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Spinal hernia in a newborn child: symptoms, treatment

Spinal hernia in newborns is a fairly rare, but very severe developmental pathology that occurs in only 0.1-0.3% of children. And almost 2/3 of children remain chained to a wheelchair for life. Congenital spina bifida can be determined at the stage of pregnancy.

Causes of spinal hernia in newborns

Why manifestations of spinal hernia in newborns may occur is not well understood. Therefore, one can only name the factors that can influence the development of pathology, based on the opinion of leading professors of medical sciences. Risk factors include:

• a pregnant woman's lack of adequate amounts of folic acid, also known as vitamin B9, as well as other vitamins, is now recognized as the main cause of spina bifida in infants; nine0016
• pregnancy intoxication;
• early pregnancy;
• hereditary factor.

The formation of the neural tube occurs before the eighth week of gestation, and it is at this time that one or more of the listed factors can provoke the onset of pathology. As a result of this phenomenon, one or more vertebral bodies are separated in the region of the spinous process. The membranes of the spinal cord, fluid and even nerve endings can go into such a gap. nine0003

Forms of spinal hernia in newborns

A spinal hernia in a child can be divided according to its location and structural features. Where the protrusion is located is very important, since further treatment, the complexity of the symptoms and its elimination will depend on this factor. The easiest variety is hidden splitting, when one vertebra is slightly deformed, which will not bring much discomfort to the child. If the defect is more serious, a hernial split occurs when a clearly visible protrusion is detected, which is visible under the skin. In severe cases, the spinal cord itself comes out into this protrusion. If we talk about where the spinal hernia is located in a child, we can distinguish: nine0003

• cervical - the rarest, affects the upper parts of the spinal cord, innervation can occur in the neck and face, respectively, coordination is disturbed, and malfunctions of the lungs and heart occur;
• chest - occurs more often in the neck, but much less often in the lumbar, and the pathology can affect the work of the arms and legs, lungs, heart, stomach, spleen, liver, etc .;
• lumbosacral - occurs most often, affects the functioning of the pelvic organs, kidneys and lower extremities. nine0016

Whatever the protrusion, the severity of the condition will be determined depending on its size.

Symptoms of spinal hernia in newborns

A photo of a spinal hernia in newborns is often found on the Internet, and almost every pregnant woman is afraid of this pathology. To determine if a newborn has such a disease, look for signs of a hernia. These include:

• paralysis of limbs, disorders and nutrition, paresis; nine0016
• pelvic troubles, fecal incontinence;
• malfunctions of the heart, lungs, gastrointestinal tract and endocrine system.

All these symptoms may be accompanied by secondary complications, which include muscle atrophy, edema, trophic ulcers and lack of skin thermoregulation, etc.

Diagnostics

To determine the presence of the disease, the doctor collects an anamnesis of a small patient, and also conducts a complete examination of him. If there were no abnormalities during pregnancy, doctor will determine the health status of the child, taking into account his age. He will check how well the muscles are developed, whether there is any weakness, difficulty in muscle activity, etc. In addition, to determine the presence of the disease and the consequences of spinal hernia in newborns, you will need:

1. Visit neurologist .
2. Carry out a light scan, called transillumination, to identify the obsession of the protrusion.
nine0015 Myelography with contrast - allows you to determine the damage to the spinal cord.
3. MRI or CT.
4. Visit a neurosurgeon who will determine the need for surgery and give prognosis.

Timely detection of the disease will increase the chances of a successful cure for the baby from the disease.

Treatment

The disease is usually treated with surgery. It can be performed both before and after birth. nine0003

Perinatal surgery

It can be prescribed at 19-26 weeks of gestation and is recognized as the most effective method of ridding a child of a hernia. The operation will close the anatomical anomaly in the spinal column, as a result of which the spinal cord returns to its place and is protected from influences. Among the reasons for the appearance of a spinal hernia in newborns in this case may be natural childbirth, therefore, after the operation, the woman will be delivered by caesarean section. This method allows you to ensure the most normal life for the child. Among the shortcomings of the method is that such operations, like those for premature babies, are performed only abroad. At the moment, there are only a few specialists capable of performing such an operation in Russia. nine0003

Postpartum surgery

This type of treatment is possible in the first few days after birth, then it does not make sense. Surgery will remove the growth, but there will be significant developmental problems and additional surgery may be needed. Life expectancy is affected not only by the type of hernia, but also by the presence of hydrocephalus.

Rehabilitation

Your healthcare provider will be able to tell if a baby's spinal hernia can be treated with ozone gas, and will also determine what rehabilitation measures are needed. If we are talking about foreign clinics, then often they have sanatorium branches where doctors monitor the child's condition after the intervention. Rehabilitation may include massages and exercise therapy. nine0003

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Intervertebral disc herniation. Treatment of spinal hernia, symptoms, causes, diagnosis

Video

Title

• Manifestation
• Methods of treatment

Herniated discs are the most common and most severe manifestation of spinal osteochondrosis. At the same time, a pain radicular syndrome develops, which may be accompanied by paresis or paralysis of the muscles of the lower extremities, a sensitivity disorder, and a dysfunction of the pelvic organs. nineteen% of patients with herniated discs need surgical treatment.

Dystrophic changes in the lumbosacral spine are most pronounced at the age of 20 to 50 years and are one of the most common causes of temporary disability and often - disability of the patient. Up to 50% of all surgical interventions in neurosurgical hospitals are performed for the pathology of discs at the lumbosacral level.

