Is there a hernia of the spine in children. Spinal cord herniation in newborns

A spinal hernia in children is a congenital anomaly due to which one or more vertebrae do not close in the area of ​​the spinous processes during their development, resulting in a gap into which the spinal cord itself and its membranes fall out. This problem is most common in the lower spine, although in some cases it can occur in other regions. In this case, the severity of the disease is determined by the size of the area of ​​\u200b\u200bnerve tissues that were left without appropriate protection.

Such a hernia in the fetus is determined by the results of an ultrasound scan, so intrauterine diagnosis of this disease is quite possible.

Why does a spinal hernia appear in babies?

So far, no one can name the exact cause of the development of this disease, but it is generally accepted that the most important factor in this case is vitamin deficiency.

In addition, this disease is congenital, but not genetic. There is an opinion that if a woman gave birth to a child with such a defect, then there is a possibility of such an anomaly occurring in other pregnancies. But in practice, in cases where a woman began to take care of getting all the necessary vitamins and minerals for the development of a child, the appearance of such a defect is practically impossible. Thus, a congenital hernia may well be a "one-time" problem, and it will not occur in the next pregnancy.

What are the types of spina bifida?

Two main types can be distinguished - hernial and hidden splitting.

Latent cleavage is the most common situation and is considered a mild form of the disease. In this case, the shape of only one of the vertebrae is usually slightly disturbed. Most people with this type of disease do not have any problems and do not notice any symptoms of the disease, except for a small depression located above the affected area of ​​​​the spine.

Hernial splitting is considered a severe form of the disease, since with it vertebral defects are much more serious. The most noticeable sign of the presence of this disease is a hernial protrusion, which contains the membranes and the spinal cord itself, as well as cerebrospinal fluid. But at the same time, quite often the nerve roots remain intact and function normally. The situation is much more complicated when not only the spinal cord and its membranes, but also nerve roots and trunks are located in the hernial protrusion. In this case, the child is often born with a number of severe sensory and motor disorders.

What are the symptoms of such a disease?

As we have already said, with a latent type of disease, there are practically no symptoms. Hernial splitting declares itself quite seriously, with it it can be observed:

• leg defects and incorrect position of the legs;
• complete or partial paralysis of the legs with loss of sensation;
• almost always a hernia and hydrocephalus appear simultaneously. Moreover, if such a disease is not treated, then in its advanced form it leads to the appearance of serious disorders in the brain;
• almost always there are problems with the bladder up to its paralysis, which leads to urinary incontinence, the rapid spread of infections and the destruction of the kidneys themselves. Often, the anus and rectum are also paralyzed.

Is this disease treatable?

Unfortunately, this disease is practically untreatable. This is exactly the case when you need to take care in advance that it does not appear, since it is almost impossible to cure it completely.

In the general case, a patient with such a disease is constantly under the supervision of the attending physician, which is especially important for children in whom hydrocephalus is accompanied by spinal hernia. To get rid of problems with the bladder, hygienic methods of keeping and a number of urological procedures are used. To eliminate chronic constipation caused by problems in the work of the rectum, a special diet is prescribed, which involves a large amount of coarse plant fiber.

Partly, some physiotherapy procedures help restore mobility, so that a sick child can become completely independent. Otherwise, you will need a wheelchair.

It is better not to joke with such a diagnosis as a herniated disc, since the spinal cord passes through the spinal canal, from which the nerves that provide innervation to organs and systems depart. Naturally, when squeezing nerve endings, not only symptoms of pain can appear, but also disturbances in the work of certain organs. According to statistics, it is the lumbar region that is often affected, since it accounts for not only physical activity, but also the need to withstand body weight. The lower back is often prone to trauma during sudden movements, due to muscle strain when lifting weights, and, as you know, anesthetize the condition when the lumbar region does not hurt so easily. Consider the causes and signs of a herniated lumbar spine, as well as the principles of treatment, including pain relief, physiotherapy, advice on how to sleep and how to sit properly. Let's analyze what a hernia is in terms of anatomy and physiology.

The lumbar spine consists of 5 large vertebrae, interconnected by intervertebral discs, which, in turn, create a cushioning function. Also, discs are needed to evenly distribute the load across the lumbar. The reliability of the disk is provided by the fibrous ring, and inside this ring there is a core, of a semi-liquid consistency. With an increase in loads, after injury to the back or from other circumstances, destruction of the fibrous ring is possible, that is, the appearance of cracks through which the core partially enters the spinal canal - protrudes. So, over time, a hernia of the intervertebral discs is formed, which, in turn, can compress the nerve endings, blood vessels, narrow the lumen of the spinal canal, which leads to negative consequences. The patient may be at risk of disability with a hernia that disrupts the functions of the genitourinary system, the gastrointestinal tract, causing paralysis of the lower extremities, so we will consider the causes and risk factors in order to protect ourselves from this pathology.

Causes

An intervertebral hernia is one of the rare pathologies that can result from both an overly active lifestyle and a sedentary lifestyle. Most often, a person is faced with the fact that he has signs of a hernia of the cervical spine and lumbar zone. A hernia of the spine in the lumbar region can be caused by constant stress on the muscular apparatus, that is, people suffer whose work is associated with lifting weights, working with vibrations. The second risk group is athletes, and weightlifters are especially susceptible. If at a young age intensive training keeps the muscular apparatus in good shape, then with the cessation of training, chronic injuries begin to appear, damage to the musculoskeletal corset in the lumbar region.

In women, childbirth is often the cause of the appearance of a hernia, and it may not be the birth itself that is to blame, but the weight gain during pregnancy, and after it, carrying the child in her arms. There are problematic births, when the fetus is large or has an incorrect presentation, then the risk of spinal injury increases.

