Bulging Disc
Description of a Bulging Disc
A bulging disc is a disc that extrudes into the spinal canal. It is also referred to as a ruptured disc or slipped disc. As a disc degenerates, it can herniate (the inner core extrudes) back into the spinal canal, as shown in this picture on the left. The light blue oval area is the disc and it is bulging into the spinal canal on the lower right side of the disc. In the lumbar area, this can cause pain to radiate all the way down the patient's leg to the foot. In the area of the cervical spine, the pain would radiate from the neck down the arm to the fingers.
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Approximately 90% of bulging discs will occur at L4- L5 (lumbar segments 4 and 5) or L5- S1 (lumbar segment 5 and sacral segment1), which causes pain in the L5 nerve or S1 nerve, respectively.
Recommended treatment is generally open back surgery, with high risks, hospital stays and lengthy recuperation time.
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Causes of a Herniated or Bulging Disc
As you grow older, your discs become flatter -- less cushiony. If a disc becomes too weak, the outer part (annulus) may tear. The inside part of the disc pushes through the tear and presses on the nerves beside it. Herniated discs are most common in people in their 30's and 40's.
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At Laser Spine Institute (LSI), herniated discs are removed through minimally invasive arthroscopic, laser surgery in an outpatient surgical center.
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The spine is made up of a series of connected bones called "vertebrae". The disc is a combination of strong connective tissues that hold one vertebra to the next, and acts as a cushion between the vertebrae. The disc is made of a tough outer layer called the "annulus fibrosus" and a gel-like center called the "nucleus pulposus." As you get older, the center of the disc may start to lose water content, making the disc less effective as a cushion. This may cause a displacement of the disc's center (called a herniated disc or ruptured disc) through a crack in the outer layer. This can occur in the neck (cervical region) or the back (lumbar region) and the mid back (thorasic spine).
Symptoms of a Bulging Disc
The weak spot in a disc is directly under the nerve root, and a bulging disc in this area puts direct pressure on the nerve. Click Here to see how you can get your life back in 5 days When part of a disk presses on a nerve in the lumbar region, it can cause pain in both the back and the legs. The location of the pain depends on which disc is weak. How bad the pain is depends on how much of the disc is pressing on the nerve. In most people with bulging discs, the pain spreads over the buttocks and goes down the back of one thigh and into the calf. This is commonly referred to as Sciatica.
A bulging disc in the lumbar region can also cause numbness and tingling down the legs and into the feet. In the area of the cervical spine (the neck), the pain, numbness and tingling can radiate from the neck through the shoulders, down the arm and even in the fingers.
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Approximately 90% of disc herniations will occur at L4- L5 (lumbar segments 4 and 5) or L5- S1 (lumbar segment 5 and sacral segment1), which causes pain in the L5 nerve or S1 nerve, respectively.
A bulging disc pressing on the nerves in the spine can also cause weakness of the leg. The group of muscles that are weak depends on which nerve is being impinged. A bulging disc in the lumbar region may also cause back pain, although back pain alone (without leg pain) can have many causes other than a bulging disc.
The pain from a bulging disk is usually worse when you're active and gets better when you're resting. Coughing, sneezing, sitting, driving and bending forward may make the pain worse. The pain gets worse when you make these movements because they put more pressure on the nerve.
Treatment of a Bulging Disc
Recommended treatment is generally open back surgery, with high risks, hospital stays and lengthy recuperation time. Laser Spine Institute (LSI) has a minimally invasive, outpatient surgery, laser-assisted, that can relieve the symptoms of a bulging disc and typically leave the patient free of the painful symptoms, called Percutaneous Arthroscopic Discectomy.
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This laser spine procedure will remove the portion of the extruding or bulging disc that is now pressing against a nerve causing the symptoms. By removing or shrinking the bulging disc with the laser we can decompress the spinal cord or nerve root that is being impinged. At this point excess disc material is removed and the symptoms of a bulging disc generally disappear.
Once the procedure is complete, the patient (with a companion) is free to go after 1 - 2 hours of monitoring. We generally encourage patients to take a long walk the afternoon or evening of their procedure. The patient then returns the following day for a post-operative visit to get clearance from the doctor to return home.