Herniated discs in the neck (cervical), back (lumbar), or more rarely in the mid-back (thoracic) are illness caused by degeneration of structures called discs located between the spinal bones, due to various reasons such as trauma, heavy lifting, excess weight, aging, poor posture, and genetic predisposition. Following the degeneration of the annulus of the disc due to the mentioned reasons, the gel-like substance in the middle of the disc protrudes towards the spinal canal and results in compression of the spinal cord and nerves.
Symptoms vary depending on the location of the problem and the size of the herniation. If a herniated or degenerated disc does not compress any nerves, it may only cause neck or back pain. However, if it compresses a nerve in the neck region, symptoms such as shoulder and arm pain, numbness, and weakness in the hands and arms may occur. When there is pressure on the spinal cord, additional symptoms such as difficulty walking, leg cramps and spasms, coordination problems, and imbalance may arise in addition. In the case of the lower back, symptoms may include pain radiating to the hips, and legs, numbness, tingling, and weakness in the legs and feet, and in advanced stages, loss of bowel and bladder functions.
Diagnosis is made based on history, symptoms, neurological examination findings, and necessary diagnostic tests, which may include:
Non-surgical treatment methods can alleviate many complaints. Pain killers and muscle relaxants may be used. Restricting physical activity and using a cervical collar can support the spine and reduce pain and irritation. Trigger point injections may temporarily reduce pain. Algological interventions (epidural steroid injection, transforaminal injection, facet injection, etc.) may be beneficial in appropriate patients. Various physical therapy applications may alleviate patients' complaints in suitable cases. Conservative treatment options can be applied for up to six to eight weeks. If you experience numbness or weakness in your arm or leg during this treatment, or if your pain worsens, be sure to consult your physician again.
There are several treatment options available for treating disk herniations. The choice of surgical treatment depends on the characteristics of your disk disease, whether there is compression on the spinal cord or nerve roots, the location and size of this compression, your age, the status of any accompanying illnesses, and previous treatments applied for this condition.
If non-surgical treatment methods do not alleviate your symptoms, or if you experience progressing numbness, tingling, or weakness in your hands, arms, or legs, or if you have complaints such as difficulty walking and imbalance, surgical treatment may be required.
If you have sudden severe loss of strength, or if you have complaints of urinary or fecal incontinence along with numbness and tingling in your genital and anal area, you should undergo surgery as soon as possible.
There are various surgical treatment options available. You should decide on this option together with your phycisian based on the factors mentioned above. These options include percutaneous discectomy methods (laser discectomy, percutaneous automated discectomy, IDET, etc.), endoscopic discectomy, microdiscectomy, and conventional discectomy. Microdiscectomy is currently considered the gold standard surgical treatment method all over the world.
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