Intervertebral Disc herniation

Generally

Intervertebral disc herniation or disc herniation is the most common cause of pain in both the upper and lower limbs.

In recent years, its occurrence is more often, as a consequence of modern lifestyle, which is characterized by lack of physical activity and sedentary lifestyle, as well as increased body weight due to poor nutrition.

What is the intervertebral disc?

Between the vertebrae (the bones of the spine) there are some “little cushions”, which are called intervertebral discs or simply discs.

They consist of an outside hard shell but their content is gelatinous, thanks to which they act as… “shock absorbers” of the spine, while allowing small movements that give us flexibility.

What is a disc herniation?

Intervertebral disc herniation or simply disc herniation is a condition in which part of the internal content of the disc “slips” into the spinal canal resulting in pressure or even complete entrapment of one or more nerves (roots).

What causes disc herniation?

In most cases, disc herniation is due to the gradual wear and tear of the discs because of aging, which we call degenerative disease or simply degeneration. As we get older, the discs lose some of their fluid content, become less elastic and therefore prone to injury. This degeneration occurs in some people earlier and in others later in life. The mechanisms that determine the rate of degeneration remain largely unknown but are thought to be linked to a combination of genetic and mechanical factors.

In most patients the problem starts with a minor injury and usually through the wrong use of muscle groups when lifting a weight. Less often it can be caused by a fall or direct spinal injury. In the neck, disc herniation can result from a car accident.

How dangerous is a disc herniation?

In general, disc herniation is a benign condition. However, in extreme cases it can cause permanent neurological damage with partial paralysis and loss of bladder and bowel control

In particular, it can cause damage to the spinal cord in the neck along with gait and balance disturbances as well as disturbances in the coordination of movements.

What are the risk factors for the occurrence of disc herniation?

There are three key factors regarding the occurrence of an intervertebral disc herniation:

  • Body Weight: The more our body weight increases, the more the mechanical stress of the discs increases, and in fact it affects the discs in the lumbar region of the spine.
  • Profession: Jobs that require physical activity such as lifting, pushing or pulling heavy objects, frequent and prolonged twisting and bending of the waist, pose a higher risk of developing disc herniation. It is also more frequently observed in occupations where the spine is subjected to constant stress and minor injuries, such as drivers, pilots and flight attendants.
  • Genetic factors: Scientists agree on the existence of a genetic mechanism that makes certain individuals prone to the disease. Unfortunately, it has not yet been revealed.

What should I do so as to avoid disc herniation?

There are three main factors that significantly decrease the possibility of an intervertebral disc herniation:

  • Exercise: Strengthening the muscles of the waist stabilizes and supports the spine, unloading the discs.
  • Proper body posture: Proper posture reduces pressure on the discs. We need to keep our waist straight, especially when sitting for a long time, and use our legs and not our waist to lift weights.
  • Healthy body weight: Excess weight puts pressure on the spine and discs, increasing the chance of a herniation.

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Symptoms

What complications can a disc herniation cause?

A serious but rare complication is cauda equina syndrome, in which the disc herniation compresses the cauda equina nerves (a complex of nerves that is a continuation of the spinal cord). It is a serious neurological condition that causes partial or total loss of mobility of the lower limbs and the control of the bowels and the bladder. Certainly, is one of the most urgent conditions in spine surgery.

Seek immediate medical attention if:

  • The symptoms are worsening. The pain, numbness or weakness increases to such an extent that you cannot perform your normal daily activities.
  • You have bladder or bowel dysfunction. People with cauda equina syndrome may have urinary incontinence or difficulty urinating even with a full bladder.
  • “Saddle” anesthesia. This progressive loss of sensation affects the areas of the body that would contact a saddle, namely the inner thighs, the back of the legs, and the area around the rectum.

What are the symptoms of disc herniation?

A herniated disc can irritate nearby nerves and cause pain, numbness or weakness in a limb.

Diagnosis

How is disc herniation diagnosed?

In most cases of disc herniation, clinical examination and obtaining a medical history are all that is needed in order to make a diagnosis.

However, if your doctor suspects another condition or needs to see which nerves are affected, then, depending on the case, you may be required to have an X-ray, MRI/CT scan, myelogram, electromyogram.

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Treatment

How is disc herniation treated?

The treatment of intervertebral disc herniation depends on the stage of the disease and its symptoms. If the symptoms allow it, then it is preferable for the patient to start with conservative treatment. However, when there are serious neurological symptoms, surgical restoration of the problem is the only solution.

Conservative treatment is done mainly by avoiding painful postures, following an exercise program and receiving painkillers. In most people symptoms fade away within a few days or weeks.

However, if pain has not been treated within a few weeks, then physiotherapy is required. Physiotherapists can show you postures and exercises to minimize the pain of a herniated disc.

If conservative treatments do not improve the symptoms of disc herniation after some weeks, then surgery is recommended, especially if the patient is experiencing:

  • Numbness or weakness,
  • Difficulty standing or walking,
  • Loss bladder and bowel control

How is disc herniation treated surgically?

A very small number of people with herniated discs eventually need surgery. In many cases, surgeons remove only the part of the disc that protrudes and causes the problem.

Rarely, however, a complete removal of the disc may be required. In these cases, the vertebrae may need to be fused along with the placement of a metal material so as to ensure stability in the spine.

Are there any alternative treatments for disc herniation?

Some alternative and complementary therapies can help prevent chronic disc herniation, such as:

  • Chiropractic. Spine chiropractic has been found to slightly relieve low back pain that has lasted for at least a month. Rarely, chiropractic treatment of the neck can cause certain types of strokes.
  • Acupuncture. Although the results are usually mediocre, acupuncture seems to relieve chronic back and neck pain quite well.
  • Massage. This practical treatment can offer short-term relief to people who have chronic low back pain.
  • Yoga. Yoga is the combination of physical exercise, breathing exercises and meditation and can improve spinal function and relieve chronic back pain.

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Frequently asked questions

Which method of treatment is better and safer for me?

The doctor will evaluate all the parameters and taking into account the main symptoms, the size and duration of the hernia, its location, the structures it presses, and in general the condition of your spine, will suggest the most suitable methods for the solution to your problem. You will choose which of them best suits your requirements/expectations.

Is disc herniation treated with laser?

No.

What type of anesthesia will I receive?

Surgeries which restore an intervertebral disc herniation are usually performed under general anesthesia.

How many days will I be hospitalized?

The patient goes home the same or the next day after the surgery

When will I return to work?

This depends on the type of your work, whether it is manual or office. Patients with herniated discs usually take a sick leave for 2 weeks to 2 months. In any case, the patient should discuss the recovery time after disc herniation surgery with his treating physician.

When will I be able to lift weights and exercise?

Weightlifting and hard workouts are allowed at least 2 months after surgery. In any case, consultation with your surgeon is required.

Are there any postoperative complications?

Although surgical restoration of disc herniation is generally a very safe operation and one of the safest spine surgeries, there is a statistically minimal chance of postoperative complications.

Why should I choose Dr. Starantzis?

Dr. Starantzis has been highly trained in centers abroad and has extensive experience of numerous surgeries at the University Hospital of North Midlands, in the United Kingdom.

Dr. Starantzis offers intervertebral disc herniation patients the most contemporary and safe method to deal with this problem.

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