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Understanding Your Spine
There are 24 bones that make up your spinal column. These bones are called vertebrae. There are three areas of the spinal column. The first is the cervical spine (neck); the second is the thoracic spine (middle back); and the third is the lumbar spine (lower back). The base of your spine has a bone that is called the sacrum and the coccyx is located at the end of the sacrum.
Each area of the spine has a specific number of vertebrae. The cervical spine has seven vertebrae; the thoracic spine has 12 vertebrae; and the lumbar spine has five vertebrae.
Each pair of vertebrae is cushioned by a disc. The discs are soft and are made up of a water like substance. This part of the disc is known as the nucleus pulposus. The outer part of the disc is called the annulus fibrosis. These discs act as shock absorbers. The spinal column has 23 discs that start between the second and third cervical vertebrae and continue through to the fifth lumbar vertebra and the sacrum. Each disc is named by referencing the vertebrae above and below the disc. As an example, if you were to reference a disc in the cervical spine and if this disc was between the second and third vertebrae, you may be told you have a disc protrusion in the C2-C3.
Now that you understand the spinal column and the parts that it is made up of, you will hopefully gain a better understanding of the types of damaged discs and determine whether you may suffer from any of the following. If you experience symptoms such as pain in your neck, back, arms or legs, you may have a disc protrusion.
Types of Damaged Discs
Over time, disc can become damaged either through injury, or poor posture or weak supporting muscles. Any of the foregoing can cause the annulus to tear.
The majority of conditions with a torn annulus is a disc protrusion. This is more commonly known as a bulging disc. What this means is that the nucleus releases through the tear, however it does not release in its entirety. Depending on the location of the tear, will determine whether the disc protrusion presses straight back or on either side of the disc.
A disc herniation occurs when the nucleus protrudes through the tear and becomes displaced, surrounding either the spinal cord or the nerve roots.
If the nucleus pushes out beyond the disc and nearby ligaments, this is known as an extruded disc.
When the herniated disc completely separates from the disc, it then becomes a free fragment. This means that the disc is at the end stage of an extruded disc and is said to be sequestered.
Treatment for Disc Protrusions
A high percentage of patients with disc protrusions do not require surgery due to successful, conservative therapy. There are, however those that after an extended period of therapy, there is no long term relief and it is those that may consider surgery.
Before discussing surgery for disc protrusions, let us first look at some forms of conservative disc protrusion therapy.
The first and most important thing to do is follow controlled physical activity. A short period of bed rest is the primary step. A gradual return to your normal activities is next. Sitting should be avoided, most especially for extended periods of time. When we are seated, we place a great deal of stress and pressure on the lumbar spine.
Anti-inflammatory medication, muscle relaxants and analgesics are a regular part of conservative treatment for disc protrusions. Many suffering from this condition, find relief when taking controlled medication.
For patients who have first tried conservative treatment for an extended period of time and have not found relief from such treatment, the option of surgery may be discussed. Due to the risks and possible complications that may arise with conservative back surgery, all surgical procedures should be explored. It is important to ask for all surgical options and to then look at the pros and cons for each type of surgery available to you. It is equally important to ask as many questions as possible to ensure you make the best choice for you and your lifestyle.
With evolving medical technology, non-invasive surgeries are being performed more often and patients have had excellent results. There are a multitude of benefits for minimally invasive surgeries in comparison to traditional or conservative surgery. Most notably is the little to no risk, complications are few to none. In fact, most patients are encouraged to take a lengthy walk the same day as their surgery. With the traditional or conservative surgery for disc protrusions, there are often lengthy hospital stays with a slow return to normal activities.