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Ruptured Lumbar Disk Treatments
This is an abbreviated version of the complete article.*
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| Basic Facts |
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Intervertebral disks are firm rubbery plates that lie between the vertebrae (the spinal bones) and serve as shock absorbers when the spine moves. |
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The 5 lumbar disks run from near the bottom of the rib cage to the top of the buttocks. |
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When a disk ruptures, or herniates, the soft inner layer may compress the nerve roots that exit each vertebra (lateral rupture) or the spinal nerves, known as the cauda equina (central rupture). |
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Treatments may include rest, medication, traction, physical therapy, exercise therapy, and surgery. |
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Intervertebral disks are rubbery plates located between the vertebrae (the spinal bones). Disks serve as shock absorbers when the spine moves. A disk ruptures, or herniates, when the soft inner layer punches through the tough outer layer, compressing the nerve roots nearby. Ruptured disks can cause pain, weakness, loss of coordination, and, depending on the location and severity, loss of bladder and bowel control and paralysis.
The goal of treatment for a ruptured lumbar disk is to alleviate the compression of the nerve root or the spinal cord.
WHEN IS IT INDICATED?
Nonsurgical treatment is indicated in 80 to 90 percent of patients with ruptured lumbar disks. If symptoms worsen or cause intense pain or disability, the physician will recommend surgery.
PRE-TREATMENT GUIDELINES
If conservative therapy fails, surgery may be indicated. Before performing surgery, the physician may order tests, including x rays, electrocardiogram (ECG), myelogram, and computed tomography (CT) scan.
RISK FACTORS FOR POSSIBLE COMPLICATIONS
Risk factors for possible complications of surgery include other existing health problems, such as cardiac, respiratory, or other systemic diseases and smoking.
WHAT TO EXPECT
Surgical intervention includes open surgery, microsurgery, and minimally invasive procedures. The difference between the 3 types of procedures involves the size of the incision, how the physician gains access to the disk, and the amount of disk material the physician removes. The most common procedure is called a diskectomy, which is the removal of the portion of the disk that is compressing the nerve root or spinal cord.
For open surgery, the physician makes an incision in the back to gain access to the spine. Next, the physician removes a part of the vertebra and removes the part of the disk that is pressing on the nerve.
In minimally invasive surgical techniques, the physician inserts an operating microscope or endoscope and guided by that uses microsurgical instruments to remove the portion of the disk that is pressing on the nerve.
In some cases, the physician will perform spinal fusion to strengthen the area by filling the space of the removed disk with a small piece of bone. The vertebrae and the bone piece fuse or heal together. Often metallic screws, rods, and cages are used to facilitate fusion.
POST-PROCEDURE GUIDELINES AND CARE
Patients who have had a minimally invasive procedure are usually able to return home that day. Following open surgery, most patients are discharged from the hospital in a few days.
The physician will provide specific postoperative instructions to the patient about pain management, wound care, and resumption of physical activity.
POSSIBLE COMPLICATIONS
Possible complications from surgical or minimally invasive procedures to repair a ruptured lumbar disk include bleeding, infection, and paralysis.
LIFESTYLE ADJUSTMENT
Patients who have had a ruptured lumbar disk can take steps to maintain the health of their backs, including maintaining an ideal weight, exercising, and lifting objects properly.
Medical Review Date: June 1, 2009
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