Lumbar Herniated Disc
What is a Lumbar Herniated Disc?
disc degenerates, it can herniate (the inner core leaks
out), which is known as a disc herniation or a
herniated disc. The weak spot in the outer core of the
disc is directly under the spinal nerve root, so a
herniation in this area puts direct pressure on the nerve,
which in turn can cause
sciatica. Pain that radiates down the leg and is caused
by a herniated disc is called a
If you are considering spine surgery as a treatment for your
herniated disc or spinal condition, please
contact us to determine
what option is best for you, what your insurance will cover
and any additional surgery costs.
impingement from a herniated disc can cause
weakness in extending the big toe and potentially in the
Lumbar Herniated Disc Symptoms
Approximately 90% of disc herniations will occur toward the
bottom of the spine at L4- L5 (lumbar segments 4 and 5)
or L5- S1 (lumbar segment 5 and sacral segment1), which
causes pain in the L5 nerve or S1 nerve, respectively.
drop). Numbness and pain can be felt on top of the
foot, and the pain may also radiate into the buttock.
S1 nerve impingement from a
herniated disc may cause loss of the
ankle reflex and/or weakness in ankle push off (patients
cannot do toe rises). Numbness and pain can radiate
down to the sole or outside of the foot.
Lumbar Herniated Disc Treatments
cases, if a patientís
low back and/or leg pain is going to get better after a
lumbar herniated disc it will start to do so within about
six weeks. While waiting to see if the disc will heal on its
own, several non-surgical treatment options can help reduce
the back pain, leg pain and discomfort caused by the
Several of the most common nonsurgical treatments include:
- Physical therapy
- Osteopathic/chiropractic manipulations
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Oral steroids (e.g. prednisone or methyprednisolone)
An epidural (cortisone) injection
If the pain and other symptoms continue after six weeks,
and if the pain is severe, it is reasonable to consider
microdiscectomy surgery as an option to alleviate the
pain from the herniated disc.
Lumbar Herniated Disc Surgery
microdiscectomy is designed to take the pressure off the
nerve root by removing the portion of the disc that is
pressing on it, and to provide the nerve with a better
healing environment. Using microsurgical techniques and a
small incision, a microdiscectomy can usually be done on an
outpatient basis or with one overnight stay in the hospital,
and most patients can return to work full duty in one to
experienced surgeon like those at United Spine & Joint,
the success rate of surgery for a lumbar herniated disc
should be about 95%. Usually, only the small portion of the
disc that is pushing against the nerve root needs to be
excised, and the majority of the disc remains intact.
Unfortunately, approximately 10% of patients will
experience another disc herniation at the same location.
This is most likely to happen early in the postoperative
period (within the first three months), although it can
happen years later. Usually a recurrence can be handled with
another microsurgery, but if it keeps recurring multiple
fusion surgery to stop the motion at the disc level and
remove all the disc material may be considered.