What Are Extruded Discs?
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A hernia occurs when a tissue protrudes from where it is normally located. This happens to a spinal disc when significant wear and stress causes the nucleus pulposus, the disc’s jelly-like center, to push against the annulus fibrosus, the disc’s thick outer wall, as a result of trauma, injury, or age. When the nucleus pulposus pushes completely through the annulus fibrosus, this is referred to as an extruded disc. In extreme cases, sequestrations may occur, which is when the herniated tissue can separate and seep into the spinal column.
The most common part of the spine to experience an extruded disc is the lumbar spine or lower back. When the displaced material comes in contact with a nerve root, spinal nerve, or spinal cord, the extruded disc causes pain to the patient. Other symptoms of an extruded disc include dull aches, spasm-like pain, shooting pain, weakness in the region of the lower back, numbness, or incontinence of the bowel or bladder.
There are several actions that can injure the lower back, so it is important to be aware of these factors. Many of these factors are common in our daily lives, such as continuous standing, sitting at a desk for several hours a day, overexerting ourselves during exercise, or heavy lifting. There are ways to help protect the lower back, including low impact exercises, stretching, good posture, and sufficient calcium in our diets.
Causes Of Extruded DiscsA common cause of extruded discs in older patients is degeneration with age. Regular wear on the discs of the spine from everyday use and stress causes them to weaken as we get older. This continuous wear can lead to tears in the annulus fibrosus, making it easier for the inner part of the disc, the nucleus pulposus, to protrude into the surrounding area, causing lower back pain.
Another cause of extruded discs is injury or trauma. A sudden impact or severe damage to the spine or lower back can also weaken the tissues involved. In addition to sudden trauma, repeated heavy use may also contribute to an extruded disc. This is often the cause for athletes and other people who sustain frequent injuries due to extreme use of their lower backs.
Treatments For Extruded DiscsWith proper management, an extruded disc can return to normal. Depending on the patient, various combinations of therapies are available, including a healthy diet, low impact exercise, warm and cold compresses, and non-prescription anti-inflammatory medications such as NSAIDs.
In more severe cases, a more aggressive treatment may be necessary. For treatment of extruded discs associated with severe pain, a patient may require epidural injections of a steroid or an anesthetic to reduce pain and inflammation. These injections significantly reduce the symptoms of nerve root compression and the associated pain and inflammation. Other treatments may include radiofrequency ablation and spinal cord stimulation.
When these therapies are unsuccessful, surgery is an option. This surgery is called a discectomy, in which the problem tissue is removed to prevent it from pressing on the surrounding tissue and nerves. This procedure is common, with nearly half of a million discectomies performed each year. The procedure is minimally invasive and removal of the disc material has been successful in reducing pain and inflammation.
ConclusionExtruded discs are most common in the lower back. A herniated disc becomes extruded when the spinal disc material has been squeezed through the annulus and begins to seep into the surrounding space. When the nucleus pulposus is displaced and presses on nerves or the spinal cord, it may cause pain that ranges from mild to severe. Extruded discs can often be treated with over-the-counter medications and hot and cold compresses, although more severe cases may require injections or surgery such as a discectomy to remove the herniated tissue.
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