Herniated Disk / Ruptured Disc

A herniated disc, often referred to as a ruptured disc, or slipped disc is a common source of pain in the neck and lower back that may also spread to the arms and legs.  In order to explain how a herniated disc occurs, it’s important to first describe the anatomy of the spine and how it’s affected by age.

Spinal anatomy and degenerative disc disease

The spine is made up of two major parts: hard bones (vertebrae) and soft, compressible, sponge-like pieces of cartilage called spinal discs.  The discs sit in between each vertebra, where they act as shock absorbers and allow the spine to bend, flex and twist.  The discs themselves also consist of two parts: a thick outer ring made of cartilage, which contains the nerves, and a soft, gel-like core that contains proteins.

As the body ages, these discs eventually break down or degenerate, and this process may lead to a condition called degenerative disc disease in some people.  More of a general term than an actual disease, degenerative disc disease describes these normal changes of the discs that comes with age, and the results may be painful.  The two primary age-related changes are a loss of water and other fluids in the disc, and tiny tears or cracks that may develop on the outer layer of the disc.1

Herniated disc

Once a disc begins to lose fluids through the aging process, its ability to act as a shock absorber reduces, which makes discs less flexible and narrows the space between vertebrae.  As degeneration continues, or with any other additional stress on the spine—such as from an injury, being overweight or any repetitive strenuous activities like lifting—the inner jelly-like nucleus may be forced out through tears in the outer layer, which can cause the disc to break open, or rupture.  This rupture is called a herniated disc, and fragments of the disc may then press on nerves and cause symptoms in the neck or lower back, where herniated discs are most common.

Symptoms

  • Neck pain and low back pain are extremely common in the general population, but herniated discs lead to certain symptoms that distinguish them from normal pain.
  • Neck Pain in the muscles between the neck and shoulder, which may shoot down the shoulder or cause headaches in the back of the head
  • Weakness in one arm
  • Loss of bladder or bowel control
  • Burning pain, numbness or weakness in shoulders, arms or neck

Lower back

  • Most common symptom is sciatica: a sharp, often shooting pain that extends from the buttocks down to the back of the leg
  • Weakness in one leg
  • Tingling/pins and needles/numbness in one leg or buttocks
  • Loss of bladder or bowel control
  • Burning pain centered in the neck

Diagnosis

If you’re experiencing significant weakness in both arms or legs along with loss of bladder or bowel control, please seek immediate medical attention, as a serious problem may be present.  Otherwise, if you’ve regularly been experiencing any of the symptoms listed above, please visit us at Raleigh Neurosurgical Clinic Inc.  We will review your complete medical history and perform a physical examination to help determine if your nerve roots are affected and a herniated disc is present.  If pain continues, a magnetic resonance imaging (MRI) or computed tomography (CT) scan may be required to confirm your diagnosis.

Surgical treatment

In many cases, your lower back or neck pain will be alleviated with some simple measures such as rest, over-the-counter pain relievers and ice and heat therapy.  Additional treatment such as physical therapy, injections and targeted exercises may also be helpful for reducing pain in cases that don’t improve with initial treatment.

In some cases, though, surgery is the most effective way to relieve symptoms and quickly get you back to your normal self.  If you’re experiencing leg pain for more than four weeks that interferes with your normal functioning or significant weakness, loss of motion or abnormal sensitivity, surgery should strongly be considered.  Surgery may also be necessary if a disc fragment gets lodged in the spinal canal and presses on a nerve, which can cause significant loss of function.

At Raleigh Neurosurgical Clinic Inc., we offer the following surgical treatments for herniated discs of the neck or lower back:

Neck

  • Anterior cervical discectomy
  • Spinal fusion
  • Anterior cervical corpectomy
  • Posterior microdiscectomy
  • Posterior cervical laminectomy

Lower back

  • Microdiscectomy (most common)
  • Laminectomy
  • Lumbar spinal fusion
  • Anterior or posterior lumbar interbody fusion
  • Posterolateral lumbar fusion
  • Transforaminal lumbar interbody fusion
  • Foraminotomy
  • Medial facetectomy
  • Sextant fusion

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