Minimally Invasive Spine Surgery for Herniated Disc – Causes, Symptoms and Treatment from World Class Hospitals in India
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Surgery for Cervical Herniated Disc or Ruptured Disc
The vertebrae that form the spine are cushioned by round, flat intervertebral discs. Each disc contains a tire-like outer band (called the annulus fibrosus) that encases a gel-like substance (called the nucleus pulposus).When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. If they become damaged, they may bulge abnormally or break open (rupture), in what is called a herniated or slipped disc.
Herniated discs can occur in any part of the spine, but they are most common in the neck (cervical) and lower back (lumbar) spine. The seven vertebrae between the head and the chest make up the cervical spine. Pain develops when the damaged intervertebral disc pushes into the spinal canal or nerve roots. Terminology referred to are herniated disc, prolapsed disc, ruptured disc and slipped disc.
A herniated disc usually is caused by wear and tear of the disc (also called disc degeneration). Due to age, the discs lose some of the fluid that helps them stay flexible.
Injuries to the spine might also cause a herniated disc, which may cause tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material (nucleus) inside the disc may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.
Herniated discs in the neck or cervical spine can cause pain, numbness, or weakness in the neck, shoulders, chest, arms, and hands. In some cases a very large herniated disc in the neck may cause weakness or slight prickling which affects different body parts. The arm pain from a cervical herniated disc results because the herniated disc material presses on a cervical nerve, causing pain to radiate along the nerve pathway down the arm. Along with the arm pain, numbness can be present down the arm and fingertips.
- C4 – C5 (C5 nerve root) – Can cause weakness in the deltoid muscle in the upper arm. Can cause shoulder pain.
- C5 – C6 (C6 nerve root) – Can cause weakness in the biceps (front upper arms muscles) and wrist extensor muscles. Numbness and tingling along with pain can radiate to the thumb side of the hand. This is one of the most common levels for a cervical disc herniation to occur.
- C6 – C7 (C7 nerve root) – Can cause weakness in the triceps (back upper arm muscles and extending to the forearm) and the finger extensor muscles. Numbness and tingling along with pain can radiate down the triceps and into the middle finger. This is also one of the most common levels for a cervical disc herniation .
- C7 – T1 (C8 nerve root) – Can cause weakness with handgrip. Numbness and tingling and pain can radiate down the arm to the little finger side of hand.
Stages of a Cervical Herniated Disc
- Disc Degeneration: Due to chemical changes associated with aging, intervertebral discs weaken. As part of the aging process, it can cause the disc to dry out, making it less able to absorb the shock. Disc can also become thinner in this stage.
- Prolapse: The position of the disc changes with some slight impingement into the spinal canal or spinal nerves. This stage is also called a bulging disc or protruding disc.
- Extrusion: The gel-like nucleus pulposus (inner part of the intervertebral disc) breaks through the tire-like wall (annulus fibrosus) but remains within the disc.
- Sequestration or Sequestered Disc: The nucleus pulposus breaks through the annulus fibrosus and can move outside the interverterbral disc and into the spinal canal.Get Estimate
Treatment of Cervical Herniated DiscSpine surgery is considered if non-surgical treatment does not relieve symptoms of the cervical herniated disc or if spinal cord compression is suspected.
Anterior Cervical Discectomy and Spine Fusion: This is by far the most commonly preferred method among spine surgeons for most cervical herniated discs. To relieve nerve pressure, it involves partial disc removal or discectomy. Surgery is usually done from the front of the neck, through a small one-inch incision. After removing the disc, the disc space itself is fused. A plate can be added in front of the graft for added stability and possibly a better fusion rate.
Posterior Cervical Discectomy: This surgery is applicable for discs that occur laterally out in the neural foramen (the “tunnel” that the nerve travels through to exit the spinal canal). However, it is technically more difficult because there are a lot of veins in this area that can result in a lot of bleeding, and the bleeding limits visualization during the surgery. This approach also necessitates more manipulation to the spinal cord.
Nowadays, these procedures can often be done utilizing minimally invasive spine surgery techniques. Minimally invasive spine surgery does not require large incisions, but instead uses smaller cuts and tiny specialized instruments and devices such as a microscope and endoscope during the operation.
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