In our spine there are numerous discs which contain a tire like outer band that is surrounded by a gel like substance called nucleus pulposus. That gel is the one that absorbs all the shocks from the movements of the spine. When those discs are worn out then we suffer from disc herniation which for example if there is a cervical herniated disc causes neck, shoulder and arm pain. If the herniated disc is to the lumbar spine, patient may experience low back pain, leg pain, numbness and tingling to the same areas. There are many factors which play a major role in disc herniation such as aging, poor diet, lack of exercise, prior injuries of the spine, poor posture, smoking etc.
Disc herniation can be diagnosed through a thorough medical examination where muscle weakness, reflexes and loss of sensation are being tested. The physician through the medical history of the patient tries to rule out other basic factors such as tumors or inflammation or even viral infection and might also request an x-ray or CT scan or MRI scan to obtain a more detailed image of the patients spine.
The good news is that most cases of disc herniation do not require surgery. It can be treated or eliminated through
- Anti-inflammatory drugs and pain killers
- Spinal injections
- Physical therapy
- Physiotherapy exercises
If non-operative treatment is not effective, surgery may be the best solution for you.
Micro Endoscopic Discectomy (Lumbar)
This minimally-invasive procedure is performed through a tubular device. It is designed to relieve pain caused by herniated discs pressing on nerve roots. A guide wire is inserted through a small incision and is pushed to the affected disc level. The surgeon uses a special type of x-ray machine called a fluoroscope to ensure that the route to the herniated disc is made in the correct location. A series of dilating tubes are passed over the guide wire to push apart the tissue down to the vertebrae. The guide wire is then removed. The tubular retractor, through which the surgery will be performed, is slid over the dilating tubes. It is positioned on the bone surface. All the dilating tubes are then removed. A surgical light and small camera or microscope are used to see through the tube. Surgical instruments are used to clear away bone and soft tissue in order to access the spinal canal.The surgeon uses a nerve retractor to gently move the nerve away from the herniated disc.The herniated portion of the disc is removed and the area is cleared, which allows room for the nerve to move back to its normal position.The tubular retractor is removed, allowing the body tissue to close around the surgery area. The surface wound is closed with a small bandage.
Anterior Cervical Discectomy and Fusion (ACDF)
This surgery removes a herniated or degenerative vertebral disc in your neck and replaces it with a graft. This can relieve painful pressure on spinal nerves. In preparation for the procedure, you are positioned on your back. You are anesthetized. The surgeon creates a small incision in the front of your neck. The structures within your neck are gently moved aside to create a path to your spine. The surgeon carefully removes the damaged disc. This leaves a space between the vertebrae. The surgeon inserts a graft into this space. The graft may be made from a piece of bone taken from your hip. It can also be made from donor bone, or from a synthetic material. The graft fills the open space. It holds the vertebrae in the proper position. The surgeon may secure the graft with a metal plate and screws.When the procedure is complete, the incision is closed. As your spine heals, new bone will grow. The graft will become permanently attached to the vertebrae. This is called a "fusion”.
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