Intervertebral hernia treatment in a newborn. Spinal hernia in newborns

Pathologies of the spine in the fetus, among all developmental disorders, are detected by screening 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 pregnancy management, 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 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 with a careful examination 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 intrauterine 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.

Among the known congenital anomalies, herniated spinal cord in newborns is the most common and occurs in 65% of cases. This is a combined defect, which is often accompanied by clubfoot, hydrocephalus and other anomalies of intrauterine development of the fetus. With this pathology, one or more vertebrae do not close, which leads to the formation of a gap through which the spinal cord and its membranes prolapse.

Most often, this problem occurs in the lower parts of the spine, where the central channel closes last. But spinal hernia can occur in any other part of the spinal column. Spinal cord herniation belongs to the category of serious diseases, and its severity depends on the size of the area of ​​nerve tissue that is deprived of appropriate protection.

Thanks to modern equipment and new research methods, a tumor in the fetus can be detected during pregnancy with ultrasound scanning.

Causes of congenital hernia of the spinal cord

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.

It is customary to distinguish two types of splitting:

1. hidden, considered the mildest form, in which there are no symptoms of the disease, but only a slight depression is noted above the affected spine;
2. hernial splitting is a severe form of the disease with an obvious hernial protrusion, including the spinal cord and cerebrospinal fluid. Such a pathology may not involve the nerve roots, then their functions are not violated.

A difficult situation is observed if the formation contains not only the spinal cord with part of its membranes, but also nerve trunks and roots. In this case, doctors state that the child has severe motor disorders, sometimes incompatible with life.

Symptoms that manifest hernia in newborns:

• defects of the lower extremities and their incorrect position;
• in most cases, congenital spinal hernia is accompanied by manifestations of hydrocephalus, which, if left untreated, leads to disruption of the brain;
• often there is partial or complete paralysis of the lower extremities with loss of sensation;
• almost always, the tumor causes problems with urination and defecation, which leads to urinary and fecal incontinence.

Based on symptoms alone, it is impossible to make a diagnosis of spinal hernia in newborns. The defect can be judged even before the birth of the child by the high content of alpha-fetoprotein in the amniotic fluid and mother's blood. After childbirth, the tumor is clearly defined on the back of the newborn by a protruding leather bag. Hidden splitting is detected during x-ray examination, although in most cases this spinal defect is detected already in adulthood.

The most difficult thing is to determine the form of a hernia of the spinal cord, which is of decisive importance in the appointment of surgical treatment. Therefore, along with x-rays, computed tomography and ultrasound are performed. With the help of these modern techniques, it is possible to change, as well as supplement the ongoing treatment.

When diagnosing, it is necessary to take into account that in children under 10-12 years of age, non-fusion of the vertebral arches is not a pathology, but is considered one of the development options.

Unfortunately, the treatment of this disease is due to certain difficulties. We can say that a hernia of the spine of newborns is exactly that rare case when it is necessary to take all possible measures in advance to prevent it, since it is impossible to cure the disease completely.

In general practice, patients with this pathology are under constant medical supervision. This is especially important given that spinal hernia is most often accompanied by manifestations of hydrocephalus.

Problems with urination can be avoided by applying various hygienic methods of patient care, as well as with the help of urological procedures. To eliminate chronic constipation, which are the result of disruption of the gastrointestinal tract, such children are usually prescribed a special diet.

The food of patients should contain more coarse fiber of plant origin. Physiotherapeutic treatment helps to restore partial mobility to patients suffering from congenital hernia. Regularly receiving procedures makes it possible for some sick children to do without outside help in everyday life.

But very often a congenital hernia leads to a wheelchair. Therefore, it is important to teach parents how to properly care for a sick child. Specialists at consultations explain to fathers and mothers what symptoms may indicate a change in the patient's condition. This is necessary to prevent the development of various complications.

With good care, children with congenital spinal hernia can lead relatively normal lives and even learn individually. Of course, it all depends on the severity of the disease and the location of the formation.

Surgical treatment methods

The only correct option for this disease is surgical treatment. With minor defects, the operation will give a result if it is done in the first few days of the child's life after the diagnosis is established. It is necessary to be very careful when prescribing a surgical intervention, since during the operation it is possible to injure the elements of the spinal cord soldered to the hernia, which will lead to neurological disorders.

