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SPINE - HERNIATED DISCS
Herniated Discs Herniated discs may occur at any level of the spinal column. Symptoms may vary depending on the level that is affected and the degree of the herniation. The disc consists of a soft inner region called the nucleus pulposus. A fibrous outer layer called the annulus fibrosus surrounds it. The nucleus pulposus may bulge and stretch the annulus but not rupture it in a contained disc herniation. The nucleus may also rupture the annulus. When nucleus material protrudes through the annulus it is called a herniated disc. The disc may extend into the spinal canal or the neural foramen causing a “pinched nerve” or spinal cord compression. It is possible to have a herniated disc and not have any nerve problems or pain. |
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Cervical Disc Herniations
Herniated cervical discs can cause a variety of complaints. These may initially begin with pain in the neck and between the shoulder blades, but eventually can lead to shoulder, arm and hand pain. Patients frequently complain of sensory symptoms including numbness and tingling in their arms or hands. If the herniation is severe enough, the patient may complain of significant weakness in the arms and hands as well. Large herniations may actually compress the spinal cord leading to possible leg symptoms as well including weakness, sensory loss and occasionally paralysis. Treatment is typically initiated with anti-inflammatory medications, physical therapy including cervical traction, or steroids. If symptoms do not improve with non-surgical measures, surgery may be recommended. The most common surgery in the cervical spine is an anterior discectomy and fusion. The goal of this surgery is to remove the herniated disc and replace it with bone so that the spine’s normal height and shape may be maintained while freeing the nerve roots or spinal cord from compression. Bone spurs (also known as spondylosis or arthritis) may cause the same symptoms as a herniated disc.
Thoracic Disc Herniations
Although less common than cervical herniations, thoracic herniations may cause back pain, pain wrapping around the chest if the nerves are compressed or more serious symptoms if the spinal cord is compressed. Spinal cord compression may lead to weakness in the lower extremity, loss of bladder control, trouble walking and occasionally paralysis. Surgery in the thoracic spine is also designed to remove the offending disc in order to free the nerve root or decompress the spinal canal.
Lumbar Disc Herniations
Perhaps the most common type of herniation is in the lumbar spine. Typically, lumbar herniations result in sciatic nerve irritation (sciatica), which may result in buttock, hip, leg and foot pain as well as numbness, tingling and sometimes weakness. Severe disc herniations may cause profound weakness, loss of feeling, loss of bladder function, and sexual dysfunction. Surgery can usually be performed through a small incision to remove the herniated portion of the disc without removal of the entire disc. This is called a microdiscectomy or a partial discectomy. Occasionally, larger herniations may require the removal of the lamina, which is the bone that covers the spinal canal in order to achieve adequate removal of the disc herniation. Bone growth and ligament thickening can cause many of the same symptoms as a herniated disc. Sometimes the problem is due to a combination of factors. Each patient’s treatment is tailored to the unique situation.
Contact our New Patient Coordinator at 404-256-2633 to arrange for evaluation of your disc herniation.
