Herniated disc: pay attention to interpret the diagnostic result!
Written by:Dr. Claudio Dell'Anna, specialist in Neurology in Rome and expert in Pain, talks about the diagnosis and therapy of the herniated disc
How to form a herniated disc?
In the condition called "disc herniation" the pulpy nucleus of the intervertebral disc (placed between one vertebra and the other to absorb mechanical stress) is displaced to a significant extent by the rupture of the fibrous ring which contains it in its physiological seat. Sometimes it happens that the fibrous ring is flattened without breaking, allowing the nucleus pulposus a certain degree of sliding towards the outside, technically defined as "disc protrusion". Both the hernia and the disc protrusion can affect any spinal segment and can variously be associated with Cervical Pain, Low Back pain, Chronic Pain and stiffness of the spine.
How to know if you suffer from disc herniation?
Usually it comes to the awareness of suffering from one or both conditions (hernia and / or disc protrusion) when the complained symptoms lead us to the doctor. After the necessary clinical examination these usually indicate an MRI (Magnetic Resonance Imaging) which confirms the suspicion. It is also necessary to perform electrophysiological examinations (such as electromyography) to ascertain whether the nerve we are suffering with actually corresponds to the intervertebral disc that we see herniated in the NMR images. Not observing this important survey supplement exposes to the risk of a diagnostic error about the relationship between the cause (herniated disc) and the effect (pain, functional deficit) that has as serious consequence the indication of a Spinal Surgery operation destined to failure.
What to do in case of a herniated disc?
When one of the two diseases (or both) is highlighted, the mistake is often made of formulating a wrong judgment that can have important consequences: the RMN allows us to observe the dislocated disks but does not specify if this constitutes the cause or the effect of a disorder affecting the spine! Some hernias and disc dislocations are in fact the expression of compensatory mechanisms that the spine puts in place to lighten the effects of a disorder against it. In such cases, surgical or manipulative activities aimed at the reduction of disc dislocations (hernias or protrusions) may have serious consequences (eg Failed Back Surgery Syndrome, or Syndrome of Failure of Spinal Surgery). It should be noted that if we identify a herniated disc that with absolute certainty seriously compromises a nerve root and we can not find another solution to the problem we must necessarily resort to Spinal Surgery.
Editor: Marta Buonomano