Herniated Disc – Intervertebral Disc Herniation
Herniated Disc – Herniated Disc (Lower Back & Neck):
What is it
The spinal disc is like a rubbery jelly that maintains a softer core in its center, which is surrounded by a hard shell. Herniated disc occurs when part of the soft spot protrudes outward, through the hard “wrapping”.
The immediate result is irritation of the adjacent nerves, leading to pain, numbness and weakness in the arm or leg.
Disc Herniation - Intervertebral Disc Herniation:
Causes
Usually normal wear and tear – aging causes disc degeneration, and dehydration makes the discs inelastic and more prone to cracks.
Finally, an injury or a serious fall is a very common cause to cause or accelerate the creation of a herniated disc.
Factors that increase the risk of intervertebral disc herniation
1.
Body weight. When the weight has exceeded the permissible limits, excessive pressure is exerted on the lumbar discs
2.
Professional activity. People with demanding jobs, where the body is strained or sedentary work are at high risk of developing a hernia
3.
Heredity. Some patients have a genetic predisposition to develop a herniated disc
Herniated Disc – Herniated Disc:
Symptoms
The primary symptom of a herniated disc is pain that occurs in the lumbar or cervical spine. The most common symptoms of a herniated disc are:
1.
Pain in the lower extremities, when the herniation is near the lower back. Usually the pain is located in the buttocks, thigh, calf and foot. If the problem is higher up, the pain is evident in the neck and upper extremities
2.
Tingling in the part of the body, which is innervated by the nerves that have been recruited
3.
Muscle weakness and weakness (paresis – paralysis)
Complications
Cervical Disc Herniation
A large herniation in the cervical spine can cause myelopathy with severe and irreversible neurological damage (functional paralysis) if not treated in time.
Complications
Lumbar disc herniation
A serious but rare complication is the cauda equina syndrome, in which the herniated disc compresses the nerves of the cauda equina (a complex of nerves that is a continuation of the spinal cord). It is a serious neurological condition that causes partial or total loss of mobility of the lower extremities and is one of the most urgent conditions in Spine Surgery.
Symptoms that should make you particularly concerned are:
1.
Pain, numbness, or weakness that increases to the point that you cannot perform your usual daily activities and extends to both legs.
2.
Bladder or bowel dysfunction (incontinence or difficulty urinating even with a full bladder – fecal incontinence).
3.
Saddle anesthesia. This progressive loss of sensation affects the areas of the body that would be touched by a saddle, namely the inner thighs, the back of the legs, and the area around the rectum.
Herniated Disc - Treatment
Surgical Treatment (Perineural Injections – Surgery)
Epidural perineural injections
The technique involves the administration of drugs via injection, selectively into the spine, in order to find the point of pain. These injections have both a diagnostic and therapeutic purpose. They are performed in an operating room environment, without anesthesia, under radiological guidance, with a duration that does not exceed 10 minutes.
A very small number of people with a herniated disc ultimately need surgery. In many cases, spine surgeons remove only the part of the disc that is protruding and causing the problem.
Rarely, however, the entire disc may need to be removed. In these cases, the vertebrae may need to be fused together with metal to provide stability to the spine.
The method with the best results for a herniated disc, which is close to perfect, is a microdiscectomy. Simply put, through a small hole in the lower back and using a microscope and special tools, the doctor gains access to the part of the disc that is protruding and pressing on the nerves. Then, he removes the part of the disc that is causing the problem. This method is bloodless, extremely safe with minimal complications and excellent results in treating pain. The patient is usually discharged the same day.
A newer method is endoscopic discectomy, which is essentially a variation with even less surgical trauma and even faster postoperative recovery. The microscope is replaced by a microscopic camera and the entire procedure is performed through a working “tube”.
Spinal surgeries should only be performed by doctors specialized in spinal surgery. The same applies to the monitoring and guidance of patients with any spinal condition.
Herniated Disc – Conservative Treatment
Conservative treatment for the treatment of herniated disc includes anti-inflammatory drugs in combination with muscle relaxants. If there is acute pain, opioid painkillers are also prescribed to reduce the pain.
Physiotherapy and mild mobilization and exercise usually help. Bed rest does not help, on the contrary, it can cause problems and serious complications.
