diagnosis of intervertebral hernia

In order for the disease not to lead to disability, a timely diagnosis and treatment of the dorsal hernia of the disc should be performed by the physician. It is possible to suspect this pathology by such symptoms as an increase in painful sensations when walking, tilting and turning the trunk.

To confirm the diagnosis, instrumental examination methods are conducted. The first thing to do is to perform a radiograph of that part of the spine in which pains are observed. In some cases this is not enough.


Therefore, when suspected of a dorsal hernia, a computer tomography of the spine is often performed. Thanks to CT, it is possible to establish the dimensions of the protrusion and its exact location. In addition to instrumental diagnosis, a neurological examination is performed.


Thus, the zones of compression of the nerve roots, the presence of complications (paresis, compression of the vessels) are determined.

Treatment of dorsal disc herniation

Treatment of dorsal hernia of the intervertebral disc begins with medical therapy and compliance with the regime. It is required to completely exclude physical activity, as little as possible to move.

Assign anti-inflammatory drugs "Diclofenac "Midokalm "Prednisolone." Also it is necessary to take the medicines needed to strengthen the bone tissue.

They include preparations "Chondroitin sulfate "Glucosamine "Calcium-D3 Nycomed". In most cases, a special rigid corset is required to strengthen the back in one position.

Also shown gymnastics (held in the position of lying), physiotherapy procedures.

With the progression of pathology and the lack of effectiveness of drug therapy, surgical treatment is necessary. Operation with a large hernial protrusion is a laminectomy.

Doctors resort to it only with acute necessity, since this intervention is accompanied by a risk of developing relapse and complications. With small hernias of the cervical region, microdiscectomy is performed.

It can be performed with a laser.

Prophylaxis of intervertebral hernia

To prevent the emergence of a hernia, it is necessary to perform special exercises to strengthen the muscles, to exclude smoking, to periodically take vitamins containing calcium. In the presence of osteochondrosis, it is necessary to visit a neurologist at least 1-2 times a year and follow the doctor's recommendations.

A source: http://.ru/article/276457/dorzalnaya-gryija-diska-chto-eto-takoe-klassifikatsiya-i-osobennosti-lecheniya

Symptoms and treatment of the dorsal hernia of the spine

The rupture of the fibrous ring of the intervertebral disc, followed by the release of the gelatinous (pulpous) nucleus, is a hernia. Such a concept as a dorsal hernia of the disc or "posterior" is a protrusion into the epidural region, clamping the spinal canal and nerve roots.

Dorsal hernia is more often formed in the lumbar (L4-L5), lumbosacral (L5-S1) and cervical vertebral segment (C5-C6).If the hernial protrusion exceeds 5-6 mm, it can squeeze the dural sac (canal), and this is fraught with serious complications.

Etiology of the disease

Such a disease as osteochondrosis usually precedes the formation of a hernial protrusion.

The disease is accompanied by degenerative-dystrophic processes, dehydration, deterioration in the supply of connective intervertebral tissue (intervertebral disc) - thinning, it, cracked and out comes out the nucleus, formed hernia.

Dysplasia (congenital disease) also contributes to the formation of protrusion - the connective intervertebral tissue does not withstand the stress exerted on the spine. Dorsal hernia of the disc occurs due to some other reasons:

  • excessive body weight, excessive physical activity causes the hernia of the lumbosacral segment (L5-S1);
  • incorrect posture - a factor provoking the ailment of segment C5-C6;
  • suffered injuries;
  • infectious ailments of the spine;
  • advanced age;
  • bad habits (especially smoking);
  • deterioration of metabolic processes.

The formation of a hernia is often accompanied by such diseases as spondylosis, spondylarthrosis, protrusion, but an integral part is nevertheless osteochondrosis.


Pressing the nerve roots and the spinal canal, dorsal protrusion provokes a pronounced neurologic syndrome. As already mentioned, the "posterior" or dorsal hernia of the disk affects segments L5, L4, S1, C5, C6.