Risk factors for the development of a hernia in the spine:

• getting a back injury, especially in an accident, when the body body experiences a concussion or a jerk;
• a blow to the back with a blunt object or a fall from a height onto the back;
• impaired metabolism due to alcohol abuse, junk food, diabetes, smoking;
• lack of vitamins and minerals, the condition with aging of the body is especially pronounced;
• obesity, which increases the load on the lower back.

Most often, these reasons are combined, for example, people with diabetes are prone to obesity and a sedentary lifestyle. It is worth noting that a hernia of the lumbar spine can not be noticed immediately, since the disease is characterized by progression, a slow onset of the development of the pathological process. A degenerative-dystrophic process is observed in the spine, accompanied by malnutrition of the discs, which is why it loses its strength. That is why the disease can also be caused by various infections, such as tuberculosis, syphilis, which affect the body systemically.

And of course, do not forget about the factor predisposing to hernia - osteochondrosis. Most patients with a hernia have a history of this disease, since osteochondrosis affects the structure and nutrition of the spine.

Symptoms

Most often, a hernia in the lower back develops between the L4-L5 vertebrae, a little less often the sacral region is also involved in the process, that is, in L5-S1, which makes it possible to conclude that the lower lumbar region suffers and this is due to increased loads on this area.

Consequently, the symptoms often involve in the process not only the lumbar region, but also the buttocks, lower limbs, which is why the disease is characterized by such complications as lumbago, infringement in the sciatic nerve, radiculopathy and others. Therefore, it is better for patients with a hernia not to joke with their health so as not to start the disease, since complications of a hernia lead to the fact that the patient often cannot not only run or swim, but also walk normally.

Pathology is characterized by symptoms of pain, the strength of which increases with exercise. If compression of the nerve endings occurs, then backaches appear - a sharp pain with every movement, which disappears at rest. Anesthesia for lumbago with conventional drugs (analgesics, NSAIDs) is not always helpful, therefore, as a rule, patients seek medical help. In addition to pain, a person with such a diagnosis suffers from stiffness in the lower back, sensitivity is disturbed, a burning sensation and tingling appear at the site of hernia formation.

When inflammation develops associated with compression of the spinal cord or nerve endings, additional symptoms appear. In addition to the fact that the pain increases sharply from turning or tilting the body, so the sensations of pain spread to the buttocks, go down the legs, up to the toes. The patient may have problems with the genitourinary system, manifested in a decrease in potency, retention, or, conversely, uncontrolled urination. The digestive tract can suffer. If the hernia is not treated, then the patient is threatened by the occurrence of paresis and paralysis.

Conservative treatment

With the help of conservative treatment, it is unlikely that a hernia will be completely cured, in many respects it all depends on the size of the hernia, but if you start treatment in the early stages, you can stop its growth, that is, stop progression. At the same time, if you strengthen the muscle corset, you can avoid squeezing the nerve endings, which is why doctors often resort to non-surgical treatment.

Therapy has two directions at once, the first of which is aimed at eliminating the symptoms of pain. For this, the following methods are used:

• drug therapy - drugs of the NSAID group (Ibuprofen, Diclofenac, Meloxicam), muscle relaxants (Sirdalur, Mydocalm);
• non-traditional methods - acupuncture (acupuncture), by the way, acupuncture is only allowed to be performed by a doctor;
• blockade of the spine with hormones - Diprospan, Kenalog in combination with Lidocaine.

A blockade for a hernia of the lumbar spine is prescribed when other methods of anesthesia are ineffective, since with the introduction of hormones there is a threat of side effects. A hernia blockade is performed every 3 months, in advanced cases more often. To reduce the symptoms of pain, acupuncture is used for hernia.

The second direction of treatment is aimed at strengthening the muscles, for which it is necessary to train in order to pump up the muscles. But do not forget that the training program should be selected individually. A popular technique is hyperextension for a hernia of the lumbar spine, that is, special exercises aimed at strengthening the muscles of the lower back. For this, special simulators for hernia are used.

A lumbar brace, which must be worn according to the doctor's indications, helps to reduce the load on the spine. Some doctors advise using an exercise bike for exercise. By the way, it is not recommended to pump the press with a hernia in the usual position from the floor, so you should not perform those exercise therapy exercises that the doctor did not prescribe.

Swimming is effective for hernia, which is why swimming is also recommended for prevention, especially for people with spinal curvature. A swimming pool can replace sea water, and if you go to the pool with osteochondrosis, then the chance of developing a hernia decreases. If a woman is expecting childbirth, then she is also recommended to visit the pool, but you need to work with a trainer and after consulting a gynecologist, then the birth will be successful.

By the way, about the issues of prevention. You can bring a technique that helps to strengthen, pump up all muscle groups and protect the spine from osteochondrosis, hernia - this is a fitball. Fitball is an excellent prevention of diseases of the musculoskeletal system, which consists in exercising with a special elastic ball.

Do not forget about nutrition with a hernia of the spine. It is necessary to exclude alcohol, cigarettes, fatty and fried foods. It is recommended to add vitamins to your diet.

Often, to relieve inflammation, physiotherapy is indicated for a hernia of the lumbar. The question arises - is it possible to apply all the FZT techniques, the answer to it is no. A doctor can choose the procedures, since electrical stimulation has a number of contraindications. Well helps electrophoresis with a hernia of the lumbar spine.

Prevention of complications

Now he will talk about what is possible and impossible in case of a disease, that is, contraindications for a hernia of the lumbar spine. A diet for hernia is necessarily observed, walking helps, as a sedentary lifestyle negatively affects the disease.