The disease results from a ruptured intervertebral disc . The resulting spinal hernia , protruding back and to the side, puts pressure on the nerve root at the point of its exit from the spinal canal and causes inflammation, accompanied by edema. This explains why pain and loss of sensation appear only a day after the onset of the disease. The pinched nerve root sends pain impulses to the brain, which are perceived by the patient as if they were coming from the leg. Part of the nerve outside the pressure site hernia almost ceases to function, which leads to a sharp decrease in sensitivity and the appearance of weakness in the leg.

Manifestation

In almost all patients, the main complaint is pain. As a rule, pain occurs in adolescence after moderate physical exertion, an uncomfortable position at the workplace or in bed. As well as with "lumbago", the disease often occurs when tilting with a simultaneous turn to the side, often in combination with heavy lifting. Sudden, not particularly severe pain in the lumbar region is also characteristic. Then, during the day, pain and weakness appear in one of the legs, sometimes with loss of sensation on the inside of the foot and lower leg or on the outside of the foot and the inside of the leg. When moving, coughing, sneezing or straining, the pain in the back and leg intensifies and often becomes so intense that the patient needs bed rest. Some relief can be achieved by lying down, raising your legs or placing them on a pillow. nine0003

There are two stages in the development of the disease. At the first stage, there is pain in the lumbar region, which indicates the beginning of the degenerative-dystrophic process. Under the influence of degenerative changes in the spinal motion segments, the rather complex structure of the fibrous ring changes, radial cracks form in it, which reduces its strength. The nucleus pulposus protrudes, the blood circulation of this zone is disturbed, there is swelling of local tissues, hypoxia of the spinal cord root, adhesions. Annulus fibrosus, posterior longitudinal ligament, dura mater, intervertebral joints are well innervated by branches of the sinuvertebral nerve. A pain syndrome occurs, which leads to myopically fixation of the pathological zone due to the tension of the back muscles and, as a result, compensatory curvature of the overlying sections of the spine occurs. Thus, a vicious circle is formed. Subsequently, prolonged pathological impulsation leads to degenerative changes in the articular-ligamentous apparatus.

And at the second stage, the nature of the pain syndrome changes. There is a compression radicular syndrome, which is caused by mechanical compression and tension of the root. In this case, swelling of the root occurs, its blood supply is disturbed. With direct contact herniated disc with root chemical irritation causes more intense pain. Often, when radicular pain occurs, pain in the lumbosacral region weakens or disappears. Apparently, this is due to a decrease in intradiscal pressure due to rupture of the annulus fibrosus. Vertebrogenic pain syndrome can be caused not only by compression of the root (radiculopathy) or spinal cord (myelopathy), but also by the vessel feeding the root - radiculomyeloishemia. nine0003

Distribution and localization of radicular pain generally corresponds to the zone of innervation of the compressed root. Pain is more often "lamp" in nature, may be constant or coming. The disks L4-L5 and L5-S1 are mainly affected. The L3-L4 level suffers only in 2-4% of cases. In addition to pain, sensitivity disorders, such as hypoesthesia and anesthesia, sometimes hyperesthesia, can be determined.

Vegetative disorders are observed in the form of hypothermia of the skin, their pastosity, sweating changes, dryness of the skin increases. nine0003

Quite often, patients are in a forced position. Compensatory postures that reduce the degree of compression and tension of the root are manifested by scoliosis, flattening of the lumbar lordosis, limitation of flexion and extension of the body, and tension of the long back muscles.

Sometimes patients cannot straighten their leg due to pain. Motor disturbances in the form of paresis or paralysis are rarely noted, they are more typical for advanced cases. There may be trophic disorders in the form of "weight loss" due to muscle atrophy. In the early stages of the disease, symptoms of irritation are more pronounced, in the later stages - symptoms of loss of functions. nine0003

Treatment of intervertebral disc herniation.

The human body has a powerful ability to self-heal, which also applies to damaged intervertebral discs . Usually this disease goes away in 2-3 months, subject to bed rest and rest - the best prerequisites for a quick recovery without complications. As with other diseases of the lumbar spine, it is recommended to lie on your back with your legs raised or placed on a pillow, changing body position and looking for a comfortable, painless posture. Painkillers and anti-inflammatory drugs can be taken to relieve severe pain, although they do not speed up recovery, they reduce suffering. After 3-4 weeks, the pain usually subsides significantly, but the damage itself disk is not yet healed, therefore, in order to avoid possible complications in the form of chronic back pain, rest for another whole month is necessary.

Surgical treatment is indicated in the presence of intractable pain syndrome (treatment period from 2 weeks to 3 months), an increase in neurological deficit, cauda equina syndrome (impaired function of the pelvic organs, decreased potency, numbness of the perineum).

Other herniated disc treatment in the acute stage - traction of the spine. This is a very old method, interest in which has recently been increasing. Traction creates a pressure drop in the intervertebral space, which makes it possible to “suck in” a hernia of the spine . In this case, it is necessary to find the correct direction of influence and select the appropriate force so as not to damage the spine even more. Sometimes the patient is recommended to carry out traction himself, in accordance with the pain sensations. With the right procedure, the pain should decrease, not increase. nine0003

So, treatment of hernia is as follows:

• If the pain is moderate or tolerable, bed rest and pain medications are recommended until the condition improves or at least for 3-4 weeks.
• The spinal traction method can also be used to quickly relieve pain. If they are still unbearable despite bed rest and drug therapy, mechanical stretching may also be a way out. nine0016
• However, if the pain is unbearable despite repeated traction and complete rest, surgery is not excluded.

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