Nghe An Rehabilitation Hospital: A trusted address for treating spinal disc herniation

(Baonghean) - Nghe An Rehabilitation Hospital is the largest hospital in Nghe An province specializing in neurological diseases; musculoskeletal diseases; respiratory diseases; complications from diseases or after surgery. In particular, the hospital can rehabilitate spinal disc herniation - one of the diseases with a high incidence in many different age groups, which if not treated promptly will leave unpredictable consequences.

Initial diagnosis

Spinal disc herniation is a condition in which the nucleus pulposus of the spinal disc escapes from its normal position in the fibrous ring, compressing the spinal canal or spinal nerve roots. Causes of spinal disc herniation: In the elderly, there is often degeneration of the spinal disc, at which time the annulus fibrosus loses its elasticity, from which the nucleus pulposus easily breaks the annulus fibrosus to move backwards or to the side when the spine performs daily movements, causing the spinal disc to bear forces in all directions. Young people often have incorrect posture, causing the spinal disc to be compressed too heavily, leading to damage to the annulus fibrosus, such as when the spine is flexed, extended, and tilted.

Lumbar traction in the treatment of spinal disc herniation.

Herniated discs often cause pain in the lumbar spine. Lumbar syndrome, sciatica... occur when the herniated disc compresses the sensory nerve roots. This pain area gives us a diagnosis of which nerve is compressed.

The patient has symptoms of pain in the lumbar spine and pain syndromes of the corresponding nerves in the spinal area with herniated disc. Pain along the nerve pathway, depending on the nerve root coming out of the corresponding herniated disc vertebra, is continuous or intermittent, pain is relieved by rest, and movement is difficult. In the late stage, there is muscle atrophy, muscle weakness, limited movement, and stiffness of the paraspinal muscles. There are signs of Vallex pain points, bell-clicking, Lasegue... Tendon reflexes are reduced or lost due to nerve root damage depending on the location of the herniated disc, Achilles tendon reflexes are reduced in S1 nerve root damage, and tendon reflexes are reduced in L4 nerve root damage.

Electroacupuncture in the treatment of spinal disc herniation.

When a patient has a herniated disc, a clinical examination will be prescribed, including: a routine X-ray of the lumbar spine or cervical spine, or a straight and tilted thoracic spine (depending on the location of the pain in the lumbar spine or thoracic region, or the nape of the neck): there are images of a fractured angle of the spine, disc collapse, loss of physiological curve... X-ray of the root sheath with iodine contrast agent; computed tomography (CT) is less accurate than MRI (magnetic resonance imaging); electromyography helps detect damage to nerve roots; MRI is the most advanced and accurate paraclinical technique to diagnose and determine the location of the damage on film images.

On the film, it is possible to determine anterior, posterior, lateral or intraspondylolisthesis, corresponding to the clinical localization. Herniation can occur at one location or at multiple levels, commonly at L5-S1 (lumbar-sacral region); C6-C7 (cervical region); D12 - L1 (thoracic-lumbar transition region) - these are the locations of curvature and are subject to a lot of force on the position of the spine as well as a lot of twisting of the spine in these regions. However, herniated discs can occur at multiple locations, called multilevel herniation; can occur from C1 - C7; D1 - D12; D12 - L1; L1 - L5; L5 - S1. Hematological indices rarely change.

Hydroacupuncture in the treatment of spinal disc herniation.

Regarding differential diagnosis: Due to inflammation: Sacroiliitis, spinal arachnoiditis, spinal tuberculosis, polyradiculitis, polyneuritis, neuritis due to other causes, pelvic floor myositis, spondylitis, ankylosing spondylitis, hip arthritis. Due to spinal abnormalities: Double spines, sacralization, calcification, degeneration, hyperkyphosis, spinal stenosis, nerve root sheath malformation... Due to tumors, spinal cancer, nerves... Nerve pain due to other causes.

Regarding diagnosis of the cause: Spinal trauma; Unstable disc; Wrong working posture; Degeneration, osteoporosis, spondylitis, or back, chest, neck pain due to other joint diseases.

Rehabilitation and treatment

In principle, rehabilitation and treatment usually combine drug treatment, rehabilitation and surgery; active medical treatment within 1 to 3 months, if the condition does not improve and the pain persists, surgery may be indicated. About 90 - 95% of all patients with spinal disc herniation are treated conservatively with internal medicine; about 5 - 10% are treated with surgery. The goal of treatment is to eliminate or reduce pain; restore biomechanical function of the spine; restore nerve conduction function.

Nghe An Rehabilitation Hospital attracts many patients for treatment.

Rehabilitation methods and techniques: Acute phase: Rest in place, on a hard mattress, immobilized in a non-load bearing lying position. Physical therapy with infrared heat, paraffin, therapeutic ultrasound, shortwave, electrolysis, electropulse, interference... Passive, active, impedance and isometric muscle contraction gentle exercises.

