How is the blockade for a hernia of the cervical spine
The spine is an important part of the human body, thanks to which not only the possibility of upright walking is carried out, but also most movements are performed. Sometimes the health of the spinal column suffers, and one of the common reasons for this is an intervertebral hernia, which can develop in different places and lead to various consequences.
The most common symptom of a hernia of any location, including the cervical region, is severe pain. It is their relief that the use of various injections is aimed at hernia of the cervical spine and the formation of pathology in any other parts of it. Elimination of pain syndrome is one of the main goals of therapy, without which a full-fledged treatment is not possible.
So what pain relief injections do doctors use today? What are the indications and contraindications for these procedures, and is there a risk of complications? Due to what the procedure is effective, and is it possible that the blockade will not work and the pain syndrome will remain?
How is the procedure performed
Blockade with a hernia of the cervical spine is not something complicated. The essence of the technique is as follows: with the help of a special injection, the anesthetic substance is injected directly into the area of localization of the pain syndrome. Due to the delivery of the active substance directly to the problem area, discomfort completely disappears after a few minutes.
As anesthetics, drugs such as Lidocaine or Novocaine are mainly used, as well as their combinations with antispasmodics or glucocorticosteroids.
What is the analgesic effect? Anesthetics injected into the pain zone block sodium ion channels located in the nerve endings. As a result, the transmission of the pain impulse stops. The disappearance of unpleasant sensations caused by a hernia is associated precisely with the precise administration of the drug precisely in the area where the greatest pain is determined.
In modern traumatology, blockades are used not only to achieve therapeutic effects, but also as a diagnostic measure. The doctor may recommend that the patient undergo the procedure if there is reason to suspect that the pain syndrome is provoked not by a cervical hernia, but by some other pathology. If the targeted use of anesthetics does not give an effect, and the patient continues to complain about the presence of pain, then, in addition to the detected hernia, it is necessary to look for another disease. Then the search is already conducted on the basis of the results of additional examinations, which are selected individually.
Another important feature of blockades is that they are forbidden to be carried out by personnel without appropriate qualifications.
Only specialists in the field of topographic anatomy, vertebrology or traumatology are allowed to perform the manipulation. At the same time, the patient must sign papers stating that he is familiar with the possible risks and contraindications. Without signing the relevant documents, no doctor will undertake to perform such a procedure.
Types of blockades
Blockades performed in the presence of a cervical hernia can be divided into several types depending on the method of drug administration and the medication used. The choice of the method of drug delivery to the painful area, as well as the choice of the drug itself, is always carried out only by the attending physician. This necessarily takes into account the size of the hernial protrusion, as well as the patient's allergic reaction to various medications.
Such a procedure is considered important so that it is possible to immediately stop the pain syndrome, which causes inconvenience to a person and interferes with further treatment. After all, if the patient complains of acute pain, any serious therapy cannot be carried out.
First of all, all blockades are divided into:
- intramylinar , in which the injection is carried out in the region of the middle segment, which is located between the two vertebral processes;
- transforaminal , in which an injection is given at the place where the spinal nerve exits the spinal foramen.
Regardless of the type of procedure, it is necessary that the attending physician has extensive experience. Great precision is required in order not to make a mistake when administering a drug.
According to the technique of introduction, all blockades are divided into:
At the same time, paravertebral blockades, which are used most often, have their own separate classification.
It looks like this:
- paravertebral tissue injection , in which the injection is made into the soft tissues around the pain zone, but the bone structures are not affected;
- paravertebral receptor injection , in which the injection is carried out strictly in one area with the highest receptor activity (it can be a muscle, ligament, tendon);
- paravertebral conduction injection , in which the drug is administered in the area of the exit of nerve endings, due to which it is possible to block their activity;
- ganglionic injection involves the introduction of a healing agent directly into the nerve plexus or nerve ganglion, due to which it is also possible to relieve pain.
An epidural blockade is a type of procedure that many doctors put into a separate category. Its use is recommended if the patient suffers from very pronounced, aggressive pain. The procedure is performed by a specialist doctor under the control of special devices and with the introduction of a contrast agent. Thanks to this, it is possible to track not only the course of the procedure, but also how the medicinal substance will spread in diseased tissues.
In most cases, pain can be relieved after the first procedure. Doctors, in turn, recommend a course of treatment to consolidate the effect. The course can be from two to fifteen injections, which are performed with an interval of five to six days.
When is the procedure performed and what are its advantages
A hernia of the cervical spine is a pathology that can be accompanied by acute pain, which significantly reduces the quality of life of a person. The main task of anesthetic injections in this case is to stop the pain syndrome as soon as possible.
Use the procedure in the following cases:
- an intervertebral hernia or protrusion in the area of the intervertebral space was diagnosed;
- acutely flowing neuritis (inflammatory reaction in nerve fibers) was determined;
- diagnosed with neuralgia;
- radiculitis or osteochondrosis of the cervical spine was found;
- the patient suffers from muscular myositis.
According to indications or for diagnostic purposes, blockades can also be performed for other pathologies of the musculoskeletal system.
Why is this procedure so commonly used today? The fact is that it has a number of distinct advantages.
The pluses include:
- the rapid development of the analgesic effect, which is assessed by patients as satisfactory;
- in the lesion, it is possible to reduce or completely eliminate the inflammatory process in order to more effectively use other therapeutic techniques;
- it is possible to eliminate spasms, regardless of their severity;
- it is possible to remove tissue edema, which certainly develops along with an inflammatory reaction in the area of \u200b\u200bthe nerve roots;
- minimize the risk of developing various complications;
- the technique can be repeated if the pathology of the spinal column has again entered the stage of exacerbation.
