Disc Problems/Back Surgery
The disc is a part of the spine that has received a lot of attention in recent years. We hear the terms “slipped disc”, “ruptured disc”, “herniated disc”, “prolapsed disc” but what do these terms really mean?
What is the Intervertebral Disc?
The disc is a structure located between the spinal bones
(vertebrae). Because it’s found between the vertebrae it’s officially called the intervertebral (inter between, vertebral – the vertebrae) disc.
The disc is made up of two parts: a tough fibrous outer ring (called the annular fibrosis) and the gel-like center (the nucleus pulposus).
The intervertebral disc performs many functions. It separated the vertebrae and acts like a shock absorber between the bones. It helps give the spine its curves and also joins the vertebrae together.
There are 23 discs in our spinal column. In fact, in the morning we are about a quarter inch to half inch taller then we were the night before because the discs lose fluid after a day of standing and thin out a little, causing us to lose some height.
The Disc and Spinal Pain
Today researchers are in general agreement that disc lesions are the single most common cause of lower back pain. What is the disc lesion?
Disc Protrusion and Prolapse
Surprisingly, the disc may start showing signs of wear and tear as early as age 15. Over the years the disc loses a little fluid and small cracks (lesions) begins to form in the outer walls.
The nucleus pulposus begins to bulge and push the annular fibrosis out of shape. This is called a protrusion. If the part bulges out too much it may actually separate from the rest of the disc and become a disc prolapse.
If the prolapsed disc goes into the spinal cord or puts extreme pressure on the nerves it may cause severe pain that could make sitting, standing, walking, lifting, urinating, defecating, sneezing, standing, coughing and moving nearly impossible. In extreme cases numbness of the leg or foot or a loss of muscular control may occur.
Disc degeneration often damages lumbar and sacral nerves of the lower spine. Because of that, various conditions in the pelvic area may occur.
Among these endometriosis, infections (bladder, vaginal, kidney), prostate problems, miscarriage, sterility, sexual impotence, problems of urinary retention, cystitis, menstrual cramps and constipation.
It is not uncommon for an individual who has a chronic back problem to suffer from one or more of the above problems as well.
The term “slipped disc”” is really a misnomer since the disc cannot slip – it is knitted into the vertebrae from both above and below.
What sometimes do slip are the vertebra, which if they do slip out off position may put pressure upon the disc and contribute to its damage.
Most accurately called “slipped discs” would probably be more accurately called slipped vertebrae or disc prolapse.
The Typical Approach to Treating Disc Problems
The typical approach to disc problems is often a combination of pain killers, muscle relaxers and bedrest.
Sometimes a myelogram is performed to diagnosis disc problems. This involves injecting dye into the spinal cord and then X-raying the area to see if the dye is going places it shouldn’t – a sign of rupture or tearing of the disc.
The problem with myelogram is that they have a large margin of error (30-40%). Their use is being abandoned for MRI which is much more sensitive as well as being more accurate and more detailed.
Surgery can involve the removal of the back of the vertebrae (laminectomy) and the scraping away of the disc. With no disc between them the vertebrae may fuse into a solid bone.
In some procedures sections of bone are taken from the pelvis and are placed into the space formerly occupied by the disc.
How successful is this type of lowback surgery?
Recent studies have shown that following laminectomy, symptomatic improvements such as a lessening of the pain is often short lived. After about six months to one year there isn’t much difference between patients who had the surgery and another group that did not.
A twenty-year-study of World War 2 veterans found that in 400 surgical cases 52% had the same low back and leg pain following surgery as before.
Another study of 886 surgeries found that 56% were cured and 44% were unchanged or worse after the operation.
In still another study of 7,391 operations performed by 71 different surgeons 48% had the same symptoms within one year after surgery as before.
The failure of back surgery in so many cases is now called by a special name: Failed Back Surgery Syndrome.
The Chiropractic Record
Chiropractic has an excellent record with disc sufferers, often saving them from a bleak prospect of surgery. Chiropractic care is also effective at helping those who already have gone through surgery.
According to one study of 1,536 lumbar spinal problem patients who were under chiropractic care, 96.4% had a satisfactory result. Surgery was resulted to in only 3.4% of the patients. This study showed two things: one, that chiropractic is extremely effective with spinal disc problems and two, that of those who had surgery, the delay in time while they explored chiropractic care did not cause them any harm.
What If You’ve Had Surgery?
It is possible for a chiropractor to adjust someone ‘s spinal column if they’ve had surgery. Although the surgery may have permanently altered some of the spine, it is not too late for chiropractic care.
The chiropractor can often help relieve the pain (and frustration) of Failed Back Surgery Syndrome and may help prevent the need for future operations.
The best results of chiropractic care are the one’s you never hear about- the health problems that re prevented from getting worse because of prompt action.
Clearly, before your spine starts complaining to you, it’s wise to get a simple chiropractic spinal check-up. You get your eyes, your hearing, your blood pressure checked, why not your spine?