A herniated disc has often described by patients as a "bulging disc, ruptured disc or a slipped disc.” These descriptions can be misleading and should be better understood. Herniated disc can be very common in the low back (lumbar spine) and at The Jasper Spine Institute, we treat these conditions everyday with conservative care, spinal injections and sometimes surgical interventional with excellent results.


Our spine and disc take a lot of stress over time. Most herniated disc’ are a result of a trauma or an accident putting direct stress on the disc. Gradually over weeks or months the outer annulus develops cracks and the inner gel-like nucleus is pushed out of the disc. When this occurs the herniated disc puts pressure on the spinal cord (dura) and or nerve roots that branch our at each level and travel down your legs connecting to your muscles. This pressure and nucleus fluid that leaks out causes inflammation and pain sometimes localized to the back, buttock, thighs and sometimes all the way down into your calves and feet.

The following are symptoms of the a herniated disc:

• Sharp or dull pain in the lower back which gets worse with physical activity such as lifting, bending, or as simple as coughing or sneezing, muscle spasms or cramping.
• Sciatica (pain, burning, tingling, and numbness that extends from the buttock into the leg or foot).
• Leg weakness or loss of leg function.

Diagnosis

Most cases of lumbar disc herniation do not require surgery. Research evidence suggests that pain associated with a herniated disc often diminishes without surgical treatment within 4-6 months. Thus, patients are usually prescribed non-surgical treatments initially to help relieve symptoms.

Non-Operative Treatment


• Pain medications: anti-inflammatories, muscle relaxers and on rare occasions narcotic painkillers
• Alternating heat/cold therapy during the first 24-48 hours
• Physical therapy exercises to include: stretching, massage strengthening
• Epidural steroid injections are used two-fold, first, to relieve inflammation of the affected spinal nerve and secondly, diagnostically to confirm the correct affected level at which the pain originates from.

Surgical Treatment

The following surgical options can treat herniated disc with 90% success:

• Microdiscectomy: Usually an open procedure or using tubular retractor with an incision of 1 inch. The surgeon usually observes through a microscope or set of eyeglass loops that helps magnify the anatomy. Recovery can be long and painful. Most of the pain post-operative is from the approach the surgeon made through major muscle support in your back. Anesthesia is necessary.
• Laminectomy: During the microdiscectomy surgeons often have to resect the bone called the lamina in order to see the affected nerve and herniated disc. Recovery from microdiscectomy can be long and with bone resection adds to possible scarring in the area the surgeon is working. Anesthesia is necessary.
• Endoscopic Discectomy (transforaminal or interlaminer): With an incision less than a ½ inch. The surgeon can avoid all lamina bone resection and enter the spinal canal without disturbing or cutting muscle. The surgeon directly observes the herniated disc in a water (arthroscopy) environment with a surgical working channel endoscope coupled with a HD camera. Recovery is superior to microdiscectomy with most patients returning to work within a week. Conscious sedation is used with the patient awake, comfortable and aware during the procedure.

Spinal Fusion

At our practice, most patients can begin getting out of bed one hour after surgery and go home shortly afterwards. Activity is gradually increased and patients are typically able to return to work within a few days. There will probably be some pain after the procedure and is usually localized to the incision site. However, we want to be as comfortable possible and will provide you adequate pain medications.

At The Jasper Spine Institute, your return to health is our first concern. If you have any questions about any condition or treatment please do not hesitate to contact us by phone or submit an inquiry below. We have offices located in Millburn and Brick, NJ serving Northern and Southern New Jersey.