Overview of herniated disc
Invariably, people complain about backache that radiates down towards leg and foot. Such a pain is indicative of herniated disc which is also referred as a slipped spinal disc or slip disc. Our spine consists of vertebrae that are cushioned by small, spongy discs. These discs are round in shape, with a tough outer layer i.e. annulus that surrounds a gel-like center called Nucleus Pulposus.
These discs are located between each of the vertebrae of spinal column and, act as shock absorbers for spine and maintain its flexibility. The disc, when damaged, may push out or ‘herniates’ the spinal disc tissue. Such a disc is termed as slipped, bulged, ruptured or herniated disc.
Displacement of herniated disc tissue puts pressure on spinal nerves and cause severe and shooting pain. Herniated discs can occur in any part of the spine. Mostly, herniated discs affect the lower back i.e. lumbar spine. However, these herniated discs can often occur in neck i.e. cervical spine but rarely in upper back i.e. thoracic spine.
When occur in lumbar region, herniated discs cause sciatica and severe pain of sciatic nerve. Herniated disc of cervical spine can cause Cervical Radiculopathy that indicates nerve compression in the neck. It may appear as dull or sharp pain in neck or between shoulder blades. Cervical spinal pain radiates down the arm, hand or fingers along with numbness or tingling in the shoulder or arm.
Diagnostic procedures include:
- X-ray of vertebrae and joints.
- Myelogram – X-ray of the spinal canal to note pressure on the spinal cord or nerves, bone spurs or tumors.
- Computed tomography i.e. CT/CAT scan for detailed images of spinal canal and surrounding structures.
- Magnetic resonance imaging (MRI) to produce 3-D images of spinal cord and nerve roots and discs.
- Electromyography or Nerve Conduction Studies (EMG/NCS) for measuring electrical impulses along nerves and muscles.
Symptoms and Causes of Herniated Disc
Symptoms of herniated disc are:
- Severe, sudden and shooting pain
- Pain radiating to legs and feet
- Numbness in the buttocks, rarely
- Signs of paralysis in some cases
- Cramping or muscle spasms in back or leg
- Leg muscle weakness, or knee or ankle reflex loss
- Restricted movement
In severe cases, patients may also experience foot drop i.e. foot flops while walking. If patient reports difficulty in controlling the functioning of bladder or bowel, the situation is termed as Cauda Equina Syndrome (CES) which is a serious medical emergency.
Same way, pain accompanying numbness and tingling in buttocks, leg or foot of lack of sensation i.e. paralysis are signs of a more serious nerve damage problem.
What kind of surgery is done for a herniated disc?
The surgical procedures employed for herniated disc surgery include:
- Lumbar Spine Surgery. Lumbar laminotomy – to remove a small piece of bone called the lamina from the vertebra.
- Discectomy- to remove your damaged disc to relieve pressure on nerves and relieve pain
Artificial Disc Surgery- to replace a damaged disc with an artificial one, made of plastic or metal.
- Spinal Fusion – by fusing the two discs to stop the bones from moving and prevent pain
- Microsurgical Discectomy/Microdiscectomy – new minimally invasive technique for Discectomy to dissect and move aside muscles to expose vertebra and remove portion of ruptured disc
- Minimally Invasive Microendoscopic Discectomy- done through small tubes i.e. dilators to enlarge tunnel to vertebra remove the ruptured disc by using endoscope or a microscope
Can a herniated disc heal on its own?
Usually a herniated disc heals on its own over time. Although the pain from a herniated disc will get better within a couple days but completely resolve in 4 to 6 weeks. Patient is required to restrict activity, use ice/heat therapy or take pain killing and anti-inflammatory NSAIDs or opioid derivatives.
Herniated disc can heal on its own through:
· Immune system reaction of body
· Regular extension exercises
- Water absorption– water in herniated disc is absorbed by body leading to shrinking of disc in size that pulls it away from the surrounding nerves
How much does it cost for a herniated disc surgery?
It also depends upon:
- Expertise, status and reputation of surgeon
- Condition of patient
- Other treatments required in conjugation with herniated disc surgery
- Medical support and other facilities availed
Yet when it comes to overall cost of herniated disc surgery in India, it is certainly much less than medically advanced countries like USA, UK, Australia and neighboring country like Singapore.
Why patients prefer India in case of surgery?
India is a preferred choice for herniated disc surgery not only because of cost effective reason but due to:
- Highly qualified, experienced and skilled surgeons
- World class hospital infrastructure
- Impeccable medical and nursing care
- Ease in obtaining medical visa