Slipped Disc/ Sciatica
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Lateral view & Superior view
Anatomy
The bones (vertebrae) that form the spinal column in the back have a cushioned substance called inter-vertebral disc in between them. They have an outer layer (annulus) that surrounds the inner jelly like material (nucleus pulposus) . They act as shock absorbers for the spinal bones.
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What is a slipped disc?
Slipped disc (also called as disc prolapse) occurs when a soft cushioned tissue between the bones in your spine bulges out. It causes pain by causing compression on the nerves.
Symptoms of slipped disc:
- lower back pain
- numbness or tingling in your arms, hands, legs or feet
- neck / back pain
- problems bending or straightening your back
- muscle weakness
- pain in the buttocks, hips or legs if the disc is pressing on the sciatic nerve (sciatica).
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What is Sciatica?
The sciatic nerve is the longest and thickest nerve in the body. Sciatica refers to nerve pain from an inflammation or irritation of the sciatic nerve, which originates in your buttock/gluteal area. It is commonly used to describe any pain that originates in the lower back and radiates down the leg; although true damage to the sciatic nerve is rare.
Normal disc
Slipped(herniated) disc
MRI picture of slipped disc
Slipped disc causing nerve impingement
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What is treatment for slipped disc?
Acute slipped disc can be usually treated with bed rest, painkillers and gentle exercises once pain subsides.
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When is surgery recommended for slipped disc?
When patients fail to respond to rest and pain-killers/ conservative line of management, your doctor may recommend surgery to relieve you of your trouble.
Options:
- Open discectomy - Its an open surgery via a 5 cm incision, wherein bony part of your spinal column is partially removed to access the protruded disc and the disc is then removed.
- Endoscopic discectomy - It is a minimally invasive procedure in which an endoscope (camera) is inserted via small (0.5 cm) incisions and the disc removal achieved by observing on a tv monitor. It is done for specific types of slipped disc only.