Schmorl defects in endplates. Causes of acquired Schmorl defects. Complications - what is the risk of Schmorl's hernia

Schmorl defects: symptoms and treatment

Doctor A. Deryushev

Schmorl's defects or Schmorl's nodules are hernia-like protrusions of the pulpous (or gelatinous) nucleus of the intervertebral disc.

For the first time, these defects were described and studied by the German pathologist, Professor Christian Schmorl, in connection with which they were named after him. The causes of the formation of a Schmorl defect can be curvature, compression fractures and bruises of the spine, ruptures of intervertebral fibrous rings, as well as various pathological processes affecting the vertebral bodies. In this case, a rupture of the hyaline cartilage plate occurs, which leads to prolapse of the nucleus of the intervertebral disc. Such changes in the cartilaginous part of the intervertebral disc as physiological resorption may also play a role in the formation of Schmorl defects.

By the end of the first year of life, proliferative processes are noted in the plate of hyaline cartilage, which forms a support for the nucleus pulposus. Subsequently cellular elements in different departments intervertebral disc disappear. These changes lead to a decrease in the strength of the intervertebral disc, which may be a predisposing factor for the formation of Schmorl's nodules in childhood and adolescence.

Externally, Schmorl's nodules look like hernial protrusions of the nucleus pulposus of the intervertebral disc, directed into the spongy substance of the vertebral bodies, and in some cases into spinal canal. The diagnosis is based mainly on a careful analysis of the results. x-ray examination, and at present it is primarily the use of the capabilities of a spiral computed tomograph, which makes it possible to more accurately determine all the details of this phenomenon.

Of great importance is the fact that the organizing mass of the nucleus pulposus, protruding into the spinal canal, can exert pressure on the roots of the spinal nerves.

The main clinical symptom is pain, which depends both on the compression of the roots (this is the so-called radiculalgia) and on the injury of the fibrous-ligamentous ring (this phenomenon is called dyscalgia). Patients complain of acute, sudden onset of intense pain in cervical region spine or in the arm (like plexitis). When moving the head, the pain may increase and often depends on the posture of the patient. The irradiation of pain is quite extensive; it can spread along outer surface shoulder and sometimes forearm. AT thoracic region these defects are less common and give the syndrome of ordinary thoracic sciatica.

Localization of defects in lumbar spine is manifested by "classic" lumbosacral sciatica. Hernias located at the level of 1 and 2 lumbar vertebrae are manifested by pain along the anterior surface of the thigh, and at the level of L3 and L4 pain is localized on the anterior surface of the lower leg and inner ankle. There is limited mobility spinal column especially back and forth.

If there is compression of the roots or the substance itself spinal cord, then, of course, the radical method is surgical intervention. The operation is indicated for prolonged radicular pain, which is accompanied by severe scoliosis and, of course, in the absence of effect from conservative methods treatment. Conservatively applied different kinds physiotherapy, dehydration therapy, which helps to reduce hyperemia and swelling in the area nerve root, resorption and even disappearance of adhesions. It is possible to use dosed traction, massage, exercise therapy, blockade.

Surgical intervention consists of decompressive laminectomy as well as dissection of the so-called odontoid ligaments.

Exercises for Schmorl's hernia

Physical exercises for Schmorl's hernia are included in the list of recommendations of vertebrologists, orthopedists, neurologists, surgeons and other specialists to whom the patient, frightened by the mysterious name of the pathology identified, will turn. True, there will be plenty of reservations about what exercises cannot be done.

Do they take Schmorl's hernia into the army?

Very often, a conscript and his parents are interested in the question: "Do they take Schmorl's hernia into the army?" Let's first understand what kind of disease it is and what symptoms accompany it. With Schmorl's hernia, cartilage is pressed into the vertebral body from the intervertebral disc. This ailment may be one of the syndromes of Scheuermann's disease - Mau. In addition, Schmorl's hernia often appears with kyphosis - a strong stoop.