Massage is allowed, going to the pool, that is, swimming is not only possible, but also necessary. Of the exercise therapy exercises, weight lifting is prohibited, that is, strength exercises, techniques that can greatly stretch muscles and ligaments. Squats are shown only in the early stages. By the way, squats, pumping up the press help with a preventive purpose, and as you know, prevention is better than cure.

You can not independently prescribe painkillers for a hernia, lift weights, sit in a chair for a long time. Many are concerned about the question of how to live with such a diagnosis, and so with early treatment and following the recommendations, you can even prevent disability.

Of course, in advanced cases, an operation is necessary and a long rehabilitation period is required, which includes a pool, FZT, exercise therapy.

2017-01-19

Achondroplasia (photo) is a congenital disease that is associated with a violation of the growth and development of bones. Most often, pathology affects the skull and skeleton. Features of the disease - low human stature (maximum 130 cm).

Why does the disease appear

What is achondroplasia? Parro-Marie syndrome (another name for the disease) develops due to a mutation in the FGFR3 gene. Less commonly, the pathology is inherited. Sometimes the fetus dies.

The main reasons for the development of achondroplasia are violations of bone formation, which are the result of dystrophy of the epiphyseal cartilage.

This leads to slower bone growth. The skull and tubular bones are usually affected. One of the reasons for the occurrence of pathology is the relatively late age of the parents. If the father is over 40 years old, then the chances of developing the mutation increase.

Characteristic features

Symptoms of the disease can be recognized immediately after the birth of the child. Such children have a rather large disproportionate head, short legs and arms. Sometimes there is hydrocephalus.

Parro-Marie syndrome is noted in the form of violations of the structures of the facial skeleton, which occur due to abnormal development of the bones. Patients with this disease have wide-set eyes that are located deep in the orbits. Additional folds form near the inner corners of the visual organs.

Signs of pathology can be recognized by the characteristic nose. It has a saddle-shaped flattened shape with a wide top. The patient's tongue is rough and the palate is high. The arms and legs of patients with achondroplasia are uniformly shortened. Differ in patients and feet - they are wide and short.

Infants with this disease often die in their sleep. This is due to compression of the medulla oblongata and spinal cord. 1-2 years of a child's life is accompanied by the formation of cervicothoracic kyphosis, which disappears after the baby begins to move actively.

Children with achondroplasia develop slowly. They can hold their heads 3-4 months after birth, babies learn to sit when they are one year old. Such children can move only from 2 years. The intelligence of patients is at the same level as that of healthy people.

Adults with Parrot-Marie disease can be recognized by the growth deficit that occurs when the legs are shortened. Women with this pathology reach 124 cm in height, and men grow up to 131 cm. In some patients, deformities of the head and nose remain noticeable. Often there is strabismus. Adults with achondroplasia are often overweight. They may develop conductive hearing loss and otitis media.

Carrying out diagnostics

It is not difficult to determine the diagnosis of pathology, since Parro-Marie disease is noticeable by characteristic changes in appearance. Patients must first be carefully examined to determine the level of deviation from normal skeletal formation and development. All data are entered into a table, which is compiled specifically for such a disease, and compared with the indications.

If a newborn needs an analysis for achondroplasia, then first the baby should be examined by a neurosurgeon. You can also see the changes on ultrasound. Doctors recommend an MRI and CT scan of the brain. To study the condition of the nasal passages and ENT organs, the patient is examined by an otolaryngologist. Sometimes a consultation with a pulmonologist is additionally required. For the diagnosis of pathology, radiography is used:

• skulls;
• chest;
• pelvis
• spine;
• tubular bones.

If a child has Parro-Marie disease, then he is observed by a doctor from the moment of birth until the end of his life.

Therapy Methods

The genetics of the disease is such that the pathology cannot be completely eliminated. At a young age, conservative treatment is used, which helps to strengthen the muscles and stop the deformity of the limbs. It is better for patients with achondroplasia to wear only orthopedic shoes, they are prescribed a complex of exercise therapy and massage. Obesity prevention is often recommended. For this, patients are prescribed a special menu and exclude dishes that lead to excess weight.

Treatment of achondroplasia with surgical intervention is justified only if the patient has severe deformities of the limbs and narrowing of the spinal canal is noted. To eliminate such symptoms, a laminectomy is prescribed. Sometimes surgeries are performed to increase height. The limbs are stretched in 2 stages. Initially, the thigh is lengthened on one side and the lower leg on the other, and then similar actions are carried out on the remaining parts of the body.

Other operations are often carried out:

1. Fusion of vertebrae. Manipulations are carried out to connect individual vertebrae to each other. The intervention helps to cope with kyphosis of the back.
2. Osteotomy. An incision is made in the leg bone, through which the individual parts of the vertebrae are connected. The procedure is used in severe form of modification of the knee joint. Also practiced for patients who have crooked legs.

Achondroplasia is sometimes treated with the use of a special growth hormone. But the drug affects each person differently.

Life expectancy with Parro-Marie disease depends on the patient's individual health indicators and compliance with all medical recommendations.

In recent years, experts have noted an increase in applications for various diseases of the spine in children and adolescents. Unfortunately, children are not immune from injuries and injuries, as well as from the development of deformities and injuries of the spine. Intervertebral hernias, caused by severe complications of spinal injuries, are quite common reasons why teenagers turn to a doctor.

Diseases of the spine such as intervertebral disc herniation, displacement of the vertebrae (spondylarthrosis), scoliosis and even osteochondrosis occurring in children can significantly reduce their overall performance, ability to absorb educational material, and attention.

The development of such a common disease in children as scoliosis, which can lead to the development of osteochondrosis with its subsequent complications, can be caused by uncomfortable shoes, poor posture, and injuries of the ligamentous-muscular apparatus. Parents may not immediately suspect the pathology of the spine in their children, since the child in the initial stages of the development of the disease may not respond to soreness and not complain of malaise. Therefore, the disease progresses and it becomes more and more difficult to fight it in the future.

