The spine, also called the back bone, is designed to give us stability, smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs. Disc protrusion, also called herniated disc, is a condition caused by a tear in an intervertebral disc allowing the disc contents to bulge out. Disc protrusions in the low back area are the most common cause of Sciatica. Sciatica occurs when the disc contents put pressure on the sciatic nerve. Symptoms related to herniated discs in the lumbar region include sharp, continuous back pain, weakness in the legs, and some loss of sensation to the leg and foot.
Disc protrusions in the cervical or neck area places pressure on nerve roots (nerve root compression) or the spinal cord causing radiculopathy. Radiculopathy is a medical term used to describe the neurological deficits that can occur from pressure on the nerves and spinal cord, such as arm or finger weakness, numbness or pain.
Other conditions that can cause nerve root compression and radiculopathy include:
- Degenerative Disc Disease: A condition caused by wear and tear on the discs between the vertebrae causing them to lose their cushioning ability.
- Spinal Stenosis: Narrowing of the spinal canal as we age, most commonly due to degenerative arthritis.
- Degenerative Spondylolisthesis: This condition is degeneration (wear and tear) of the vertebral components, usually occurring after age 50, causing slippage of a vertebra onto another, leading to spinal stenosis, a narrowing of the spinal canal.
When conservative treatment measures such as rest, medication, physical therapy, and pain blocking injections are ineffective, your surgeon may recommend spine surgery.
The most common spine surgery to relieve symptoms of nerve root compression involves removing the disc and fusing the two vertebrae above and below it with a bone graft. A newer treatment option is now available to replace the herniated disc with an artificial disc. Artificial discs are used in place of a bone fusion to preserve neck movement and flexibility.
Benefits of artificial discs over fusion surgery include:
- No need for instrumentation (plates and screws)
- Shorter healing time with no waiting for fusion to occur
- No bone harvesting from hip which requires an incision, pain, and risks.
- Reduced risk of degeneration of adjacent vertebrae
- Maintain normal neck movement
- No post-operative neck bracing needed
As with any surgery, there are risks involved. It is important you discuss the benefits and risks to make an informed decision on moving forward with the surgery. Talk to your surgeon about any questions you may have.