Understanding the problem
A disc protrusion is the result of two bones of the spine (vertebrae) compressing on a weakened intervertebral disc. The disc then protrudes horizontally past the disc’s normal anatomic limits.
Disc protrusion is a common form of spinal disc deterioration that can cause neck and back pain. Changes occurring with the regular aging process are responsible for disc deteriorations, although an injury might speed the degenerative process. However, a protruding disc may go undetected unless it encroaches upon a nearby nerve. When functioning correctly, the spinal vertebrae are cushioned by pliable, oval-shaped “discs” that essentially act as shock absorbers for the neck and back. Over time, however, discs deteriorate and might bulge beyond their normal anatomical positions in the spinal column.
Discs usually degenerate in stages:
- With age, all body parts change, including the components of the spine. Discs dehydrate and lose elasticity. This weakens the disc and makes it more vulnerable to other changes.
- The first stage following natural weakening may be classified as a disc protrusion, when the disc’s core (contained within the disc’s outer fibro-elastic wall) has begun pushing into the spinal column. Disc protrusions may involve 180 degrees or less of the disc’s circumference.
- The next stage of disc deterioration is often a bulging disc, when the disc’s inner material, called nucleus pulposus, moves farther around the disc circumference beyond its normal parameters as it pushes into the disc’s fibro-elastic outer wall, called the annulus fibrosus, creating a bulge. A bulging disc is said to involve more than half (more than 180 degrees) of the disc’s circumference.
- The final stage may be a herniated disc, which means the disc’s outer wall finally tears, allowing the inner nucleus pulposus material to escape containment by the outer wall.
Understanding who suffers
While degenerative disc diseases often occur naturally over time, there are certain factors that can expedite the process or increase a patient’s risk for developing the condition. Additionally, there are uncontrollable causes for a disc to protrude, such as:
- Lifestyle habits - Smoking cigarettes excretes toxins into the body and has been linked to disc degeneration. Other issues such as obesity, an unhealthy diet and lack of exercise further contribute to the weakening of the discs.
- Trauma - Falling from a high altitude and landing on the feet or buttocks can create enough of a jolt to cause a disc protrusion. Picking up heavy items while bent at the waist (instead of lifting with the legs) and or getting involved in a car accident are other situations that can result in neck and back trauma that can damage the discs.
- Genetics - A few genes carry mutations that predispose some people to degenerative disc disease, thereby placing them at a higher risk for the condition.
The condition is commonly diagnosed in people older than 35. However, anyone older than 20 years old may have this condition.
Potential Signs and Symptoms
The severity, duration and location of the disc protrusion symptoms can depend on which disc becomes weakened and the extent of the nerve compression. Some common disc protrusion symptoms include:
- Radiating or “traveling” pain
- Chronic, local neck or back pain
- Sciatica (in cases of a lower back, or lumbar, disc protrusion)
- Numbness in the legs or arms
- Muscle weakness
- Tingling or pins-and-needles sensations
Examinations Usually Required
Making a disc protrusion diagnosis can sometimes be complicated by the fact that the area requiring treatment can often be in a different location than the pain or other symptoms a patient is experiencing. Therefore, it’s important that the physician provides a thorough examination, understands the medical history and uses some type of imagery (X-ray, MRI, CT scan) to pinpoint the source of the discomfort before suggesting a treatment strategy.
Proposing Treatment and Why AIMIS
Following the diagnosis of a disc protrusion, conservative non-surgical treatment will initially be proposed. If conservative treatment fails to provide relief, your physician might recommend surgery. Treatments can vary depending on the severity of your symptoms and how much they limit your everyday activities and your level of pain. Effective treatment of disc protrusion depends on correctly diagnosing the issue and developing a comprehensive plan to treat the condition that takes age, medical history and lifestyle into account.
AIMIS is an expert in spine surgery and can provide minimally invasive procedures for disc protrusion and can review and propose your type and course of treatment.
- Laminotomy - removal of a portion of the lamina, the smooth layer of bone near the top of the vertebral arch. The procedure opens up space in the spinal canal to take pressure off of nerves that have been affected by extruded disc material
- Foraminotomy –involves clearing out and opening up a foramen (a small opening between vertebrae that allow nerve roots to exit the spinal canal to the rest of the body. This procedure can treat situations where a bulging or extruded disc has caused foraminal narrowing and compressed nerve roots, causing painful symptoms.
