A herniated disc in the spinal column is a condition in which the pulpy nucleus of an intervertebral disc protrudes through a tear in the fibrous ring and invades the spinal canal, displacing or pinching nerve roots. It is one of the most common causes of radicular and back pain and can become disabling. In this article, Doctors explain how a herniated disc is diagnosed.
The vertebral column can be separated into vertebral segments that, for biomechanical purposes, behave as functional units. Each segment is composed of two vertebrae and their respective intervertebral disc.
These discs are round, like small pillows, with a tough outer layer (the fibrous ring) surrounding their pulpy nucleus. Thus, the discs act as shock absorbers for the bones of the spine when supporting weight.
A herniated disc is a fragment of the pulpy nucleus of a disc that protrudes out through a torn or ruptured ring into the spinal canal. Herniated discs are often in an early stage of degeneration. The spinal canal has limited space, which can become inadequate for the spinal nerve if there is also a large herniated fragment. Due to this displacement, the disc presses on and displaces spinal nerves, often producing pain that can be severe.
Types of herniated disc
A herniated disc is one of the most common degenerative diseases of the spine. Depending on the region of the spine where damage occurs and the symptoms, different types of herniated discs can be distinguished:
Lumbar disc herniation. Low back pain is the most common symptom in this type of herniation, and discomfort can radiate to the leg, buttock, or thigh. The most common herniations are usually at the L4L5 and L5S1 levels. Sometimes, if it is large or has been affecting a root for a long time, there may be a loss of strength to flex or extend the foot. In the most severe cases, in addition to the lack of strength and sensitivity in both legs, control of the sphincters may be affected. This is known as “cauda equina syndrome” and constitutes a surgical emergency.
The main cause of lumbar hernias is the natural wear and tear of the disc, in most cases due to incorrect postural habits, and affects mainly patients between 30 and 50 years old. In most cases, surgery is not necessary, unless it is necessary to release the compressed nerve root or conservative treatment does not work.
Cervical disc herniation. Trauma, neck injury, poor posture, or age-related degeneration are the main causes of cervical disc herniation. It can affect all cervical discs, but it is most common at the C4C5 and C5C6 levels. Symptoms include arm pain, numbness and tingling, or weakness in the limb, whether to lift the shoulder or to grasp things with the hand, depending on the affected root. If the herniation compresses the spinal cord, it can affect the legs and sphincter control. This is known as cervical myelopathy and is also a certain urgency in terms of surgical resolution. Physiotherapy, postural changes, and supervised exercise are part of the non-surgical treatment options.
Thoracic disc herniation. It is the least common of disc herniations, and among its symptoms are discomfort in the shoulder blades and upper back. Strength and sensitivity in the limbs and abdomen are affected, and it can cause sphincter problems.
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Disc Replacement has been growing in popularity and is now used regularly as an alternative to spinal fusion surgery.