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Collapsed Disc

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Have you been diagnosed with a Collapsed Disc?

 

Are you getting conflicting information? Not sure what to do? Let us provide you with a global consultation and recommend spinal treatment options.  All  consultations are provided by Dr. Chiu himself.

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A collapsed disc in the spinal column  has lost a significant amount of the water content, causing it to lose its height and its ability to serve as a cushion between vertebrae.

  • Introduction

    While a collapsed disc can be caused by a damaging injury, it’s more often the result of wear and tear—a natural part of the aging process. This degeneration occurs most often within the cervical (neck) and lumbar (lower back) areas of the spine, where the vertebrae bear significant body weight and are subjected to a wide range of wear-inducing motion. The collapsed disc itself doesn’t usually produce symptoms on its own; only when the condition leads to compression of a nerve root or the spinal cord itself will you experience pain, muscle weakness, tingling, or numbness.

     

    The discs are often called the body’s shock absorbers. It is the disks water content that gives them their resilience. With age, the water content in the disks decreases, the discs get smaller and lose some of their elasticity and hydration. The pain associated with collapsed discs is similar to that of arthritis, sometimes making the problem difficult to diagnose. Like arthritis, the aging process the discs go through is gradual. It is not always easy to remember exactly when the pain started.

     

    A collapsed disc can occur in any part of the spine, including the cervical spine (creating neck pain) and the lumbar spine (creating lower back pain). Depending on the location of the collapsed disc, symptoms can include lower back pain that extends down through your buttocks to your upper thighs, or pain in the neck that extends down through the arms and hands, causing tingling and numbness in the arms or legs, unresponsive leg muscles, and a condition known as "foot drop."

  • Symptoms

    Collapsed discs don’t typically cause pain in an among themselves. Only when compress or impinge on nerves, the spinal cord or other tissues do symptoms develop. The most common symptoms include localized or radiating pain, numbness, tingling, and muscular weakness. The location of these symptoms can vary, depending on the position of the collapsed disc and impacted spinal nerve. Occasionally, a disc can collapse to the point that the adjacent vertebrae touch one another, which can lead to the development of bone spurs. Bone spurs can compress nearby spinal nerves, or even the spinal cord itself, which can also cause localized or radiating pain, numbness, muscular weakness, and/or tingling.

     

    Collapsed discs don’t typically cause pain in an among themselves. Only when compress or impinge on nerves, the spinal cord or other tissues do symptoms develop. The most common symptoms include localized or radiating pain, numbness, tingling, and muscular weakness. The location of these symptoms can vary, depending on the position of the collapsed disc and impacted spinal nerve. Occasionally, a disc can collapse to the point that the adjacent vertebrae touch one another, which can lead to the development of bone spurs. Bone spurs can compress nearby spinal nerves, or even the spinal cord itself, which can also cause localized or radiating pain, numbness, muscular weakness, and/or tingling.

  • Diagnosis

    After doing a thorough physical examination, the doctor may put the patient through a number of flexibility and muscle-strength tests.

     

    In any case, any or all of the following steps can be used to diagnose a collapsed disc.

     

    Physical examination

    Depending on the patient’s symptoms, a physical exam may include one or more of the following tests:

     

    Nerve function in certain parts of the leg or arm–tapping different areas with a reflex hammer, with little or no reaction possibly indicative of a compressed nerve root. Sensory tests may also be conducted, utilizing hot and cold to determine how the nerve roots react to such stimuli.

    Muscle strength–In order to get a better understanding of whether the spinal nerve root is compressed by a herniated disc, the doctor will likely conduct a neurological exam to assess muscle strength. The doctor may also ask the patient to undress in order to view the muscles, particularly whether there is muscle atrophy, twitching or any abnormal movements.

    Pain with palpation or motion - Palpating certain structures can give some idea of what really is generating pain. For example:

     

    • Pain over the sacroiliac joint to palpation may indicate the patient has sacroiliac joint dysfunction.

    • Pain with straightening the leg can be indicative of a pinched nerve.

