What Is a Spinal Disc?
A spinal disc is a pad of rubbery tissue with a soft, gel-filled center like a jelly doughnut, between two vertebrae. The spine is not a single bone. Rather, it is a column of interlocking ring-shaped bones called vertebrae. The spinal cord passes through the center. This structure allows the spine to bend, flex, and twist, giving the body mobility while still protecting the spinal cord.
There are 23 individual spinal discs in the spinal column, which perform several crucial functions:
- Separating the vertebrae, keeping them from rubbing against one another
- Absorbing shock, preventing or reducing damage from hard landings
- Adding extra mobility with their flexible structure
What Conditions Affect Spinal Discs?
Spinal discs are designed to withstand large amounts of lifelong stress, meaning they are highly resilient. They are not, however, infallible. Age, acute trauma, repetitive strain, and other causes may damage spinal discs, leading to malfunction and failure. The following are conditions that commonly affect spinal discs:
- Herniated disc: If a spinal disc’s tough exterior is damaged, its gel center may burst through the weak point. This creates a leak into nearby tissue and leads to pain in the neck or back.
- Slipped disc: Damaged discs do not always leak. In some cases, they may instead slip out of place. This reduces padding between vertebrae while creating an outward bulge, resulting in discomfort or pain.
- Degenerative disc disease: Gradual wear and tear causes spinal discs to stiffen and shrink. They lose their flexibility and are less able to absorb shock, causing pain and stiffness.
Herniated, slipped, or degenerated discs may also lead to myelopathy or radiculopathy. These conditions develop when a disc presses against the spinal cord or a root nerve. The pressure impedes nerve function, resulting in shooting pains or loss of sensation.
What Are the Symptoms of Spinal Disc Conditions?
The signs of a disc condition often appear slowly, and the person may not notice anything wrong at first. Pain and other symptoms gradually develop as the condition worsens, sometimes progressing to the point of disability. In other cases, symptoms appear all at once.
Specific symptoms depend on the location of the damaged disc. When the condition develops in the lumbar spine (lower back), it may cause:
- Lower back pain
- Numbness or tingling sensations in the buttocks and legs
- Sharp or “electric” pain that travels through the buttocks and legs
- Muscle weakness in the legs
- Difficulty walking
- Loss of urinary or bowel control
Disc conditions in the cervical spine (neck), meanwhile, may cause:
- Pain in the neck or between the shoulder blades
- Numbness or tingling sensations in the arms and hands
- Sharp or “electric” pain that travels through the shoulders, arms, and hands
- Pain that increases with certain neck positions or movements
Disc conditions in the thoracic spine (mid-back), can cause the following symptoms:
- Shooting or traveling pain in the chest, upper back, or legs
- Numbness or tingling in the legs
- Loss of strength in the arms or legs
- Difficulty walking
- Loss of urinary or bowel control
- Headaches, especially in certain positions
Spinal discs do not receive a consistent blood supply, so they cannot self-repair as easily as other tissues. That means disc pain will not go away by itself. Unless the patient seeks medical treatment from a spine specialist, symptoms will only get worse over time.
When Is Surgery Recommended?
Spinal disc pain always requires medical treatment. In many cases, however, a conservative approach is enough to provide relief. Pain relief medications, steroid injections, rest, and cold or heat therapy help to reduce inflammation, while physical therapy builds strength around the painful area. A supportive brace may also be used to relieve pressure on the problematic disc.
While these methods may reduce discomfort, however, they do not address disc conditions at their root. This means they do not always lead to long-term improvement. If the patient’s pain is severe, or if it does not respond to conservative methods, then a surgical solution may be considered. Patients struggling with disc-related pain should speak with their physician about treatment options. Surgery, such as microdiscectomy, could provide permanent relief.
What Is a Microdiscectomy?
Microdiscectomy is a cutting-edge treatment for back pain and a minimally invasive form of discectomy. The procedure involves cutting and removing parts of a spinal disc, removing pressure on the spinal cord, and eliminating pain at its source. There are three types of microdiscectomy, categorized by the section of the spine to be operated on:
- Cervical microdiscectomy, which treats pain in the neck
- Thoracic microdiscectomy, which controls pain in the upper back
- Lumbar microdiscectomy, which remedies pain in the lower back
Traditionally, disc pain was treated with a discectomy. This procedure involved removing the whole spinal disc, then stabilizing the spine with an artificial replacement or a spinal fusion. However, not all damaged discs need to be fully removed. Microdiscectomy is a less-invasive alternative that leaves most of the original disc in place. This allows for an easier recovery and less loss of mobility after treatment.
Advantages of Minimally Invasive Surgery
Microdiscectomy is a minimally invasive spine surgery. This means the surgeon uses specialized tools to work through a smaller incision than usual. A tiny camera, called an endoscope, helps the surgeon guide his tools for extreme precision without requiring open surgery. The result is reduced surgical trauma. With less damage to the skin, muscles, and nerves, patients experience the following benefits:
- Reduced post-surgical pain and bleeding
- Less risk of infection and complications
- Shorter hospital stays and recoveries
- Faster results from surgery
These benefits are why NU-Spine emphasizes minimally invasive treatments whenever possible. While not all patients may be candidates for procedures like microdiscectomy, those who are will experience improved surgical outcomes with less pain and stress.
