Friday, April 12, 2024

Back Surgery For Bulging Disc

Treatment For Disc Prolapse

How to Fix a Bulging Disc (NO SURGERY!)

Treatment for disc prolapse usually involves a conservative approach, i.e., modifying activities and taking pain medications. The conservative treatment successfully relieves symptoms within a few days or weeks in most people. Your doctor may recommend the following treatment options based on your condition:

Research: Latest Information On Conservative Care For Herniated Discs Outdated

While many people will find great pain relief from the above conservative care measures, some will not. Some doctors feel that conservative care failures are based on outdated information about what will work, for whom it will work, and when it will work for these people indicating as we did above that there is a window of opportunity when these treatments or any treatment will be most effective in helping the patient avoid surgery.

Lets look at the first choice of herniated disc treatment through the eyes of a Canadian research team who reviewed the current concepts and clinical guidelines for the management of low back pain to assess their quality of care.

In this February 2017 study published in the European Pain Journal, doctors and researchers found according to high-quality guidelines:

  • All patients with acute or chronic low back pain should receive:
  • and instruction on self-management options
  • Patients with acute low back pain should be encouraged to return to activity and may benefit from:
  • Patients with lumbar disc herniation with radiculopathy may benefit from spinal manipulation.
  • This new study found some of these guidelines to still be in practice but outdated, specifically the use of paracetamol for acute low back pain and other herniated disc symptoms.

    The other problem they found was the recommended education, staying active/exercise, manual therapy, and paracetamol or NSAIDs as first-line treatments., were guidelines targeted to nonspecific low back pain.

    Who Is A Candidate

    You may be a candidate for discectomy if you have:

    • diagnostic tests that show a herniated disc
    • significant pain, weakness, or numbness in your leg or foot
    • leg pain worse than back pain
    • symptoms that have not improved with physical therapy or medication
    • leg weakness, loss of feeling in the genital area, and loss of bladder or bowel control

    Posterior lumbar discectomy may be helpful in treating leg pain caused by:

    • Bulging or herniated disc: The gel-like material within the disc can bulge or rupture through a weak area in the surrounding wall . Irritation and swelling occurs when this material squeezes out and painfully presses on a nerve .
    • Degenerative disc disease: As discs naturally wear out, bone spurs form and the facet joints inflame. The discs dry out and shrink, losing their flexibility and cushioning properties. The disc spaces get smaller. These changes lead to stenosis or disc herniation.

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    Conditions That Cause Bulging Discs

    A wide range of conditions can cause bulging discs, says Dr. Wahlquist. He reviews some of the more common conditions that cause disc damage.

    • Degeneration of the disc over time as we age.
    • Genetics that predispose our discs to deteriorate.
    • Wear and tear from work or extracurricular activities can take a toll on disc health.
    • Traumatic injury is another component that can result in disc damage. You can hurt your disc in a fall or by doing something heroic like trying to lift a car off a child, notes Dr. Wahlquist. On the other hand, something as minor as a cough or sneeze sometimes causes a disc to give out.

    What Is The Treatment For Foraminal Narrowing

    Spine Surgery

    A foraminotomy is a minimally invasive surgical procedure that involves the removal of a small piece of bone or soft tissue that is compressing the nerves. The foraminas openings can be expanded. Because there is more space, the nerve can no longer be pinched.

    Spondylolism is a type of spinal canalitis characterized by narrowing of the spinal spaces. There is no pain associated with spinal narrowing, and people who have minimal narrowing may not experience any pain or symptoms. When open spaces tighten enough to pinch or compress nerve roots as they pass through them, the condition becomes painful. In many cases, people with foraminal stenosis find relief by placing themselves in forward-leaning positions, which relieves pressure on the spine and allows more space for their nerves. If youre experiencing severe pain, try walking or leaning on a shopping cart. Physical therapy and exercise are essential for pain management and to manage your condition. The narrowing of the aortic valve cannot be reversed.

    Pressure is relieved from pinched nerve roots via minimally invasive surgery. Integrity Spine and orthopedics provides minimally invasive spine procedures. Aside from pain management and general orthopedic services, we offer treatment for acute and chronic back and joint pain.

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    Medical History And Physical Examination

    After discussing your symptoms and medical history, your doctor will perform a physical examination. The exam may include the following tests:

    • Neurological examination. A neurological examination will help your doctor determine if you have any muscle weakness or loss of sensation. During the exam, the doctor will:
    • Check muscle strength in your lower leg by assessing how you walk on both your heels and toes. Muscle strength in other parts of your body may also be tested.
    • Detect loss of sensation by checking whether you can feel a light touch on your leg and foot.
    • Test your reflexes at the knee and ankle. These may sometimes be absent if there is a compressed nerve root in your spine.
  • Straight leg raise test. This is a specialized test to predict if a disk herniation in present, especially in younger patients. During the test, you lie on your back and your doctor carefully lifts your affected leg. Your knee stays straight. If you feel pain down your leg and below the knee, it is a strong indication that you have a herniated disk.
  • Clinical photo of a doctor performing the straight leg raise test.