    • Pain with pressure on the low back may indicate pain from a degenerative disc.

     

    Review of specific symptoms

    A complete review of symptoms will include the location of the pain, a description of how the pain feels, and whether certain activities, positions or treatments make the pain feel better or worse.

     

    Review of medical history

    A full medical background is important to rule out (or identify) other possible conditions that may cause the patient's pain. The history includes information such as any recurring health problems, previous diagnoses, past treatments and surgeries, and so on.

     

    Diagnostic tests

    After forming an opinion on the cause of the patient's pain, a diagnostic test may be ordered to confirm the disc problem and/or to gain additional information, such as the location of a herniated disc and impinged nerve roots. Diagnostic tests may include:

     

    • CT scan – Computerized tomography (CT) scans work like x-rays in that an x-ray beam is shot through the body, with a computer reformatting the image into cross sections of the spine.

    • MRI scan – Magnetic Resonance Imaging (MRI) allows doctors a sensitive and accurate assessment of the spinal nerves and anatomy, including disc alignment, height, hydration and configuration.

     

    Discogram

    If surgery for disc pain is considered, some practitioners may recommend a discogram with the goal of confirming which disc is painful. In this test, radiographic dye is injected into the disc, with the belief that a patient is suffering from disc pain (degenerative disc disease) if the injected dye recreates the normal pain. This test is controversial as to whether or not it is a valid, accurate test, and many doctors do not use discography except in rare situations

  • Conservative Non-Surgical Treatment

    In many cases, collapsed disc symptoms go away on their own after a few days or weeks and the patient is able to go back to routine activities.

     

    At first, rest may be necessary until inflammation in the nerve is reduced. To keep the patient comfortable, anti-inflammatory drugs or simple pain medications may be taken. Applying heat or cold to the affected area may also help relieve the symptoms. Non-operative treatment may include epidural injections into the spinal canal.

     

    As soon as possible, the patient should resume being active by going back to work, doing physical therapy, walking, and stretching. This is the best way to reduce symptoms from a collapsed disc. In addition, low-impact exercise to improve flexibility and cardiovascular health may help, as well as light weight training to improve core strength, and behavior modification to improve posture and cut down on painful activities.

  • Conventional Surgery

    Surgery is recommended only if compressed disc symptoms become overwhelming and lasts for an extended period of time. Until recently, often this was a major operation that required general anesthesia, the dissection of muscle, removal of bone, manipulation of nerve roots, and, at times, bone fusion. Often, these types of procedures require large incisions and the manipulation bones and muscle tissue.

     

    Conventional back surgery attempts to solve this and other back problems with extreme measures—such as removing a spinal disc or fusing parts of the spine together, so that they no longer move independent of one another, significantly decreasing the spine's mobility, or ability to move freely. Too often, considering the risks and sustained trauma, these solutions fail to relieve the patient's pain or make it and the overall spine condition worse.

     

    As you can imagine, major alterations like this to your spine (not to mention the huge access wound) take a long time to heal, several weeks or months. Full recovery, or returning to 100 percent original functionality, occurs infrequently. Also, this kind of surgery can require lengthy hospital stays, entails significant blood loss, and renders the patient vulnerable to several possible complications.

  • Minimally Invasive Spine Surgery

    Minimally Invasive Spinal Surgery (MISS) is a procedure for decompressing nerve roots and other tissues affected by a collapsed disc, as well as several other types of back conditions. The term minimally invasive, of course, speaks volumes. It defines a category of procedures designed to do as little damage—to be as non-invasive and non-intrusive—as possible. Minimally invasive surgery, then, refers to surgical procedures designed to do as little collateral or malingering damage as possible.

     

     

     

    In other words, we perform the procedure with minimal disruption to:

     

    • The offending disc, joint, bone spurs, or facet area itself

    • The entry point and access path

    • The immediate area surrounding the problem area

    • The patient’s overall health.

