Circular protrusion of the disk l3-4: what is it?

Circular protrusions of the spine discs L3-L4, L4-L5, L5-S1

Circular protrusion of the disc (what is it)? Given the prevalence of the problem, this question sounds quite relevant.

The problem with this pathology arises from the negligent attitude towards it, when the doctor only needs to go to the advanced stages.

However, it should be clearly understood that the most effective treatment is carried out only at an early stage of the disease, and when irreversible changes occur it becomes a long and complex process.

The essence of pathology

In general, the notion of protrusion of the spinal discs involves their protrusion beyond the anatomical boundaries. Unlike the intervertebral hernia, the protrusion develops without destroying the outer shell, i. E. fibrous ring.

Given this condition, it is often considered the initial stage of a hernia. When protrusion is not observed significant destruction of tissues, but pinching of nerve fibers occurs, which causes pain syndrome.

The development of the disease conceals the danger of serious destructive complications.

Circular protrusion of intervertebral discs is one of the types of this pathology, in which There is an extrusion of the disk evenly along the vertebral perimeter, i.e. in a circle or circularly.

As a result, the internal tissues of the ring may be damaged, but the sheath itself remains intact, which ensures that the gelatinous core is retained inside.

Circular protrusion can develop in any of the departments of the spine. In this case, the dimensions of the protrusion can be in the range 4-11 mm, and the deviation of the uniformity of extrusion is not more than 1 mm.

Because of the formation of lordosis of anatomical nature, lesions are most often localized in the lumbosacral vertebral column. Very often they speak of a circular protrusion of the L3-L4 disc.

Especially dangerous is the protrusion of the L5 - S1 disc, which connects the fifth lumbar and first sacral vertebra, right here leaves the spinal nerve plexus, involved in the regulation of the functions of the lower limbs and organs of the small pelvis.

Also very often people suffer a circular protrusion of the L4-L5 disc.

Varieties of pathology

Circular protrusions can have their own specific characteristics, and therefore classify such varieties of the disease:

1. Uniform (ring) protrusion. This type implies a uniform flattening of the disc, which leads to its bulging circularly. In this case, the symptoms of pathology most often do not have a clear expression.
2. Back-circular or circular-dorsal type. The main deformation is directed towards the spinal cord, which causes the risk of developing stenosis and transformation into a herniated spine.
3. Circular-foraminous type. This is the most dangerous form of protrusion; causes severe pain due to pinching of nerve fibers. This pathology is dangerous even when the size of the protrusion is less than 5 mm. There may be loss of sensitivity and peripheral paralysis.

In the pathogenesis of pathology, there is a fairly clear tracing of the degree of severity of the lesion:

• Stage 1 or mild degree. Characterized by the appearance of microscopic cracks and small structural changes in the internal fibers of the fibrous ring.
• Stage 2 or moderate severity. A small protrusion is formed outside the vertebra, but its size does not exceed 3, mm. As a result of the compression of the nerve roots, a pain syndrome appears on the affected area of ​​the spine.
• Stage 3 or a dangerous degree of injury. The extrusion size of the fibrous ring exceeds 6 mm, which causes the risk of destruction of the membrane with the subsequent transition to the intervertebral hernia.

Etiology of the phenomenon

Most often protrusions of the disc develop in people older than 40 years, which is due to the fact that the intervertebral node undergoes degenerative-dystrophic changes, especially during flow osteochondrosis.

The protrusion of the disc occurs when the structure of the cartilaginous tissue is disturbed and excessive loads are exerted. We can single out the following factors that provoke an abnormal process:

1. spine trauma;
2. frequent physical overloads and excessive size, which is especially dangerous if they are mis-distributed on the spinal column;
3. diseases of an exchange character;
4. pathology of the spine;
5. malnutrition;
6. posture with curvature of the spine;
7. poor development of muscles;
8. hereditary predisposition.

How does the disease manifest itself

The symptomatology of circular protrusion depends on the localization of the lesion, i.e. from which part of the spine suffered most severely.

At the initial stage of the pathology manifestations are not of a pronounced nature.

There is a slight discomfort, especially in the evening, after a working day, which is usually perceived simply as fatigue.