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If the pathological protrusion occurs in the cervical segment (C5-C6):

  • there are dizziness, headaches;
  • vision deteriorates;
  • there is a noise in the ears;
  • pain when turning the head;
  • blood pressure rises.

The dorsal hernia of the C5-C6 disc clamps the blood vessels, which poses a serious danger to the brain - a lack of oxygen and nutrition leads to complications, even a stroke.

Also, if the segment C5-C6 is affected, numbness of the upper limbs arises, the paresis of the fingers - lack of proper treatment is fraught with complete paralysis of the hands.

The pathology of the lumbar segment (L4-L5) is accompanied by:

  • a pronounced pain syndrome in the lower lumbar region, with a sharp movement, sneezing, or coughing aggravating the patient's condition;
  • there is swelling;
  • Foot and toes numb, pain appears.

Dorsal hernia of the disc L4-L5, S1 can squeeze the spinal canal - this is fraught with paresis of the lower extremities.

Pathology of the lumbosacral segment (L5-S1):

  • Lumbar pains that give to the lower limbs;
  • reduction of skin sensitivity, numbness of the legs, which complicates movement;
  • there are problems with urination and defecation.

All neuro-reflex syndromes are characteristic for pinching the nerve endings of the intervertebral discs of segments S1, L5, L4.

Types of vertebral hernia

The posterior (dorsal) hernial protrusion of the disc may be of different directions in relation to the spinal canal, so the dorsal pathology is subdivided according to the types:

  • diffuse;
  • paramedical or paramedian;
  • medial or median;
  • medial-paramedial;
  • foraminous.

"Back" diffuse hernia - the danger of this pathology is that the entire disk is affected and under the influence of unfavorable factors (excessive loads), the risk of its complete destruction is great, the person becomes disabled. Treatment is purely surgical intervention.

Paramedic hernia (segment L5-S1) and medial-paramedial - is fraught with the development of scoliosis in the opposite protrusion side - there is a curvature of the spinal column. Curvature can lead to the displacement of the hip joint, dysfunction of internal organs.

Paramedial hernia also implies treatment by surgery. Median or medial pathology (L5-S1) - is reflected in the function of urination, the act of defecation.

It causes a decrease in the sensitivity of the lower extremities, coccyx, buttocks. The danger is a complete loss of motor activity of the legs.


At the initial stage, conservative treatment is applied, if the disease progresses, surgical intervention is indicated.


Foraminal hernia occurs in segments L5-S1, L4-L5, less often L3-L4 - accompanied by intense pain syndrome, with which the patient is difficult to move, tendon, flexion-extension reflexes become dull, a person can not rely on on his feet.

Conventional analgesic drugs do not help, drugs are used. This type of hernia involves surgical intervention.

Conservative therapy and surgery

The doctor or neurologist or vertebrologist diagnoses and prescribes treatment. The patient undergoes a CT or MRI scan, while he is prescribed NSAID (ibuprofen, midokalm, other), as well as bed rest. With severe pain, lidocaine or novocain blockade is done.

A week later the patient is allowed to get up, but the load on the spine is forbidden. In this case, the doctor recommends wearing an orthopedic supporting corset.

To the drugs of the NSAID group the patient is added the use of chondroprotectors, muscle relaxants, vitamins and minerals - this is a recovery therapy for bone-cartilaginous tissue, metabolic processes. In addition, the patient undergoes a course of massage and physiotherapy procedures.

Further, after cupping the pain syndrome and improving overall well-being, a set of physical exercises is recommended - exercises are performed, lying down or using inclined simulators.

Surgery is indicated if conservative therapy has not yielded results and the patient's condition has worsened. In the absence of proper treatment, dorsal hernia can provoke serious complications - complete loss of sensitivity of the limbs and, as a consequence, disability.

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A source:

Diagnosis and treatment of the dorsal diffuse hernia of the L4 L5 disk

  • 06-03-2015
  • 49


  • The main characterizing parameters
  • Timely diagnostics
  • Qualitative and correct treatment

During the degeneration of the intervertebral disc, complications such as a dorsal diffuse hernia of the L4 L5 disc may occur.

