Orthopedic and Neurosurgical Spine: Herniated Disc

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Orthopedic & Neurosurgical Spine


When we think of the spine, it seems like a long, slightly bendable column of bone. That could not be farther from the truth. In actuality, the spine is a collection of several bones that fit with each other, joined at every intersection by discs that create a cushion between the bony joints, and creating an interlocking system that makes flexibility possible.

The discs that cushion each spinal bone are very important. They act as shock absorbers and keep the bones flexible.

Disc herniation is most commonly seen between the fourth and fifth lumbar vertebrae, situated in the lower back.

Causes and Symptoms of a Herniated Disc

When thinking of the spinal discs, visualise a doughnut with a jelly filling in the middle. The discs are tougher on the exterior, but the middle is softer and jelly-like-which is necessary to enable the joints to slide across each other fluidly. However, when that jelly middle ruptures, the jelly-like part of the disc pushes into the harder part of the disc through the rupture. This breach in the integrity of the joint will cause the disc to press against nerve endings in some cases, causing severe pain. The disc could be so damaged that the two vertebrae being cushioned might start to rub against each other, causing no end of discomfort in movement.

Disc herniation can be a normal by product of aging and the winding down in body function that accompanies it. It could also result from trauma to the back and neck in general.

The most common symptoms of a herniated disc are:

  • Pain radiating from the affected area down to the arms and legs, made worse by movement.
  • Muscle weakness when the nerves affected get weaker, causing impairment in motor function
  • Numbness, tingling and stabbing pain in the back, arms or legs.
  • In severe cases, there is progressive loss of motor function and sensation in the affected muscles.

Common Treatment Options

Pain Management of a Herniated Disc

Usually, the most overwhelming problem of patients with herniated discs is pain. Therefore, pain management is high on the priorities of the physician.

The pain from the nerves being compromised by the herniated disc can be managed with some medication. NSAIDS, which can be gotten over the counter, are the first port of call for pain that is mild. With more serious pain, the doctors can recommend some narcotics containing codeine, of course, given under strict supervision.

When muscle spasms are a concern, muscle relaxants and anti-convulsants can be given to the patients. They can also be placed on cortisone injections or other steroids to reduce the inflammation in the area.

Alternative Therapy for a Herniated Disc

Some patients who want to go the alternative route to deal with the pain opt for therapy like acupuncture, yoga, chiropractics and massage. While these methods are not clinically approved, they do provide a measure of pain relief to the patients, however short-lived.

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Surgery for a Herniated Disc

Surgery might be needed when other treatments have failed to cause relief. It is also the recommended treatment for when the symptoms of the herniated disc are impairing the patient’s ability to function. The affected disc is removed and the two vertebrae fused together. In some cases, an artificial disc can be placed to replace the herniated one.

It is important that a good medical center be chosen for the surgery, as it is quite delicate. There is also the matter of the after-surgery care that will be needed by the patient, including physical therapy so that the patient can regain most or all of their range of motion.

Our patient care at Pine Creek Medical Center in Dallas provides state of the art facilities before, during and after the surgery. Our procedures are minimally invasive and formulated for the highest comfort to the patient, and a short recovery time.