Disk Herniation
Disk herniation is one of the most common conditions of the spine. Other terms used to describe herniation include fragment, protrusion, bulge, and/or sequestration. Herniation can occur in any segment of the spine, although is most common in the lumbar spine followed by the cervical then the thoracic spine. Symptoms of a disk herniation include numbness/tingling, weakness, and pain. The term radiculopathy refers to the pain in a band-like distribution down the extremity. This pain is due to the compression of one or more nerve roots by the herniated disk.
Disk herniations are very common in the population. In fact, many patients who have herniations often do not have symptoms (are asymptomatic). Therefore, the most important decision-making step in treatment is to determine the exact symptoms that the herniation is causing. Surgeons can often predict which herniations are symptomatic because each nerve root that is being compressed causes a specific distribution of pain. Your doctor must match the distribution of the pain and any weakness with the nerve root being compressed on the MRI. For instance, a L5/S1 disk herniation typically compresses the S1 nerve root and can lead to pain in the buttock, back of the thigh and calf, and bottom of the foot. In addition, patients may have weakness in foot plantar flexion (ability to stand on the toes). If a disk herniation is determined to be symptomatic, then multiple treatment options are available. Surgery is one of many treatment options.
Microdiskectomy Surgery
Lumbar discetomy is one of the most common spine procedures performed today. After a small incision over the lumbar segment that has the herniation, a small opening is made in the bone of the spine (called a laminotomy). The spinal sac and nerve are visualized, gently retracted, then the disk herniation is located and removed.