The intervertebral disc consists of a jelly-like (gelatinous) core enclosed in a rigid fibrous capsule.When this core protrudes outward (protrusion of the disc) through the weak place of the capsule, disc herniations occur.

The main characterizing parameters

Dorsal hernias can be caused by the following reasons:

  1. Degenerative age processes in the spine (due to osteochondrosis). The rigid fibrous ring begins to weaken, the jelly-like inner core under pressure of weight is pushed through it, forming a herniated disc.
  2. Herniated disc may be caused by trauma.
  3. Combination of degenerative process and spine trauma.

Predisposing factors:

  • excess body weight causes additional stress on the spine, especially its lumbar region;
  • occupation - people with physically hard work, athletes (for example, weightlifters) have an increased risk of disc herniation;
  • genetic predisposition.


  1. Degeneration of the disc - at this stage there is no protrusion of the gelatinous nucleus, it is weakened due to chemical processes in it and age.
  2. Prolapse (protrusion) - there is a protrusion of the nucleus through a fibrous capsule, which can squeeze the roots of the nerves or the spinal cord and cause the corresponding symptoms.
  3. Extrusion - gelatinous core breaks the fibrous capsule, but still remains inside the disc.
  4. Sequestration - the core moves beyond the intervertebral disc.

Dorsal hernia of the disc can directly press on the nerve roots that go to the buttock, leg, pelvic organs.

Common symptoms of hernia:

  • pain in the lower limb (sciatica), lower back and buttock, which can be independent or combined with lower back pain, usually the pain in the leg is more pronounced than in the lower back;
  • paresthesia in the lower limb (numbness, goose bumps);
  • loss of control over acts of urination and defecation, which may be a symptom of such a serious complication as horse tail syndrome.

Symptoms that have a dorsal diffuse hernia of the disc L5 S1 and L4-L5, are due to its localization:

  • a violation of innervation at the level of L4-L5 can cause difficulty in withdrawing the thumb and raising the foot in the ankle joint;
  • loss of function at the level of L5-S1 can cause weakness in the calf muscles (a person can not push off, lift the toe of the foot).

To diagnose this disease, you need to consult a doctor (neurologist, neurosurgeon), who examines the patient's back, checks the volume movements of the legs in different positions (lying, standing), muscle strength, walking ability, sensitivity, presence or absence of reflexes on the lower extremities.

To clarify the diagnosis and localization of intervertebral hernias, the following methods of instrumental diagnostics are prescribed:

  1. Radiography - with her help, hernias are not detected, but she helps to exclude other causes of pain: swelling, curvature, trauma.
  2. Computed tomography - with its help a series of images of transverse sections of the spine, which can be seen the presence of hernias.
  3. Magnetic resonance imaging is the most reliable diagnostic method in this case.

Apply painkillers and anti-inflammatory drugs (ibuprofen, diclofenac sodium), narcotic drugs (for a short time), muscle relaxants (to relieve muscle spasm), hormonal drugs (especially in the form of blockades - the introduction of the place of departure of the nervous rootlets).

Physiotherapy is one of the most effective methods of treatment. It consists of a whole complex of body positions and exercises, stretching, massage, ultrasound method, electrostimulation.

A small number of patients need surgical treatment.

A doctor can offer surgery if the patient has a conservative treatment ineffective for 6 weeks.


Especially if the patient is experiencing numbness or weakness in the leg, the inability to walk or stand, the loss of control over the bladder or rectum.


In most cases, the neurosurgeon removes only the protruding part of the disc. If the entire disc is removed, it may be necessary to implant the metal to stabilize the vertebrae. Implantation of artificial intervertebral discs is also possible.

A source:

Dorsal hernia of the disc

Dorsal herniation of the intervertebral disc- this is one of the varieties of hernias, in which the extension of the vertebra occurs in the lumen of the spinal canal and is accompanied by a jamming of the nerve roots. The danger in this case is that this pathology can lead to a change in the conductivity of signals over the spinal cord or roots due to narrowing of the spinal canal.