Progression of the disease leads to characteristic manifestations. When protrusion discs in the cervical spine, the following symptoms are distinguished:

• pain sensations of different intensity in the neck region with irradiation into the shoulder girdle and upper limbs;
• decreased muscular tone;
• loss of sensitivity (especially numbness of the fingers);
• multidirectional change in blood pressure;
• headache;
• noise in ears.

When the focus is located in the lumbosacral spine, such characteristic signs appear:

1. lumbar pain syndrome with chronic course and its irradiation during exacerbation in legs;
2. symptoms of sciatica;
3. low muscle tone in the gastrocnemius and femoral region;
4. disturbances of urination;
5. loss of sensation in the feet.

As a result of muscle spasms, the motor capacity may be limited. The defeat of the thoracic region is recorded very rarely. In this case, there are pains in the center of the back, in the form of intercostal neuralgia, weakness of the muscles of the press.

Diagnostic measures

The primary diagnostic method for detecting disc protrusion is radiography.

These studies do not allow for an accurate diagnosis, but the probability of this pathology can be estimated.

With the development of the disease in the first stage, clear boundaries of the vertebrae and small deflections of their plates are observed.

Damage to the end plates of the vertebrae is observed, and the discs themselves become similar to the biconcave lens, but sometimes take the form of a fin fin.

In the study of vertebral protrusions, it is senseless to use ultrasound; this method will not give any information.

Clarification of the diagnosis after X-rays is performed with the help of MRI and computed tomography.

These methods make it possible to determine the size of the protrusion, the state of the fibrous ring, structural changes in the disc.

Therapeutic possibilities

At an early stage, the disease does not conceal a great risk to human health, and the measures taken at this stage help restore the intervertebral node.

The most important principle of treatment is the timeliness of its onset.

At the third stage, the risk of complications is very high, sometimes you have to resort to prompt surgery.

The main method of treatment of circular protrusions is complex conservative therapy. In the process of its carrying out the following tasks are solved:

• elimination of symptomatic manifestations (pain syndrome);
• cessation of disease progression;
• restoration and strengthening of the structure of tissues;
• prevention of neurological disorders, development of vertebral hernia and other complications.

The most common treatment is provided by the following scheme:

1. Medication effect. The basic drug is Diclofenac. For anesthesia, non-steroidal anti-inflammatory drugs (Ibuprofen, Ketoprofen) are used. The complex therapy includes diuretics in the formation of puffiness; muscle relaxants for normalization muscle activity (Tizanidine, Tolperisone, Baclofen); corticosteroids in severe course of pathology (Tizanidine).
2. Extraction and fixation of the spine on special equipment. This procedure is not recommended to conduct independently.
3. Medical gymnastics, and exercise therapy should develop a specialist, taking into account the localization of the lesion, the state of the organism, age and sex of the patient.
4. Acupuncture and manual therapy, which involves exposure to special biologically active points.
5. Physiotherapy. The most effective technique is the effect of diadynamic current pulses. It finds application of temperature influence, electrophoresis, mud therapy and some other technologies.

With the timely adoption of adequate measures, circular protrusion is not very dangerous for human health. However, if the pathology is started, then serious complications that could lead to disability are possible.

A source: https://OrtoCure.ru/pozvonochnik/protruziya/tsirkulyarnaya-protruziya-diska-chto-eto-takoe.html

L3-L4 disc protrusion: varieties, complications and distinctive features

Protrusion - displacement of the disk located between the vertebrae, to the side. In modern medicine this is a common phenomenon.

Every day a lot of people are drawn to the neuropathologist, who are concerned about back pain. Recently, this worries not only adults and the elderly, but also youth.

L3-L4 disc protrusion is rare, in only 4% of cases, but it can be very inconvenient. This intervertebral disc is located in the mid-lumbar region, an area that experiences large loads every day.

Difficulties

The pathology in the area of ​​the L3-L4 disc is difficult to diagnose. The most difficult thing is not just to determine the presence of the disease, but to reveal the stage of its development and the form of the course. It is from these factors that the subsequent treatment depends.

When the right or left bundle of nerves of the L3-L4 department is irritated, the probability of developing vertebrogenic radiculopathy is not ruled out.