Clinical manifestations and symptoms of intervertebral hernia depend on the level of the lesion. In adolescents, the lumbosacral spine is most often affected. This may be due to early sports with heavy physical exertion (lifting barbells, kettlebells). Such overloads can cause pain syndrome of varying severity - from heaviness and stiffness in the lumbar region to pain attacks that make it difficult to move and even walk. If a child complains of the appearance of a constraining tension, pain in the spine, parents should seek help from a doctor. In recent years, even children and adolescents aged 9-12 often complain of back pain.

There are several types of back pain. In children, most often the pain is local in nature, i.e. limited to the affected area of ​​the spine. As a rule, its character changes depending on the position of the body.

Radicular pain - the second most common type of pain - is a "shooting" pain, aggravated by movement. It can be sharp, cutting, give to the lower limb. Sometimes there is a violation of the sensitivity of the skin in the form of hyperesthesia. The pain syndrome enhances any movement in the lumbar region: physical activity, any kind of sport, as well as prolonged static loads. Being in one position for a long time, lying on the stomach also increases the pain syndrome, as this increases the degree of displacement of the vertebrae and intervertebral discs. And in case of spinal pathology (intervertebral hernia, spondylolisthesis, etc.), this increases the compression of nerve endings.

Pathology of the spine can be manifested by other than pain symptoms. These are parasthesias or unpleasant sensations in the form of numbness, tingling in the feet, legs. With a herniated disc in the lumbosacral region, a decrease in muscle tone of the buttocks, thighs, and lower legs may occur. As a result of hypotension, these muscles can later be subject to atrophy. Often painful muscle cramps and spasms, scoliotic deformities of the spinal column.

If the cervical spine is affected, vascular syndrome often develops. In children, intervertebral hernias of the cervical spine are manifested by headaches, dizziness, irritability, etc. This disease immediately affects learning - sleep, memory, and attention disturbances lead to poor academic performance. The child becomes apathetic, he is of little interest, drowsiness is expressed or, conversely, hyperexcitability, the falling asleep phase is disturbed, the development of restlessness, irritability, and obsessive movements syndrome is characteristic. With prolonged disruption of the blood supply to the brain due to hernial disease, the child may be disturbed by dizziness, headaches, impaired vision, hearing, and speech. Pain is disturbing in the cervical spine, restriction of movement develops when turning the head.

With pathology in the thoracic region, pain syndrome, intercostal neuralgia, pain in the chest or in the region of the heart are most often noted. Sometimes such pains are accompanied by herpetic eruptions along the intercostal nerves.

Having found the first signs of damage to the spine in a child, do not postpone a visit to the doctor. Today, with timely access to specialists, intervertebral hernias are treated painlessly and non-surgically.

Pathologies of the spine in the fetus, among all developmental disorders, are detected on a screening study in the vast majority of cases. Most often, pathologies of the spine are localized in the lumbar zone, somewhat less often - in the neck area, infrequently - in the thoracic region and in the sacrum.

The population frequency of defects in the spine and spinal cord of the fetus is 1 case per 1000.

Diagnosis of defects of the spine and spinal cord of the fetus - terms and types of studies

Since, in parallel with developmental disorders of the spinal column, changes in the spinal cord are most often detected, which leads to very serious consequences - the death of the fetus in utero at a later date, the death of the child immediately after birth or at an early age, or a profound disability in survival, it is difficult to overestimate the importance of timely and high-quality screening of pregnant women.

Screening study allows diagnosing developmental anomalies in utero and make a decision on the advisability of further management of pregnancy, consider the possibility of correcting the detected defects, predict the outcome of the disease according to objective diagnostic indicators.

Most often, diagnosis is limited to ultrasound examination, as the most reliable in any trimester of pregnancy.

If spinal defects or other fetal pathologies are suspected, after the first screening study, a pregnant woman is prescribed individual diagnostic program with additional research and expert advice.

Defects of the spine and spinal cord that can be detected in utero

Dysraphia - spina bifida, or spina bifida

The bone structures of the fetal spine are well visualized from the 15th week of pregnancy - it is from this period that it is possible to diagnose vertebral defects on ultrasound with a high degree of probability.

The tissues of the spine of the fetus from the 15th week have ossification centers, which are normally visible in the transverse section as parallel linear structures. With defects of the spine on ultrasound, their divergence will be noticeable.

Longitudinal sections on the study can reveal the presence and size of the hernial formation.

It should be noted that spina bifida can be of varying severity, and not all defects will be visible on ultrasound.

Myelomeningocele - spinal hernia

Ultrasound imaging shows a mass with fluid on the posterior surface of the fetal spine.

It should be borne in mind that the open fissure of the spine does not have a formation with fluid over the defect. If the spinal cord with the membranes does not bulge into the gaping lumen, then it is quite difficult to determine the pathology on ultrasound, and in many cases it remains undiagnosed until delivery.

Klippel-Feil syndrome

This is a genetically determined pathology, which is manifested by a significant shortening of the neck due to congenital fusion of the cervical and upper thoracic vertebrae. Pathology in the fetus can be seen already in the first trimester of pregnancy upon careful consideration of the visualization of the cervical region - it appears to be a single formation, without separate segments.

If this pathology is suspected, additional diagnostic tests.

Children with this disease are quite viable, mental development does not suffer. But the disease is incurable and the defects cannot be corrected afterwards.

On the visualization of an MRI study of the fetus in the last stages of pregnancy, it is sometimes possible to notice the following pathologies of the development of the spinal column and spinal cord:

Syringomyelia and hydromyelia

Gaps in the structure of the spinal cord (single or multiple) or cavities with fluid.