- Discectomy and minimally invasive stabilization - involves partial removal of the protruding disc that is causing nerve compression and symptoms.
- Minimally Invasive Stabilization – involving a stabilizing implant inserted into between surrounding vertebrae, where a full disc is removed, to keep the spine as stable as possible by grafting together two adjacent vertebrae.
For a variety of cases there are a range of treatment options which AIMIS perform and include:
- Minimally Invasive Decompression Surgery
- Minimally Invasive Fusion Surgery,
- Minimally Invasive Stabilization Surgery Discectomy
- Artificial Disc Replacement Surgery,
- Total Disk Replacement (TDR),
- Anterior Cervical Discectomy & Fusion,
- Decompressor Discectomy,
- Lumbar Disc Microsurgery Treatment
- AxiaLIF or Axial Lumbar Interbody Fusion
- Stem cell transplantation – see page on Degenerative Disc Disease for more information
Why minimally invasive spine surgery?
Minimally invasive spine surgery was developed to treat spine problems with less injury to the muscles and other normal structures in the spine. It also assists the surgeon to see where the problem exists in the spine. Minimally invasive spine surgery (MISS), does not involve a long incision as is open surgery which helps to avoid damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a significant faster recovery.
Spine surgery is normally recommended once a period of nonsurgical treatment likely including medications and physical therapy has not provided pain relief caused by the back problem. Surgery is considered when the source of your pain and underlying cause can be identified and surgical procedure proposed. Minimally invasive techniques today are common and being used for a wide range of spine procedures.
Benefits of minimal invasive spine surgery include:
- Small incisions
- Less pain. Often less pain than open procedures because less of the natural anatomy is disrupted
- Shorter Hospital stay
- Quicker return to daily activities
- Lower infection and complication rate
- Less blood loss. Smaller incisions also mean less blood loss, which can ultimately improve outcomes.
Minimally invasive procedures take a surgery that could be a dramatic event and makes it have less of an impact!
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Reputable and Prestigious Surgeons
AIMIS' skilled team of neurosurgeons, orthopaedic surgeons and ancillary professionals has one of the leading experiences in the world for minimally invasive spine surgery. Our full team are consulted with each case to find the most suitable experienced doctor for the patient’s exact issue, to ensure the maximum potential outcome of treatment
Getting More Information Before Moving Forward
You may have questions like:
- Can I get more information before I commit to this?
- Can I get a second opinion from you before I commit to this?
- How can I find out the cost before I have any obligation?
What AIMIS Can do:
AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide. AIMIS’s mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.
AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.
Further information on the problem:
There are several types of disc protrusion. The different types typically refer to the part of the spine where the protrusion is located. Physicians typically use the following classifications to distinguish between the different types:
- Lumbar protruding discs, which occur in the bottom part of the spine in the lower back
- Thoracic protruding discs, which occur in the central part of the spine in the middle back
- Cervical protruding discs, which occur in the upper part of the spine in the neck Physicians will also note several types of disc protrusion based on how severe the condition is. A mildly protruding disc may barely show up on imaging scans and likely will not cause any symptoms, while a severely protruding disc may be easy to spot and quite symptomatic.
Further Information on Increased Risk Groups
While natural spinal degeneration due to aging is unavoidable, there are some steps that can be taken to keep the spine healthy and strong and help prevent disc protrusions:
- Don’t smoke, or make a plan with the physician to cease tobacco use
- Exercise regularly, especially with methods that strengthen the core
- Sit and stand with good posture
- Use proper lifting technique
- Maintain a healthy body weight
- Practice good nutrition habits
Why AIMIS for this Surgery
AIMIS strives for excellence in delivering the best surgical outcomes, via the extensive expertise of its prestige surgeons, its technologies, its highly trained staff and superior facilities to provide an individualized and compassionate experience in a comfortable environment. All patients are treated with the individual care they deserve in an effort to provide the best chance of successful treatment.
Other Services Provided by AIMIS
In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.