Classification

Varieties of protrusions have different effects on the human body. This will determine the symptoms of the disease and the subsequent treatment. All pathologies in the mid-lumbar region can be divided:

• The posterior protrusion is directed towards the cerebral canal. It is the cause of compression of nerves and fibers, and the emerging pain sensations while concentrating exactly in the affected area;
• Diffusive - an uneven variety of protrusion, which is observed simultaneously in several segments of the spine;
• Lateral - a pathology that occurs in 25% of cases. It is detected quickly, the main symptom is a sharp pain;
• Circular - a dangerous lesion, in which the sciatic nerve is squeezed.

Symptomatology

Symptoms in the lesion of the L3-L4 zone include:

1. Painful sensations. At the first stages of the formation of pathology, they are mild in nature, but with time, they begin to increase and become more frequent. As a result, this syndrome turns into chronic low back pain;
2. A characteristic click in the affected area, after which the pain begins to increase sharply;
3. The pain subsides in a calm and relaxed position, but again increases with movements or after sports;
4. With further development of the pathology, pain begins to be transmitted to the lower limbs. Over time, it will capture the entire surface of the legs;
5. A distinctive syndrome is a symptom of Lasega. Thus the patient feels unpleasant sensations at an inclination of a head in the right or left party. And also when lifting an even foot.

Distinction

The difference between L3-L4 protrusion is that, with further development without treatment, the disc will pinch the rootlet L3. This is possible in those situations, if there is a foraminal or lateral pathology.

Signs of his pinching:

• The pain instantly spreads over the leg, most of all it is felt in the knee area and the front side of the thigh;
• Numbness of the lower limbs, tingling in the big toe;
• Gradual weakening of muscles. This affects the functionality of the shin and performance.

Another characteristic feature is the possibility of pinching the spine L4. This can happen if the central protrusion was diagnosed.

The following symptoms are observed:

1. Pain in the upper thigh area;
2. Tingling in the lower leg;
3. Disturbance of sensitivity;
4. Significant weakening of the quadriceps muscle.

Treatment

Attention! Protrusion is the beginning of the formation of intervertebral hernia, so it is recommended not to hesitate with its treatment.

Pathology in the mid-lumbar region can be cured without surgery. Conservative methods include:

• Carrying out of sessions of massage. Trust this only recommended to an experienced professional. It is recommended to carry out the procedure using essential oils, warming ointments or creams. They improve blood circulation, which has a positive effect on the affected segment;
• Manual therapy- a procedure that allows you to remove swelling of muscles and tissues. This allows you to quickly restore the previous activity and mobility;
• Therapeutic exercise or gymnastics- a set of measures aimed at strengthening the muscles of the affected spine and improving blood circulation. Before starting the classes, it is recommended to coordinate their implementation with the attending physician. During exercise, the patient should not feel discomfort or fatigue;
• Spine Extraction- this procedure allows you to increase the space between the vertebrae. The disc and vertebrae are fixed in this position, so their displacement and swelling slows down or stops completely.

These measures are recommended only at the first stages of the appearance of pathology. If the protrusion is already started, but there is no pain, the doctor will prescribe a course of acupuncture. It activates the movement of blood and its inflow to the affected area.

Also, during the treatment period, it will be necessary to abandon physical activities of any kind, with the exception of exercise therapy, and lifting heavy loads.

The food should be in accordance with the following principles:

1. On the day the patient is recommended to take food five times in small portions at regular intervals;
2. It is forbidden to eat pure fats. They need to be combined with proteins;
3. All products must be fresh. Poisoning or overeating leads to destabilization of the affected area;
4. You can eat vitamins separately. The rules and the course of their admission must be agreed with the doctor.

When protrusion it is recommended to take turpentine baths. They have a positive effect on the circulatory system and relax the lumbar muscles, which eliminates muscle spasms.

Baths are recommended to be taken twice a week. The period of admission should not be more than twenty minutes. They are forbidden to people with a weak cardiovascular system.