It is rarely diagnosed in utero or in early childhood.

(single-sided or double-sided)

This pathology is characterized by underdevelopment of the vertebral arches on one side or on both sides. As a result of the defect, adjacent vertebrae become more mobile relative to each other, and one of them slips forward. The spinal canal narrows at the site of the defect, and there is a threat of compression of the spinal cord and roots.

In utero, this pathology is diagnosed extremely rarely, although a defect occurs at the stage of formation of spinal structures, in the first months of fetal development.

Malformation of individual vertebrae or additional vertebrae

These defects form the wrong structure of the spinal column even in utero, which manifests itself in the child immediately upon birth.

Vertebral structural defects and accessory vertebrae and hemivertebrae can sometimes be seen on fetal ultrasound or MRI imaging.

cervical rib

The defect occurs in 0.5% of newborns.

Pathology is characterized by the presence of fibrous processes on the cervical vertebrae (more often on the 7th, less often on the 6th). May be unilateral or bilateral, these ribs may be complete or incomplete, true, resembling true ribs and connecting to the rib cage, or false.

In utero, cervical ribs can be seen on ultrasound or MRI if they are sufficiently developed and formed like the bones of real ribs.

Very small rudiments can go unnoticed at the birth of a child, and at a later age.

16.12.2015

The majority of young patients with herniated discs have some form of malformation of the vertebrae in the lower spine, according to a study published in the December issue of the journal Neurosurgery, the official publication of the Congress of Neurosurgeons.

The study was conducted by Dr. Zh. Liu and colleagues from the Peking University Hospital (PRC). This work helps to understand why this pathology develops in children and adolescents with lumbar intervertebral hernias, because in young patients, natural age-related tissue wear cannot cause the disease. The results of the study also showed that single disc surgery without spinal fusion - the fusion of adjacent vertebrae - can be effective in treating young patients with low back pain caused by a herniated disc.

The authors revealed differences in the anatomy of the lumbar spine in healthy children and young patients with a herniated disc. To look for malformations that might increase the susceptibility to herniated discs in children and adolescents, the authors analyzed x-rays of 63 patients under the age of 20 with low back pain and herniated discs in the lumbar spine. There were 37 males and 26 females among the subjects. The average age of the participants is 17 years. All of them have tried various types of therapeutic treatment, which did not help to get rid of severe back pain. Therefore, patients needed surgery.

Almost all patients in the pictures had at least one malformation of the lumbar spine or sacrum. Malformations were absent only in three cases, the authors noted.

Some patients had an abnormally "high" pelvis, and these patients most commonly had disc herniations between the L4/L5 lumbar vertebrae. In patients with an abnormally "low" pelvis, mainly, a hernia appeared between the L5 and S1 vertebrae - in the lumbosacral region. Patients were also identified who had a "transitional vertebra" between the lumbar and sacral spine. This malformation increased the risk of hernia formation between the L4/L5 or L5/S1 vertebrae, depending on the location of the structural formation.

The researchers assessed how patients responded to surgery for chronic low back pain and a herniated disc in the lumbar spine. Surgical treatment was performed in 36 patients. The operation consisted in removing the damaged area of ​​the disc - discectomy. 27 patients underwent arthrodesis - immobilization, fastening of the affected vertebrae.

In all patients, surgery resulted in a significant reduction in back pain and disability.

Lumbar disc herniation in adults is usually associated with repetitive strain and age-related degeneration. However, these reasons cannot explain the appearance of a hernia in children and adolescents.

Dr. Liu et al note that congenital malformations of the lumbosacral spine are strongly associated with herniated lumbar spine in children and adolescents. These malformations may be associated with abnormalities in the structure or lumbar ligaments, which are short, strong ligaments that connect the lumbar spine to the pelvis. These anomalies lead to a violation of the stability of the lower part of the spine.

The study also shows that pediatric patients with a herniated disc in the lumbar spine can achieve significant improvement after surgical treatment, which consists only in the impact on the affected disc. At the same time, spinal fusion does not bring additional benefits to patients.

The authors noted some important limitations in the study. In particular, they did not assess the presence and level of spinal malformations in the control group among patients without disc herniations.

Spinal hernia in a newborn is a congenital disease, the etiology of which has not yet been fully elucidated. There is irrefutable evidence that a lack of vitamins and minerals in the body of an unborn child can lead to the development of pathology.

The disease is often accompanied by clubfoot, hydrocephalus (dropsy), as well as related diseases associated with disorders of the urinary system and digestive tract.

Congenital spinal hernia in the fetus in most cases is formed in the lumbosacral region, less often in the thoracic region.

Depending on the clinical manifestations, it is customary to distinguish several types of pathological disorders.

Causes of pathology

The etiology of this defect has not yet been studied well enough, so scientists and physicians cannot name specific causes leading to a hernia of the spinal cord. Many chemical, biological and physical factors during the formation of the fetus affect his body. According to experts, a predisposing factor is a deficiency of folic acid in the mother's body.

If during the study a congenital spinal hernia is detected, for medical reasons, the pregnancy is terminated with the consent of the parents. Although the condition is congenital, it is not genetic in nature.

If a woman receives the whole complex of necessary vitamins and minerals, then during a second pregnancy she has a chance to give birth to a completely normal child.

The vertebral split has received the Latin name spina bifida.

There are three degrees of this defect

• spina bifida occulta
• meningocele
• myelomeningocele

The immediate cause of a spinal hernia is a malformation in which the process of development and closing of the vertebral arches, which normally form the back wall of the spinal canal and close the spinal cord, is disrupted. Through a bone defect, under the influence of increased pressure of the cerebrospinal fluid, the spinal cord protrudes along with the roots and membranes, forming a hernia.

