Lumbar Disc Herniation is a condition stemming from the degeneration or damage of the discs that act as cushions between the vertebrae of the spinal column, primarily caused by age or trauma-induced excessive pressure. The severity of the herniation ranging from mild degeneration to sequestration determines the symptoms and subsequent treatments, with surgery being the resort for persistent and severe cases.

Disc Anatomy

Annulus: The strong, fibrous outer wall of each disc.
Nucleus: The softer, gel-like core located within the annulus.

Forms of Herniation

Degeneration: Disc weakens, becoming thinner and may shrink, without nucleus breaching the annulus.
Prolapse: The disc showcases a prominent bulge impacting the spinal canal or a nerve.
Extrusion: The nucleus perforates through the annulus but remains integral.
Sequestration: The nucleus exits the annulus, detaching from the main disc portion.

Symptomatology

Mild Cases: Back pain due to smaller protrusions.
Advanced Cases: Pain, potentially sciatica, radiating from lower back and hip down the leg, involving aches in the lower back and buttocks, and possibly leading to numbness, tingling, muscle weakness, and urinary or bowel issues.

Treatment Approaches

Conservative Treatments: Initial approaches involve rest, medication, corticosteroids, and physiotherapy, addressing 90% of small disc herniations, typically healing within two weeks to six months through resorption or scar tissue development.
Surgical Intervention: For severe, persistent symptoms or cases not amenable to conservative treatments, surgery is contemplated. The surgical goal is to excise the herniated disc portion compressing the nerve through a 2 cm incision, utilizing retractors, micro-instruments, and an operating microscope. The procedure approximately spans 1.5 hours, with a postoperative hospital stay of 1-2 days, allowing patients to resume normal activities subsequently.

Lumbar Disc Herniation manifests through the abnormal protrusion of the disc’s nucleus, with varying degrees of herniation dictating the symptom severity and treatment trajectory.

Conservative treatments predominantly suffice for mild cases, while surgery becomes pivotal for unresolved or severe herniations, aiming to alleviate compression through minimal invasive techniques, and generally yielding a swift and favorable recovery pathway.

Navigate your treatment options and receive optimal care with the skilled Neurosurgeon and Spine Surgeon, Dr BSV Raju.