    Reproduced from JF Sarwak, ed: Essentials of Musculoskeletal Care, ed. 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

    Bulging Disc Symptoms You Should Know

    Its a popular misconception that bulging discs are the same as herniated discs. And, as far as spinal problems go, each issue does fall within the same category. The conditions even boast similar symptoms, and in some cases, they share the same root causes.

    Considering these facts, its no wonder that people often confuse the two for one another. At the end of the day, however, follow this simple piece of advice: Seek out medical treatment if your symptoms persist over a period of two weeks or more.

    Naturally, the most common similarity between these conditions is the area of the body that they affect. As you have perhaps guessed, each of these ailments results in damage to the bodys discs. For context, intervertebral discs are spongy structures that rest between the bony vertebrae of the spine. They are essentially akin to jelly donuts. They have a hard outer shell with a softer filling in the center.

    Similar to how synovial fluid lubricates your joints, discs serve as a special type of cushion in between your vertebrae. These rubber spacers increase the flexibility of your spine and safeguard it from damage. When these structures suffer injury, however, it can result in a slew of painful symptoms.

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    Will A Herniated Disk Get Worse

    An untreated herniated disk can get worse. Thats especially true if you continue the activities that caused it for instance, if it developed because of your work. A worsening ruptured disk may cause chronic pain and loss of control or sensation in the affected area. See your healthcare provider if you still have symptoms after four to six weeks of conservative care.

    Transforaminal Endoscopic Lumbar Discectomy

    Back Pain Lifting (Herniated & Bulging Disc Recovery)

    Some of you exploring treatment options may have been made aware of Transforaminal Endoscopic Lumbar Discectomy. This is a minimally invasive surgical technique akin to arthroscopic surgery. Instead of an incision, the surgery is performed through a needle puncture and an endoscope. Much has been made of this technique recently both good and not so good. The not-so-good surrounds the challenge of the surgeon making this a successful surgery. Two very recent studies point us in that direction of concern.

    A December 2021 paper in the International Journal of Spine Surgery writes: Open microdiscectomy is the gold standard surgical technique for radiculopathy with lumbar disc herniation. Transforaminal endoscopic lumbar discectomy has been developed as an effective and minimally invasive alternative to open surgery. As a result of these remarkable technical evolutions, the clinical outcomes of Transforaminal endoscopic lumbar discectomy have become comparable to those of conventional open surgery. However, considerable learning curves and endoscopy-related adverse events may emerge as critical problems.

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    The Worst Mri Ever I Was Told I Must Get Surgery

    Some patients tell us that they started losing patience with this hit or miss treatment method and that they need surgery. Their doctors sometimes disagree. Others tell us that their doctors have told them that they have a terrible MRI and that they should get online for surgery. Some of these terrible MRI people are the ones who contact us. They want an option other than surgery and one with a realistic chance of providing some type of long-term relief, or enough relief that they can go about their routine daily business without making a game plan in the morning to decide if they need their back brace, anti-inflammatories, or other remedies to get them through the day and into bed at night feeling no worse.

    You may be reading this article convinced you that you have the worst MRI ever, and based on this, you must have surgery. You may be a business owner, a physical laborer, someone on their feet all day, someone sitting in front of a computer all day, or a caregiver. If your pain is so significant, your MRI confirms that you have significant disc degeneration and you have constant, radiating pain into your legs with numb neurologic problems, you cant walk for example, then yes, surgery should be explored and you should follow recommendations from your surgeon. Again, this is not the patient we usually see. We see the patient who despite a terrible MRI, still manages to get along in their daily activities and responsibilities but not without moments of severe pain.

    Herniated Disc Surgery: What To Expect

    Causes, effects, and when surgery is right

    Between each of the bones in your spine is a disc. These discs act as shock absorbers and help cushion your bones. A herniated disc is one that extends beyond the capsule containing it and pushes into the spinal canal. You can have a herniated disc anywhere along your spine, even in your neck, but its most likely to occur in the lower back .

    You might develop a herniated disc from lifting something the wrong way or from suddenly twisting your spine. Other causes include being overweight and experiencing degeneration due to disease or aging.

    A herniated disc doesnt always cause pain or discomfort, but if it pushes against a nerve in your lower back, you may have pain in the back or legs . If a herniated disc occurs in your neck, you may have pain in your neck, shoulders, and arms. Besides pain, a herniated disc can lead to numbness, tingling, and weakness.

    Surgery involving the spine is typically not recommended until youve tried all other options. These may include:

    • nonsteroidal anti-inflammatories
    • steroid injections

    If these are ineffective and you have persistent pain that is interfering with your quality of life, there are several surgical options.

