The spine or back bone is composed of vertebrae separated by disks. The disks support and cushion the spine. Over time the disks may become damaged and wear out causing back pain. If the outer disk lining (annulus fibrosis) tears the inner jelly nucleus (nucleus pulposus) may herniate out of the disk and “pinch” a leg nerve causing sciatica. This usually is felt as back pain shooting down the back or side of the leg.
The disk pushing on the nerve causes inflammation around and in the nerve leading to irritation, swelling and pain. The pain and inflammation may settle quickly over a few weeks in some people, but other people the pain may continue for years. Unfortunately long term nerve pinching may cause breakdown of the nerve myelin covering and loss of nerve fibers causing nerve damage. Nerve damage may or may not improve even after the nerve is “un-pinched”.
People with a pinched nerve and pain, numbness and weakness usually require removal of the disk “pinching” the nerve. Sometimes recovery will be longer if the nerve has been “pinched” for a long time.
Yes it is recommended to have surgery for an old ruptured disk if:
1) The disk is still pinching nerve on recent MRI (usually 6-12 months old)
2) The disk causes the type of pain the patient has
3) The disk causes the type of weakness or numbness the patient has
Today Endoscopic Spine Surgery is a new answer to disk surgery. The disk can be found with a small high definition video camera that is inserted into the spine through a skin incision the size of a finger nail. The nerve is then “unpinched” relieving pain and suffering. For more information on minimally invasive endoscopic laser spine surgery please contact Executive Spine Surgery 908-452-5612 or email firstname.lastname@example.org Good Luck!