     

    MISS is performed with micro instruments, fiber optics, lasers and digital imaging, as opposed to conventional highly invasive knives, bone saws and other equally trauma-inducing devices. Compared to conventional open back surgery, which usually entails huge incisions, displacing muscle tissue and nerve roots, and sometimes the removal of bone, MISS is without question much less traumatic. Also, it doesn’t destabilize the spine, unlike many conventional back surgeries. It can also be performed on multiple discs or other offending areas, even at widely spaced levels, during the same surgical session. Working on multiple levels with open back surgery often requires additional destructive entry wounds—far too much traumatic damage for patients to endure or recover from.

     

    Collapsed discs—one of the more common back problems—for example, can cause pressure on the nerves in your spine, causing severe pain. Conventional back surgery attempts to solve this and other disc problems with extreme measures—such as removing a spinal disc or fusing parts of the spine together, so that they no longer move independent of one another. Either method significantly decreases the spine’s mobility, or ability to move freely. Too often, considering the risks and sustained trauma, these solutions fail to relieve the patient’s pain or make it and the overall spine condition worse.

     

    As you can imagine, major alterations like this to your spine (not to mention the huge access wound) take a long time to heal, several weeks or months. Full recovery, or returning to 100 percent original functionality, occurs infrequently. Also, this kind of surgery can require lengthy hospital stays, entails significant blood loss, and renders the patient vulnerable to several possible complications.

     

    MISS, on the other hand, is performed with very small “micro” instruments and tiny cameras inserted through a small tube. We also use x-ray, and other types of visualization technology to help guide the instruments, allowing us to “see” what we’re doing without cutting and clearing obstructing vital tissues and structures. We reach the offending disc through a very small incision. Damage to tissues and other vital structures in the immediate vicinity are, in nearly all instances, so minuscule that within a very short time the access point and path are healed, with little to no impact on the patient’s body and overall health.

  • After Surgery

    There  are numerous advantages to MISS compared to open spinal surgery.

     

    (Note: Patients with large free fragments of disc in the spinal canal, as determined by the x-ray, cannot benefit  from the endoscopic procedure, but might benefit  from the arthroscopic  procedure. However,  the laser can shrink the bulging disc further for disc decompression.)

     

    Some  advantages are:

     

      •Much less tissue trauma when compared to an open  surgical procedure

      •Hospitalization is not required, MISS is an outpatient  procedure

      •Faster recovery, since MISS is an outpatient procedure

      •Minimal to no scarring in and around the nerves post  operatively

      •Earlier return to work and to daily activities

      •Patients can begin an exercise program the day after  surgery  •

      •We estimate the cost of endoscopic surgery is 40% less  than conventional spine surgery

     

    Please feel free to contact my staff at (800) 354-8554 or email us at info@spinecenter.com any questions you might have concerning these procedures.

     

    Do you need a second opinion? Click here to fill out our Global Online Consultation form.

  • Advantages of Minimally Invasive Spine Surgery

    There are numerous advantages to MISS compared to open spinal surgery, including:

     

    An outpatient  or  “same day surgery“, no hospitalization

     

    Less traumatic

     

    Faster recovery

     

    Costs less - approximately 40% less than a open spinal  surgery/fusion

     

    Minimal to no scarring in and around the nerves post operatively

     

    Earlier return to work and to daily activities

     

    Patients can begin an exercise program the day after surgery

     

    Multiple level spinal discectomy can be performed at one sitting with minimal risk

     

    Can be done for high risk anaesthesia patients with morbid obesity, emphysema, and cardiac conditions under local anaesthesia/IV sedation at much less risk

     

    Preserves spinal motion

     

    After surgery, most patients require little analgesics

     

    MISS requires no hospitalization, allows for earlier recovery and earlier return to work and return to daily activities, when compared to conventional spine surgery.

     

    Please feel free to contact my staff at (800) 354-8554 or email us at info@spinecenter.com any questions you might have concerning these procedures.

     

    Do you need a second opinion? Click here to fill out our Global Online Consultation form.

     

 

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