Possible complications

Complications in the mid-lumbar region, in the absence of proper treatment, can be as follows:

• Lumbago - pain in the lumbar region, because of which the patient can not straighten his back. Often this complication is observed with dorsal pathology. Even the loss of the L3-L4 disc by 2-3 mm can lead to the appearance of a lumbago;
• Weakening of the gluteal muscles and fast fatigue of the legs - all this is observed in this disease. At the same time there may be paresthesia - loss of sensation of the legs;
• Involuntary urination, disruption of the excretory system, lack of control of the bladder - this leads to a diffuse protrusion of the mid-lumbar region;
• Rear protrusion at the first stages of formation can lead to a strong pain symptom, which does not abate until the moment of taking painkillers.

The protrusion of the L3-L4 disc requires special attention. It is located in the mid-lumbar region, so this pathology is often accompanied by many complications.

A source: http://gryzhi-net.ru/protruzija-diska-l3-l4/

L4 L5 disk protrusion: what is it, causes, symptoms, diagnosis and treatment

The human spine acts as a shock absorber. The anatomical structure of the spinal column makes it possible to soften the axial load on it. In some situations, the pressure on the spine may increase.

There are a number of professions in which the vertebrae experience loads all working hours (driver, accountant, writer, athlete). Intervertebral interlayers can extend beyond the vertebrae, and this is called protrusion.

Pathology is more common in the lumbar region. The protrusion of the L4 L5 disk - what is it?

What is most important in the spine?

Between the vertebrae are disks, which by their nature are cartilage. The disc repeats the rounded shape of the articular surfaces of adjacent vertebrae.

The periphery of the disc is a multilayered fibrous capsule, and the center is a gelatinous nucleus. The central component of the disk is a gel-like substance. It smooths the pressure on the vertebrae during the load.

The greatest height of the disc in the lumbar region, then it decreases in the direction to the coccyx.

Changes

The protrusion of the L4 L5 disk - what is it? How is it determined?

It is a protrusion of the disk beyond the intervertebral space. Most often occurs in the lumbar region, because it carries the greatest burden. The disk most often suffers between L4 and L5.

When exposed to damaging factors, the fibrous ring becomes thinner, microscopic fiber breaks occur. At the same time, its integrity is preserved.

When the degree of protrusion increases, the fibrous capsule breaks and the jelly substance exits into the space between the vertebrae. This pathology is called the intervertebral hernia.

Causes of protrusions

1. Osteocondritis of the spine. The discs are fed diffusely from above and below the vertebrae. When osteochondrosis, metabolic processes and blood circulation in the spine are disturbed. Intervertebral "interlayers" lack nutrients, water, and lose their elasticity. Protrusion is the end result of osteochondrosis.
2. Injuries to the spine, which can disrupt the structure of the disc.
3. Excessive burden on the spine. It can occur with a sudden rise in gravity.
4. Background diseases of the spine - Bechterew's disease, tuberculosis spondylitis, osteomyelitis.
5. Overweight.
6. Hereditary diseases of connective tissue.
7. Weakness of the muscular corset of the back.
8. Violation of posture and curvature of the spine.
9. Age changes.

The main types of protrusion of the intervertebral disk L4 L5

Differ by the nature and direction of protrusion.

• Circular - there is a uniform protrusion of the gelatinous nucleus along the entire circumference of the disk. The most common form of protrusion.
• Posterior (dorsal) - protrusion extends toward the spinal canal. Often leads to serious neurological disorders.
• Diffuse - is a posterior type of protrusion, but degenerative changes affect a small area of ​​the disc.
• The median (Schmorl's hernia) is characterized by protrusion of the central part of the disc in the direction of the higher or lower vertebra.

Clinical manifestations of protrusion of the disk L4 L5

According to the sequential degenerative processes in the intervertebral disk, several stages of the disease are distinguished.

1. Stage 1 (initial) - is a consequence of neglected and untreated osteochondrosis of the spine. Pain syndrome in the form of short-term outbreaks, arising during prolonged sitting position, during intense physical exertion, with lifting of weights. The process is organized by the level of the lumbar region.
2. Stage 2 - painful sensations become longer and extend to other parts of the spine, lower extremities, inguinal region. This is due to a more significant protrusion of the disc and compression of the roots of the spinal cord. Neurological disorders are manifested as a feeling of numbness in the limb, weakness of the muscles of the thigh and lower leg.
3. 3 stage. The degree of extension of the fibrous ring is maximal, the disk swells even more and causes serious disorders of the nervous nutrition. Is a condition bordering the hernia of the intervertebral disc. In general, everything is very serious.