An extensive defect is difficult to correct surgically, although it is possible to save a child's life. But such children suffer from physical and mental retardation.

Surgical treatment consists in removing the tumor sac followed by plastic surgery of the defect formed in the vertebral arches.

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.

All diagnostic measures and treatment are carried out immediately after the birth of a child in a specialized clinic staffed with specially trained personnel and the necessary equipment.
The main point in choosing treatment tactics are severe symptoms and examination results.

Treatment will be optimal only when the congenital spinal hernia is removed on the basis of a correct assessment of the operability criteria. If children have pronounced symptoms of somatic disorders and with a significant extent of the spinal cord tumor, the operation is not performed. In such a situation, symptomatic treatment is considered as an alternative therapy for such patients.

Treatment of concomitant developmental anomalies is carried out as soon as possible after the spinal hernia in the child is removed. Children who have symptoms of paresis of the lower extremities need long-term rehabilitation. They are prescribed massage, gymnastics, physiotherapy. Particular attention should be paid to the development of the patient's reflex to defecate and urinate at a certain time of the day. The success of treatment and prognosis largely depend on the form of spinal cord herniation, its location and extent.

Preventive measures

In conclusion, I would like to note that in order to prevent the appearance of a hernia of the spinal cord in newborns, the expectant mother, even before conception, should consult with a geneticist about the planned pregnancy. This is especially advisable if the previous pregnancy was complicated by spina bifida in the child.

You should also balance the diet and make sure that the food has a sufficient content of folic acid. By following these simple recommendations, you will reduce the risk of having a child with such serious birth defects.

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 vegetable 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 motor 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 is a core, of a semi-liquid consistency. With increasing 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 this article, we will consider ways to treat a herniated disc in a child and we will tell you in detail about the cases in which it is shown surgery to remove a herniated disc lumbar.
Intervertebral hernia in children, which is also called a herniated disc - a disease of the spine, from the category of degenerative-dystrophic pathologies. After injury to the spine, due to stretch marks and rupture of the fibrous ring, the disk with the share of the nucleus pulposus is forced to move to a place not intended for it. Intervertebral hernia is one of the rather dangerous pathologies of the spine and treatment with conservative methods is not always effective.

Vertebral discs in children flexible enough. In most cases, too large spinous processes of the vertebrae in the lumbar region interfere with straightening, and poorly developed (short) ligaments hinder bending. If the child's posture deteriorates, the back is loaded unevenly. Then, due to various circumstances and the negative influence of the environment, damage appears on the discs, the lower back hurts, which contributes to the appearance of an intervertebral hernia of the lumbar. The child feels squeezed and sometimes cannot perform simple movements. Pathologies of the spine can be congenital, or occur after an injury.

With osteochondrosis, intervertebral hernia- one of the frequent and unpleasant symptoms in children. There is a possibility of developing a pain radicular syndrome, in which paresis occurs, sometimes paralysis of the legs, the sensitivity and functioning of the pelvic organs worsens, the perineum becomes numb.

Every fifth patient with lumbar disc herniation lies down on the operating table. Indications for surgery: uncontrolled pain syndrome, progressive neurological deficit, affected cauda equina syndrome. Next, you need to be treated under the supervision of doctors for 2-12 weeks (depending on the neglect of the disease, and on how the patient underwent surgery).

If health problems appear, all organs begin to work hard to restore their previous state and recovery. For a person with a herniated disc, it is enough not to break bed rest and not be nervous for 9-13 weeks for everything to heal by itself.

At the present time, it is gaining more and more popularity method of treatment like traction of the spine. It is especially effective in the acute stage. With traction, the pressure between the vertebrae is unstable, which makes it possible to restore the shifted disc.

Therapeutic gymnastics is most often used for both treatment and prevention of intervertebral hernia. Exercise improves muscle function and the immune system. You need to do it constantly, but so that the child does not feel pain, everything is done easily. At the acute stage, physical activity is not recommended, only during the recovery period.

Below, we will elaborate on the reasons why intervertebral hernia in a child What is the most effective treatment for the disease? You will learn what a lumbar disc herniation is in children and adolescents and whether it is possible to do without spinal surgery by observing only precautions in everyday life and doing strengthening exercises.

