What is a herniated disk?
This is a common question. The disk is sort of a cushion that rests between the bones of the spine. It is in front of the spinal cord. The disk acts as a cushion and is made of up multiple types of collagen. Functionally, it bears some weight when sitting or standing, and helps with motion as in looking left or right or with twisting your body left or right.
So what happens to the disk when it herniates?
In essence, the disk leaves its home. It leaves the space between the bones and acts as an irritant. It can press on the spinal cord to cause weakness in the arms and legs. The herniated disk can rupture and press on a nerve causing shooting pain down the legs or arms. It can cause a drop foot, where the ankle does not work correctly. This can interfere with walking, climbing stairs and even driving.
How to diagnosis a herniated disk? Classically, an examination can give the physician a good idea as to whether the disk herniation is causing impingement on the spinal cord or nerve root. Management may necessitate an MRI that can show the disk herniation and where it herniated.
How do we manage herniated disks? Herniated disks are common in society. A vast majority of them are treated with conservative care, including injections, physical therapy and anti-inflammatory medications. When there are neurological deficits such as weakness in the arms or legs, or when conservative care fails, surgery is often considered. Depending on what part of the spine is affected, the herniated disk can often be treated with a same day procedure that will relieve the pressure on the spinal cord or nerve root. Patients often go home the same day and are back to work or life in about 10-14 days. I tailor every surgical decision making process to each unique patient and their specific disc pathology. This can vary, obviously, depending on the pathology and the patient. There are no guarantees, but described above are common scenarios that it is in the evidenced based literature.