Therapeutic exercises for Schmorl's hernia

One of the main pathological changes in the intervertebral discs, it is with which patients most often turn to trauma departments due to constant aching pains that is a disease such as Schmorl's hernia. This pathological (congenital) disease is a degenerative process in the intervertebral discs. Schmorl's hernia is mainly pathological disease, but in some cases it can be acquired, this most often occurs as a result of injuries or posture disorders.

Vertebral hernia of Schmorl

Schmorl's hernia is pathological condition due to changes in the spinal column of a degenerative nature. Pathological changes in Schmorl's hernia occur in the endplate of the intervertebral disc, as a result of which its cartilaginous part protrudes into the vertebral body located above or below.

The spine is made up of vertebrae, which are no different in structure from ordinary bones. They consist of spongy substance and bone tissue. The vertebrae are connected to each other by discs located in the space between them. The upper shell of each disc is covered with cartilaginous tissue. Main function it consists in cushioning the vertebrae and ensuring movement.

Due to certain diseases bone tissue does not grow as fast as the cartilage layer. Because of this, wide cavities are formed, into which discs located between the vertebrae often fall. Such structural defects are called usurative Schmorl defects.

Causes of appearance, symptoms

The reasons for the development of usurative defects are different factors. They appear in equal parts in the advanced and young age. In particular, this can happen after a significant injury or heavy lifting. Often, the cause of a hernial protrusion, accompanied by usurative defects, is an incorrect structure of the bone tissue. In such cases, there are multiple Schmorl's hernias, each of which is accompanied by usurative defects.

As a rule, Schmorl's protrusion is an asymptomatic disease. Most people are not even aware of its existence. Just on final stages development of the disease can be observed back pain, local fatigue, some discomfort. The pain syndrome increases with sports, but gradually weakens in a lying and relaxed position.

How can we detect usurative defects?

Usurative defects of Schmorl's hernia cannot be found on x-ray They are not visible to x-rays. You can track them after an MRI or computed tomography.

What do the usurative defects indicate?

Usurative defects are a harbinger of the immediate start of treatment for Schmorl's hernia. If there are no other symptoms, all therapy is aimed specifically at correcting them and preventing further development.

Before starting the complex therapy of usurative defects, it is required to determine the age of the patient, occurring on this moment diseases and stage of hernia development. Also, before starting treatment, it is required to identify the cause and factors of the onset of the disease.

Tasks of complex therapy:

If there is a pain syndrome, then it needs to be eliminated;
Treatment is aimed at improving metabolism;
It is necessary to accelerate the inflow and outflow of blood to the affected spine;
Restoration of the previous mobility and flexibility of the spinal column;
liquidation muscle spasms, if available;
Prevention of the development of consequences that can cause usurative defects.

Therapy for Schmorl's hernia, which is manifested exclusively by usurative defects, is aimed at strengthening the skeleton and muscles. It consists in the following:

Also, for the treatment of usurative Schmorl defects, you can resort to folk methods. They involve the use of gymnastics and massage. Alcohol decoctions and tinctures are also used. positive impact render medicinal plants- chestnut, potato flowers, dandelions.

Physiotherapy

Therapeutic exercise is a set of exercises aimed at treating usurative defects of Schmorl's hernia. In itself, it combines several methods at the same time - running, swimming, exercising on the simulator. Therapeutic exercise can be used as component complex therapy, as preventive measure or after surgery to strengthen.

With the right exercise:

All metabolic processes in the body will be improved;
rise the immune system, the body's resistance to infectious diseases will increase;
The trophic state of tissues will be improved;
Exercise has a positive effect on the musculoskeletal system.

Attention! The load during physiotherapy exercises is selected individually! Otherwise, it will not correspond to the capabilities of the body, which will lead to the opposite result.

