What is a Herniated Disc?

How is a Herniated Disc Diagnosed?

Accurate and thorough diagnosis is key to selecting the best treatment options. The following is part of a comprehensive diagnostic workup:

• Medical History Assessment of symptoms, previous treatments and care.
• Physical Examination A careful examination by a spine specialist for limitations of movement, problems with balance, and pain. The examination should also cover loss of reflexes in your extremities, muscle weakness, loss of sensation or signs of spinal cord damage.
• Diagnostic Tests Generally, plain x-ray films are taken which allows the physician to rule out other problems such as infections. CT scans and MRIs are often used to give them a three-dimensional view of the lumbar spine and can help detect herniated discs.

Non-Operative Treatment

Most cases of lumbar disc herniation do not require surgery. Research evidence suggests that pain associated with a herniated disc often diminishes without surgical treatment within 4-6 months. Thus, patients are usually prescribed non-surgical treatments initially to help relieve symptoms.

• Pain Medications Anti-inflammatories, muscle relaxers and on rare occasions narcotic painkillers
• Alternating Heat/cold Therapy during the first 24-48 hours
• Physical Therapy exercises to include stretching, massage strengthening
• Epidural steroid injections are used two-fold, first, to relieve inflammation of the affected spinal nerve and secondly, diagnostically to confirm the correct affected level at which the pain originates from.

Least Invasive Procedures


If pain still persists and patient is intolerant to the pain after non-surgical treatment and there is evidence by CT Scan, MRI or X-ray or neurological deficit, then surgical intervention is usually recommended.

The following minimally invasive procedures can treat herniated disc with 90% success:

• Endoscopic Discectomy (transforaminal or interlaminer)With an incision less than a ¼ inch. The surgeon can avoid all lamina bone resection and enter the spinal canal without disturbing or cutting muscle. The surgeon directly observes the herniated disc in a water (arthroscopy) environment with a surgical working channel endoscope coupled with a HD camera. Recovery is superior to microdiscectomy with most patients returning to work within a week. Conscious sedation is used with the patient awake, comfortable and aware during the procedure.

Minimally Invasive Spine Surgical Options For A Disc Herniation

• Microdiscectomy Is a surgery to remove herniated disc material that is compressing a nerve root or the spinal cord. This surgery is usually done as a microdiscectomy using a microscope or surgical loops. Before the discectomy is done the surgeon removes a small piece of bone called the lamina from the targeted intervertebral body in order to access the herniated disc. This bone resection is referred to as a laminectomy of laminotomy. A microdiscectomy can be done as an open or with a tubular retractor.
• Spinal Fusion Two or more vertebrae are immobilized with surgical rods and screws. Bone graft is placed in the space between the vertebrae to encourage growth of the bones together. Sometimes it is possible that the fusion does eliminate the patient’s pain for whatever reason and additional surgery may be required.

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