Despite the fact that a spinal hernia in a newborn is a pathology of a congenital nature, it is not inherited. Therefore, in subsequent pregnancies, a woman can give birth to a completely healthy child.

Important! If this pathology is detected in a child at an early stage, that is, in the first trimester of pregnancy, the doctor is obliged to offer parents an abortion for medical reasons.

The decision to have an abortion is made by the parents, however, it should be clarified that a slight spinal cord split without the inclusion of a hernia in it can be successfully eliminated by surgery, which is carried out in the first days after the birth of the child.

On the other hand, if a child has a severe spinal cord injury, there is a high chance that the child will suffer mental and physical disabilities throughout his life.

But therapeutic tactics are not limited to some surgical methods. The desired effect can only be given by complex treatment, consisting of several stages. As a rule, the process is not complete without the involvement of various specialists: a urologist, a neurosurgeon, an orthopedist and a psychoneurologist. After all, the symptoms of the disease most often confirm violations of various organs and systems.

Classification

Two main types can be distinguished - hernial and hidden splitting.

Depending on the location, a spinal hernia can be:

• cervical;
• chest;
• lumbosacral (2/3 cases).

Other anomalies in the development of the neural tube in a child

In case of violation of the closure of the anterior part of the neural tube at the time of its formation, the child may be born with a herniated brain, a disease that affects intelligence and motor functions. A hernia of the brain is a protrusion of its individual sections through a defect in the skull.

The hernia can be located in the frontal region, the back of the head, often combined with other anomalies in the development of the bones of the facial skeleton of the head.

The formation may be small, in the form of swelling, with pressure, a pulsation is felt, the skin over the tumor is usually not changed. Herniated brain increases in size when crying, sneezing, coughing, tilting the head. The disease may be accompanied by a violation of the act of swallowing, sucking, later pathologies of movements are observed.

Brain herniation is treated only surgically, the prognosis depends on the contents of the tumor. The operation is performed in the first months of a child's life, the absence of surgical intervention can lead to a hernia rupture, which provokes an unfavorable outcome.

Since the normal formation of the neural tube in the fetus depends on the sufficient intake of trace elements and minerals in the mother's body, their use in the first weeks after conception is considered the main preventive measure. Particular emphasis should be placed on folic acid, the ideal option would be preliminary planning of conception.

The expectant mother can visit a geneticist and receive detailed recommendations on the use of drugs that contribute to a favorable pregnancy. Folic acid is necessary not only for a woman planning to conceive, but also for a man - a future dad. These trace elements are transmitted with a set of chromosomes and have a significant impact on the fetus.

In the first weeks after conception, self-administration of any pharmaceutical preparations is not recommended, the excessive use of cosmetics and household chemicals should be abandoned. After 20 weeks of pregnancy, all the organs of the child are almost formed, and the main thing for a woman is not to harm the baby at the time of development of the main systems.

Spinal hernia in newborns

When a baby has symptoms of a spinal hernia since birth, a series of studies are carried out to identify all associated disorders and select a treatment.

Diagnostics includes the following activities:

• consultation with a neurologist- examination by a doctor of a child, assessment of the baby's motor activity, muscle tone, determination of the localization of the hernia and its severity;
• magnetic resonance imaging or CT scanto study layered images and clarify all pathological processes in the spinal cord, MRI can be performed several times; for a newborn, this is a safe study;
• examination of the baby by a neurosurgeonto assess the feasibility of surgical treatment and predict postoperative recovery;
• performing contrast myelography- study of the structure of the damaged area of ​​the spinal cord, the substance is injected intravenously and accumulates in separate areas of the pathological focus, highlighting diseased areas;
• transillumination- light scanning to assess the contents of the hernia.

Congenital spinal hernia is a rare but severe developmental anomaly. This defect of the spinal cord manifests itself in only 0.1-0.03% of newborns, and approximately two-thirds of them remain disabled for life.

Doctors divide different cases of spinal hernias according to their localization and structural features. The location of the defect plays a big role for the patient and the doctor treating him, since the severity of the symptoms and the complexity of treating the pathology depend on it.

Accurate diagnosis of a spinal hernia requires a complete physical examination, which begins with an anamnesis. In the case of contacting a doctor after childbirth, in which no pathologies were found, special attention is paid to age indicators during the period of manifestation of the symptoms of the disease (weakness in the limbs, signs of atrophy and difficulty in muscle activity).

Examination by a neurologist, during which an assessment of motor activity is carried out, a check of the muscle tone of the limbs, the detection of protrusion and the fixation of relevant medical indicators;

Transillumination is a special light scanning, thanks to which it is possible to detect and characterize the contents of the hernial protrusion;

Contrast myelography is an intravenous injection of a contrast agent that accumulates in certain parts of the spinal cord. Gives an idea of ​​the structure of damage inflicted to the spinal cord during the formation of a hernia;

Read more: Causes and symptoms of muscle atrophy, diagnosis and treatment

• perinatal surgery
• postpartum surgery
• Additional methods of surgical intervention

Spinal hernia in newborns, which is difficult to treat, occurs in 60% of all cases of disorders of the musculoskeletal system. It is impossible to completely cure this disease in infants, but with timely measures taken, it is possible to reduce the number and intensity of complications and help the child lead a relatively normal life.

• With a mild degree of pathology, the child grows and develops in accordance with age.
• If the spinal cord and nerve roots are partially affected, then the baby will experience urological problems, as well as problems with defecation. Such children need constant care and special hygiene procedures. With severe constipation, nutrition should be based on foods with a high fiber content.
• Children with this pathology, complicated by hydrocephalus, should be under constant supervision. Parents of such patients are taught how to care for them.
• With impaired mobility of the limbs, patients are prescribed courses of physiotherapy.
• With severe complications and paralysis, children cannot walk, they need a wheelchair and constant care at home.

