Ruptured Lumbar Disk

Intervertebral disks are firm, rubbery plates that lie between the spinal bones and act as shock absorbers when the spine moves. The 5 lumbar disks run from near the bottom of the rib cage to the top of the buttocks. A disk ruptures when the soft inner layer protrudes through the outer layer and compresses spinal nerve roots or the spinal cord.

WHAT ARE THE SYMPTOMS?

Symptoms of a ruptured lumbar disk include:

Pain in the lower back
Numbness, tingling, weakness, or pain in the buttocks, thighs, legs and feet;
Sciatica;
Pain with movement, straining, or coughing;
Loss of bladder or bowel control; and
Paralysis.

CAUSES AND RISK FACTORS

Causes of ruptured disks include:

Aging;
Traumatic injury;
Wear from use;
Being excessively overweight; and
Poor posture.

Smoking increases the risk of a ruptured disk and slows healing. DIAGNOSIS

Tests to diagnose a ruptured lumbar disk include:

X rays;
Myelogram;
Computed tomography (CT) scan;
Magnetic resonance imaging (MRI); and
Electromyogram and nerve conduction studies.

TREATMENT APPROACH

The goal of treatment of a ruptured disk is to decrease pain and relieve the nerve irritation. Most lumbar disk ruptures will heal without surgery in 2 to 6 weeks. Nonsurgical treatments of ruptured lumbar disks include:

Decreased physical activity;
Cold and heat therapy;
Medications;
Epidural steroid injections;
Transcutaneous electrical nerve stimulation (TENS);
Traction; and
Physical therapy or other types of exercise therapy.

Surgery is used to physically relieve the pressure on the nerve roots or spinal cord, usually by removing the portion of the disk that is causing it. Surgery can be open (performed under general anesthesia and involve an incision into the body) or minimally invasive (local anesthesia is used and a smaller incision is made).

Surgical and minimally invasive procedures include:

Diskectomy;
Endoscopic diskectomy;
Spinal fusion; and
Newer procedures such as disk replacement.

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