PATIENT
EDUCATION

A herniated (sometimes referred to as a ruptured) disc occurs when the spinal disc, which is the cushion between the vertebrae, bulges outside its regular position. As a result, nerves can become pinched, sending pain down a leg or arm. The condition can occur suddenly from trauma or over time from repetitive stress on the spine. There are also several conditions that can weaken the spinal discs, such as smoking and being overweight.

Lower Back Symptoms

• Electric-type shooting pain that radiates down one or both legs
• Weakness in one or both legs
• Numbness and tingling in one or both legs
• Loss of bowel or bladder control (which can in most cases be a sign of something more serious and should be evaluated immediately)

Neck Symptoms

• Electric-type shooting pain that radiates down one or both arms
• Weakness in one or both arms
• Numbness and tingling in one or both arms
• Burning that radiates to the neck, shoulder, shoulder blade, or arm

TREATMENTS FOR HERNIATED/RUPTURED DISCS

There are nonsurgical and surgical treatment options available for herniated/ruptured discs. Both treatment types are performed by our back, neck, and spine specialist at Orthopaedic Specialists.

Nonsurgical Treatments

Anti-Inflammatories

Oral medications can be used to reduce inflammation, thereby improving pain. By reducing pain, the hope is to allow patients to resume a more normal lifestyle while natural healing is given time to occur.

Physical Therapy

Our team of spine physical therapists is trained to promote pain relief and educate the patient on techniques to reduce reinjury.

Epidural Steroid Injections (ESI)

This treatment option includes the injection of an anesthetic along with a steroid medication. They can be used for both diagnostic and therapeutic reasons in the spine. Dr. Dolphin reviews every patients’ physical exam and imaging studies to determine the type of epidural steroid injection that will offer the patient the most relief.

Surgical Treatments

Minimally Invasive Microdiscectomy

Dr. Michael Dolphin, our extensively trained back and neck surgeon, performs minimally invasive outpatient microdiscectomy, which is designed to relieve pain from a disc bulge/herniation. This procedure is done for patients who have not responded to conservative treatment methods. The procedure removes the herniated part of the disc material that is pressing on the nerve or the spinal cord, retaining the unaffected disc for continued function. Once the part of the disc that is pinching the nerve is removed, the pain and numbness improve. Dr. Dolphin performs this procedure in the lower back utilizing muscle-sparing techniques and, when indicated, utilizing tubular retractors to minimize tissue injury. His techniques have been perfected over 10 years and result in less damage to the muscles, allowing for a quicker return to normal activities.

Dr. Dolphin also performs a similar procedure for herniated discs in the neck. The patient is positioned in a sitting position and, using a muscle-sparing approach, the cervical disc herniation is removed. This relieves the pressure on the nerve(s), improving the numbness and radiating pain. The cervical laminoforaminotomy is a minimally invasive procedure that relieves pain without performing a fusion, thus not causing any issues with decreased neck range of motion.

Posterior Cervical Laminoforaminotomy (Minimally Invasive)

Dr. Dolphin performs the posterior cervical laminoforaminotomy procedure for herniated discs in the neck. The patient is positioned in a sitting position, and utilizing a muscle-sparing approach, the cervical disc herniation is removed. This relieves the pressure on the nerve(s), improving the numbness and radiating pain down the arm. The cervical laminoforaminotomy is a minimally invasive procedure that relieves pain and numbness without performing a fusion. Compared to the cervical fusion, this allows for a completely normal range of motion after surgery as well as less chance for future neck deterioration.

When either a lumbar or cervical microdiscectomy procedure is complete, a few stitches are placed in the incision, which is then covered with Steri-Strips and a water-resistant dressing. This allows the patient to shower immediately. Patients can return to non-strenuous work within 1 – 2 weeks following surgery. However, more physically demanding professions usually require 4 – 6 weeks before returning to full activity.

Anterior Cervical Discectomy With Fusion (Minimally Invasive)

Cervical disc herniations can also be removed through the front of the neck (anterior approach) to alleviate pain, numbness, and tingling resulting from nerve root and spinal cord pressure. This procedure is utilized in situations where there is not only a disc herniation but also arthritis, with bone spurs causing nerve compression. When performing this procedure, stabilization of the disc space is then performed in the form of a fusion. Typically, a plate and screws made of metal are inserted to provide immediate spine stabilization while the bone fusion is healing. Dr. Dolphin performs this procedure with a minimally invasive approach through an incision approximately one inch in length, allowing for a quicker recovery and also the ability to do the procedure on an outpatient basis.