Intervertebral hernia in adults

Symptoms of the disease

As we have already said, with a latent type of disease, there are practically no symptoms. Hernial splitting declares itself quite seriously, with it it can be observed:

• leg defects and incorrect position of the legs;
• complete or partial paralysis of the legs with loss of sensation;
• almost always a hernia and hydrocephalus appear simultaneously. Moreover, if such a disease is not treated, then in its advanced form it leads to the appearance of serious disorders in the brain;
• almost always there are problems with the bladder up to its paralysis, which leads to urinary incontinence, the rapid spread of infections and the destruction of the kidneys themselves. Often, the anus and rectum are also paralyzed.

A hernia of the spinal canal with a protrusion of the spinal cord has a very characteristic clinical picture, noticeable immediately after the birth of a child. A tumor-like formation of various sizes is visually determined, located along the midline of the back, most often in the lumbar region.

The hernial sac is covered with thin cyanotic skin with cicatricial changes, and at the base, excessive hair growth or spots of vascular origin are often determined. The tumor has a soft elastic consistency, a defect in the vertebral arches is palpated at its gate.

Often there are other signs of local soft tissue dysmorphism: lipomas, hemangiomas, fibromas.

• paralysis of the limbs, disorders and nutrition, paresis;
• malfunctions of the pelvic organs, bowel incontinence;
• malfunctions of the heart, lungs, gastrointestinal tract and endocrine system.

As noted above, the latent type of defect is rarely accompanied by any symptoms or health problems.

The open type of splitting has the following symptoms:

1. Unnatural position of the legs, asymmetry of the lower extremities, their other defects.
2. Complete or partial loss of sensation of the body and limbs below the affected area, complete or partial paralysis of the lower extremities.
3. In the vast majority of cases, hydrocephalus is observed, resulting in other pathologies - epilepsy, paralysis and impaired sensitivity of certain parts of the body, various vision problems up to its complete loss, impaired brain and psyche activity.
4. Inability to control the functions of urination and defecation, as a result of which the patient may experience enuresis and encopresis, complete incontinence of urine and feces, or acute urinary retention and chronic constipation. In turn, these disorders eventually lead to infection and inflammation of the kidneys.
5. Hernial protrusion on the back of a newborn is visually noticeable immediately after birth. It is a bag covered with thin skin, with soft or liquid contents. In some cases, the brain part of the hernia is open to the outside.

Diagnostics

In modern conditions, it is important to diagnose congenital pathology at the stage of intrauterine development of the child. This is done thanks to the ultrasound method, and the first study is shown to all women up to 12 weeks of pregnancy. If the child was already born with a hernia, it is necessary to perform a clarifying examination, which may include:

1. Radiography.
2. Computed tomography.
3. Magnetic resonance imaging.

Methods of additional diagnostics allow us to assess the nature of the pathology, its prevalence, identify possible associations and differentiate with other conditions.

Treatment

The malformation of the spinal column can also be judged according to ultrasound diagnostics during pregnancy. When determining splitting, additional research is shown - a large amount of alpha - fetoprotein indicates a presumptive neural tube defect. Amniocentesis is also performed - the study of amniotic fluid.

Unfortunately, this disease is practically untreatable. This is exactly the case when you need to take care in advance that it does not appear, since it is almost impossible to cure it completely.

In the general case, a patient with such a disease is constantly under the supervision of the attending physician, which is especially important for children in whom hydrocephalus is accompanied by spinal hernia. To get rid of problems with the bladder, hygienic methods of keeping and a number of urological procedures are used.

To eliminate chronic constipation caused by problems in the work of the rectum, a special diet is prescribed, which involves a large amount of coarse plant fiber.

Partly, some physiotherapy procedures help restore mobility, so that a sick child can become completely independent. Otherwise, you will need a wheelchair.

Intrauterine treatment of spinal hernia is carried out only abroad. An anomaly of the fetus can be determined already at 7-8 weeks, with the help of prenatal surgery at 19-26 weeks, you can get rid of the problem even before the baby is born.

Surgical intervention

Removal of a hernia in newborns is performed only by surgery. Do the reconstruction of the spinal column, unfused vertebrae are closed. Non-viable tissues of the hernial sac are excised, the rest are restored in the spinal canal. To avoid high intracranial pressure, shunting is performed - the establishment of a shunt to drain the cerebrospinal fluid into the thoracic lymphatic duct.

Conservative Therapy Options

Appropriate only as an additional measure to prevent complications and maintain the general condition of the patient.

Treatment includes:

• taking drugs to normalize the function of the nervous tissue;
• vitamin therapy;
• physiotherapy for motor function;
• diet high in fiber.

Spinal hernia is an anomaly that is very difficult to treat and has serious consequences. Therefore, it is very important at the beginning of pregnancy for a woman to pay special attention to her health, to undergo the prescribed diagnostics in a timely manner, and to take vitamin preparations (including folic acid). This will help minimize the risk of developing fetal pathologies and give birth to a healthy baby.

To achieve a positive effect in the treatment of spinal hernia, it is necessary to start therapy in the first days after the birth of a child. In this case, it should be noted that the operation should be performed by a surgeon with rich professional experience, since any mistake can lead to spinal cord injury and irreversible consequences in the development of the child.

Surgery involves the complete removal of the baggy neoplasm, after which the spinal cord begins to return to its normal anatomical position. The split is then closed by plastic surgery.