What is the protrusion of the L4 L5 disc? This is a borderline between the last stage of osteochondrosis and a hernia of the spine.

Diagnostics

The disease may not manifest itself for a long time. First you need to understand the condition of the disc - protrusion or hernia.

It is necessary to analyze the patient's complaints, find out the history of life (focus on occupational hazards), the history of the disease (whether there is an osteochondrosis). It is necessary to examine the neurologist to identify neurologic symptoms.

Instrumental types of diagnostics:

X-ray of the spine

What helps to find out?

• Curvatures that can cause protrusions.
• The condition of the vertebrae and the degree of their damage.
• Estimating the distance between the vertebrae where the disks are located.

The method carries little information, because it is aimed only at the bone structures of the spine of the column.

Мрт (magnetic resonance tomography)

Carry out and such procedure. At the MRI of the lumbosacral spine, prices range from , 00 to , 00 rubles. Pretty available.

In detail it is possible to study vertebrae L4 L5, where the protrusion of the gelatinous nucleus is located, and evaluate the integrity of the fibrous membrane. It is carried out in two projections and is the gold standard for the diagnosis of protrusions.

Exhausts all questions when stating the final diagnosis.

Where is the MRI of the spine?

So. Where is the MRI of the spine? Tomographs are located in almost every city. There are specialized diagnostic centers.

If a person from the district, he can apply to the central district hospital or regional clinic. At the MRI of the lumbosacral spine, the prices in each region are different. Some cities have quotas.

There you can make an MRI of the spine for free. Minus - there is an entry, you need to wait for your turn.

CT scan

Used rarely, because it has a low degree of informativeness.

The results obtained help to choose the most optimal therapy. How to treat protrusion, the neurologist or vertebrologist decides. Each of them has its own methods.

Treatment of protrusion of disk L4 L5

To the treatment of the disease of the lumbosacral spine, doctors are suitable for complex treatment. The protrusion is well treatable at the initial stages of the process. The last stage of development of pathology often has to be treated surgically.

Conservative methods

1. Elimination of causes and factors of the disease.
2. Physical rest, exclusion of increased axial load on the spine.
3. Wearing an orthopedic corset for the waist.
4. Elimination of pain syndrome. They use a group of non-steroidal anti-inflammatory drugs (Naise, Ibuprofen) and non-narcotic analgesics (Tempalgin, Pentalgin).
5. Chondroprotective therapy (restoration of cartilaginous tissue). Chondroitin sulfate injections are used. The course of treatment is 25 injections, which are carried out every other day.
6. The appointment of drugs that improve cerebral circulation ("Cavinton").
7. Reception of vitamin and mineral complexes.
8. Massage. It allows passively strengthen the muscular corset of the back, relax the strained parts of the muscles, improve the local blood supply of tissues. It is carried out by a specialized medical worker.
9. Physiotherapy. Allowed when pain syndrome is eliminated. Should become a daily procedure. It is developed individually for each patient by a physician-rehabilitologist.
10. Physiotherapy and manual therapy. Allow to improve local metabolic processes, remove tissue swelling, increase blood circulation and reduce pain syndrome. The courses are conducted after the main drug treatment and include methods: acupuncture, magnetic and laser treatment.
11. A hardware extension of the spine, the need for which is determined by the doctor.

How to treat protrusions, when the effect of conservative treatment is not achieved for a long time. What to do?

Surgical treatment of protrusions is rarely used (10% of cases). Apply minimally invasive techniques:

• Bone blockade. In the spine is introduced non-narcotic analgesic, which removes signs of inflammation (swelling and pain). A persistent improvement in well-being is achieved.
• Hydroplastic. It is the most effective and physiological method. Under the control of the X-ray apparatus, a liquid is injected, which flushes the destroyed part of the core and fills the remaining part with water. Negative symptoms disappear almost immediately.
• Laser treatment. It is effective in the early stages of protrusion, when the gel-like substance does not ossified. It is based on burning out the protruding part of the pulpous core.
• Cold-plasma nucleoplasty. A cold plasma is introduced into the gelatinous nucleus, the part of the disc is evaporated. The pressure inside it falls, and this reduces the expansion of the fibrous membrane. Disappear clinical manifestations.

