When a disc in the lower spine becomes ruptured, serious health consequences can ensue. The center of the disc, called the nucleus pulposus, can bulge outward into the spinal canal, compressing the cauda equina, a collection of nerves that exits from the bottom of the spinal cord. The cauda equina—so named for its resemblance to a horse’s tail—contains nerves that supply the legs, feet, bladder and bowels. If left untreated, cauda equina syndrome can cause permanent nerve damage, leading to paralysis and incontinence.
Microdiscectomy
Microdiscectomy is also called microdecompression back surgery. In an article at Spine Health, Dr. Peter Ullrich, an orthopedic surgeon at NeuroSpine Center of Wisconsin, states that it is not always necessary to remove an entire ruptured disc to relieve the pressure on the lumbar nerves. Microdiscectomy is removal of a portion of the disc, rather than the whole thing.
Microdiscectomy procedures are successful approximately 95 percent of the time, according to Ullrich. Compared with spinal fusion, another procedure used in the treatment oflumbar disc herniation, microdiscectomy does not impair spinal mobility at the site of surgery and allows continued movement between the vertebra above and below the treated disc.
Disc Replacement
When the herniation is severe enough that microdiscectomy will not resolve the problem, artificial disc replacement is another possible option. Cedars-Sinai Medical Center was at the forefront of U.S. Food and Drug Administration studies evaluating the Charite SB-III artificial disc, which is widely used in lumbar disc replacement surgeries. A surgeon removes the damaged disc completely before inserting metal plates into the vertebral bodies above and below it. Then he places a polyethylene core between the plates to replace the disc.
This procedure has faster recovery time, less pain and fewer complications than lumbar spinal fusion, according to Cedars-Sinai.
Arthrodesis
Arthrodesis of the lumbar spine is a surgical process that involves the removal of a damaged intervertebral disc followed by the use of bone grafts to fuse the vertebra above and below the disc into one bone. By fusing the bone, the procedure prevents any further movement at that particular vertebral level, thus ending the joint’s ability to impinge on the spinal nerves.
The University of Maryland Spine Program states that in the past, physicians relied solely on bone grafts to facilitate the fusion. These grafts were successful only 70 percent of the time. The development of metal hardware that braces the fused joint has increased the success rate of this procedure.
