Herniated disc is an important disease. There are 5 vertebrae in our waist. There are cartilages called discs between these bones. The disc is a special connective tissue organ and serves to ensure the durability, mobility and resistance of the spine to stress, to absorb shock-like impacts applied to the spine and to distribute the force evenly to the surrounding tissues. It is a disorder that occurs as a result of the herniation of these discs, which are located between the vertebrae and function like a shock absorber. On the inside of the discs, there is a jelly-like soft part called the nucleus pulposus, outside of this, a harder fibrous layer called the annulus fibrosus, and on the sides facing the vertebrae bones, there are cartilage structures called end-plates on both sides. When the anatomical integrity of the outer layer is disrupted and the soft part inside bulges out, it is called herniation. The herniated disc, that is, protruding outward, compresses the nerves passing through the spinal canal (spinal canal) or from its back-side, and the disease manifests itself. In addition, some chemicals released into the environment from the herniated disc also affect the nerve roots and cause pain. .
Why and How Does a Herniated Disc Occur?
There are many causes of herniated disc. There is a factor. In addition to many external factors, such as lifting a heavy load or performing an adverse movement, personal factors also play an important role in the formation of a herniated disc. Because there are people who weigh 120 kg. removes it, nothing happens; There are also those that weigh 5 kg. It lifts, a herniated disc occurs.
The primary factor affecting the individual is the degeneration of the cartilages called discs located between the vertebrae. Just as nothing in the universe is left to chance, the feeding of the disk takes place within a certain plan and program. Certain substances pass through certain parts of the disk. However, as age progresses, the vessels feeding the disc decrease and are not seen at all after about eight years of age. After this age, the disc is nourished by diffusion. The water content of the discs gradually increases from childhood onwards. Work begins to decrease. While the water content in the disc of a fetus is 90%, this rate decreases to 80% in children and 50-60% in adults. As a result, the disc gradually becomes smaller and its height decreases. This is accompanied by malnutrition in the discs, micro-level changes, chemical changes and degeneration caused by mechanical forces applied to the disc. As the amount of oxygen and nutrients entering the disc gradually decreases, it becomes difficult to remove metabolic wastes. The disc loses its elasticity over time and is no longer able to transmit force and distribute the force evenly in the surrounding tissues. The number of supporting cells within the disc that undertake repair duties also decreases with age. Repair becomes weaker. When excessive load is placed on the micro-level cracks or when the person makes a wrong movement, the soft part inside the disc easily tears the capsule around it and comes out, resulting in a herniated disc. In other words, after the ground is ready, a final straw is needed, which could be lifting a light object or simply coughing.
Degeneration in the cartilage structure occurs at a relatively earlier age in all members of some families, so it is more frequent and easier. They get herniated disc. There are families where we have operated on the grandfather, father and various close relatives for herniated discs. In other words, it can be said that degeneration in the cartilage structure has a genetic aspect.
Vasin diseases, diabetes and smoking accelerate degeneration by negatively affecting the amount and quality of blood flow to the disc, and therefore its nutrition.
The most important external factors that play a role in the formation of a herniated disc are unconscious movements during daily activities. When we lift a load by bending or lying down, the load on the discs in the waist is not symmetrical, but asymmetrical.
1. The fibers that make up the outer part of the disc are lined up at a 30-degree angle and prevent the inner part, called the nucleus, from protruding outward under the influence of various forces. In other words, these fibers constitute a serious obstacle to the development of a herniated disc.
2. When the load is applied symmetrically on the disc, the structures that make up the inner and outer parts of the disc are clearly deformed. However, since this deformation is symmetrical, a herniated disc cannot easily develop.
3. If the load is placed asymmetrically on the disc, two adjacent vertebrae on the side where the load is applied come closer to each other, the distance between them narrows and the capsule part of the disc is deformed and protrudes outwards.
4. The part inside the disc, called the nucleus, tends to move towards the opposite edge due to the pressure it is exposed to. However, the fibers forming the outer part of the opposite edge are stretched and weakened in this position. In this case, the load applied asymmetrically will easily cause the nucleus to protrude from the opposite side, that is, the formation of a herniated disc.
When looking at the vertebral bones from the side, a normal disc and a herniated disc inside the spinal canal are seen.
>As a herniated disc develops, if some of the outer fibers of the annulus fibrosus have not yet ruptured and the entire disc material is inside the disc, as seen in figure A, it is called a contained disc. However, if all of the annulus fibrosus fibers have lost their integrity and the material inside the disc has protruded beyond the annulus, as in Figure B, this is called an uncontained disc.
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