Effective exercises:

Pulling up - has an effect on the spinal muscles, strengthens the muscles of the hands;
Bench press with a barbell without arching the back;
Mahi's sitting position using dumbbells;
Shrugs are an occupation that influences trapezius muscle. The lesson must be performed with the help of raising and lowering the shoulders with permissible load. It is allowed to perform it in any position: standing, lying down, etc.
Hyperextension - stretching. These exercises help to strengthen the rectus muscles and hip flexors. In particular, this exercise is recommended for owners of a weak back.

Gymnastic exercises

Physiotherapy with usurative defects of Schmorl's hernia, it is considered one of the categories of physiotherapy exercises. It can only be done under supervision. professional doctor. To strengthen muscular system and ligamentous apparatus corrective exercises are applied. In particular, it allows you to increase the flexibility of the spinal column and eliminate many defects.

Attention! Therapeutic exercises for usurative defects will be more effective in combination with breathing exercises.

Therapeutic gymnastics must be carried out in combination with massages. With usurative defects, it is important that they are carried out experienced specialist! All manipulations should be soft and gentle, so as not to aggravate the situation. Massage will increase blood circulation and also strengthen the spinal muscles.

Surgical intervention

Operation with usurative defects of Schmorl is not shown. After their discovery in without fail held complex therapy including physiotherapy.

Surgical intervention can be prescribed only for complications of a hernia, for example, a compression fracture. As a result, the patient's condition deteriorates. conservative therapy unable to produce results. Observed muscle weakness, pain, dysfunction of internal organs.

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Increased back fatigue It's a dull pain when walking, painful head turns - all this can be a sign of the presence of a spinal hernia in the spinal column. The name of the pathology in the intervertebral discs sounds intimidating, but it is much more terrible to know what diseases ignoring a small hernia can turn into in the future. People who lead sedentary image life, growing children and adolescents, the elderly.

What is Schmorl's hernia

In medicine, this radiological term in 1927 thanks to the German physician Christian Schmorl. Named after him this disease. Schmorl's nodes are formed in the process of pushing the cartilaginous tissue of the end plates into the cancellous bone. Falling can occur in both the upper and lower vertebrae. With these cartilaginous nodes, there is no pain. To prevent the disease, it is necessary to active image life, watch your weight, go in for swimming, which will help strengthen your back muscles.

Schmorl defects in the vertebral bodies

The spinal column is part of the skeleton of 32-34 vertebrae, which consist of bone tissue and spongy substance. Discs are the connecting element between the vertebrae. Them upper shell contains cartilaginous tissue, the purpose of which is the depreciation of the vertebrae during movement. If the bone tissue does not grow as fast as the cartilaginous tissue, cavities appear, where the discs fall. The described phenomenon is called usurative defects in the vertebral bodies.

The reasons

The collapse of the cartilaginous tissue appears if a person received a blow, non-vector loads, lifted excessive weights. Pathology is formed not only in young people, but also due to age-related changes. Osteoporosis occurs in older people due to reduced bone strength. With such clinical syndrome bone fracture occurs. The cartilage from the intervertebral disc becomes stronger than the vertebra, pushing through the bone. Small hernias are minor pathologies at birth, and intracorporeal ones occur with a lack of trace elements in the vertebral region.

There are other reasons for the appearance of a hernia of the spine:

The peculiarity of the structure of the end plates of the vertebrae was inherited.
Teenager or child early age began to grow rapidly.
Strong physical activity during sports.
Fall injury or heavy lifting.
The circulatory system of the spinal column worsened with stoop, with little mobility.
There was a calcium deficiency in the bone tissue.
In the intervertebral disc there was a violation of metabolic processes.

Symptoms

Schmorl's disease does not cause severe pain, because the bone tissue of the vertebra suffers, it does not hurt. Signs of Schmorl's hernia can be detected using x-rays. First stage pathology is asymptomatic, causing discomfort, increased feeling of fatigue. If the cartilaginous Schmorl nodes reach a large size, then aching pain may appear when walking and general fatigue. This is explained defensive reaction spinal muscles on a weakened vertebrae that they are forced to protect, so they begin to whine. The disease increases the level of vertebral curvature.