After the acute phase, the patient's pain is relieved and can be treated with additional lumbar, thoracic, and cervical spine traction using a spinal traction machine to increase the intervertebral foramen and reduce nerve root compression. Physical therapy with infrared heat, paraffin, therapeutic ultrasound, shortwave, electrolysis, electropulse, interference, etc. Exercise of various types...

1-7 days after surgery, practice breathing, coughing, and flexing the quadriceps and lower limb muscles, triceps, upper limb muscles, trapezius, neck and chest muscles... After 2 weeks, sit with a lumbar brace, chest brace, and neck brace. After 3 weeks, sit up straight. The patient must wear a brace for 3 months.

Use traction machine to treat spinal disc herniation.

Other treatments: Medical treatment: Medications: Pain relievers according to WHO ladder; Non-steroidal anti-inflammatory drugs; Diclofenac 50mg tablets, 2 tablets/day divided into 2 times or intramuscular injection 15mg/day for the first 2-3 days then switch to oral route. Meloxicam (Mobic) 2 tablets 7.5mg/day after meals or intramuscular injection 15mg/day x first 3-5 days, then switch to oral route. Pirocecam (Felden), Celecoxib (Cerebrex)... and topical anti-inflammatory drugs. Muscle relaxants: Myonal, Mydocalm... Slow-acting symptomatic treatment drugs (Glucosamine, Viatril-S..), IL1 inhibitors (Artroda) 1-2 tablets/day; Local Corticoid injection, epidural block injection, facet joint injection; Vitamin B group drugs; Neurotransmitter enhancing drugs such as: Nucleo, Nivaline, Methylcoban, Galantamine, Dibencozide, Neurbion...

Laser or radiofrequency decompression treatment is often used for mild cases such as disc protrusion and posterior longitudinal ligament herniation. Some cases can cause complications such as discitis.

Surgical intervention: Only after medical treatment is ineffective, or there is muscle atrophy, sphincter dysfunction, the purpose is to relieve nerve compression: open surgery has a high success rate, minimally invasive surgery through the posterior, classical way; surgery under a microscope has similar results to open surgery; laparoscopic surgery is the safest method today, surgery through the posterior way, high success rate, less blood loss, patients can walk sooner.

There are many methods such as injecting cement into the vertebral body... Microsurgical discectomy; intervertebral discectomy; nucleus pulposus resection with a special knife; orthopedic surgery, implantation of a prosthetic disc; and hardening surgery (removing the disc and then injecting a substance to harden the disc cavity).

Treatment with traditional medicine

Using decoctions or pills: Depending on each type of disease diagnosed according to traditional medicine, there are different "treatment methods" such as promoting qi and blood circulation; relaxing muscles and activating collaterals; nourishing kidney yin, nourishing liver blood, calming the mind, consolidating essence, regulating qi and blood; dispelling wind, dispelling cold, removing dampness, nourishing the liver and kidneys. In addition, it is possible to use traditional medicine prescriptions such as: "Doc hoat tang ky sinh"; "Tam ty thang"; "phong phong thang"; "quyen ty thang"...

Massage and acupressure in the lumbar region in the treatment of spinal disc herniation.

Spinal massage and adjustment: Using the techniques: "Kicking, pressing, squeezing, pressing, pushing" to impact the back and spine, following the nerve pathways corresponding to the diseased areas.

Acupuncture: (Electroacupuncture or Laser acupuncture): Depending on the location of the spinal disc herniation and the compressed nerve area, appropriate acupuncture points are indicated as follows: Cervical disc herniation: Acupuncture points Jiaji from C2 - C7, Fengchi, Fengmen, Jianjing, Jianngung, Tiantong, Quchi, Hegu, Ashihue. Thoracic disc herniation: Acupuncture points: Jiaji D3 - L1, Xindu, Phedu, Pidu, Ashihue.

Paraffin application is very effective in treating cervical spondylosis, spinal disc herniation and many other diseases.

Lumbar disc herniation: Acupuncture points: Giap tich L3 - S1; Bat lieu, Than du, Can du, Dai truong du, Trat bien, Hoan khieu, Thua phu, An mon, Phong long, Luong khau, doc ty, Duong lang tuyen, Tuc tam ly, Huyen chung, Duong khe, Uy trung, Thua son, A thi huyet. Hydroacupuncture: Hydroacupuncture on the above mentioned points as appropriate with Vitamin B group drugs, neurotransmitters, pain relievers, muscle relaxants, anti-inflammatory drugs...

Follow-up and follow-up

Education and advice on exercises that are good for the spine, correcting bad postures. Career guidance appropriate to the condition, regular health check-ups for workers, and MRI (magnetic resonance imaging) if necessary.

PV