If a child is diagnosed with a spinal hernia, then the only treatment is surgery. It is prescribed as soon as possible, preferably in the first week after birth.

perinatal surgery

postpartum surgery

When neural tube defects in the fetus are established by prenatal screening, the question of terminating the pregnancy is raised in order to avoid the birth of a child with severe pathologies.

Effects

Total posts: 134

03/23/2015, Sysoev Kirill VladimirovichTreatment of children with consequences of spina bifida: http://spinabifida.su/

12/24/2014, SvetlanaI wish strength and patience to everyone who is faced with the problem of spinal hernia. My daughter is now 3 years old.

SMG was operated on on the 2nd day of her life in the Tushinskaya hospital in Moscow. The forecasts were the same.

The feet were sluggish, the legs generally did not move well, even in the thigh. She could not poop for a long time.

At the moment, the child walks, talks, usually poops on his own, feels the urge to urinate, although sometimes he does not have time to run. Feet feel normal.

What did I do? I visited an osteopath - it's expensive, but it helps, and I have to go once a month. Perhaps osteopathy proved to be the most effective remedy.

Every day I kneaded the legs and feet of the child, while always reading poems and nursery rhymes - always the same words for the same movement. I carried the child in my arms a lot, I talked a lot with her.

I did massage and physiotherapy, but I would not say that it helps a lot. Went to the pool with the baby.

This is great. I tried not to see doctors too often.

Regularly visited orthopedists. The most important thing: I put a lot of effort into believing all the time with all my heart that my child is healthy, will walk soon, will speak soon, everything is in order with my child and all impaired functions will be restored.

And do not allow the thought that it will be otherwise. I think that this is the most important thing, because the child always and in everything tries to live up to the expectations of his parents.

Wait for your child to recover, believe in it, find confirmation of this - and the results will be better. Keep believing and firmly expecting improvements even if everything seems hopeless.

For adults who had a spinal hernia as a child, I can recommend osteopathy and Feldenkrais or Thomas Hanna (Hanna Somatics) classes. Books can be downloaded for free on the Internet and studied from them.

True, amazing, very simple and effective techniques, I highly recommend reading. Good luck to you all and ease.

Remember, your confidence that everything will be fine works real miracles.

Prevention

Since spinal hernia is a congenital anomaly of development, the prevention of this disease is the elimination of its causes even before conception. The primary measure is to provide the unborn child with all the necessary microelements and vitamins.

Even if the pregnancy is unplanned, the use of drugs and appropriate foods can be started after conception - the sooner the better. In the specific case of preventing spinal cord herniation, the emphasis is on vitamin B9 (folic acid).

Interestingly, this substance can enter the body of the fetus not only from the mother, but also from the future father, since it is transmitted through the seminal fluid, while having a significant effect.

Any future mother should consult a gynecologist and consult about diseases that develop at the stage of fetal formation. The doctor should talk about ways to ensure a favorable bearing of the child.

To begin with, most pharmaceuticals are stopped for at least the first eight weeks, while the neural tube forms in the embryo. Also, do not get carried away with cosmetics, the same applies to any household chemicals.

Recall that the normal formation of the neural tube in the fetus depends entirely on the adequate intake of essential trace elements and minerals in the mother's body.

Therefore, the basis of prevention is always the use of vitamin complexes and the intake of folic acid in the first weeks after conception.

It can also be noted that it would be ideal to take folic acid before planning conception. It is important to emphasize that folic acid, as
the main component of prevention, should be taken not only by the expectant mother, but also by the future father.

To get acquainted with this tool, you can study the material - Folic acid for conception. which will help to correctly understand the full significance of this drug in planning a future pregnancy.

In the first weeks after conception, a woman should avoid taking any pharmaceutical preparations without consulting a doctor, in addition, it will be necessary to reduce contact with cosmetics and household chemicals.

Particular attention should be paid to the fact that after the 20th week of pregnancy, almost all the organs of the child are already formed, and during this period the main thing is not to harm the child in his intrauterine development.

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megan92 2 weeks ago

Tell me, who is struggling with pain in the joints? My knees hurt terribly ((I drink painkillers, but I understand that I am struggling with the consequence, and not with the cause ... Nifiga does not help!

Daria 2 weeks ago

I struggled with my sore joints for several years until I read this article by some Chinese doctor. And for a long time I forgot about the "incurable" joints. Such are the things

megan92 13 days ago

Daria 12 days ago

megan92, so I wrote in my first comment) Well, I'll duplicate it, it's not difficult for me, catch - link to professor's article.

Sonya 10 days ago

Isn't this a divorce? Why the Internet sell ah?

Yulek26 10 days ago

Sonya, what country do you live in? .. They sell on the Internet, because shops and pharmacies set their margins brutal. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. Yes, and now everything is sold on the Internet - from clothes to TVs, furniture and cars.

Editorial response 10 days ago

Sonya, hello. This drug for the treatment of joints is really not sold through the pharmacy network in order to avoid inflated prices. Currently, you can only order Official website. Be healthy!

Sonya 10 days ago

Sorry, I didn't notice at first the information about the cash on delivery. Then, it's OK! Everything is in order - exactly, if payment upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried traditional methods of treating joints? Grandmother does not trust pills, the poor woman has been suffering from pain for many years ...

Andrew a week ago

What kind of folk remedies I have not tried, nothing helped, it only got worse ...

Ekaterina a week ago

I tried to drink a decoction of bay leaves, to no avail, only ruined my stomach !! I no longer believe in these folk methods - complete nonsense !!

Maria 5 days ago

Recently I watched a program on the first channel, there is also about this Federal program for the fight against diseases of the joints spoke. It is also headed by some well-known Chinese professor. They say they have found a way to permanently cure the joints and back, and the state fully finances the treatment for each patient