Next article.

Article publication date: 07/08/2015

Article last updated: 10/23/2018

One of the most severe congenital anomalies is a spinal hernia, which occurs when the posterior wall of the spinal canal is not closed with an exit through the formed defect of the dura mater, spinal cord, cerebrospinal fluid, and spinal nerve roots. This is an exclusively infantile disease.

Child with congenital spinal hernia. Click on photo to enlarge

The prevalence of the anomaly is 1 case per 1000-3000 newborns. The most typical localization of a spinal hernia is the lumbosacral spine, less often, non-fusion of the arches with the formation of a protrusion is observed in the thoracic and cervical regions.

The anomaly is accompanied by serious motor and sensory disorders, dysfunction of internal organs, which lead to disability. Without treatment, a spinal hernia ends in death for most children, and the survivors become disabled.

After timely adequate treatment, most children survive, however, violations in varying degrees of severity persist. Only in 10% of patients it is possible to achieve the restoration of pelvic, motor and sensory functions.

Causes of pathology

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.

The factors leading to such developmental disorders of the spine are still not well understood. It is believed that a spinal hernia can form due to:

• heredity;
• deficiency of vitamins in the body of a pregnant woman (primarily folic acid);
• numerous factors that cause abnormalities in the fetus (medication, drugs, alcohol during pregnancy; certain infections, exposure to toxins).

Symptoms

Symptoms of a hernia are determined by its size, location and contents. The easiest and most favorable prognosis is in formations of small size with the release of only the meninges (meningocele) as part of the protrusion. Since with this option the spinal cord is formed correctly, no neurological symptoms are observed, and only an external defect is noted - a volumetric formation above the spine, covered with thinned skin.

Types of spinal hernia

In the case of exit through the unfused arches of the spinal roots (meningoradiculocele) or the spinal cord along with the roots (myelomeningocele), in addition to the external formation above the spine, severe neurological symptoms develop in a child:

• paralysis and paresis (complete or partial lack of movement) of the lower extremities;
• loss of pain and tactile sensitivity;
• disorders of the function of the pelvic organs (the impossibility of forming arbitrary control over defecation and urination).

Nerve signals and nutrition do not pass to the legs, which is why trophic disorders occur over time: the legs become thin, with flabby weak muscles, thin skin, edematous, with trophic ulcers. Bedsores appear on the skin of the lower back and buttocks (even with adequate hygienic care). Without treatment, children die from an attached infection or become severely disabled.

Treatment Methods

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.

The essence of the operation is the removal of the hernial sac and the closure of the bone defect of the spine.

The operation can be delayed only in the case of a small meningocele in the absence of motor, sensory disorders and pelvic disorders and with well-preserved skin (premature intervention in this type of hernia can cause neurological disorders due to damage to the structures of the spinal cord during the operation). In all other cases, the operation is mandatory, and only it can save the life of the child.

After the operation, the baby will need a long period of rehabilitation, including regular thorough hygiene measures, prevention of constipation, therapeutic massage and gymnastics, and physiotherapy.

The result of treatment largely depends on the size and location of the hernia:

With meningocele, after the elimination of the formation, usually there are no problems in the further development of the child, he recovers and leads a completely normal, active lifestyle.

With meningoradiculocele and myelomeningocele, the prognosis is ambiguous. Usually, paralysis and paresis with appropriate postoperative care and full rehabilitation after surgery does not happen, but the function of the pelvic organs, even with a small size of the formation, recovers much worse, and many operated children retain involuntary urination (possibly - only at night - enuresis), it happens fecal incontinence, and in adulthood - infertility in women and potency disorders and erectile dysfunction in men.

Commentary on the video: "back Bifida" includes a spinal hernia.

Conclusion

Insofar as Since spinal hernia is a serious intractable disease, the issues of preventing its occurrence are of great importance. Pregnant women need to take care of their health, avoid negative factors, take vitamins and folic acid recommended by the doctor in the early stages of pregnancy. A hernia in the fetus detected on ultrasound serves as the basis for artificial termination of pregnancy for medical reasons (with the consent of the pregnant woman).

Owner and responsible for the site and content: Afinogenov Alexey.