An intervertebral disc disorder is a protrusion of one of the gel-like cushions called discs that separate the vertebrae of the spine. It is more commonly referred to as a herniated disc. This can be a frequent source of back pain as the discs deteriorate and become unable to absorb shock correctly. The intervertebral discs act as shock absorbers and are found between the bodies of the vertebrae. They have a central area composed of a colloidal gel, called the nucleus pulposus, which is surrounded by a fibrous capsule, the annulus fibrosis. This structure is held together by the anterior longitudinal ligament, which is anterior to the vertebral bodies, and the posterior longitudinal ligament, which is posterior to the vertebral bodies and anterior to the spinal cord. The muscles of the trunk provide additional support.
Disc disorders can include disc bulges, disc protrusion, disc extrusion, and disc sequestration. Surgery for patients with disc disorders of the spine is usually reserved for those who have failed exhaustive attempts at conservative treatment over a period of 6-12 weeks. An exception to this is the patient with a neurologic deficit; in this patient, it is wise to consider early surgical decompression to maximize the likelihood of neurologic recovery. Surgery is done under general anesthesia. An incision is placed in the lower back over the area of the herniated disc. Some bone from the back of the spine is removed to gain access to the area where the herniated disc is located. Typically, the protruding part of the disc and any extra loose pieces of disc are removed from the disc space.
After surgery, restrictions may be placed on the patient’s activities for several weeks while healing is taking place in order to prevent another herniated disc from occurring. A long stay in the hospital is unlikely, but each case will be treated individually and you may be required to stay longer for observation if healing is not progressing as it should.