Christa R. Haggai, Attorney-at-Law
The bones that form the spine are called vertebrae, these bones protect the nerve roots. The bones that form the spine in your back are cushioned by small, spongy discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. But when a disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc. If the herniated disc impinges on the nerve roots, it can cause significant, pain, tingling and numbness in your arms and legs. While a herniated disc can be caused by normal wear and tear on the back, it can also be caused by trauma, including trauma from falls or car accidents.
If you herniate a disc in your neck, or cervical spine, this may cause pain in the neck and shoulder area. If the nerve root is impinged by the herniated disc, this could also cause pain radiating down one or both arms into the fingers depending upon where the injury as occurred. The patient may also experience numbness, tingling and weakness in the upper extremities from the herniated disc. A herniated disc in the lower back can cause pain and numbness in the buttock and down the leg. This is radiating pain down either or both legs is called sciatica. Your doctor may suspect a herniated disc, but in most cases it is confirmed by either a CT or MRI scan to your neck or back area.
Most people who have a herniated disc will not need surgery. Herniated disc can be treated with physical therapy, chiropractic treatment, anti-inflammatory medication and rest. However, some cases do require surgery. Discectomy is the surgical removal of herniated disc material that presses on a nerve root or the spinal cord. It is also used for bulging discs or ruptured discs. Discectomy may be the most effective type of surgery for people who have tried nonsurgical treatment without success and who have severe, disabling pain. There are other types of surgical treatment including spinal fusion and artificial disc replacement surgery.
Spinal fusion can be implemented from the front, the back or both. It involves spinal instrumentation in the form of intervertebral cages and/or pedicle screws provide internal structural support while the bone fuses, and bone graft can either be harvested from the patient or one of a number of synthetic bone graft substitutes or extenders can be used.
An alternative to spinal fusion surgery, artificial disc replacement is a procedure that involves replacing a painful disc that is causing chronic back pain with an artificial disc that provides pain relief without compromising the spine’s natural anatomical structure. Artificial disc replacement surgery may be performed on the lower back or the neck. Artificial discs are structurally similar to the damaged discs that are replaced and share similar functions, including acting as shock absorbers in the back or neck. This surgery is often recommended in younger patients.