The Bonati Institute Glossary: Herniated Disc

The mission of The Bonati Institute is to provide hope to people suffering with chronic pain from a back or neck condition, and herniated discs. We believe that a well-informed patient is vital to restoring hope and finding answers to pain. We developed this web site primarily to help educate herniated lumbar sufferers and their families. We've found that the more individuals in pain learn about their anatomy, their condition and the options available to them the more likely they will be to choose the advanced arthroscopic procedures offered by The Bonati Institute.

• Description of Herniated discs
• Causes of Herniated discs
• Symptoms of Herniated discs
• Treatment for Herniated discs

What is a Herniated Disc?

A herniated disc is a condition in which part, or all, of the soft, gelatinous central portion of an intervertebral disc (the nucleus pulposus) is forced through a weakened part of the disc. This results in back pain and leg pain (lumbar herniation) or neck pain and arm pain (cervical herniation) due to nerve root irritation.

Causes of Herniated Disc

The bones of the spinal column, or vertebrae, run down the back connecting the skull to the pelvis. These bones protect nerves as they exit the brain and travel down the back and then to the entire body.

The spinal vertebrae are separated by cartilage discs filled with a gelatinous substance, which provide cushioning to the spinal column. These discs may or rupture from trauma or strain, especially if degenerative changes have occurred in the disc.

Most herniation takes place in the lumbar area of the spine. Lumbar disc herniation occurs 15 times more often than cervical (neck) disc herniation, and it is one of the most common causes of lower back pain. Nerve roots (large nerves that branch out from the spinal cord) may become compressed resulting in neurological symptoms, such as sensory or motor changes.

Disc herniation occurs more frequently in middle aged and older men, especially those involved in strenuous physical activity. Other risk factors include any congenital conditions that affect the size of the lumbar spinal canal.

Symptoms of Herniated Lumbar discs

• Severe low back pain
• Pain radiating to the buttocks, legs, and feet
• Pain made worse with coughing, straining, or laughing
• Tingling or numbness in legs or feet
• Muscle weakness or atrophy in later stages
• Muscle spasm

Symptoms of Herniated Cervical Discs

• Neck pain, especially in the back and sides
• Deep pain near or over the shoulder blades on the affected side
• Pain radiating to the shoulder, upper arm, forearm, and rarely the hand, fingers or chest
• Pain made worse with coughing, straining, or laughing
• Increased pain when bending the neck or turning head to the side
• Spasm of the neck muscles
• Arm muscle weakness

Treatment for Whiplash

The Bonati Arthroscopic Laser Discectomy

The procedure is designed as an answer to stenosis, herniated discs, disc disease and spinal instability from previously failed open surgeries.

In this procedure the portion of the disc that is causing nerve compression can effectively be removed through a small incision. With the patient awake, a needle is placed into the area of the disc that is producing symptoms. A small incision is made on the patient’s back and the endoscopic tube is inserted.

Using specially adapted endoscopic instruments the diseased disc material is removed and then a laser vaporizes the surrounding problem tissue. A laser is then used to shrink and remodel the remaining disc. A small loose dressing is used to cover the incision.

Often patients feel immediate relief following this procedure. Rehabilitation begins within hours of surgery, and involves gait training, back or neck support, and walking. Post-operative pain management program avoids narcotics in favor of a Transcutaneous Nerve Stimulator that blocks pain messages to the brain.

The benefits of this procedure:

• Fewer risks, local anesthesia, a small incision
• Minimal blood loss
• Short recuperation time
• Minimal damage to tissues
• Surgeries are done in an outpatient setting
• Patient sees a faster return to a normal lifestyle