In the cervical spine

At home, it is impossible to detect a Schmorl's node on the spine, because. symptoms of a hernia are not pronounced. Randomly, the disease is detected during an examination using radiology and fluorography, in which the cervical spine is clearly visible. Schmorl's nodes in the vertebral bodies cause a state of weakness and increased fatigue. When a hernia in the cervical spine begins to progress, patients experience the following symptoms:

decreased concentration;
memory impairment;
dizziness;
performance deteriorates;
nasal congestion, the head begins to hurt on one side, tears flow, the occurrence of fear of light;
noise in ears;
vomiting, nausea;
neck muscles tense;
in the cervical spine, pain manifests itself when turning the head;
numb and tingle upper limbs.

Thoracic

With a hernia in the thoracic spine, pain is not felt. With age, other diseases begin to join this pathology: Bechterew's disease, rheumatoid arthritis, osteochondrosis, intervertebral hernia. In this case, Schmorl's hernia in the thoracic region can manifest itself through tingling on the skin, numbness of the upper extremities, increased heart rate, shortness of breath, and be accompanied by other painful sensations:

in the thoracic spine;
when turning the body;
at deep breathing;
when moving upper limbs;
in the area of the hypochondrium and stomach.

In the lumbar

Long years symptoms of Schmorl's hernia of the lumbar spine may not manifest themselves in any way. With age, degenerative-dystrophic diseases of the spine in the lumbar region join the existing defect. There are problems with the stool ( prolonged constipation), erectile dysfunction, pain when urinating, "goosebumps" on the skin lower extremities. Other symptoms include pain:

in the lumbar spine;
in the buttocks;
when walking and turning the body.

Multiple hernias of Schmorl

When cartilage in several parts of the spinal column penetrates into the bone tissue of the vertebrae, an anomaly occurs. Multiple hernias of Schmorl are easy to recognize on an x-ray by a special diamond-shaped pattern. The disease is diagnosed in children and adolescents due to the fact that during the period active growth the bone tissue becomes soft and cannot withstand the pressure of the cartilage. The disease does not pose a significant threat to health, because. may go away on its own with changes in lifestyle and diet.

How to diagnose a spinal hernia

To establish the causes of pain in the lower back and back, it is necessary to consult a doctor with an examination of the patient. Diagnosis of spinal hernia is carried out using magnetic resonance or computed tomography, and the transillumination method will help evaluate the contents of the hernial sac. To date, in medical clinics can offer the following options for diagnosing a hernia:

collection of cerebrospinal fluid lumbar puncture);
Ultrasound of the spinal cord;
X-ray method, myelography;
procedure for detecting nerve conduction disorders;
CT scan;
MRI (magnetic resonance imaging).

How to treat Schmorl's hernia

At the doctor's consultation, the patient is informed about how to take care of his spine, what exercises to perform in physical education, how to build a rest regimen. Qualified specialist will give you a list of medicines. It is important to combine the treatment of Schmorl's hernia with the intake of calcium in the amount of 1000 ml. Instead of buying additional drugs calcium, you can build the necessary diet from fermented milk products, vegetables, fruits, fish, sesame seeds, sunflower seeds, beans.

Medical treatment

Methods of treatment without surgical intervention based on taking a complex of drugs that will help the patient overcome discomfort during daily physical activity on the spine. Treatment of spinal hernia with medicines is carried out under the close supervision of a doctor in three therapeutic stages:

Etiotropic - elimination of the cause of occurrence.
Symptomatic - elimination unpleasant symptoms.
Pathogenetic - stopping pathological processes.

