copyright © 2023
A slipped disc is also known as a prolapsed or herniated disc. It is a condition when the inner soft part of the disc (known as nucleus pulposus) bulges out through the weakened or ruptured part of the disc pressing on the structures close to it (nerves coming out from the spinal cord) and cause pain, numbness or tingling sensation.
The term ‘slipped disc’ does not explain the phenomenon exactly- it is not the disc which has slipped from its place, but the inner gel like part of the disc which bulges out towards the spinal cord.
Slipped disc or disc herniation can happen at any level, but usually occurs in the lumbar region. The extent of the prolapsed and herniation can vary from person to person, the larger the prolapse the severe the symptoms.
Early stage symptoms of degeneration of the spine are intermittent and lingering back pain, but you would be able to perform your daily activities. However, as the ‘jelly’ pushes its way out from the ‘shell’, symptoms begin to get severe- pain gets intense, frequent and lasts longer. You may also experience numbness or weakness in legs and buttocks when the spinal nerves in the lumbar region begin to get pinched by the pressing gel.
If there is a rupture in the neck (cervical spine), there would be discomfort in shoulder and arms and further compression could lead to permanent paralysis.
Slipped disc is usually the last stage of degeneration of spine. When your disc is subjected to repeated bending or awkward bending, compression, rotation, lifting heavy objects, sitting in the same position for long, increasing age etc the shell of the disc begins to tear. If no efforts are made to prevent further damage, the gel inside the disc starts to move out causing severe back pain. If the pressure continues to build, it causes tear and the water inside the nucleus pulposus leaks, just like a punctured car tyre – causing the disc to lose its buoyancy and strength.
Factors that lead to injury from a slipped disc include aging with associated degeneration and loss of elasticity of the discs and supporting structures; improper lifting, especially if accompanied by twisting or turning; and excessive strain. Sudden forceful trauma is a more rare cause.
The nerves of the body exit the spine at each spinal level. A herniated disc can therefore produce symptoms anywhere along the course of that nerve, though the injury and irritation of the nerve are at the spine itself (this is known as referred pain). A slipped disc can produce varying degrees of pain in the back or neck along with numbness or weakness.
• For slipped discs in the neck – Numbness, tingling, weakness, or pain in the shoulder, neck, arm, or hand.
• For slipped discs in the lower back.
• Numbness, tingling, weakness, or pain in the buttocks, back, legs, or feet.
• Numbness and tingling around the anus or genitals.
• Pain down the back of each leg from the buttocks to the knee (this is called sciatica).
• Pain with movement, straining, coughing, or doing leg raises.
• Difficulty controlling bowel movements or bladder function.
Surgery is often the last resort and is advised in patients where symptoms have not settled in six weeks of conservative treatment like medication, injections and physiotherapy. The aim of the surgery is to remove the prolapsed part of the disc releasing pressure from the spinal cord. Various techniques of herniated disc surgery include:
• Discectomy or open discectomy removes herniated disc material that presses on a nerve root or the spinal cord.
• Percutaneous discectomy is used for bulging discs and discs that have not ruptured into the spinal canal.
• Laminotomy and laminectomy- Laminotomy removes a portion of the thin part of the vertebrae that forms a protective arch over the spinal cord (lamina). Laminectomy removes all of the lamina on selected vertebrae and also may remove thickened tissue that is narrowing the spinal canal.
Candidates
People with back pain, numbness or weakness in upper or lower limbs who are not responding to non-surgical treatments like pain killers, non-steroidal anti-inflammatory drugs and physiotherapy can consider surgery. They need further investigations like X-ray/ CT scan/ MRI to confirm bulging or protruding disc which can be corrected by surgery.
Surgery for herniated disc should be considered emergency if there are symptoms of pressure on the spinal cord or on the cauda equine or cases involving serious or increasing paralysis
Expected Results
The results of herniated disc surgery are good. A successful surgery relieves the symptoms of herniated or slipped disc in up to about 90% of the patients.
Recovery
Recovery is different for each patient. However, it is normal to feel pain at the site of surgery for the first few days which can be controlled with medication. You would be advised to start physical therapy after a week of the surgery for rehabilitation. You would be able to return to normal activities in about two weeks while full recovery may take few weeks to months. Your treating surgeon would advise you about the rehabilitation and when to start rigorous activities.
Comprehensive Spine Surgery and Treatment in India:
• Comprehensive management of spine disorder from birth defects to degeneration of tumor and trauma.
• Expert evaluation of spinal problems by dedicated team of experienced spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist
• Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral CT scanning , MRI and Electrophysiology unit all under one roof.
• Close monitoring and control of the entire treatment process.
• Professional and comprehensive management of each case through case management to achieve best treatment outcome and avoid errors
• Use of most advanced Surgical techniques for treatment of spinal ailments with focus on Minimal Access Micro Endoscopic spine surgeries, Functional spine preservation techniques and Spinal Arthroplasty for all( disc diseases) as well as instrumentation.
• Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.
• Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral CT scanning , MRI and Electrophysiology unit all under one roof.
• Use of most advanced Surgical techniques for treatment of spinal ailments with focus on Minimal Access Micro Endoscopic spine surgeries, Functional spine preservation techniques and Spinal Arthoplasty for all( disc diseases) as well as instrumentation. Minimally Invasive Surgery ensures quicker recovery and return to active life.
• Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.
