The spine is composed of a column of vertebrae that houses the spinal cord. The bony vertebrae are separated by intervertebral discs. The discs, in turn, are composed of a semi-fluid gelatinous material surrounded by a cartilaginous outer ring. The discs permit movement of the vertebrae and act as cushions which absorb compressive and rotational forces.
Over time, repetitive loading forces on the disc structures lead to degenerative disc changes. The outer cartilaginous ring (annulus fibrosus) undergoes microscopic tears which can cause “bulging” of the disc. An accumulation of these small tears can sometimes lead to a “rupture” of the annulus (also called a disc herniation). When a disc “herniates,” the inner semifluid material (nucleus pulposus) can escape the confines of the disc and enter the spinal canal. The herniated material can press on the spinal nerves as they leave the spinal cord.
Symptoms and signs of disc disease
Pressure on the spinal nerves can cause pain which “radiates” into the arm (in the case of cervical disc rupture) or leg (in the case of lumbar disc rupture). Spinal nerve root irritation can cause numbness and/or weakness of the arm (cervical disc disease) or leg (lumbar disc disease).
Treatment of a herniated disc: decompressive discectomy
When conservative measures fail to control neck/arm or low back/leg pain, the aim of surgery is to relieve pressure against the spinal nerve. This surgical procedure is called a decompressive discectomy. The herniated portion of the disc is removed which “decompresses” the spinal nerve. Sometimes, the interior of the offending disc is explored and any loose fragments within the disc are also removed with the intention of preventing “repeat” herniation.
The initial goal of treatment is to prevent the need for surgery including decompressive discectomy. Dr. Grimm specializes in non surgical treatments that help relive back pain and alleviate the need for surgery.