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Happens When a Disc Ruptures?
the outer lining (annulus) of a disc "tears," its
center (the nucleus ) may rupture and press
a spinal nerve(s) against the bony surface of a vertebra
(Fig. 5). This condition is often referred to
as a ruptured disc. You could think of it as
having a tube of toothpaste with a crack in it. Exert
pressure on the cracked tube (disc annulus,)
and toothpaste (disc nucleus) flows out the
crack. Even pressure from everyday activities can push
the disc's nucleus through the ruptured annulus and
pinch a spinal nerve root(s).
Causes a Disc to Rupture?
we've discussed, your lumbar spine supports the weight
of your entire upper body and is under stress every
day. Simple "wear and tear" or the effects of aging
can contribute to a disc rupture. In some cases, the
rupture happens during the course of normal, everyday
activities. In other cases, it occurs as the result
of a specific injury. Usually there is no way to "prevent" it
from occurring, however, you can reduce your risk by
staying in good physical condition and by using proper
are the Symptoms of a Ruptured Disc?
a lumbar spinal nerve is pinched, you may experience
pain in your lower back, pain or numbness in your leg(s),
weakness in your legs or feet, or numbness in one or
both of your feet. The pain can come from the pressure
on the nerve, the swelling within the nerve (caused
by the pressure) or injury to the nerve itself. Taking
pain medication or drugs which reduce the swelling
may provide relief, but healing may not occur as long
as the nerve itself remains pinched. It's similar to
having your finger caught in a door. An aspirin may
help to ease the pain, but healing won't begin until
the door is opened and your finger is no longer being
is a Ruptured Lumbar Disc Diagnosed?
diagnosis of a ruptured lumbar disc is based on:
history of back and/or leg pain;
physical examination of your back and legs; and
tests, which may include spine x-rays, an MRI,
a CAT scan or a myelogram. (Each of these examination
has a specific purpose.)
are a number of treatment options for a ruptured lumbar
disc, each accompanied by its own set of risks and
benefits. The four basic approaches are as follows:
Time: For some patients, all that is required
in order to heal and recover is time.
Medication: For others, medication may reduce
the inflammation or ease the pain in the affected
area and thereby provide relief from their symptoms.
Physical Therapy: For some, physical measures
such as physical therapy (or gentle exercise)
may provide relief and aid in the recovery from
a ruptured disc.
Surgery: For those patients whose ruptured
disc is causing a "pinched" nerve, lumbar microdiscectomy
often is the recommended treatment.
Lumbar Microdiscectomy is NOT an Option
severity of your symptoms (pain, weakness, lack of
mobility) and your general health and physical condition
will play an important part in determining when surgery
is not an option for you. In general, surgery is
not an option when:
back and leg pain is not caused by a ruptured disc;
do not have leg symptoms;
is a medical reason which prevents you from having
which reduces swelling or relieves pain would provide
you with adequate relief;
measures would improve your condition.
Their Risks and Benefits
Lumbar Microdiscectomy IS an Option
microdiscectomy is usually recommended only when
specific conditions are met. In general, surgery
is recommended when a ruptured disc is pinching a
spinal nerve root(s) and you have:
pain which limits your normal daily activities;
in your leg(s) or feet; or
in your extremities; or
bowel and/or bladder function.
Risks of Having Surgery
of the more common risks of having any surgery include
excessive bleeding, infection, or a negative reaction
to anesthesia. Certain unforeseen circumstances could
even lead to death. Clinical experience and scientific
calculation indicate that these risks are low, but
surgery is still a human effort. You should feel free
to ask any questions you have about your specific risk
microdiscectomy involves surgery in and around
the spine, further nerve damage is a possibility. In
some cases, the nerve is already so damaged that
the surgical procedure required to simply reach
the nerve could be the "straw that breaks the camel's
back." The end result could be numbness, paralysis
or a loss of bowel and bladder control. (However,
deciding not to have surgery may have exactly the
same consequences. Your decision should be based
on a weighing of the risks of having surgery versus
the risks of not having surgery.)
Benefits of Having Surgery
can think of surgery as the first step in the
healing and recovery process. It can help relieve pressure
on your spinal nerve(s) and, thereby, help relieve your
pain. It also may help you begin the process of regaining
some of the lost mobility in your extremities.
and its Specific Benefits
microdiscectomy is an operation on the lumbar spine performed
using a surgical microscope and microsurgical techniques
(Fig. 6). A microdiscectomy requires only a very
small incision and will remove only that portion of your
ruptured disc which is "pinching" one or more spinal
nerve roots. The recovery time for this particular surgery
is usually much less than is required for traditional
Chances for Success
level of healing will be determined by your age, your
general health and the severity of the damage to your
spinal nerve, as well as your attitude and your willingness
to work at recovery.
||When you consider your
options, keep in mind the impact your condition has on
your way of life and carefully weigh the risks and benefits
of having surgery against the risks and benefits of not
having surgery. The decision is yours!
You Decide to Have Surgery...
your surgery with a positive mental attitude and with
full confidence that you have made the right decision.
While the surgeon concentrates on finding and removing
the cause of your pinched nerve, you must concentrate
on the recovery process. Cooperate fully with your
surgeon and focus on the improvements you will make in
the future-not on the problems of the past.
microdiscectomy - page 1
microdiscectomy - page 3
Lumbar microdiscectomy - page 4