Herniated disc
1. What is an intervertebral disc?
The spine consists of vertebrae that are connected to each other by intervertebral discs. These intervertebral discs act as shock absorbers and enable movement and stability of the spine.
2. What happens with a slipped disc?
An intervertebral disc has a soft, gelatinous core and an outer, fibrous, firm shell. If there are tears in the outer shell, parts of the soft core can protrude outwards. This is known as a herniated disc. This can exert pressure on the surrounding nerves.
3. Symptoms
A herniated disc can cause pain in the lower back (lumbar spine) or neck (cervical spine), which can radiate into a leg or arm. It can also lead to numbness, tingling or weakness in the arms or legs.
4. Causes
Herniated discs can occur as a result of wear and tear as part of the ageing process. Genetic factors, occupational stress or incorrect posture can increase the risk.
5. Diagnosis
A herniated disc is diagnosed through a combination of physical examination and imaging such as MRI.
6. Treatment options
Most herniated discs improve with conservative measures such as rest, physiotherapy and pain medication. In certain cases, injections directly to the nerves, so-called periradicular therapy (PRT) under imaging can also help. If conservative therapy is not successful within a period of 6-12 weeks, surgery may be necessary. In most cases, this can be performed endoscopically. This is almost always possible in the spine. In the cervical spine, herniated discs are operated on both endoscopically from behind and microscopically from the front. The choice of procedure depends on the localization of the herniation. If surgery is performed from the front, an implant must also be placed in the intervertebral space. This is either a cage, in which case the spine is stiffened, or an artificial disc, in which case the spine remains mobile.
Only a doctor with experience in all techniques can decide which procedure to use in each individual case and then make the right choice for their patient.
