Herniated Disc

The spine is a column of bones that are separated by spongy intervertebral discs. These discs prevent the bones of the spinal column from grinding against one another by acting as shock absorbers and allow the spine to move. Each disc is made up of annulus fibrosus, which is a strong outer ring of fibers and a soft, gel-like center called the nucleus pulposus.

An Overview

Herniated discs occur when the strong fibers of the annulus tear or rupture and the gel-like center migrates or pushes out of its normal position and into the limited space of the spinal canal. The displaced disc may exert pressure on the spinal cord or compress nearby spinal nerves.

In addition, chemical irritants with the disc material are released that can cause nerve inflammation and pain. Herniated discs are more likely to be found in the neck or lower back but can occur in any area of the spine. Fortunately, Dr. Akamnonu's herniated disc surgery can treat these symptoms and problems.

Causes

In New York, herniated disc surgery is most commonly performed on a wide age range of adults and frequently caused by age-related wear and tear or acute spinal injuries. Spinal discs can naturally dry out with age, losing resiliency and strength. This can make them more likely to tear or rupture.

Additional factors that can increase the risk for disc herniation include:

Excessive force to the spine i.e., falling or collision injuries
Incorrect and/or repetitive lifting or twisting
Obesity, lack of regular exercise, tobacco use

Symptoms

When a herniated disc presses on a nerve, you may experience pain, numbness, and/or weakness of the affected area. In contrast, for those patients without significant nerve compression, mild pain or discomfort may be the only symptom. The location and severity of the herniated disc usually dictate the symptoms.

Symptoms of a herniated disc in the lower back include:

Mild to severe lower back pain that is aggravated by movement.
Muscle spasm.
Sciatica (pain, burning, tingling, or numbness that extends from the buttock into the leg or foot).
Leg weakness or loss of leg function.

Symptoms of a cervical (neck) herniated disc may include:

Mild to sharp pain in the neck or between the shoulders blades that is aggravated by movement.
Pain that radiates down into the arm, hand or fingers. This is called a radiculopathy.
Numbness or tingling in the shoulder or arm.

Diagnosis

If you have back pain and you suspect that a herniated disc is the underlying cause, you will need to schedule a consultation to confirm the diagnosis and receive a customized treatment plan that can treat your condition.

If you have a herniated disc during your visit, you will undergo a complete physical examination and neurologic examination of the spine. An x-ray, CT scan, MRI, or specialized nerve tests may also be needed if another condition is involved or the specific nerves that may be affected needs further evaluation.

Treatment

Most disc herniations do not require herniated disc surgery. The condition often resolves within four to six months. In the meantime, there are many non-surgical treatments that can help relieve symptoms including:

Medications, such as anti-inflammatory medications to reduce swelling and pain, muscle relaxants to calm spasms, and narcotics to alleviate acute pain.

Epidural corticosteroid injection(s) may help relieve significant radiating pain in the arm or leg.
Physical therapy, which may include massage, stretching, therapeutic exercise, bracing, or traction to decrease pain and increase function
For those patients that do not need herniated disc surgery in New York, you will find our outpatient non-surgical microdiscectomy has a multitude of benefits. Click here to learn more.

Surgical Treatment

During your consultation, we will formulate a custom treatment plan that is based on your symptoms. Conservative approaches may be all that’s required if your condition is steadily improving. If your condition continues to worsen, surgery may be the best treatment option.

The standard surgical procedure for the treatment of a lumbar herniated disc is laminotomy and discectomy. During the procedure, Dr. Akamnonu will remove a small piece of the bone to gain access to the spinal canal (laminotomy) and then removes a portion of the herniated disc (discectomy). Spinal fusion may be required in certain cases.

For lumbar disc herniation patients requiring surgery, the most advanced minimally invasive treatment options uses extremely small incisions and allows for outpatient treatment. During a tubular microdiscectomy, a robotic microscope will be used to remove the offending herniated disc through an incision of 16-18mm. Endoscopic discectomy is a procedure that utilizes a specialized camera inserted into the spinal canal through a ¼ inch incision and dedicated instruments to treat damaged discs. Benefits of these minimally invasive approaches include decreased pain, quicker recovery, and an enhanced cosmetic result.