Surgery Gives Herniated Disk Sufferers a Lift
Carol Harlos Herniated Disk Patient
Prevention
To avoid lower back problems:
- Use good posture.
- Lift heavy objects with your thigh muscles rather than your back.
- Exercise and stretch back muscles carefully.
- Lose excess weight.
- When walking or running, wear appropriate shoes that are in good condition.
- When sitting, keep your feet flat on the floor. A lumbar support or towel roll will maintain the lumbar curve.
- If you sit for long periods of time, stand up and stretch every 30-60 minutes.
- Before lifting an object, try to move it with your foot. If you can move it with your foot, attempt to lift it using the proper technique: place your feet shoulder width apart, bend your knees, keep your back straight, hold the object close to you and stand up using your leg muscles.
September 2002 — Carol Harlos first noticed the pain on a Thursday morning last spring. It started in her hip and gradually moved down to her ankle. She thought it was stress, but within a week the pain was unbearable.
"I waited until there was so much pain I couldn't sit and I couldn't stand, and then I saw a doctor," says Harlos, vice president of a title insurance company in Dade County. "I'm no baby, but it was agony. On a scale of 1 to 10, it was a 12."
As painful as it was, Harlos' problem was an all-too-common one: a herniated disk.
Pinpointing the Problem
Herniated disks — also called slipped or ruptured disks — occur most often in the lumbar region, five vertebrae of the lower back. The disks are "shock absorbers," surrounded by cartilage to hold them in place. When the cartilage ruptures and the disk pushes out between the vertebrae, pressure on a spinal nerve can cause pain, weakness and numbness.
Very often, a doctor can pinpoint the problem disk based on the part of the body affected. If symptoms appear in the buttocks and legs, the problem is in the lumbar region; if they're in the arms, neck or shoulders, the patient has a cervical rupture.
Herniated disks are generally not found in young adults and used to be more common in men than in women. But that's not necessarily true anymore. "It's still rare to see someone younger than 25 with this problem," says Greg Zorman, MD, neurosurgeon and Chief of Neurosurgery at Memorial Regional Hospital. "But now that more and more women are in the workforce, it's a 50/50 split between men and women."
Sudden lifting, twisting or a direct injury can cause a rupture. In older patients, the problem can result from gradual weakening of the cartilage. But the cause may not be obvious, and Harlos doesn't know what brought on her condition. "I fell down a flight of marble stairs 40 years ago," she says. "Absolutely nothing physically traumatic has happened to me since."
Treatment Options
Surgery is usually not required to ease the pain of a herniated disk. "About 80 percent of patients get better with conservative care: over-the-counter medicine, rest, perhaps physical therapy, steroid injections and chiropractic treatment," says Dr. Zorman.
For those who do not benefit from conservative care, surgical options include:
- Diskectomy — trimming the ruptured disk and removing part of the vertebral bone
- Laminectomy — removal of the ruptured part of the disk and a small piece of the vertebral bone
- Spinal fusions or bone grafting
In Harlos' case, Dr. Zorman performed a diskectomy. Thanks to improved technology, diskectomies can be performed with incisions less than one inch long. The procedure also spares muscles from damage, minimizing atrophy and post-operative pain.
Relief came immediately for Harlos. "When I woke up at noon after the surgery, the discomfort from the surgery was there but the pain was gone," Harlos says. "I was walking with help at 2:30 pm, without help at 4 pm, and I went home the next day. I was thrilled."
For more information about preventing back problems, read Oh, My Aching Back: Tips for Prevention and Treatment. If you have back problems, see a physician. For a referral to a physician in your area, please call the Memorial Healthcare System Physician Referral Service at (800) 944-DOCS.