The degenerative process of the spinal column contributes to Herniated Disc. The wear and tear of the disc weakens the tough outer layer and causes the inner core to leak out. The condition is commonly known as Disc Herniation. The spinal nerves are located at the outer core of the disc. This is called annulus fibrous. The herniated portion of the disc causes pressure on the nerves, leading to sciatic pain. It is associated with tingling, numbness and weakness. The pain radiates from the back, down into the buttock and the leg and is called a radiculopathy. A very serious type of Herniated Disc is called Cauda Equina Syndrome. This results from central disc herniation and causes severe leg pain, loss of sensation in the perianal region, bladder paralysis and incompetent anal sphincter.
The most common locations in the spine where herniations occur is the lumbar sacral region between L4 and L5 or L5 and S1. This area absorbs approximately 90% of herniated discs. Progressive disc degeneration otherwise called traumatic event, can lead to incompetent annulus fibrous. This results in expulsion of nucleus pulposus which is the inner core of the disc. This condition is known as Herniated Nucleus Pulposus (HNP). Patients with HNP experiences back and leg pain with dysthesias and anesthesias which is a bad sensation and loss of sensation respectively.
Herniated Disc occurs at different levels. The mildest form which is called disc bulging is relieved by non-operative treatment options without surgical intervention. Non-steroid anti-inflammatory medication and routine physical therapy are ideal to treat moderate or severe cases. Steroid and facet injections are also ideal to treat pain caused by herniated disc which offers immediate relief.
Surgical intervention is recommended if non-operative treatment does not give good result after six weeks of use. The surgery of choice is called Discectomy, through which the herniated portion is dissected to alleviate pressure from the disc. This is the preferred surgical option which has a very high success rate. However, lifestyle modification is recommended in order to achieve optimum success from the surgery and to remain pain free. Urgent surgical intervention is recommended for Cauda Equina Syndrome.
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