User:Somaia fayal alkasbi/Spinal disc herniation

A herniated disc, or spinal disc herniation, is a condition that occurs due to a problem within one of the discs (rubber pads) in the cervical vertebrae, which separates the vertebrae of the spine. These discs are like a filled donut disc, as they consist of an outer, frame-like strip called the annulus fibrosus containing a gel-like substance, called the nucleus pulposus. And with enough pressure on these discs, the inner gelatinous content of the disc may burst through cracks or weaknesses in the outer shell, which leads to the inflating of the weak fractured part as a balloon that appears to come out from between the vertebrae to compress the nerves in the spinal tunnel,Or that the nucleus pulposus leaks through a rupture of the outer envelope of the disc. A slipped disc can irritate the nerve roots that exit the spinal cord, causing pain, paresthesia, or even weakness in an arm or leg. However, many affected individuals do not experience any symptoms, and even most of those who suffer from symptoms do not need surgery to correct the problem. A herniated disc is accompanied by a decrease in the intervertebral space

Types and symptoms
The spine consists of bony vertebrae starting at the neck and ending with ossicles adjacent to the bottom of the pelvis, and the vertebrae of the spine have been divided into 3 three groups, starting from the top with the cervical vertebrae and it consists of 7 vertebrae corresponding to the neck area or is the neck brace and 12 thoracic vertebrae opposite the chest And 5 lumbar vertebrae meet the abdomen, 5 sacral vertebrae and 4 coccygeal vertebra meet the pelvis to its end from the bottom, and the symptom may be similar to several neurological diseases, including narrowing of the cervical or lumbar spinal canal and can only be diagnosed by an advanced hospital.

Cervical herniated disc
A cervical herniated disc occurs in the cervical vertebrae, where the patient complains of pain in the neck.

Symptoms: Symptoms of a cervical herniated disc include:

Severe neck pain either on one side or on both sides of the neck.

Pain around the shoulder blade

The pain may increase when sneezing, coughing, laughing, or stretching.

The pain may increase when doing the head movement or when bending the neck.

Neck muscles stiffen and hard to move due to pain

Symptoms:

Severe cartilage pain in the lower back, and the pain may extend to the base of the buttocks and legs

Feeling of sharp cramps in the muscles of the buttock or legs when walking.

The pain may increase when sneezing, coughing, laughing, or stretching

Feeling of numbness and wren in the lower extremities.

Inability to stand for a long time or walk for long distances

Impaired ability to control the functioning of the bladder (involuntary urination in severe cases).

Thoracic herniated disc
Symptoms:

Pain in the back that may radiate to the rib cage and ribs.

-قد تتأثر العضلات التي تساعد على التنفس ما قد يعاني من ضيق في التنفس.

The pain may increase when sneezing, coughing, laughing, or stretching. - The patient may be accompanied by psychological fatigue, and the patient is advised to take some nerve-relaxing drugs [citation needed]

Sciatica
Symptoms:

Pain may be moderate to severe spreading to the lower back, buttock, leg and foot.

Feeling of numbness and paresthesia.

Muscle weakness.

Difficulty doing movement, such as standing or walking.

the reasons
Between the bony vertebrae there are cartilages that reduce pressure on the sub-nerves and facilitate the movement of the bony vertebrae when making changes in the position of the body such as standing and bending, as these cartilages contain gelatinous material and the condition may develop so that the cartilage bursts after sliding, which requires surgical treatment to prevent complications arising from what An irritation of the nerves and a dysfunction of some muscles in the body occurred, and among the common reasons for the occurrence of a herniated disc are:

Weakness of the neck and back muscles: which are the main support in the spine, there may be a sliding of the cartilage between the cervical and lumbar spine, and the weakness of the neck and back muscles may be due to genetic or lifestyle reasons, i.e. the unhealthy and normal lifestyle of work for some, lack of exercise and obesity And spinal injuries.

Herniated disc: Herniation occurs when the outer strip of the disc is torn or cracked and the gel-like substance leaks out, putting pressure on the spinal canal or nerve roots. In addition, the nucleus secretes chemicals that irritate the surrounding nerves, leading to inflammation and pain. Most cases of herniated (slipped) lumbar discs occur as a result of sudden pulling, as they do in accidents. This may happen gradually, over a period of weeks or even months. Below are the risk factors that can contribute to the possibility of a herniated disc.

Aging: As we get older, the tablets gradually dry up, losing their strength and elasticity.

Heavy lifting: Improper posture, incorrect and / or repetitive lifting or twisting may cause additional stress on the lumbar spine.

Lack of exercise: Lack of regular exercise, not eating a balanced diet, being overweight, and smoking are some of the factors that contribute to damaging the health of the disc.

the diagnosis
The diagnostic process includes:

Medical history: It is to discuss the health history, the patient’s complaint, and the nature of the patient’s work and life.

Physical examination. Examination of the nerve response and muscle reflexes, and the patient may be asked to stand on the tips of his toes and this is difficult in the case of a lumbar herniated disc, and a herniated disc can be diagnosed by trying to bend the head down with pressure on the head from the top, which may cause severe pain in the neck Muscle stiffness.One of our spine specialists will carefully examine you for limits of movement, problems with balance, and pain.During that examination, we will also look for loss of reflexes in the extremities, muscle weakness, loss of feeling, or other signs of spinal damage.

X-ray imaging with dyes.

Magnetic resonance imaging.

CT imaging.

Electromyography-EMG

Most patients with herniated discs may use a combination of follow-up treatments:

surgical treatment
If, after nonsurgical treatments, the patient continues to experience intolerable pain, or if there is evidence of neurological deficit (such as weakness in the calf muscles), we may recommend surgery to treat a herniated disc.

Surgery usually involves removing part or all of a damaged disc, to relieve pressure on the nerve and leg pain. This is called a discectomy. We do this procedure frequently, using minimally invasive methods. In minimally invasive surgery, small incisions are made and specialized techniques such as microscopes and endoscopes ("video cameras") are used. In many cases, microdiscectomy and minimally invasive methods lead to a faster recovery for patients than traditional methods, because they reduce muscle trauma and reduce blood loss during surgery.

Rarely, a first herniated disc is a need for intervertebral fusion. When necessary, the space left by disk removal can be filled with a bone graft - a small piece of bone usually taken from the patient's hip. A bone graft or bone replacement is used to join or fuse the vertebrae together. In some cases, specially designed instruments (such as rods or screws) may be used to stimulate fusion and give stability to the spine.

In addition to a discectomy, part of the bone covering the nerve may need to be removed. This procedure is called a laminotomy.

Most patients can get out of bed on the same day as the surgery. The activity is gradually increased so that the patient is usually able to return home within 24 hours after the procedure, depending on the extent of the surgery. This may cause some pain after the procedure.

Upon returning home, the patient needs to continue resting. You will be given instructions on how to gradually increase your activity. You may need to take pain medication for some time. However, the pain and discomfort should begin to subside within a week or two after surgery. We will discuss with you other ways to reduce pain and increase flexibility before returning home. We will also discuss with you the timeframe regarding when to resume basic activities such as walking, driving, and lifting light items, and when you will return to more advanced activities such as work, sports and yard work.