Prevention of protrusion of the disk L4 L5

Worry about the health of the spine follows from early childhood.

Do not engage in self-medication, which in most cases leads to aggravation of the pathological process.

With pain in the spine, you should see the doctor and be examined. In the early stages of the disease, they are successfully treated. The main thing:

1. In time to identify and treat impaired posture, fixed curvature of the spine, osteochondrosis and other degenerative diseases of the osteoarticular apparatus.
2. Eat food with sufficient calcium (cottage cheese, milk, cheese). To restore the structure of cartilage, products based on gelatin and agar are recommended: marmalade, jelly, fruit jelly, bone broth.
3. Refusal to drink alcohol and smoking. These bad habits disrupt the exchange of calcium in the body and lead to osteoporosis.
4. Regular exercise. Trained muscles are a physiological corset for the waist.
5. Do swimming, yoga, skiing, cycling.
6. When lifting the gravity, evenly distribute the load on both hands.
7. With sedentary work arrange small fizkultminutki. Ensure a proper fit at the table. Do not stoop your back.
8. Keep your weight in the norm, because every extra kilogram additionally loads the spine.
9. Use an orthopedic mattress and pillow. The bed should be rigid.
10. Courses of preventive massage.

What is the protrusion of the L4 L5 disc? This is a serious disease requiring immediate treatment and an adequate rehabilitation program.

The prognosis is favorable with timely treatment in the clinic and the implementation of the recommendations of the attending physician. Without specialized therapy, the disease will inevitably lead to intervertebral hernia, strengthening of the pain syndrome.

Pressure of a hernia on the spinal cord and its roots can lead to the development of paresis and paralysis.

A source: http://.ru/article/350829/protruziya-diska-l-l-chto-eto-takoe-prichinyi-simptomyi-diagnostika-i-lechenie

Protrusion of m / n disk L3-L4

Disc protrusionL3-L4- a protrusion of the intervertebral disc without rupturing the fibrous ring, in the lower region of the back, the mid-lumbar region.

The clinic of Doctor Ignatieff specializes in the diagnosis and treatment of protrusion of intervertebral discs L3-L4. Reception is carried out by appointment.

L3-L4 protrusion occurs no more often than in 4-5% of cases among the total number of lumbar protrusions.

In 40-45% it is combined with other vertebrogenic radiculopathies, in particular with lesions in the L4-L5, L5-S1, hernia, antelisthesis, retrolistesis, spondylolisthesis.

The most common combination of protrusion L3-L4 and L4-L5 (4%).

The designation "L3-L4" refers to the lesion of the intervertebral disc between the third and fourth lumbar vertebrae.

L3-L4 protrusion

Depending on the type of protrusion in this area, 4 nerve roots or a whole bundle of nerve processes ("Cauda Equina" - pony tail) can be affected. In particular, protrusion can cause irritation of the right or left nerve root L3, L4, thereby causing vertebrogenic radiculopathy.

In order to properly interpret the diagnosis and symptoms, you need to know what type of protrusion L3-L4 and its size.

Clinically, only rear-located protrusions are considered, in fact, only they can affect the nervous structures.

There are the following types of protrusions (most frequent):

Diffuse (posterior, dorsal) protrusion of the disk L3-L4 - disc damage by 25-50%. Can affect both nerve roots.

Circular protrusion of the disk L3-L4 - uniform expansion of the intervertebral disc over a large area.

Median (posterior-medial) protrusion of the L3-L4 disc - protrusion in the direction of the cauda equina, spinal canal. Causes bilateral damage to the roots of L4, with aggravation can cause infringement of the horse's tail, lower paraparesis, stenosis of the spinal canal.

The paramedian protrusion of the L3-L4 disc causes left or right side lesions of the L4 nerve root.

It is a relatively dangerous protrusion, which is prone to overgrowth in the intervertebral hernia.