Choosing a Microdiscectomy Doctor
When planning for any surgical procedure, it is important to work with an experienced physician. Microdiscectomy is a proven procedure with high success rates. The right surgeon, however, makes a difference – both in positive outcomes and patient comfort levels.
Treatments at NU-Spine are performed by our resident neurosurgeon, Dr. Branko Skovrlj. He is a board-certified neurosurgeon who focuses exclusively on the spine. Though he has expertise in all kinds of spine surgeries, minimally invasive procedures such as microdiscectomy are his specialty. He regularly contributes to research efforts to improve the effectiveness and availability of minimally invasive treatments. His work has earned multiple awards, including:
- North American Spine Society Resident Research Award
- North American Spine Society Value Award
- AO Spine North America Fellow Research Award
- Neurosurgery Publication Special Recognition Award
Though Dr. Skovrlj is world-renowned for the quality of his work, he believes in small-town values. Back pain can be a difficult subject to approach, especially when it limits a person’s lifestyle or creates insecurities about one’s body or abilities. Dr. Skovrlj understands this and strives to make patients comfortable in a compassionate environment.
Preparing for Your Microdiscectomy Procedure
Preparation for microdiscectomy begins with extensive evaluations. The physician performs physical examinations, evaluates the patient’s medical history, and takes medical images such as X-ray, MRI, or CT scans. This helps confirm a diagnosis, determine the location of the damaged disc, and decide whether surgery is the most appropriate treatment.
If the surgeon decides on a microdiscectomy, surgery will be scheduled. The appointment comes with preparation instructions, which may include:
- Not smoking on the day of surgery
- Stopping certain medications before surgery
- Not eating or drinking
- Bathing with a special cleanser before surgery
- Wearing comfortable clothes that are easy to remove
Patients should be careful to follow these instructions exactly. This will reduce the likelihood of surgical complications, ensuring a smooth operation with a successful outcome.
During The Microdiscectomy Procedure
Microdiscectomy at NU-Spine takes place in our state-of-the-art surgical facility. The procedure is performed under general anesthesia, so patients are asleep while Dr. Skovrlj is working. He begins by positioning the patient on the operating table and administering the anesthesia. Once the patient is asleep, he will perform the procedure with the following steps:
- He makes an incision on the patient’s back near the problematic disc.
- He uses a surgical dilator to gently move the back muscles aside. This lets him access the spine without cutting through muscles or nerves.
- He inserts a tiny camera, called an endoscope, into the channel made by the dilator. He will use a video feed from this camera to guide his tools with precision.
- Skovrlj removes portions of the lamina, or the back section of the vertebra, to access the problematic disc.
- He removes the leaking or bulging parts of the disc that cause pain.
- If necessary, he may perform a spinal fusion to stabilize the vertebrae. This step eliminates movement between vertebrae and is therefore avoided when possible.
- Skovrlj stitches the incision closed and protects it with a surgical dressing.
By itself, microdiscectomy can be completed in only 30 to 60 minutes. If a spinal fusion is required, the operation may take longer. The patient is taken to a recovery room afterward where nurses will monitor their condition while they wake up. Depending on the patient’s condition, they may be able to go home the same day. Other may need to stay a night or two at the hospital. This period allows healthcare professionals to keep an eye on their early recovery and prevent complications.
Microdiscectomy Recovery
Once the patient is cleared to leave the hospital, Dr. Skovrlj provides guidance for at-home recovery. Patients should make sure they understand his instructions. If anything seems confusing, ask questions to learn more. Following recovery instructions is key to avoiding complications, such as infection and re-injury, to ensure a successful recovery. Dr. Skovrlj’s guidance may include:
- Protecting the incision site with surgical dressings
- Following special instructions for bathing until the dressing is removed
- Limiting heavy lifting and strenuous activities
- Taking medications to manage pain
- Exercising gently to rebuild back strength
- Monitoring for signs of infection, like inflammation or fever
- Scheduling a follow-up appointment at NU-Spine
Most patients can return to light activities, such as driving and housework, after a week or two. Heavy lifting and strenuous chores may stay restricted for a few weeks longer. A physical or occupational therapist assists patients through a gradual return to pre-surgery activity levels, which can usually be resumed after about six weeks.
Results from Microdiscectomy
Though full recovery takes several weeks, most patients feel immediate relief from back pain. All spinal cord and nerve impingement is eliminated, meaning the patient will no longer experience nerve pain. In addition, the restored back can move freely without discomfort. Once patients recover, they can return to their normal, pre-pain mobility and function without any restrictions.
Microdiscectomy is among the most common spine surgery procedures and is considered one of the most reliable. It has higher success rates than other common procedures, such as spinal fusion, and consistently delivers results that patients are happy with.
Find Back Pain Treatment Near You in New Jersey at NU-Spine
Though surgery is a big step, understanding how it works can help patients approach their treatment with confidence. Patients can access microdiscectomy procedures from an award-winning neurosurgeon at NU-Spine: The Minimally Invasive Spine Surgery Institute. Serving patients from multiple locations near you throughout the state of New Jersey, NU-Spine helps them find relief from back pain. Contact us today to learn more about our services or to schedule a consultation.