Your Questions Answered: What is a bulging disc?

It may be likened to letting half the air out of an inner tube and applying pressure to create a longer outer circumference. Disc bulges represent a part of the natural aging process associated with disc degeneration (or Degenerative Disc Disease).

One of the ways that they describe a bulging disc is this – a disc in which the contour of the outer annulus extends, or appears to extend, in the horizontal (axial) plane beyond the edges of the disc space, over greater than 50% (180 degrees) of the circumference of the disc and usually less than 3 mm beyond the edges of the vertebral body apophysis. Or, it could be explained as a disc in which the outer margin extends over a broad base beyond the edge of the disc space.

Your Questions Answered: Can You Explain What an MRI Is?

An MRI, (which stands for Magnetic Resonance Imaging), creates a magnetic field around the body, then sends radio waves through the body to detect changes in molecules and creates a pictorial slice of the area of the body being studied.

For patients with acute low back problems who have had prior back surgery, and MRI with contrast appears to be the imaging test of choice to distinguish disc herniation from scar tissue associated with the prior surgery.

Your Questions Answered: What Specialty of Healing Arts uses decompression?

All of them, which includes pain management doctors, neurosurgeons, doctors of orthopedics, anesthesiologists, chiropractors, and some primary care physicians.

June 1st Spinal Decompression Seminar

Dr. Larry Wilkins will be presenting a Spinal Decompression Seminar on:
Saturday, June 1ST at 10:00AM.

Watch the Online Seminar Here or Call (724) 547-3377 to reserve your seat! Or fill in the form to RSVP Online.

Your Questions Answered: Can I be treated with DRS or Axial Decompression if I have already had surgery to the cervical spine or low back?

As a matter of fact 25% of my practice has already had 1, 2, 3, or even 4 surgeries to either their low backs or cervical spines.

The surgeries that the patients have had are discectomy, micro-discectomy, fusion surgeries, and Facet surgery. Also, a new one is the X-Stop Spacer. All of these surgeries require different times of healing before we can begin treating the patient. Of course, before we can let the patients know if we can help them, they have to have an extensive evaluation consisting of a complete history and review of all imaging studies, a consultation, a surface EMG, posture exam, computerized range of motion, x-rays of the area, and a neurological and orthopedic evaluation.

Your Questions Answered: How do you know if you are a candidate for DRS?

I get asked that question at least 5 or 6 times a day and it’s really an easy question to answer.

The first thing you need to do is be examined and that examination will consist of a consultation, Surface EMG, posture exam, computerized range of motion, x-rays of the area, and a neurological and orthopedic exam of the area as well as a complete review of your medical history and prior imaging studies.

Your Questions Answered: What is sciatica?

Sciatica a syndrome characterized by pain radiating from the back into the butt and into the lower extremity along its posterior or lateral aspect, and most commonly caused by protrusion of a low lumbar intervertebral disc. The term is also used to refer to pain anywhere along the course of the sciatic nerve. (Dorland’s Medical Dictionary)

The way I like to explain it to patients is this. Quite often leg pain or foot pain does not mean that there is a problem with the leg or the foot, but rather that there is a problem in the low back, causing pain and possibly other symptoms to radiate, or be referred to the leg or the foot. This can include muscle weakness. The important thing to understand is that sciatica is a symptom of a problem of something compressing or irritating the nerve roots that comprise the sciatic nerve – rather than a medical diagnosis or medical disorder. This is an important distinction, because it is the underlying diagnosis (versus the symptoms of sciatica) that often needs to be treated in order to relieve sciatic nerve pain.

Your Questions Answered: What is a herniated disc?

In order to answer this, I am going to give you the definition which was written for doctors, and then I’ll explain it in layman terms.

According to the North American Spine Society (NASS) and the American Society of Neuroradiology (ASNR), a herniated disc is:

1. Localized and displacement of disc material beyond the normal margins of the intervertebral disc space.

2. (Non-Standard) [Any displacement of disc tissue beyond the disc space]. Note: Localized means, by way of convention, less than 50% (180 degrees) of the circumference of the disc. Disc material may include nucleus, cartilage, fragmented apophyseal bone, or fragmented annular tissue. The normal margins of the invertebral disc space are defined, craniad and caudad, by the vertebral body end-plates and peripherally by the edges of the vertebral body ring apophysies, exclusive of osteophytic formations. Herniated disc generally refers to displacement of disc tissues through a disruption in the annulus, the exception being intravertebral herniations (Schmorl’s nodes) in which the displacement is through vertebral end-plate. Herniated discs in the horizontal (axial) plane may be further subcategorized as protruded or extruded. Herniated disc is sometimes referred to as “herniated nucleus pulposus,” but the term herniated disc is preferred because displaced disc tissues often include cartilage, bone fragments, or annular tissues.

Your Questions Answered: What causes the disc to herniate or bulge?

The disc works very similar to a water balloon. If we put a water balloon on the edge of a table, you would see the sides push out a little bit. When we push down on top of it, it expands out in all directions, and when we let go of it, it goes back to normal. That’s exactly the way that these discs work.

There are many ways a disc can be damaged. For example, truck drivers have this problem because of that constant vibration or pounding they experience while on the road. It could also be something as simple as years of wear and tear, repetitive lifting. You might slip and fall on your rear end, fall flat on your face, or flat on your back. You may cough or sneeze or lift or twits – even as little as to pick up a piece of paper. Or, you may do a combination of all of these incidents to cause disc damage. Basically, the liquid substance on the inside of the disc is put under a great deal of pressure. The cartilage around it can’t hold it back any longer and (snap) it just tears. So we get a little tear that forms in there. Now this is a problem, because the liquid substance squeezes out into the tear and spreads it apart. That causes a bulge to form.

Question: What is a myelogram?

A test in which dye is injected into the spinal column. It enables the doctor to see, via fluoroscopic x-ray, any bulge within the intervertebral canal that may be putting pressure on the cord or spinal nerves. Dorland’s says it’s a radiograph of the spinal cord.

Also, you could have a myelography, which is radiography of the spinal cord after injection of a contrast medium into the subarachnoid space. They can use oxygen as the contrast medium.