Disc herniation, protrusion, or rupture? If you are wondering how lumbar disc therapy works, read this article. You will learn how it works, how it compares to discectomy, and how to decide whether it is right for you. Disc herniation, protrusion, and rupture: what are the risks and benefits of each? What are the best treatment options for your specific case?
Disc herniation
Disc herniation is a painful condition caused by a ruptured inner nucleus pulposus (INP) within the lumbar disc. This condition typically occurs at the L4-5 level. Treatment involves surgical removal of the affected disc, usually a lumbar discectomy. However, disc herniation can also occur at other levels of the spinal cord. If this is the case, treatment should be sought immediately.
In a recent review, researchers found that conservative care is associated with a high rate of reherniation after two years. In 7% to 18% of patients who undergo conservative treatment, a reherniation will occur requiring surgery. This recurrence rate increases by approximately two-fold among patients with large annular defects. For this reason, patients should seek a timely consultation with a spinal surgeon.
Surgical treatment for disc herniation may be performed using a number of different techniques. A laminotomy, also known as a laminatomy, is performed through a small incision on the back or neck. The muscles are removed to expose the vertebrae and the herniated disc. In the end, the surgeon can then see the affected region of the spinal cord.
Despite the positive effects of surgery for disc herniation, this treatment may still fail to provide relief. The pressure of the disc can damage the nerves in the affected area. Even after the operation, nerves may remain damaged and still experience pain for months to years. In many cases, the nerves may not recover completely, resulting in a scar tissue around the nerves. In addition, the pain can be due to other problems in the back.
Disc protrusion
A herniated disc, also known as a bulged or slipped disc, is an injury or degeneration of the lumbar spine. The disc is made up of two layers: the outer layer is made up of tough fibrocartilage and the middle section is made up of water and collagen. Its primary function is to cushion the vertebral bodies from one another by providing a buffer from compression between bones. When a disc becomes herniated, it presses against the spinal nerve. As a result, it produces severe pain.
Because discs prolapse, patients often experience nerve root pain. Pain can occur anywhere along the nerve course, from below the knee to the calf or foot. The level of pain can be very mild or extremely severe. The sciatic nerve is the most commonly affected nerve. Symptoms can be accompanied by loss of feeling and weakness. This pain is often worse than the pain in the back. Disc protrusion surgery can correct the problem in some patients and help reduce pain and restore function.
If the pain persists after a physical examination, you may need surgery. Lumbar disc disease can look like other medical conditions. However, x-rays and other tests are necessary to diagnose the condition. An x-ray uses invisible electromagnetic energy beams to make images of the internal structures. An MRI, on the other hand, uses radiofrequencies and large magnets to create detailed images of internal organs. Electromyography, which measures muscle activity, is another diagnostic tool.
Although discs can handle a lot of pressure, certain types of pressure can weaken the outer shell and push the disc’s contents out. A disc protrusion is a result of such changes. Many of these disc changes are normal and expected throughout our lives. As we age, our bodies adapt to the daily loads that we place on them. However, there are other factors that can accelerate disc degeneration. Genetics, smoking, and strenuous physical activities are all known to increase the risk of disc protrusion.
Disc rupture
A herniated disc occurs when the center of a disc separates from the annulus and irritates the nerves in the spine. Most herniated discs occur in the lower lumbar spine, usually between the fourth and fifth lumbar vertebrae. While most herniated discs are temporary, if the condition continues for more than six weeks, surgery may be necessary.
Fortunately, the most common type of herniated disc is a herniated disk caused by a traumatic event. An accident like falling from a ladder in a sitting position can cause tremendous pressure on the spine. As a result, the contents of the disc may rupture. Repeated pressure or injury to the disc over the course of a lifetime may weaken the outer ring, making it more susceptible to rupture. As we age, these changes become more likely, and discs may begin to bulge or swell.
Surgical treatment for a herniated disc is a lumbar laminotomy. A microsurgical incision is made down the center of the back, and the surgeon will carefully remove the herniated disc and any loose pieces from the disc space. In most cases, disc surgery is successful, with eighty to eighty percent of patients recovering well and returning to normal activity after a few weeks.
There are several ways to diagnose a herniated disc. The first way is to do a physical examination. The doctor can also use x-rays and computer technology to produce a two-dimensional image of the spine. This test may not use a contrast agent to enhance the image. Other noninvasive tests include nerve conduction studies and electromyography. These tests help detect nerve compression, bony overgrowth, and tumors in the spinal cord.
Discectomy
Discectomy is a surgical procedure to remove part or all of a bulging disc in the low back. This procedure is performed under general anesthesia, and recovery time from the procedure is six to eight weeks. You may be able to resume some activities as soon as two weeks after surgery. However, disc removal may not be sufficient for symptomatic relief, and you may need additional treatment. Listed below are some important details about this surgical procedure.
Discectomy is a surgical procedure to remove the herniated disc. Discs are thin, soft bones between the vertebrae. They have a hard outer wall and a soft interior. A herniated disc, also known as a bulging disc or slipped disc, causes pressure on the spinal cord and nearby nerve roots. If left untreated, the condition can deteriorate and cause significant pain.
During the procedure, a thin incision is made in the midline of the low back over the area of herniation. A guide wire is inserted into the disc, near the neuroforamen. The surgeon then inserts a series of small tubes through the incision and pulls out the herniated disc and any surrounding soft tissue. The nerve exits through this neuroforamen, and the operative site is closed with strong sutures.
If nonsurgical treatment has not provided enough relief, discectomy may be a good option. Herniated discs may press on nearby nerves or cause numbness. Discectomy is most effective when the pain is located in the legs and arms, and is not associated with arthritis or significant weight loss. Physical therapy, weight loss, and arthritis medication are often effective ways of dealing with back pain. But sometimes it’s necessary to perform a surgery.
Nonsurgical treatment options
Patients seeking nonsurgical treatments for lumbar disc herniation have many choices. Discs have an outer layer of gel that surrounds the core of the disc, called the nucleus pulposus. This outer layer allows the disc to move with the body, but if the outer layer leaks or herniates out of the annulus fibrosis, the gel will irritate the nerves in the inner core.
Although nonsurgical treatments for lumbar disc disease can help reduce pain, they also can be long-term and require weeks or even months to fully affect a patient’s condition. Surgical treatments may cause additional complications, such as nerve inflammation, muscle spasms, and a decreased range of motion. Surgical procedures can be risky as well, and are best reserved for the most severe cases of lumbar disc disease.
Nonsurgical treatment options for lumbar disc disease include cognitive behavior therapy, massage, physical rehabilitation, and chiropractic care. Cognitive behavioral therapy teaches patients to change their habits and attitudes towards pain. Massage therapy, for instance, can increase blood circulation and release endorphins. The method you choose will depend on the severity of your pain, as well as your age and gender. Ultimately, nonsurgical treatment options are best for reducing pain and easing the effects of ongoing medical conditions.
In a recent study, comparing surgical and nonsurgical treatments for lumbar disc pain, the results showed similar improvements at 10 years postoperatively. However, the surgeons reported faster relief of pain in the surgical group and no difference in outcomes at one and two years. A similar study conducted by Jacobs et al. concluded that surgical treatment is more effective than nonsurgical treatment for lumbar disc pain.