If you are diagnosed with a "dorsal hernia" and you do not know what it is, read this article and find out all the necessary information. It should immediately mention that this type of hernia is considered the most dangerous and requires immediate treatment for medical help.

It can be obtained at the Department of Neurosurgery of the multi-field CTEL clinic. Our specialists will carry out all the necessary manipulations in order to ease your suffering and restore your health.

Depending on the type of operation and complexity category
from 100 000 - 250 000 rubles.

Included in the price:

surgery, anesthesia, dressings, medicines, food and hospital stay, observation by a surgeon in the postoperative period.

40-60 minutes

(duration of operation)


  • persistent and severe symptoms of compression of the spinal nerves of the herniated intervertebral disc, not amenable to conservative therapy
  • the patient's desire to get rid of the pain syndrome


  • chronic diseases in the stage of decompensation
  • acute inflammatory processes in the body

Clinical manifestations of dorsal hernia

Dorsal hernias of the discs of the lumbar region are characterized by strong sharp pain sensations, difficulty in movement and severe neurologic symptoms.

This is due to the fact that tissues of the nervous system are involved in pathology.

In addition to the severe pain that does not pass, the clinical manifestations of this type of hernia include the following:

  • Severe pain syndrome in the back with spreading to the arm or leg.
  • disorders of sensitivity in the pathological process;
  • complete loss of sensitivity (with a running form);
  • weakness in the muscles.

The most common dorsal hernia of the disk is L5-S1, L4-L5, since the spine in which it is located is most affected by the load. The disease leads to serious violations of motor activity, its limitations.

The dorsal hernia of the C5-C6 disc is also a frequent phenomenon. Pain sensations are localized in the cervical spine, but necessarily irradiate into the arm. As the hernia increases in size, the following symptoms appear:

  • numbness of the hand from the affected side;
  • tingling sensation in the hand;
  • muscle weakness;
  • difficulty in manipulating the hand;
  • pain similar to migraine.

Diagnosis of the dorsal hernia

Treatment of dorsal disc herniationin clinic TSELT it is appointed or nominated only after the diagnosis is precisely established or installed. Our experts are the first to direct our efforts to this.

This is helped by the best diagnostic equipment of foreign production, which allows promptly and accurately establish the diagnosis, determine the size, degree of protrusion and the location of the dorsal hernia.

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In addition to visual examination and collection of anamnesis, the following can be performed:

Treatment of dorsal hernia

Treatment of dorsal hernia in the CTELT clinic is carried out using modern equipment and preparations and allows to achieve the desired results.

As a rule, it is carried out by conservative or minimally invasive methods, operations are resorted to with indications or in the event that the above does not bring good results.

It is not the first year in our clinic that epidural blockades are practiced, which have not only an anesthetic, but also a therapeutic effect.

The introduction of the drug directly into the affected area allows you to relieve even severe pain symptoms, relieve inflammation and delay, or even abandon the operation altogether.

Surgical intervention provides for a minimal incision, which does not exceed one and a half centimeters, minimizes blood loss and a patient's health risk. The recovery period after the operation is no more than two weeks.

I want to say thank you very much! Andrey Arkadevich is a professional with a capital letter. Did or made at it or him operation on excision of a hernia of L5S1 in the extremity or end of February. I got up the next day and since then I've forgotten what back pain is. I went a long way, was at the consultations of many doctors. Since a person who was used to making the right decisions, could not afford the right to make a mistake in choosing a doctor. I can say with certainty that I have never met a doctor like Andrei Arkadevich, and among ordinary people. A person with another... Make an appointment with the application or by phone +7 (495) 788-33-88

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Herniated disc l5 s1 what is it

Herniated disc l5 s1 occurs between the first sacral and fifth lumbar vertebrae and is characterized by rupture of the vertebral disc under the influence of pressure on the lumbar part or due to the transferred injuries. The disease is deciphered as follows: L - "lumbar that is, the lumbar region, and S - "sacrum" or sacral. The numbers denote the ordinal number of the vertebra.

