The Prolapsed or Herniated Disc
In a prolapsed / herniated the strong outer fiber ring, which encompasses the jelly like nucleus, is not strong enough anymore to hold the pressure and breaks open. The jelly like material of the core squeezes outside partially or totally and presses on one or more nerves. Depending on the position and amount of prolapsed material the pain is more or less severe.
Sensation disturbances, paralyses, sexual dysfunction, problems urinating and with bowel control can be caused by prolapsed discs. These symptoms occur especially when the prolaps occurs in the lower lumbar spine. Loss of sphincter control when defecating and urinating are absolute emergency cases, which require immediate surgery. The patient should be hospitalized immediately. If this step is not taken immediately there is the risk of permanent paralysis.
The discs of the lumbar spine are affected by disc prolapses most often, because they have to bear the most weight. Second to lumbar disc prolapses are cervical disc prolapses. A disc prolapses of the thoracic spine is very rare.
An injured disc can never recover. It becomes thinner and looses part of its cushioning function. The associated vertebrae become less mobile and eventually fuse. The fusion of a single segment is not critical for the mobility of the whole spine, but can start a sequence of events accelerating spinal degeneration.
Degeneration of discs result in small fissures of the outer annulus ring quite frequently. If only a small amount of jelly is extruded and the jelly does not exert pressure on ligaments and nerves, the event will not result in pain. However, larger extrusions of disc material occurring between the age of 25 and 50 require surgery. Surgical methods are described later.