A herniated disc occurs when there is an issue with one of the rubbery cushions (discs) between the individual bones (vertebrae) that stack up to make your spine.
A spinal disk is a little like a jelly donut, with a soft centre and a tough exterior. Sometimes called a slipped disc or a ruptured disc, a herniated disc occurs when some of this soft “jelly” pushes out through a tear in the tough exterior.
A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. On the other hand, many people experience no symptoms from a herniated disk. Most people who have a herniated disc don’t even require surgery to correct the problem.
You also can have a herniated disc without knowing it — herniated discs sometimes show up on spinal images of people who have no symptoms of a disc problem.
A herniated disc is diagnosed when its symptoms are clearly present. With help of neurological examinations, abnormal reflexes can be revealed. A positive straight leg raising test may be done to determine if there is any pain when a leg is raised while sitting or lying. A herniated disc could produce abnormal sensations in the leg or foot. Additionally in order to determine any signs of infection or inflammation, blood tests are also carried out. Degeneration of the spine is indicated by plain film X-rays. CT scans and MRI scans are performed to determine whether a disc is herniated or not. Irritation in the nerves due to a disc herniation can be precisely determined by using an electromyogram (EMG).
A herniated disc treatment depends upon many factors that include –
The purpose of treatment is to relieve symptoms of a herniated disc and to provide relief from pain. Discomfort and pain caused by cervical and lumbar herniated discs can be treated with the help of non-surgical treatments. These treatments are carried out for 4-6 weeks. Patients who are still going through a high loss of function and severe pain, can consider surgery as an option.
If the pain caused by a herniated disc is mild to moderate, then nonsteroidal anti-inflammatory medication is given. For directing medication to the precise location of a disc herniation, an epidural steroid injection is given by using a spinal needle under X-ray guidance.
Physical therapy is also sometimes recommended. Physical therapy involves gentle massage, ultrasound, pelvic traction, ice and heat therapy, stretching exercises and electrical muscle stimulation. Along with physical therapy, muscle relaxants and pain medication may also prove beneficial for a patient.
Laminectomy : This procedure removes most of the lamina of a vertebra or the bony arch.
Artificial Disc Replacement : During this procedure, a diseased herniated disc is replaced with an artificial disc. To treat pain associated with degenerative disc disease, Prodisc-L is used which is made up of plastic and metal. The Charite artificial disc is yet another artificial disc comprising of a plastic core between 2 chrome plates, which gets locked into the spine.
Discectomy : Complete or part of the intervertebral disc is removed.
Spinal Fusion : During the spinal fusion procedure, a bone is grafted onto the spine in order to create a hard union between 2 or more vertebrae. Sometimes rods and screws are used to provide additional spinal support.
Laminotomy : During this procedure, an opening is created in the lamina to ease the pressure on nerve roots.
An endoscopic herniated disc surgery is performed thorugh a small incision. Both an endoscope and a camera are used in this procedure. A needle and a mechanical device is inserted into the patient’s back, followed by which the diseased part of the disc is removed by the surgeon. This procedure is done on an outpatient basis and involves faster recovery.
Percutaneous Laser Disc Decompression (PLDD) is used for treating neck or back pain caused by a herniated disc. PLDD provides instant relief without performing any surgery. This minimally invasive procedure is done under local anesthesia and is performed on an outpatient basis. A laser beam is used to vaporize a small part of the disc in order to decompress it.