Medical Management vs. Surgical Management of a Disc Herniation


Medical Management vs. Surgical Management of a Disc Herniation

I’m Ed Smith, a Sacramento Personal Injury Lawyer. There are many types of spinal cord injuries that can occur. Some of these injuries could result in paralysis while others could be a simple muscle sprain or strain. Perhaps the most common spinal cord injury is a herniated disc. The spinal cord has soft discs between the vertebrae that act as cushions for the bones and nerves. The role of the disc is to absorb the shock-like forces that travel up and down the spine with everyday life. A disc herniation occurs when this disc ruptures and the nucleus pulposus (the cartilaginous interior of the disc) bursts through the annulus fibrosis. According to a statistical review that was published in the Statistics Pearls section of PubMed:

  • The most common cause of a disc herniation is the gradual deterioration of the disc itself as people age.
  • The second most common cause of a disc herniation is an acute traumatic accident, such as a slip and fall or an auto accident.
  • Other common causes include genetic or anatomical issues that weaken the connective tissue between the vertebrae and the disc.
  • The most common location for a disc herniation is the lumbar region of the spine.
  • The second most common location is the cervical spine.
  • Disc herniations are twice as common in men as in women.
  • The most common age at which someone suffers a disc herniation is between 30 and 50 years old.

When someone has suffered a disc herniation, there are multiple treatment options to consider. For some people, their disc herniation could be managed with medications alone. In other cases, surgery may be necessary. It is essential for people to understand the risks and benefits of both treatment methods before making a decision.

Medical Management of a Disc Herniation

The first option for the treatment of a spinal cord disc herniation is medical management, also called conservative management. It has been named conservative because it does not require a trip to an operating room. For someone who has a lumbar disc herniation, conservative medical management includes some different treatments. These include:

Medications: The most debilitating aspect of a disc herniation is the pain. Someone who has a lumbar disc herniation should expect pain that radiates down one or both legs. Pain medications include anything from anti-inflammatories, such as Tylenol and ibuprofen, to narcotic pain medications. Over time, the thought is that the material that has ruptured out of the disc will be reabsorbed by the body itself and the pain will resolve.

Physical Therapy: Also, many people who conservatively manage their disc herniation will require physical therapy. In physical therapy, people will work on regaining their range of motion and managing their pain. This could include muscle stretching, rotational, flexion, and extension exercises.

Steroid Injections: For those with severe pain, steroid injections along the area of the disc herniation may be helpful. Steroids are used to reduce the inflammation in a specific area of the body. This anti-inflammatory medication could help relieve the pressure on the nerve that has been caused by the disc herniation.

The most significant benefit of managing a disc herniation medically is that people do not need to go to an operating room. One of the biggest risks of medical management is that the pain that people feel will not go away. In some cases, it could potentially get worse. As this happens, the pain medication may need to become stronger, which might open the door for potential addiction, overdose, and respiratory depression. Because of this, surgery exists as an effective alternative to medical management. Of course, this comes with its own risks.

Surgical Management of a Disc Herniation

If someone decides to go with surgery to repair a herniated disc, the procedure is called a diskectomy (also spelled discectomy). The most common indication for this surgical procedure is an intractable pain. In a diskectomy, the first step will be to take a picture of the spine to figure which disc has ruptured, how severe the rupture is, and where the pressure on the nerve is coming from.

After this, the surgeon will take the individual to an operating room and put them to sleep. Then, an incision in the back will be made along the disc. The surgeon will then start to remove the portion of the disc that is pressing on the nerve. In some cases, the entire disc may need to be taken out. By removing the disc and relieving the pressure on the nerve itself, people’s pain should resolve.

Of course, there are some risks to surgery that patients should consider. These include:

  • An allergic reaction to the anesthesia.
  • An infection may develop at the site of the incision.
  • People may need to spend extra days in the hospital to recover from the surgery.
  • Their pain may persist despite having the surgical procedure.

In some cases, individuals may need to have a spinal fusion involving screws and rods to completely relieve their pain. The biggest benefit from a diskectomy or spinal fusion is the resolution of the pain. There are risks and benefits to both treatment options, and people should consider all of these issues, discuss them with their doctor, and come to a decision that is in their best interests.

Ultimately, whenever people sustain a disc herniation in their spine, serious consequences could result. Therefore, it is essential to discuss all of the treatment options before making a decision. After this, it is a good idea to meet with a personal injury lawyer in Sacramento. The accident should be investigated fully because you and your family may be deserving of financial compensation.

Watch YouTube Video: Herniated Disc Explanation. This short 3-dimensional video explains how a herniated disc occurs.

Related Articles by Personal Injury Attorney, Ed Smith

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I’m Ed Smith, a Sacramento Personal Injury Lawyer. A disc herniation can be extremely painful. If you or a loved one suffered injuries in an auto accident, call me at (916) 921-6400 at (800) 404-5400 for free friendly advice.

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Image Source: This diagram was located first on Wikimedia Commons and has been printed here under the CC BY SA License, version 4.0.

Medical Management vs. Surgical Management of a Disc Herniation –

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