There are several groups of drugs that doctors prescribe for spinal hernia:

Non-steroidal anti-inflammatory drugs.
A group of analgesics, including: analgin, baralgin, ketorol and spasmalgon.
Sirdalud, mydocalm (muscle relaxants).
Medicines that help with neurological symptoms such as nausea, mild muscle numbness, dizziness.
B vitamins, magnesium.

Physiotherapy

Strengthening the straight back muscles, abdominals, the formation of " muscle corset", Exercises for stretching the sections of the spinal column - necessary exercises with Schmorl's hernia. When performing them, you should listen to the sensations and stop them if pain occurs. It is important to strictly follow all the rules, performing the exercises slowly, without jerking. An example of one of these exercises: lie face down on the floor, stretch your arms forward. right hand lift up with your left leg. Hold for a few seconds, gradually lowering. Perform alternately 10 times.

Corset

If Schmorl's knot causes discomfort when moving, then you need to buy supportive clothing. A corset for Schmorl's hernia fixes the muscles of the back, reducing the load on the spinal column, eliminates tension during spasm, improves blood circulation - does everything that will help strengthen the spine. Orthopedic corsets distinguish between rigid and semi-rigid. Determine for what purpose it is needed? If you need back support after an injury, then choose a hard one. Semi-rigid will help to find a beautiful posture.

with a hernia of the lumbar spine, the corset fixes part of the spine in the lumbar region, capturing part of the back to the pelvis and lower section chest;
a fixation-reclining corset keeps the thoracic spine in a stable position;
corset-vest with a holder for the head fixes damaged cervical vertebrae.

Find out what it is, how to choose the right ones for treatment.

Massage

mechanical effect on physiological active points improves lymph flow and blood circulation. Therapeutic massages for hernia are done using pneumatic cans made of glass and plastic, bamboo sticks, Kuznetsov, Lyapko applicator. Indications for massage are prescribed by a doctor in a rehabilitation or safe period when the patient does not have acute pain. What effect does massage have on the body with a hernia of the spine:

reduces pain syndrome;
reduces hypertension;
promotes speedy recovery sick;
reduces the likelihood of disease transmission from acute form into chronic.

Spinal traction

At various diseases of the spine in orthopedics, a set of methods is carried out aimed at strengthening the ligaments and muscles of the back. Gradually, the load on the discs will decrease, blood circulation and venous outflow will improve. Traction traction of the spine can be directed locally to the desired department or to all areas at once. Contraindications to the procedure are pain syndrome caused by traction, pregnancy, overweight, cancer, purulent diseases spine, cardiovascular and bronchopulmonary systems.

What is the danger of Schmorl's hernia on the spine

If a person has microusural changes in the form of cartilage nodules for a long time, then the vertebrae in the spinal column become weaker, more vulnerable to shock and physical activity. The disease is dangerous with complications that can occur if therapy is not started on time. Particular attention should be paid to people over 50 years old, women during menopause, pregnant girls. A sign of an increase in hernia will be a strong physical fatigue. The consequences of Schmorl's hernia can be more dangerous, for example:

Schmorl nodes of the intervertebral disc are minor injuries that can develop into compression fractures;
become a cause of disability (the disc is pressed into a hernia, disrupting the function of the spine);
early arthrosis occurs due to increased load on the intervertebral joints;
a hernia can develop to an intervertebral hernia;
osteoporosis.

Video

Schmorl's hernia is a pathological change in the spine, which was first described by the German physician Christian Schmorl and received his name. Schmorl's defect is characterized by the fact that the cartilage tissue pushes through the bone. In this case, both the upper vertebra and the lower one can be affected. Another name for this pathology is Schmorl's nodes in the spine.