At sizes up to 2-3 mm, the patient rarely worries, manifests a small pain in the leg and lower back.

Foraminal (lateral) protrusion of the disk L3-L4 - protrusion of the disc in the direction of the intervertebral canal. The fourth lumbar spine strikes the right or left.

There are left-sided foraminous protrusion, right-sided foraminal protrusion and bilateral.

The most dangerous type of protrusions, for a complete loss of sensitivity, often enough protrusion of 5-6 mm.

Common symptoms:

The first signs usually appear by the age of 20, sometimes against a background of some movement, a characteristic crunch in the spine can appear, after which the pain intensifies. In the first periods, pain worries in the lower back and only after a certain time begins to give in the leg.

In acute period, when the head is tilted, raising an even leg upwards - there is pain in the place of the lesion (a symptom of Lasega). It hurts to sneeze, to cough.

The problem is usually preceded by chronic low back pain or trauma. Often protrusion occurs some time after the injury, often later, -2 years. Also often in patients there is a characteristic "click after which pain gradually arises.

If L3 is affected by the nerve root (protrusion L3-L4: lateral-foraminal, posterolateral), even a small protrusion size in this area can cause considerable pain. There is pain on the front of the thigh and knee joint.

There may be a feeling of "crawling crawling a slight tingling, numbness in the knee and inner thigh. In advanced cases, there is a weakness of the extension of the tibia, flexion of the thigh.

Disappear or less noticeable adductor and knee reflexes (from the side of the affected root).

Lesion of rootlet L4 (protrusion L3-L4: paramedian, median). There are pains on the front inner surface of the thigh to the knee and upper leg.

The sensitivity on the inner part of the shin is disturbed. There is a weakness of the quadriceps muscle of the thigh, the extension and hip withdrawal is weakened.

Knee reflex changes.

Squeezing a dural sac with protrusion

It is worth remembering that protrusion is the initial stage of the intervertebral hernia, the progression of which can still be stopped and achieve good results of treatment. If the patient has a foramen protrusion L3-L4, she has the most unfavorable prognosis in terms of further symptoms.

Median and paramedian protrusions threaten to overgrow into a more serious condition with further compression of the horse's tail, spinal canal.

In the early stages of the patient, there is little to worry about, but after a while the symptoms build up and gradually disable the whole body, causing such diseases as VSD, DEP, neurosis, etc.

Diagnosis with MRI

Mert lumbar region, protrusions

Posterior median protrusion

Treatment nrosettes

Palpatory diagnosis of soreness of paravertebral points. Clinic of Doctor Ignatyev

Manipulation of the lumbar region

It is important to treat protrusions in the early stages, ideally before the age of 22, while the intervertebral discs are still prone to recovery. The most favorable prognosis in the treatment of protrusions up to 3 mm.

At a later age, treatment is aimed at preventing complications and managing the patient.

Since protrusion occurs against the backdrop of osteochondrosis, spondylosis, spondylolisthesis and other concomitant diseases, it is necessary to treat them in a complex.

Ignatiev's method involves the use of manual therapy techniques to eliminate functional blockages.

This helps to eliminate the overload of the spine, to eliminate the cause of protrusion formation.

Further, therapeutic charge is assigned to create conditions for patient recovery. Its task is to support the results of treatment.

The patient should understand that protrusion is a disease of cartilage and the use of medications has a low efficiency, and the use of various patches and linings has only a distraction act.

A source: https://spine5.com/protruziya/l3-l4/

What is circular disc protrusion?

Circular protrusion of the disc - what is it? This question may be of interest to many people, since this pathology is quite common.

The protrusion itself is difficult to attribute to serious illnesses, but negligence in relation to one's health, when ignored even obvious signs of defeat, can lead to serious consequences, in particular, to provoke the intervertebral a hernia.

In practice, treating protrusions is much easier than the consequences that may arise.

Description of pathology

The protrusion of the intervertebral disc is its extrusion beyond the vertebral column, but without destroying the fibrous ring.

Most often this phenomenon appears as a complication of osteochondrosis or as an early stage of the intervertebral hernia.

If the protrusion itself does not imply serious destructive processes, then its overgrowth into a hernia carries the danger of serious consequences.