The lumbar division consists of five vertebrae, which connect with each other by vertebral disks.

They regulate the pressure on the vertebra, ensuring its uniform distribution, and are responsible for mobility.

When a hernia arises, the mechanism fails, the disc protrudes, the nerve endings become infringed and pain syndrome arises.

Intervertebral hernia of the lumbar spine is diagnosed quite often, since it is to the area lumbar carried the greatest load: the center of gravity of the person, weight and maximum mobility disks.


The danger of a hernia is the severe consequences that arise when there is no proper treatment.


In addition to severe pain and discomfort in the back, the intervertebral hernia can be the result of a full or partial disability.

Types of hernias

In medicine, several types of disc herniation l5 s1 are distinguished, proceeding from the direction in which the output of the pulpous nucleus is formed:

  • Dorsal. The exit of the disk occurs in the region of the spinal nerves.
  • Paramedical. The core protrudes to the left or right of the spinal cord.
  • Circular. The hernia is formed over the whole area of ​​the spinal canal.
  • Medial. The formation occurs on the median line to the spinal canal.

The main causes of disc herniation l5 s1 are:

  • transferred in childhood dysplasia of the hip joints;
  • osteochondrosis, scoliosis, postural disorders and congenital curvature of the spine;
  • physical activity and sports injuries;
  • long stay in a sitting position ("sedentary" work);
  • Accident, which results in "whiplash" injuries (sudden head movement forward, then tipping back);
  • improper treatment of dysplasia in childhood, resulting in a skewed pelvis;
  • unbalanced nutrition;
  • bad habits (smoking reduces the level of oxygen saturation of blood, coffee worsens blood circulation in vertebral tissues);
  • adynamia (lack of exercise);
  • gynecological diseases that cause weakness of ligaments and muscles;
  • lack of phosphorus and calcium.

After an accident and injury, the intervertebral hernia can make itself felt after one and a half to two years. All this period the disease is asymptomatic.


Very often, a sharp pain in the lower back appears when bending forward and carrying weights in front of you. The arisen pain syndrome may persist for a long time, while periodically blocking the movement and forcing the patient to "stiffen" in one pose.

Sequestered herniated disc L5-S1 on the right.

The disease has a pronounced symptomatology that interferes with the patient's habitual way of life. Acute or increasing pain in the back is the main sign of hernia of the spine. The disease can have other symptoms:

  • pain extends to the leg, spreads through the thigh to the knee and ankles, numbness of the limbs can be felt;
  • with a long standing or standing position, the body "closes
  • a sensitivity disorder in the lumbar region, buttocks;
  • a sense of "goose bumps a weakening of the functions of the big toe;
  • presence of "a cough push" (at a sneezing and a cough the pain can amplify).

Sometimes the intervertebral hernia can occur in several places, then the symptomatology can overlay and differ from the generally accepted.

Methods of treatment

In the treatment of the intervertebral hernia of the lumbar region, it is very important to go through a comprehensive examination in advance and identify pathology.

In time the diagnosed disease lends itself to non-surgical treatment, in the early stages of the disease it is possible to stop its progression and prevent the development of complications.

At the beginning of the treatment, the main task is to eliminate the pain syndrome, restore the muscular corset, remove the subluxations of the vertebrae and strengthen the joint surfaces. Often, the patient is prescribed medication in combination with curative gymnastics.

Medicamental treatment involves the acceptance of a number of active drugs:

  • muscle relaxants (to eliminate spasm from the muscles);
  • anti-inflammatory drugs (eliminate pain and inflammation);
  • vitamins of group B (allow a nervous impulse to pass to muscular tissues along a pinched nerve);
  • Chondroprotectors (involved in the process of restoring cartilage, which carries nutrients into the intervertebral disc);
  • Novocaine-glucocorticoid blockade (for pain relief).

