A disc becomes herniated or prolapsed when an annular tear is created due to disc degeneration or injury. This tear allows the nucleus pulposus to spill outside of its normal bounds, encroaching on soft tissues in the spinal cavity. Annular tears weaken the structure of the disc, compromising the disc’s ability to act as a shock absorber between vertebrae. Meant to facilitate movement in the spine as well as countering load, intervertebral discs play an important role in everyday actions like sitting, standing and walking.
Types of Prolapsed Disc
Annular tears that give way to prolapsed herniations come in several different forms. While even the slightest tear is recognized as prolapsed or herniated disc, not all herniations are symptom causing. Typically a prolapsed disc is formed due to one or more of the following types of annular tears.
- Typically caused due to injury, concentric tears affect the disc by creating separation in the lamellae or membrane layers protecting the disc.
- Peripheral tears, while similar in orientation to concentric tears, occur on the outside of the disc and are not limited to separation of membrane layers. Frequently known to cause disc degeneration.
- Spanning the height of the disc and extending from the center outward, radial tears occur naturally with aging and are the most common cause of disc herniation in patients.
Prolapsed Disc Diagnosis
When looking at a MRI, herniated discs are often fairly easy to spot. Normally appearing as a cleanly contained disc between two vertebrae with a well formed center or nucleus, herniated discs often exhibit signs of degeneration which may include deformed centers, dehydration and/or actual nucleic spillage into the spinal cavities surrounding the disc. Through the use of a physical exam to determine the extent of discomfort and pain and a discogram to validate pain causing discs, our doctors are able to safely pinpoint the source of discogenic pain in the spine.
Prolapsed Disc Treatment
Once a disc is suspected for causing pain or discomfort, treatment is fairly straight forward. Often beginning with a series of conservative management techniques, we will attempt to aid the disc in self repair through non-surgical means. Should conservative management prove ineffective or the disc pain becomes overwhelming, our team of doctors will proceed with interventional pain management and/or surgery.