SERIOUS INJURIES – HERNIATED DISC

Herniated Discs – One of the more common injuries sustained in a motor vehicle crash or a fall, is a herniated disc. Discs are soft, rubbery pads found between the hard bones (vertebrae) that make up our spinal column. The spinal canal is a hollow space in the middle of the spinal column that contains the spinal cord and other nerve roots. The discs between the vertebrae allow the neck and back to flex or bend. Discs also act as shock absorbers.

Discs are composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus). A disc herniates or ruptures when part of the center nucleus pushes through the outer edge of the disc and back toward the spinal canal. This puts pressure on the nerves. Spinal nerves are very sensitive to even slight amounts of pressure, which can result in pain, numbness, or weakness in one or both legs.

The most common symptom of a herniated disc in the lower back is sciatica—a sharp, often shooting pain that extends from the buttocks down the back of one leg. It is caused by pressure on the spinal nerve. Other symptoms include:

• Weakness in one leg – Tingling (a “pins-and-needles” sensation) or numbness in one leg or buttock
• Loss of bladder or bowel control (If you also have significant weakness in both legs, you could have a serious problem and should seek immediate attention.)
• A burning pain centered in the neck
• A herniated disc in the neck may cause pain in the muscles between your neck and shoulder (trapezius muscles). The pain may shoot down the arm. The pain may also cause headaches in the back of the head. Other symptoms include:
• Weakness in one arm – Tingling (a “pins-and-needles” sensation) or numbness in one arm
• Loss of bladder or bowel control (If you also have significant weakness in both arms or legs, you could have a serious problem and should seek immediate attention.)
• Burning pain in the shoulders, neck, or arm

To diagnose a herniated disc, provide your doctor with your complete medical history. Be very specific when describing your accident and the symptoms you immediately experienced thereafter. A physical examination will help determine which nerve roots are affected (and how seriously). An X-ray may show evidence of disc or degenerative spine changes. MRI (magnetic resonance imaging) or CT (computed tomography) are imaging tests to confirm which disc is injured. An electromyography (EMG), a test that measures nerve impulses to the muscles, may be recommended if the pain continues.

Non-surgical treatment is effective in treating the symptoms of herniated discs in more than 90% of patients. Most neck or back pain will resolve gradually with simple measures.

Surgery may be required if conservative measures do not relieve the symptoms. Surgical options in the lower back include microdiscectomy or laminectomy, depending on the size and position of the disc herniation. In the neck, an anterior cervical discectomy and fusion are usually recommended. This involves removing the entire disc to take the pressure off the spinal cord and nerve roots. Bone is placed in the disc space and a metal plate may be used to stabilize the spine.