    When considering surgery, make sure you see a qualified spine surgeon, and get a second opinion. Before recommending one surgical procedure over another, your surgeon will likely order imaging tests, which may include:

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    What Is A Herniated Disk

    Your spine is comprised of a total of 33 individual bones. These bones are each hollow in the center, creating a space for your spinal cord and nerves to travel from your brain to your body. Each of these bones is also uniquely shaped, allowing them to stack together in an interlocking pattern.

    To keep these bones from rubbing and wearing on one another and to allow movement of your spine, there is a rubbery disk of tissue between each one. These are known as intervertebral disks.

    The intervertebral disk acts as a cushion for each of the spinal bones and helps protect the spinal cord as it travels between each of the vertebrae. It has a tough, fibrous outer layer. Within is a gel-like substance that provides the majority of the impact-relieving support.

    When the outer layer of a disk is injured the gel can be pushed out into the spinal canal, putting pressure on your spinal cord and nerves, causing unpleasant symptoms and the eventual need to seek back surgery for a herniated disk.

    A herniated disk can occur due to a number of reasons, including normal wear and tear from aging , trauma or extreme strain being placed on the disk. Some conditions can also predispose you to develop a ruptured disk.

    What Are The Possible Complications After A Procedure Of The Spine

    Diskectomy

    Though the complication rate for back surgeries is relatively low, there is still potential for a variety of health issues. The following are some common complications to consider.

    You may be less likely to experience specific complications based on your health condition. Talk to your doctor to learn about a list of complications that could be pertinent to you following a spinal surgery.

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    Bulging Disc Treatment Options

    As with most medical problems, bulging disc treatments can be divided into conservative and surgical options. Again, most of the time surgery is not necessary and typically your doctor will exhaust all conservative options before opting for a procedure. As far as conservative treatments go, there are a variety of viable options. For example, nerve root blocks and steroid injections will provide the patient with temporary relief for up to one year. . Over-the-counter pain medications may also provide adequate relief for patients with a bulging disc. In some cases, your doctor may even install a spinal cord stimulator to lessen the painful symptoms that occur with bulging discs.

    But what if these methods dont work? Generally, there are two common surgical procedures that doctors perform for bulging discs. Minimally invasive decompression surgery is a popular option that has a high success rate. As you might imagine, the goal of this procedure is to lessen the pressure that a bulging disc causes on adjacent spinal nerves. Your doctor accomplishes this feat by removing either infringing soft tissues or offending bone matter . By removing these structures that cause pressure on nearby nerves, negative symptoms begin to dissipate.

    Thoracic Herniated Disk Symptoms

    Thoracic herniated disks are the least common type of disk herniations but do still occur. The symptoms of a thoracic hernia can include:

    • Pain that will travel around on either one or both sides of the rib cage from the back into the chest or abdomen.
    • Muscle weakness in one or both legs
    • Numbness and tingling in one or both legs
    • Overactive reflexes causing spastic responses in one or both legs
    • Bowel or bladder control problems

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    Microdiscectomy Procedures For A Lumbar Herniated Disc

    Two minimally invasive procedures, microdiscectomy and endoscopic microdiscectomy, are most commonly recommended for lumbar herniated discs. These procedures take the pressure off the nerve root and provide a better healing environment for the disc.

    See Microdiscectomy Spine Surgery

    Usually, only the small portion of the disc that is pushing against the nerve root needs to be removed, and the majority of the disc remains intact.

    Small incisions are used in a microdiscectomy. For endoscopic microdiscectomy surgery, instruments are inserted through a thin tube or tubes to minimize disruption to the surrounding tissue. A tiny camera can be inserted through a tube to provide visualization for the surgeon.

    Both types of surgery are usually performed on an outpatient basis or with one overnight stay in the hospital. Most patients can return to work and their regular routines in one to three weeks.

    But Nothing Has Helped You You Need The Surgery Maybe You Dont According To These Doctors When Should A Patient Have Disc Surgery

    How To Fix A Bulged Low Back Disc WITHOUT Surgery

    People who get epidural steroid injections understand that these injections come with risks. But many people we talk to will tell us, I know the steroid injections are bad for me, but I needed something, I was in pain. The reason they are at our center is that they still need something, and it is something else.

    What we want to suggest here is that it can be difficult for people to understand that the MRI of a herniated disc can show something bad, but that is really not what is causing the problem for them. Getting on a waiting list for surgery may not be the answer. In a recent study, doctors at the University of Salzburg presented these findings on the surgical and conservative care of herniated discs.

    • When the conservative treatments did not improve clinical symptoms.
    • Persisting pain alters the quality of the patient`s life.

    The researchers however also warn, Results of surgery are strongly dependent on the preoperative duration of symptoms. Paramount is the timing of surgery: poorer surgical results associated with increasing preoperative duration of symptoms.

    The longer the patient waits for surgery, the more difficult it gets.

    Finally, the above-cited researchers suggested that surgery should be the LAST CHOICE and that all conservative treatment methods must be FIRST exhausted.

    • It is important to note again that the above paper from spinal surgeons recommended strongly, that surgery be the last choice, BUT, treatments of any kind should not be delayed.

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