The reasons

Today, doctors identify several reasons, among which:

The presence of a hereditary predisposition. If one of the relatives has problems with the structure of the spine, the risk of the same problems in the offspring increases.
Too much fast growth child during childhood and adolescence. As a result, the bones do not have time to grow behind the rest of the body, voids form between the vertebrae and intervertebral discs, which the body fills with cartilage tissue in order to maintain normal operation.
Frequent microtrauma of the spine due to active sports, severe physical work. In some cases, a hernia is first detected during pregnancy, when the load on the woman's body increases many times over.
In old age, the cause of the development of the disease can be osteoporosis, which deforms cartilage and bone tissue.
Various pathologies of the blood supply to the ridge can also be the reasons why the disease is formed.
Insufficient calcium intake can lead to softening of bone tissue with subsequent filling of the formed defects with cartilage tissue.
In the intervertebral disc may be disturbed metabolic processes, because of which the development of a hernia is also possible.

Symptoms

The disease tends to be completely asymptomatic. Moreover, often herniated protrusions in the vertebral bodies are discovered by accident when the patient is undergoing x-rays for completely different purposes.

Multiple Schmorl's hernias are suspected if the patient complains of fatigue of one or another part of the spine Load tolerance is reduced due to the fact that intervertebral disc it is tightly attached to the body of the vertebra, which makes movements in it more difficult, as well as maintaining an immobile posture.

Large or small hernias Schmorl in large quantities can manifest themselves chronic pain about which a person will complain when vertical position body. Interestingly, if we accept horizontal position the pain will gradually subside.

Schmorl defects can reduce the mobility of the spinal column, lead to redistribution of the load and rapid wear of certain parts of the spine. Over time, full-fledged protrusions and hernias can form in their place.

Large central Schmorl's hernia can give symptoms characteristic of osteochondrosis. If a patient has a central hernia, preventive treatment recommended, even if clinical symptoms missing.

What is the danger?

Why are Schmorl's nodules, despite the absence of any symptoms, considered dangerous? There are several reasons. Among them:

a negative effect on the vertebrae, which leads to thinning of bone tissues, a decrease in their tolerance to stress and, as a result, under stress may develop compression fracture the spine is a severe pathology that requires a long recovery;
Schmorl's defects in the vertebral bodies act not only on them, but also on the intervertebral discs, preventing them from performing their main functions normally, due to which the spine ceases to cope with standard loads, sometimes up to the patient's disability;
due to the disease, the intervertebral joints suffer quite a lot, because of which early arthrosis can develop in them, which is also capable of advanced cases lead to disability
if the disease is not cured in a timely manner, it can cause the formation of a protrusion or a full intervertebral hernia that are amenable to therapy is much more difficult.

Cartilaginous nodules in the vertebral bodies themselves can be harmless and even asymptomatic. The main danger of such nodules lies in the complications that they can provoke by disrupting the functioning of the spinal column. That is why even asymptomatic Schmorl's hernia is recommended to be treated.

Which doctor treats Schmorl's hernia?

However, today, alas, a vertebrologist is still a rather rare specialty, representatives of which can only be found in large cities. If there is no opportunity to visit a vertebrologist, you can seek help from an orthopedist or traumatologist. These specialists can also help manage the disease.

In some cases, for more effective therapy A consultation with a neurologist is also recommended. If the patient has any accompanying illnesses, consultations, for example, with an endocrinologist or a therapist, may be required.

Diagnostics

A protrusion of the intervertebral disc into the vertebral body is quite difficult to diagnose. This is explained by the paucity of complaints and poor visualization of the affected area. And it doesn’t matter if the lesion of the lumbar, cervical or any other department is revealed.

The first thing the doctor should do is to carefully collect complaints and anamnesis from the patient. Complaints with Schmorl's hernia may, at first glance, have nothing to do with the pathologies of the spinal column. In the anamnesis, one can often find indications of microtrauma, the presence of a hereditary predisposition. However, it should be remembered that the typical causes disease progression may or may not be present.

The main method of diagnosis is radiography. Thanks to it, pathological protrusions are visualized. Sometimes, an MRI scan is required to clarify the diagnosis. If MRI is contraindicated for any reason, CT is recommended.

