Neuro and Spine Surgeries
Brain AneurysmWhat is Brain Aneurysm?Read more...
Brain SurgeryWhat is Brain Surgery?Read more...
Brain TumorWhat is Brain Tumor?Read more...
CraniosynostosisWhat is Craniosynostosis?Read more...
Carotid Artery DiseaseWhat is Carotid Artery Disease?Read more...
Carpel Tunnel SyndromeWhat is Carpel Tunnel Syndrome?Read more...
EpilepsyWhat is Epilepsy?Read more...
HydrocephalusWhat is Hydrocephalus?Read more...
Herniated DiscWhat is Herniated Disc?Read more...
HeadacheWhat is Headache?Read more...
Lumbar Spinal StenosisWhat is Lumbar Spinal Stenosis?Read more...
Parkinson DiseaseWhat is Parkinson Disease?Read more...
StrokeWhat is Stroke?Read more...
Spina BifidaWhat is Spina Bifida?Read more...
Spinal Cord InjuryWhat is Spinal Cord Injury?Read more...
Spinal FusionWhat is Spinal Fusion?Read more...
Spinal LaminectomyWhat is Spinal Laminectomy?Read more...
Spinal TumorWhat is Spinal Tumor?Read more...
What is a Herniated Disc ?
Sometimes called a slipped or ruptured disk, a herniated disk most often occurs in your lower back. It is one of the most common causes of low back pain, as well as leg pain (sciatica). Between 60% and 80% of people will experience low back pain at some point in their lives. A high percentage of people will have low back and leg pain caused by a herniated disk.
Although a herniated disk can sometimes be very painful, most people feel much better with just a few weeks or months of nonsurgical treatment. People who are suffering from leg pain, weakness of the lower extremity muscles or back pain are diagnosed with a herniated disc. A herniated disc occurs when the cushion which sits in between the spinal vertebra is pressed outside its normal position. The condition of herniated disc can cause pain weakness or numbness in an arm or leg. It can also irritate the surrounding nerves. It has been seen that many people develop no symptoms of a herniated disc.
I can’t imagine the direction of the wind, but I can adjust my sails to alway search my destination.
When it’s dark enough, you can see the stars.
Once you choose hope, anything’s possible. Hope never abandons you, you abandon it.
The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.
Dear GOD, if today I lose my hope please remind me that your plans are better than my Dream.....
Causes of a Herniated Disc
The most common reason a herniated disc is disc degeneration (wear and tear of the disc). The normal ageing process decreases the fluid in the vertebral disc that helps in maintaining proper flexibility. Any injury to the spine can also cause a herniated disc that may cause cracks or small tears in the outer layer of the disc. Inside the disc there is a jelly like material that can be pushed out from the cracks or tears in the capsule, causing the disc to break into fragments or bulge. In children and young adults, disks have a high water content. As we get older, our disks begin to dry out and weaken. The disks begin to shrink and the spaces between the vertebrae get narrower. This normal aging process is called disk degeneration.
Injury to the disc can be due to:
Symptoms of a Herniated Disc
For most people with a herniated disk, low back pain is the initial symptom. This pain may last for a few days then improve. It is often followed by the eventual onset of leg pain, numbness, or weakness. This leg pain typically extends below the knee, and often into the foot and ankle. It is described as moving from the back or buttock down the leg into the foot.
Symptoms may be one or all of the following:
Not all patients will experience pain as a disk degenerates. It remains a great challenge for the doctor to determine whether a disk that is wearing out is the source of a patient’s pain.
Diagnosis of a Herniated Disc
The condition of a herniated disc is diagnosed when its symptoms are present. With the help of neurological examinations, abnormal reflexes can be revealed. A positive straight leg raising test is done in order to elicit the pain when a straight leg is raised while sitting or lying. An abnormal sensation could also be there in the leg or foot. In order to determine any signs of infection or inflammation, many blood tests are done. The degeneration of the spine is indicated by plain film X-rays. Also CT scan or MRI scan is performed for determining whether or not a disc is herniated. The irritation in the nerves due to a disc herniation can be precisely determined by using an electromyogram (EMG).
Herniated Disc Treatment
In the majority of cases, a herniated lumbar disk will slowly improve over a period of several days to weeks. Typically, most patients are free of symptoms by 3 to 4 months. However, some patients do experience episodes of pain during their recovery. A herniated disc treatment depends upon many factors that include: existence of worsening symptoms, symptoms experienced by a patient, patients’ activity level and age of a patient.
The purpose of every treatment is to relieve the symptoms of a herniated disc and also to provide a relief from its pain. Discomfort and pain caused by cervical and lumbar herniated discs can be treated with the help of non-surgical treatments. These treatments are provided 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 the medication to the precise level 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 also 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.
Unless there are neurological deficits - muscle weakness, difficulty walking - or cauda equina syndrome, conservative care is the first course of treatment. Because it is not clear that nonsurgical care is any better than letting the condition resolve on its own, the focus is on providing pain relief. Common nonsurgical measures include:
Rest - usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though. Take rest breaks throughout the day, but avoid sitting for long periods of time. Make all your movements slow and controlled. Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting.
Anti-inflammatory medications - medicines like ibuprofen or naproxen may relieve pain.
Physical therapy - specific exercises can strengthen your lower back and abdominal muscles.
Epidural steroid injection - in this procedure, steroids are injected into your back to reduce local inflammation.
Of the above measures, only epidural injections have been proven effective at reducing symptoms. There is good evidence that epidural injections can be successful in 42-56% of patients who have not been helped by 6 weeks or more of other nonsurgical care.
Overall, the most effective nonsurgical care for lumbar herniated disk includes observation and an epidural steroid injection for short-term pain relief.
Surgery types for a Herniated Disc
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. For treating pain connected 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 having a plastic core in between 2 chrome plates which gets locked into the spine.
Discectomy - in this, there is complete or part of an intervertebral disc is removed.
Spinal Fusion - during the spinal fusion procedure, a bone is grafted on the spine in order to create a hard union between 2 or more vertebrae. Sometimes rods and screws are used for providing additional spinal support.
Laminotomy - during this procedure, an opening is created in the lamina so as to ease the pressure on the nerve roots.
Endoscopic Procedure for treating a Herniated Disc - an endoscopic herniated disc surgery is performed by making a small incision. Both an endoscope and a camera are used and a needle and a mechanical device is inserted into the back of a patient. Then the diseased part of the disc is removed by the surgeon. This procedure is done on an outpatient basis that also involves faster recovery.
Only a small percentage of patients with lumbar disk herniations require surgery. Spine surgery is typically recommended only after a period of nonsurgical treatment has not relieved painful symptoms.
Microdiskectomy - the most common surgical procedure for a herniated disk in the lower back is a lumbar microdiskectomy. Microdisketomy involves removing the herniated part of the disk and any fragments that are putting pressure on the spinal nerve.
Rehabilitation - Most patients do not require formal physical therapy after surgery. After your surgeon evaluates you and confirms that your incision is healed, you may begin a rehabilitation exercise program. A simple walking program 30 minutes each day, along with flexibility exercises for the back and legs, can be done as a home program. If needed, your surgeon will refer you to a physical therapist.
Laser Therapy for a Herniated Disc
Percutaneous Laser Disc Decompression (PLDD) is used for treating neck or back pain which is caused by a herniated disc. PLDD provides an 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 for vaporizing a small part of the disc in order to decompress it.
"Happiness is not something ready made. It comes from your own actions".
"The purpose of our lives is to be happy" - Dalai Lama