Herniated Disc หมอนรองกระดูกทับเส้นประสาท

Herniated Disc Compressing a Nerve: Symptoms, Causes, and Treatments

Symptoms
Pain: Sharp or burning pain that radiates from the lower back to the buttocks and down the leg (sciatica) or from the neck to the shoulder and arm.
Numbness and Tingling: Affected areas may experience numbness or a tingling sensation.
Weakness: Muscles served by the affected nerves tend to weaken, which may cause you to stumble or affect your ability to lift or hold items.

What is a Herniated Disc Compressing a Nerve?

A herniated disc consists of two parts: the inner part, which is a gel-like substance called the nucleus pulposus, and the outer tissue called the annulus fibrosus.

A herniated disc compressing a nerve is a condition where the gel-like substance (nucleus pulposus) in the center of the spinal disc protrudes or extrudes through a tear or rupture in the outer tissue (annulus fibrosus). This causes the disc to press on nearby nerves.


Types of Herniated Disc Compressing a Nerve

           1. Bulging: The gel-like inner part (nucleus pulposus) protrudes outward, but the outer tissue (annulus fibrosus) remains intact without any tears.

          2. Disruption: The gel-like inner part (nucleus pulposus) protrudes outward, and the outer tissue (annulus fibrosus) has partial tears.

         3. Free Fragment: The gel-like inner part (nucleus pulposus) protrudes outward, and the outer tissue (annulus fibrosus) is completely torn.

Causes and Risk Factors of a Herniated Disc Compressing a Nerve

A herniated disc compressing a nerve can occur due to various causes and risk factors, often related to the degeneration of the spine, injury, and certain behavioral factors. These include:

Causes:
1. Disc Degeneration: Age-related wear and tear can cause discs to lose their water content, making them less flexible and more prone to tearing or rupturing with minor strain or twist.
2. Injury: Trauma or injury to the spine, such as from a fall or accident, can lead to herniation.
3. Improper Lifting:  Lifting heavy objects using improper techniques can place excessive strain on the spine, causing a disc to herniate.

 Risk Factors:
1. Age: The risk of disc herniation increases with age due to the natural degeneration of the discs.
2. Occupational Factors: Jobs that require repetitive lifting, pulling, pushing, or twisting motions can increase the risk.
3. Genetics: A family history of disc herniation may increase the likelihood of developing the condition.
4. Obesity: Excess body weight can put additional stress on the discs in the lower back.
5. Sedentary Lifestyle: Lack of regular exercise can lead to weak muscles that support the spine, increasing the risk of herniation.
6. Smoking: Smoking can reduce blood flow to the discs, leading to disc degeneration and increasing the risk of herniation.

These factors contribute to the likelihood of developing a herniated disc that can compress nearby nerves, leading to pain and other symptoms.

Treatments

Surgical Treatments:
Microdiscectomy: A minimally invasive procedure to remove the portion of the disc pressing on the nerve.
Laminectomy: Removing part of the vertebra to relieve pressure on the nerve.
Disc Replacement: Replacing the damaged disc with an artificial one.
Spinal Fusion: Fusing two or more vertebrae together to stabilize the spine.
Treatment options depend on the severity of the condition, the specific location of the herniation, and the patient's overall health and comorbidities.


Non-Surgical Treatments:

  Medications: Pain relievers, anti-inflammatory drugs, and muscle relaxants to manage symptoms.

  Physical Therapy: Exercises to strengthen the muscles supporting the spine and improve flexibility.

  Glucose Injection: Around the Nerve Root: If treatment with medication and physical therapy does not improve the condition, an additional treatment option is the injection of glucose around the nerve root. This procedure aims to reduce pain and inflammation caused by nerve compression.
  
   Epidural Steroid Injections: Corticosteroid injections to reduce inflammation around the nerve.

   Percutaneous Laser Disc Decompression (PLDD)

PLDD is a relatively new treatment method that uses laser technology to address herniated discs. The procedure involves directing a laser to the herniated portion of the disc. The laser reduces the pressure within the disc, causing the protruding disc to shrink and thus relieving the compression on the nerve.

Advantages:
- No need for hospitalization
- No general anesthesia required
- Quick recovery time
- Less expensive than traditional surgery

Limitations:
- May not be suitable for severe disc herniations

PLDD offers a minimally invasive alternative to traditional surgical options, making it an attractive choice for patients with less severe disc herniations.