Before we can explain a herniated disc, it is best that we look at the make-up of the disc itself. Found between the vertebrae in our spinal column, these soft rubbery pads act as shock absorbers and help us to flex and bend our backs. The discs that are found in our lumbar spine have an annulus and a nucleus. The annulus is a thick outer ring of cartilage and the nucleus of the disc is a soft inner gel-like substance. Other discs located throughout your spine but not in the lumbar region are similar but range in sizes (smaller).



When a disc becomes herniated or ruptured, it extrudes or ?bulges? into the spinal canal. Common terms that a herniated disc can referred to as are a ruptured disc, bulging disc or a slipped disc (although there are differences between these terms). If the disc herniates in the lumbar area of the back the pain can be felt through the leg and radiate down into the foot. When a herniated disc occurs in the cervical region of the back (not nearly as frequent as a lumbar herniated disc) the pain would be felt in the neck and radiate down through the arms and into the fingers. 90% of all herniated disc problems happen in the lumbar region of the back (L4-L5) or L5 ? S1 (lumbar segment 5 ? sacral segment 1) affect the L5 and S1 nerves respectively. Herniated disc start to become more common with people in their thirties and forties and grow more common as we age.

Herniated disc risk factors: When we are young our discs start out with high water content but as we age this water content will decrease which will cause the disc to lose flexibility and reduce its function. As the water content lessens the space between the vertebrae will start to get smaller.

This following list represents activities and lifestyle choices that can lead to and contribute in the forming of a herniated disc:

?Improper lifting

?Smoking

?Excessive body weight

?Applied sudden pressure

Repetitive activities that place strain on your back

After conservative treatment methods having been fully exhausted recommended treatment is often open back surgery which high risks, hospital stays and a lengthy recovery time.

Open back surgery is not the only method of treatment. There is also minimally invasive arthroscopic laser surgery called a percutaneous arthroscopic laser discectomy that can be performed in an outpatient environment.

Percutaneous arthroscopic laser discectomy: This surgical process is preformed to remove herniated disc or bulging disc material that is applying pressure to a nerve root or to the spinal cord.

When the patients history, physical examination and imaging, such as a CT scan or MRI indicate that a disc is herniated or there are signs of a bulging disc and the material inside the disc has not ruptured into the spinal canal a percutaneous arthroscopic laser discectomy can be performed.

If the patient has significant bony anomalies or is suffering from foraminal stenosis they are not a good candidate for a percutaneous arthroscopic discectomy. This patient would benefit from a foraminotomy procedure.