Treatment

Treatment of Schmorl's hernia is considered important, although initially this pathology classified as harmless. The task of the doctor and the patient is to prevent the progression of the disease, not to allow complications to develop.

The main task of treatment is to cope with the disruption of the spine by improving metabolism. useful substances and tissue strengthening. This can be achieved by adjusting the patient's nutrition, improving local blood circulation, and redistributing the load.

Under the supervision of a doctor, patients are prescribed rich in calcium diet. Calcium, entering the body, will strengthen bone tissue. The diet includes milk, cottage cheese, cheese and other foods rich in this element. In some cases, if calcium from foods is not enough to adjust its level in the body, it may be prescribed vitamin complexes and calcium preparations.

It is important to remember that diets rich in calcium, should be strictly controlled, as it can adversely affect the kidneys.

Gymnastics with Schmorl's hernia is prescribed by a doctor. Recommended exercise therapy classes, and when overweight need selection gymnastic exercises to help get rid of it. Not all exercises for Schmorl's hernia are useful. It is recommended to exclude riding a motorcycle and horse riding, aerobics, acrobatics and some other sports. Massage for this type of hernia is recommended, as it improves metabolic processes in the body.

Surgical treatment for cartilaginous nodules in the vertebral bodies is not indicated. The operation can be performed only if the patient has developed any complications of the disease.

Complications

The development of intervertebral hernias of Schmorl is dangerous high probability traumatization of the vertebrae with the subsequent development of osteochondrosis and other pathological changes. Also, over time, the pathology can progress, leading to a full-fledged hernia or protrusion. Another common complication is a compression fracture of the spine due to injuries or overload.

Vertebral hernia of Schmorl in most cases develop completely asymptomatically. The prognosis for this disease, if treated promptly and fully, is usually favorable. The main thing is, if a pathology is found in the picture, do not delay going to the doctor. It is better to make sure that the bulges are safe than to endure until complications appear.

Often, after an X-ray examination of the spine or CT, the patient may receive the conclusion "Schmorl defects" or "Schmorl hernia". This indicates that structural changes with the formation of the nucleus pulposus were revealed in the vertebral bodies. Subsequently, the vertebral cartilage of the neighboring vertebrae is pressed through.

Unlike a normal intervertebral hernia, with Schmorl's defects, the protrusion of the disc is not directed towards the intervertebral canal. Since compression of the nerve roots does not occur with this pathology, a pronounced pain syndrome in humans is not observed. The progression of Schmorl's hernia leads to further destruction of the disc and can cause a normal intervertebral hernia with subsequent complications.

general information

The vertebrae, which form the basis of the spine, do not differ in structure from bones. In their composition there is a spongy substance and bone tissue. The space between the vertebrae is filled with intervertebral discs. From above they are covered with cartilaginous tissue. The intervertebral discs perform a shock-absorbing function for the spine, give it the opportunity to move.

Under the influence of certain factors, degenerative processes develop in the vertebral structures. Bone begins to grow more slowly than cartilage. This leads to the formation of cavities in the vertebral body. They protrude the nucleus pulposus of the disc. Such structural changes are called defects (hernias) Schmorl.

In most cases, such indentation of cartilage into the bone occurs during the period of active growth in children (14-17 years old). The spongy substance of the bones grows more slowly than the whole body and becomes softer. cartilage tissue at this age, it is more durable, it penetrates into the spongy substance, forming a protrusion of the cartilage. Thus, Schmorl defects are limited to the vertebral bodies, in contrast to and.

Reasons for the development of defects

Pathology can be congenital and acquired. In the first case, hernias occur due to congenital design features of the vertebrae.

Causes of acquired Schmorl defects:

violation of metabolic processes;
hormonal dysfunctions;
deformities of the spinal column ( , );
spinal injuries (eg, vertical fall);
increased stress on the vertebrae (weight lifting, power sports);
systemic diseases that reduce the density of cartilage and bones.

