Normal Disk Anatomy
The intervertebral disks are composed of a nucleus pulposus and annulus fibrosis. The nucleus pulpous is a soft jelly like material held in place by the annulus fibrous. The annulus fibrosis is a hard fibrous outer covering surrounding the nucleus pulposus. Imagine a jelly dount. The jelly is the nucleus pulpous and the dough is the annulus fibrosis.
Initially the disk is water filled, but as people age the disk drys out and becomes brittle, which may lead to cracks in the annulus fibrosis. This may allow the nucleus to herniate into the spinal canal with the annulus or through a hole in the annulus.
Annular tears may cause severe low back pain. The bulging disk may pinch, irritate or damage nearby nerves causing severe pain shooting down the arms or legs, associated with pain, numbness and tingling. In severe cases it may affect the persons ability to control his bowel and bladder function.
Treatment of Bulging Disks
Initial treatment of bulging disks is rest, non steroidal anti-inflammatories drugs like ibuprofen, physical therapy and steroid injections. If pain persists surgery should be considered. Traditional surgery involved large skin incisions, bone removal and significant post-operative pain.
Today bulging disks can be removed with spinal endoscope, often called Laser Spine Surgery. The surgery is done through a small 1/3 inch skin incision using an endoscope, which is small camera placed inside of the spine to shave off the bulging disk under direct visualization. After the surgery is complete, the scope is removed and bandaid is placed over the incision. Patients are discharged home the same day with minimal pain and often do not require any post-operative pain medication.