When blockades are prohibited
Despite the fact that pain-relieving blockades have a high degree of effectiveness, they are not always used. There are a number of situations where the use of anesthetic injections is strictly contraindicated.
The restrictions include:
- the patient has systemic blood diseases that lead to increased bleeding of wounds (thrombocytopenia, hemophilia, etc.);
- long-term use of drugs that prevent blood coagulation (artificial violation of the natural ability of blood to clot);
- an active infectious process of a systemic or local (in the area of drug administration) type of flow, in which there is a high risk of further spread of pathogens;
- allergy to medicines that can be used during the blockade, lack of acceptable alternative means;
- the presence of chronic diseases of the heart and blood vessels, and especially tachycardia, which can be aggravated due to the use of anesthetics;
- severe myasthenia gravis;
- chronic severe pathologies of the liver, kidneys;
- period of pregnancy, breastfeeding, children's age;
- epileptic disorders or other mental pathologies.
Some contraindications (age, childbearing or lactation period) may be regarded by doctors as relative. This means that if the expected benefit to the mother is higher than the risk to the child, blockade is allowed.
Medications used for the procedure
When an intervertebral protrusion is detected that requires the use of a blockade, a rather limited number of drugs are used that have proven themselves in this area.
First of all, analgesics are used, which include:
- Novocain (the drug begins to act a few minutes after administration, and the effect lasts up to several hours, which can significantly improve the patient's condition);
- Lidocaine (it is in second place in terms of frequency of use, the analgesic effect can last up to three hours, which is usually enough to stop pain impulses and have a beneficial effect on the general condition of the patient);
- Merkain (used most rarely, since it begins to have a tangible effect only after 10-15 minutes, but the effect lasts up to 5 hours in a row).
All of the above drugs belong to the group of analgesics. This means that they block nerve impulses, thus removing the pain syndrome or significantly reducing it.
In addition to analgesics, doctors often use glucocorticosteroid drugs for blockades, the task of which is to stop inflammation processes, which makes it possible to strengthen and prolong (lengthen) the analgesic effect.
The most commonly used drugs of this group are:
- Hydrocortisone , which is often mixed with any of the anesthetics used;
- Dexamethasone , which is mainly used for pain relief through soft tissues, since the duration of its action is not too high;
- Diprospan is a long-acting drug that can be used with an anesthetic for any type of blockade.
In addition to glucocorticosteroids and analgesics, other medications may be included in the blockade injection. For the most part, they do not have a pronounced therapeutic effect when used alone, and therefore they are included in injections. There, their effectiveness can be most fully manifested.
Many patients who decide to undergo a blockade due to a hernia of the cervical spine are concerned about the question of how high the likelihood of complications is and, most importantly, what negative reactions from the body should be feared?
Most often you will encounter:
- increased prolonged bleeding, which can be difficult to stop even in a hospital setting;
- the introduction of pathogenic microorganisms into the injection site in case of non-compliance with the rules of asepsis and antisepsis;
- the carelessness of the doctor who administered the injection, which caused damage to blood vessels, nerve trunks or endings, muscle structures;
- an unexpected allergic reaction to one of the components of the solution for injection;
- specific complications that can be caused by glucocorticosteroids or analgesics.
It is important to keep in mind that the higher the qualification of the doctor performing the intervention, the lower the risk of encountering various complications. Naturally, the procedure is by no means carried out at home by paramedical personnel. It can be carried out only in stationary conditions under full medical supervision.
How effective is it
Many patients wonder how effective blockades are when a hernia appears between the vertebrae. The procedure is effective, and this is explained by the fact that drugs are administered in close proximity to the pathological focus.
Anesthetic injections for hernias allow not only to effectively, but also quickly stop the pain syndrome, which in some cases is unbearable.
The duration of the effects can vary significantly in different patients, which the attending physician must pay attention to. Everything will depend on the severity of the pathology, the individual characteristics of the patient's metabolism, the chosen method of administering the drug.
As an exception, there are cases when the blockade does not bring the desired effect, the pain continues to torment the patient. In this case, the doctor most often warns that the procedure is diagnostic in nature, and the cause of discomfort, most likely, lies not at all in the hernial protrusion, but in some other pathology.
How much will an anesthetic injection cost to eliminate the discomfort of a spinal hernia? If the therapy takes place in the conditions of the clinic, to which the patient is assigned, then the procedure will be free. But, for the most part, when the pain is taken by surprise, there is no way to wait for free medical care, and then the person turns to a paid clinic.
The cost of intervention will consist of:
- type of anesthesia;
- the area in which it will be carried out;
- used medicines and equipment;
- individual characteristics of a medical institution.
Paravertebral blockade on average costs about 1000-1500 rubles. If you need to control the X-ray machine or ultrasound, the cost can increase to the level of 3000-6000 thousand. The price of epidural blockade has an even greater spread. On average, the price tag starts at 2500 and ends at 8500 thousand.
It is important to remember that blockade is not a panacea for hernia pain. It is necessary to use additional methods of treatment, such as medications, exercise therapy, wearing corsets if necessary. Nevertheless, the blockade is a serious procedure, which can be repeated a maximum of 3-4 times a year. Sooner or later, this serious method will stop helping if you do not carry out additional therapy aimed at combating the disease.
The use of anesthetic blockades for a hernia of the cervical spine is an effective way to get rid of pain. The main thing is to choose a good clinic and a competent highly qualified specialist who will be able to carry out the procedure correctly, without provoking negative consequences and contributing to the fight against pain as much as possible.