Circular protrusion is one of the varieties of this pathology, characterized by protrusion of the disc along the perimeter of the vertebrae, i.e. round.

As a result of a number of factors, the fibrous ring extends beyond the boundaries of the disc, internal fibers of the ring, but the shell itself remains intact, which makes it possible to keep the gelatinous core.

With such a defect, nerve fibers are not destroyed, but their roots undergo a certain compression, which causes a pain symptom of a temporary, temperate nature.

Development of the disease

In the pathogenesis of disc protrusion, several stages are distinguished:

• 1First stage: the formation of microcracks and structural disturbances in the body of the fibrous ring.
• Second stage: the initial exit of the ring beyond the vertebra by a distance of not more than, mm. There is a pain syndrome in the affected area.
• 3Third stage: significant protrusion of the fibrous ring (up to, mm) with the risk of rupture and overgrowth in the hernial process.

Circular protrusion may appear in any part of the spine, but the most common localization in the lumbar region.

Quite often, a pathology is found in the cervical region.

The thoracic zone suffers much less often, but with the emergence of a protrusion, it can be mistakenly recognized as a violation of cardiac function.

By the nature of the development of the process, the following types of disease are distinguished:

1. 1 Uniform annular protrusion is considered the most common and is characterized by the same extrusion of the disc along the entire perimeter of the vertebra. Pathology proceeds quite easily.
2. 2Circular-foraminous type generates compression of the nerve processes along the sides of the spinal canal. An intensive pain syndrome can be felt already at low loads.
3. 3Circular-dorsal type refers to the most dangerous variant. Disk protrusion occurs in the direction of cerebrospinal fluid and nerve fibers. Failure to take timely action can cause serious complications.

Etiological factors of the disease

The protrusion develops as a result of squeezing the disc and reducing the intervertebral distance, which occurs with structural disorders in tissues and excessive loads. There are the following reasons that can cause pathology:

• trauma in the spine;
• abnormal posture;
• undeveloped muscular system serving the spine;
• excessive physical exertion, especially when their distribution is uneven;
• spine diseases (scoliosis, osteochondrosis);
• diseases associated with metabolic disorders;
• malnutrition.

One of the main reasons is osteochondrosis, which is directly related to the age factor.

Symptomatic manifestations

The disease can last for a long time almost without symptoms, only causing a slight discomfort. Symptoms begin to manifest with the compression of the nerve roots, and the nature of their manifestation depends on the localization of the process. When the cervical region is affected, the following symptoms appear:

1. pain syndrome in the neck region and irradiation of it in the shoulders and along the arm;
2. decrease in muscle tone in the shoulder and arms;
3. numbness of the upper extremities, especially loss of sensitivity in the fingers;
4. blood pressure jumps;
5. headache;
6. noise in ears.

The defeat of the lumbar spine can cause such symptoms:

• lumbar pains of a chronic nature and their irradiation into the lower limbs;
• signs of sciatica;
• lowered muscle tone in the gastrocnemius and thighs;
• disturbances in the system of urination;
• numbness in the feet.

Principles of treatment

The protrusion is treated with conservative methods, and only in particularly severe cases, when there is a real risk of complications, surgical intervention is performed. Treatment should be carried out in a comprehensive manner and only at the doctor's prescription. The most common methods of exposure are:

1. 1Medikamentoznaya therapy. The most popular drug is Diclofenac. For relief of pain, Ibuprofen and Ketoprofen are used. Complex treatment may also include the following: diuretics in the presence of edema, muscle relaxants (Tizanidine, Tolperisone, Baclofen), corticosteroids (Tizanidine).
2. 2 Extraction and fixation of the spinal column.
3. 3Therapeutic gymnastics with an individual course.
4. 4Manualnaya therapy.
5. 5 Physiotherapy. In specialized clinics, an apparatus is used to effect diadynamic current pulses. Temperature influence, electrophoresis, mud therapy, etc. are also used.

Circular protrusion will not become a serious disease if appropriate measures are taken. For this, pathology should be identified as early as possible and effective treatment started.

A source: http://LechenieGryzhi.ru/cirkulyarnaya-protruziya-diska-chto-eto-takoe/