Drugs should only be prescribed by a doctor. For children and pregnant women, individual treatment is selected, since taking medications can negatively affect a child's organism or intrauterine development of the fetus.

To strengthen the muscles and relieve tension, the patient is recommended to undergo a massage course.

Only an expert should conduct it, because unprofessional impact on the damaged part of the spine can aggravate the patient's condition and lead to irreversible consequences.

Massage procedures lead to toned weakened muscles of the legs and back, participating in strengthening the lumbar spine.

One of the alternative ways to treat a hernia is hirudotherapy.

The method itself is not capable of completely healing a hernia, but in combination with other medical measures, it significantly improves the patient's well-being.

Hirudotherapy improves blood circulation in damaged vertebrae and helps relieve tension in the problem area.

Physiotherapy methods, such as electrophoresis, magnetotherapy and diadynamic currents, relieve acute pain and promote relaxation of the invertebral muscles. After applying the physiotherapy, the patient improves the nerve conduction to the strangulated discs.

When the herniation of the lumbar region occurs, doctors recommend training on special simulators. Their application is aimed at stretching the spine and complete restoration of the muscular corset of the spine. Particularly effective is the swing Yulin.

This simulator is designed in the form of a vertical swinging frame with a counterweight located in the lower part. The patient can relieve the load from the spine and pull out the damaged segment during training.

Such exercises are recommended not only for patients with diagnosed hernia, but also for the prevention of this disease.

Healing Exercises

Physical stress on the spine and the muscles of the press relieve tension and strengthen muscle tissue.

Since the lumbar region is the main part of all the loads, the pain that arises can be quite inconvenient. There is a complex of exercise therapy for patients with vertebral hernia.

Exercise does not require additional physical training, they can be performed at home at a time convenient for the patient.

1Lying on the back, pull the upper and lower limbs along the body. Slowly lift the body, without lifting your legs from the surface. Frozen in this position for ten seconds. After, slowly rush back to the starting position. It is necessary to carry out 5-10 approaches with an interval of thirty seconds for rest.2Lie on your back, hands are placed along the trunk, and your legs are slightly bent at the knees. Try to strain the abdominal muscles and hold them in this position for a few seconds. At the same time, without holding your breath. Repeat the exercise ten times.3Lie on a flat surface, legs bend at the knees. Pull out one hand and touch it with the opposite knee. Create a small resistance. After repeating with the other hand. Necessary number of approaches 10-15.4Sit with buttocks on the heels, hands stretch out in front of you. The palms should touch the floor. Try to maximally stretch your arms forward, while not tearing your buttocks. Repeat at least five times.5Lying on a hard surface, hands are placed along the trunk. Slowly inhale and pull out the extended arms to the head. Loins do not tear off the surface, do not bend your legs. On exhalation, hands are returned to the "at the seams" position. Do it ten to fifteen times.

Operative treatment

When conservative ways to eliminate lumbar hernia do not give visible results, doctors resort to surgical ways of eliminating the disease.

The main signals to the operation can be acute pain, which can not be cured even anesthetics, defecation, urination disorders, or complete or partial paralysis of the lower extremities.

Often, the operation is carried out through a small incision. The doctor removes the damaged area of ​​the disc, which puts pressure on the spinal cord or nerve endings. Its extraction is carried out by "sucking" the negative pressure or evaporating the disk with a laser.

The procedure for the operation to remove the disc herniation l5 s1.

Very rarely a full-scale operation is performed when the affected area of ​​the intervertebral disc is removed by standard surgical instruments through a large incision. This method has many shortcomings, among which, a long rehabilitation period.


The positive result of the treatment of the lumbar hernia depends on the timeliness of the treatment started and the correct diagnosis of the disease.


The disease is easily amenable to conservative treatment without resorting to surgical intervention.

Fulfillment of all appointments of the doctor will relieve the symptoms of a hernia and help to completely eliminate pathology, while avoiding recurrence and complications.

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