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The Normal Disc
A disc is a cushion-like
substance acting as a shock absorber in between two spinal bones. It has an inner soft
jelly-like material (nucleus) covered by the outer tough rubbery ring (annulus).
The Prolapsed/ Herniated Disc
Herniation, a common issue
treated by a spine specialist in Delhi, refers to the
displacement of disk material beyond the normal boundary of the disk space. Herniated
discs
exert pressure on the spinal canal when they bulge into it. It pinches the spinal
nerves,
causing pain. It is known by different terms such as slip disc, bulging disc, herniated
disc, protruding disc, and ruptured disc.
Stages of Disc Prolapse
The earliest stage of disc
prolapse usually starts with minor tears in the outer annulus with small protrusions of the
inner nucleus through its coverings. There is no bulging or actual herniation or nerve root
compression.
- 1. The initial stage of disc bulging is where there is a small focal or diffuse bulge without any nerve compression.
- 2. In this, the herniation is more prominent. The inner nucleus protrudes through the outer annulus, causing varying degrees of nerve compression.
- 3. By this stage, there is a large fragment of the nucleus that has completely breached its covering (annulus), causing severe nerve root compression.
- 4. In this stage, the fragment can get disconnected from its main portion and migrate, causing severe nerve root compression. routine activities
Risk Factors
Any imbalance between how strong your spine is or what forces it can withstand
and what it is subjected to (stress/ strain/ wear and tear) can result in back problems and
disc herniation.
Causes, Symptoms and Warnings
Causes
- Repetitive strenuous mechanical activities
- Sudden violent trauma
- Poor posture – at work and during normal routine daily activities
- Sedentary lifestyle
Symptoms
- Continuous or intermittent back pain
- ROOT BLOCK: PAIN MANAGEMENT FOR SCIATIC PAIN AND SLIP DISC or Leg pain
- Activity related back pain
- Numbness in lower limbs
- Weakness in lower limbs
- Loss of sensation in leg and foot
- Difficulty in gripping the footwear
- Bowel and bladder disturbance (urgency, loss on control, straining- Cauda Equina syndrome –seek immediate medical attention)
- Muscle spasms
Treatment Options
- Self-care - Restricting the activity, ice/heat therapy - Too long bed rest may give you fragile and weak muscles, and rigid joints, which will make it difficult to do activities that could help curtail the pain
- Medication - Nonsteroidal anti-inflammatory medications, Analgesic (painkiller), muscle relaxants
- Local epidural steroid injection if not relived by medications
- Physiotherapy – Strengthening exercises following percutaneous electrical nerve simulation (PENS) and transcutaneous electrical nerve stimulation (TENS) to reduce muscle spasm
- No role of traction
- Steroids – No long-term benefits, can have drug related complications
Surgical Treatments at Noida
Surgery is always considered the last option only if none of the non-surgical treatments fail to deliver the desired results.
Transforaminal Endoscopic Lumbar
Discectomy (TELD)
Transforaminal Endoscopic Lumbar Discectomy (TELD) is a minimally invasive surgery for Slip Disc. It involves a small incision and an endoscope to access and remove herniated disc material through the foramen, offering rapid recovery, less postoperative pain, and preservation of spinal stability, with high success rates in symptom relief.
Interlaminar
Endoscopic Discectomy
Interlaminar Endoscopic Discectomy is a minimally invasive approach for Slip Disc, utilizing a small incision and an endoscope inserted between spinal laminae.
Tube-assisted Discectomy
Tube-assisted discectomy for Slip Disc involves a small incision through which a tubular retractor is inserted, creating a tunnel to the affected disc.