DISC HERNIATION – Causes, Symptoms, and Surgery
Increasing number of people are found to be suffering from slip disc or herniated disc. This can be caused due to aging, accidental trauma or injury, or lifting weights and excessive strain.
What is Disc Herniation?
This is a spinal disorder where the cushioning rubbery disc between spinal bones (vertebrae) is damaged. This disc is the shock protector for the bones as it absorbs shocks and jerks of the bones which we face in our routine activities like bending, walking, lifting, twisting etc.
The cushioning disc has two parts: the inner gelatinous soft core and the tough outer ring. Herniated or slipped disc arises when this gelatinous soft core protrudes through the outer ring. This happens when the outer ring is either injured, weak or degenerated or defective.
- The symptoms depend whether the location of disc herniation is in the low back, mid back or neck. Slip disc causes a debilitating pain and discomfort in the movement because it tends to compress the spinal nerve in the affected area along with numbness or weakness of surrounding arms or legs. Referred pain is also experienced along the course of that nerve.
- When the damage is in the neck a person may experience pain around the neck area and numbness, tingling, weakness, or pain in the shoulder, neck, arm, or hand. These symptoms would seem to intensify with increased motion of the neck.
- If the lower back disc is affected, a person may experience pain originating from buttocks and moving down the back of either leg to the knee or below. Numbness, tingling or weakness in the buttocks, anus or genitals, back, legs, or feet or all of these organs is possible. These symptoms are broadly known as Sciatica.
- The patient will also feel a sharp pain that might arise with movement, straining or coughing. There would be a certain difficulty in controlling bowel movements or bladder function in severe cases.
If you are experiencing any of these symptoms, it is an indication to see a specialist (Dr. Arun Saroha) immediately.
The spine specialist will perform a thorough physical examination followed by a neurological examination. This includes complete check-up of the spine, nerve function testing, sensorimotor examination of limbs.
The doctor may try to understand the history and ask for information on prior spine problems, lifestyle, any past injuries, duration of pain and existing symptoms.
A specialized imaging study is done, after a few weeks of initial treatment and if it fails to give the desired relief. This includes magnetic resonance imaging (MRI). X-rays of parts of the spine in various positions and CT Scan if indicated after above.
Sufficient rest or limited activity and anti-inflammatory medications are the first level treatment. The doctor will ask to restrict activities like lifting, bending, and straining for a short period.
Another therapeutic remedy would be to treat the injured area with ice packs initially and later switch to hot packs.
This is usually supplemented with various modules of physiotherapy. After the first few weeks, if the body responds positively to the treatment, the doctor may recommend physical therapy, exercise, and massage. If these measures do not work, surgical repair can be considered.
After the first few weeks, if the body responds positively to the treatment, the doctor may recommend physical therapy, exercise, and massage. If these measures do not work, surgical repair can be considered. The absolute indication of surgery is neurological weakness and pain which is making the patient unable to do daily activities.
About Keyhole Surgery
This is a breakthrough in minimally invasive surgery. The term ‘keyhole’ itself explains the size of the incision cut in the back. Keyhole surgery is performed through a cut just as big or less than 1inch. In an open surgery, the surgeon makes an incision depending on the levels to be operated. Keyhole surgery is performed with an endoscope, a very high definition camera and exclusively designed surgical micro-tools and monitors for indirect viewing. The fragments of the prolapsed disc are slowly removed without any harm to the surrounding tissue. The patient is awake through the procedure and only local anesthesia is administered. Another way is a microscopic surgery, involving anesthesia and <1-inch incision.
The success rate of this procedure is around 95-98% and there are many advantages for the patients.
- Since it is not an open surgery, there is a lower risk of scarring, blood loss, blood clots being formed or infection.
- Keyhole surgery reduces the danger of spinal fluid leaking and causes minimal injury to the spinal nerves.
- The muscle tissues around the affected area are carefully pushed aside. As the muscles in the back are not disrupted, recovery is quicker and less painful. In most cases, the patient is able to move freely on the same/next day of the surgery. Discharge time for this could be 2 days for a normal case.
As the person comes out of local anesthesia, there might be minimal pain and some discomfort, maybe for a couple of hours only. Keyhole surgery is a technological boon to the field of medical sciences. When conducted with precision, this surgery gives accurate outcomes and renders much shorter hospital time for the patient.
Cost of Surgery
The cost depends on the category of the hospital, the location and the extent of pre-surgery procedures. Approximate cost of Keyhole surgery for herniated disc in India amounts between 1.5 lacs-2 lacs INR or 5500-6000 USD
Taking the decision to undergo a spine surgery is very crucial and should be made on a well-informed basis. Talk to our doctor and understand the methodology, the kind of surgery most appropriate for your problem. recovery period and post-surgery care.