Lumbar Microdiscectomy

HTTP://SPINALDOC.COM/SURGICAL-PROCEDURES/LUMBAR-MICRODISCECTOMY/

What Happens When a Disc Ruptures?

What Happens When a Disc Ruptures?When the outer lining (annulus) of a disc “tears,” its center (the nucleus ) may rupture and press a spinal nerve(s) against the bony surface of a vertebra (Fig.5). This condition is often referred to as a ruptured disc. You could think of it as having a tube of toothpaste with a crack in it. Exert pressure on the cracked tube (disc annulus,) and toothpaste (disc nucleus) flows out the crack. Even pressure from everyday activities can push the disc’s nucleus through the ruptured annulus and pinch a spinal nerve root(s).

What Causes a Disc to Rupture?As we’ve discussed, your lumbar spine supports the weight of your entire upper body and is under stress every day. Simple “wear and tear” or the effects of aging can contribute to a disc rupture. In some cases, the rupture happens during the course of normal, everyday activities. In other cases, it occurs as the result of a specific injury. Usually there is no way to “prevent” it from occurring, however, you can reduce your risk by staying in good physical condition and by using proper lifting techniques.

What are the Symptoms of a Ruptured Disc?When a lumbar spinal nerve is pinched, you may experience pain in your lower back, pain or numbness in your leg(s), weakness in your legs or feet, or numbness in one or both of your feet. The pain can come from the pressure on the nerve, the swelling within the nerve (caused by the pressure) or injury to the nerve itself. Taking pain medication or drugs which reduce the swelling may provide relief, but healing may not occur as long as the nerve itself remains pinched. It’s similar to having your finger caught in a door. An aspirin may help to ease the pain, but healing won’t begin until the door is opened and your finger is no longer being pinched.

How is a Ruptured Lumbar Disc Diagnosed?The diagnosis of a ruptured lumbar disc is based on:

your history of back and/or leg pain;

a physical examination of your back and legs; and

diagnostic tests, which may include spine x-rays, an MRI, a CAT scan or a myelogram. (Each of these examination has a specific purpose.)

Treatment OptionsThere are a number of treatment options for a ruptured lumbar disc, each accompanied by its own set of risks and benefits. The four basic approaches are as follows:

Taking Time: For some patients, all that is required in order to heal and recover is time.

Taking Medication: For others, medication may reduce the inflammation or ease the pain in the affected area and thereby provide relief from their symptoms.

Using Physical Therapy: For some, physical measures such as physical therapy (or gentle exercise) may provide relief and aid in the recovery from a ruptured disc.

Having Surgery: For those patients whose ruptured disc is causing a “pinched” nerve, lumbar microdiscectomy often is the recommended treatment.

When Lumbar Microdiscectomy is NOT an OptionThe severity of your symptoms (pain, weakness, lack of mobility) and your general health and physical condition will play an important part in determining when surgery is not an option for you. In general, surgery is not an option when:

your back and leg pain is not caused by a ruptured disc; or

you do not have leg symptoms;

there is a medical reason which prevents you from having surgery;

medication which reduces swelling or relieves pain would provide you with adequate relief;

physical measures would improve your condition.