In childhood, the formation of Schmorl's hernias in most cases is associated with the formation of voids in the vertebrae due to a mismatch in the growth of bones and muscle tissues.

Types of formations

By the number of defects are single and multiple.

Single hernias are diagnosed in 70% of patients. More often they are asymptomatic. Only the occurrence of single defects in other departments leads to a violation of the mobility of the spine and its curvature. At a young age, pathology is diagnosed more often in the thoracic region, in older people - in the lumbar region.

Multiple Defects - indirect sign disease characterized by progressive kyphosis or. At the beginning pathological process there may be no symptoms, but multiple hernias often cause impaired motor function.

Depending on the type of location of defects in the vertebral bodies, there are several types of Schmorl's hernias:

intracorporeal- the intervertebral disc penetrates into the spongy substance of the vertebra;
intravertebral- the disk is displaced through the vertebral plates;
front- develop in the anterior segments of the vertebral body, which may be higher or lower;
rear- arise as a result of penetration into the vertebral body of the degenerative ligament, which runs along its back wall;
central and lateral- they are detected only with the help of radiography, they do not cause deformation of the vertebrae.

First signs and symptoms

The insidiousness of Schmorl defects in the vertebral bodies is that at the beginning of the formation process they are asymptomatic.

As the hernial node grows, the following symptoms may appear:

violation ;
pain in the area of the formation of defects;
fast fatiguability;
numbness of the limbs;
increased pain syndrome during exercise;
reflex muscle tension.

Advanced intracorporeal Schmorl defects in the lumbar region may be accompanied by:

violation of urination;
diarrhea or constipation;
nausea;
vomiting;
sexual dysfunction.

Possible consequences

For a very long time, the pathology may not progress and not give complications. An enlarged hernia can lead to the following consequences:

education ;
spine;
and joints due to increased load on them;
movement disorder.

General rules and effective methods of treatment

If during the course of radiologists Schmorl defects were detected on early stage, treatment should be aimed at arresting the progression of pathology.

You can't self-medicate! The tactics of therapy is determined by the doctor, based on the age of the patient, the severity of defects, the presence of concomitant diseases.

Treatment goals:

eliminate pain if it is present and relieve muscle spasm;
enhance metabolism in bone tissues;
improve blood supply to the spinal muscles;
restore flexibility to the spine;
prevent the development of complications.

In most cases, patients are prescribed methods of complex therapy:

Diet correction. In the menu you need to increase the amount of dairy products, fish, legumes. Limit salt.
At pain syndrome reception ( , ) is assigned.
Take calcitonin to strengthen bones fish fat, vitamin D.
Exercise therapy and massage.
(traction);
Methods of physiotherapy (electrophoresis, laser therapy and others).

Exercise therapy and gymnastics

With Schmorl defects, gymnastics helps to activate metabolism, increase blood flow, and strengthen the musculoskeletal system. Lessons physical therapy should become a regular method of preventing recurrence of pathology. A specialist selects a set of exercises for each patient separately.

Massage

It must be carried out by an experienced specialist. The main thing is that the course of massage does not aggravate the course of the pathology. It is considered very effective when acupressure. It helps relieve fatigue, relieve pain, improve tissue trophism. Massage is recommended only in combination with other therapeutic measures.

Prevention

In order to prevent yourself as much as possible from the occurrence of Schmorl defects in the vertebral bodies, you need to follow these recommendations:

move more and engage in those sports that strengthen the spine (yoga, race walking);
2 times a year to take courses of therapeutic and relaxing massage for the back;
prevent the appearance of excess weight;
eat a balanced diet, avoid alcohol;
at the slightest discomfort in the back, contact a specialist.

Although Schmorl defects are referred to as an x-ray diagnosis and pathology is often not accompanied by painful sensations, you can not neglect its treatment. The progression of the disease is fraught with the development of complications that significantly impair human life (intervertebral hernia, arthrosis).