In addition to many external factors such as lifting a heavy load or making a reverse movement, personal factors also play an important role in the formation of herniated disc. Because there are people who weigh 120 kg. removes it, nothing happens; There are also such that 5 kg. removes, herniated disc becomes.
At the beginning of the personal factors is the degeneration of the cartilages called discs located between the vertebrae bones. Just as nothing in the universe is left to chance, the feeding of the disc takes place within a certain plan and program. Certain substances pass through certain parts of the disc. However, as the age progresses, the vessels feeding the disc also decrease and they are not seen at all after the age of eight. After this age, the nutrition of the disc is by diffusion. The water content of the discs also starts to decrease gradually from childhood. While the ratio of water in a fetus’s disc is 90%, this ratio drops to 80% in children and 50-60% in adults. As a result, the disc also gets smaller and smaller in height. This is accompanied by malnutrition and micro-level changes in the discs, as well as chemical changes and degeneration caused by the mechanical forces applied on the disc. While the amount of oxygen and nutrients entering the disc gradually decreases, it becomes difficult to remove the metabolic wastes. The disc loses its elasticity over time, and it can no longer perform the task of transmitting force and spreading the force in the surrounding tissues in a balanced way. The number of support cells in the disc that take on the task of repair also decreases with age. Repair is weak. When excessive load is placed on the cracks at the micro level or when the person makes a wrong move, the soft part inside the disc easily tears the capsule around it and protrudes and a herniated disc occurs. In other words, after the ground is ready, one last drop is required, which can be lifting a light object or just coughing.
Cartilaginous degeneration in all members of some families occurs at a relatively earlier age, therefore, lumbar hernia is more common and easy. There are such families that our grandfather, father and various close relatives had surgery for herniated disc. In other words, it can be said that the degeneration in the cartilage structure has a genetic aspect.
Diseases in the veins, diabetes and smoking accelerate degeneration by negatively affecting the amount and quality of blood flow to the disc, and thus its nutrition.
One of the external factors that play a role in the formation of herniated disc is unconscious movements during daily activities. When we lift a load by bending or reaching, the load on the discs in the waist becomes asymmetrical, not symmetrical. In such a case, the figures below explain how a herniated disc can easily occur. .
1. The fibers that make up the outer part of the disc are lined up at an angle of 30 degrees and they 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 herniated disc.
2. When the load is applied symmetrically on the disk, the structures that make up the inner and outer parts of the disk are clearly deformed. However, since this deformation is symmetrical, herniated disc cannot easily develop.
3. If the load is placed on the disc asymmetrically, the two adjacent vertebrae on the side where the load is applied come closer to each other, the distance between them becomes narrower and the capsule part of the disc is deformed and protrudes outward.
4. The part of the disc called the nucleus tends to move towards the opposite side with the effect of 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 we look at the spine from the side (sagittal plane), different locations of herniated and displaced disc material are seen.
Different localizations of lumbar hernia are seen in the horizontal plane. The herniated disc may progress towards the spinal canal (B, C, D), or it may develop in the direction of the holes called foramen on the sides through which the nerves leaving the spinal canal pass (E). It may even extend beyond the foramen (F).
