Doctatoc – Expert Toc on Prolapsed intervertebral disc or disc collapse by Dr. Sunil Kutty.
Hi, I am Dr. Sunil Kutty, I work as a Consultant neurosurgeon at Apollo hospital Navi Mumbai. Today i am here to discuss about Prolapsed intervertebral disc or disc collapse in simple words . disc collapse is something which many people encounter through life and its something which causes radiating pain in the leg accompanied by back pain. so the aim of this is to answer one very specific question which would be a very relevant disc collapse , does all discs require urgent emergent surgical treatment or require any treatment in any form.
so it’s very important to pick those up , because those are those things that are lost to follow-up or the patients should not develop further problem just because we missed up that one bit of opportunity when he had come to us. Typically a patient with a neurological deficient and a disc problem definitely requires a neurosurgical attention without a doubt. apart from that patients who have significant pain radiating to one leg or significant pain which makes it impossible for him to walk properly or get proper sleep for a period of month or so are in fact candidates for surgical decompression. if there are corresponding MRI evidence of significant root compression.
apart from that if at all somebody has done a MRI , they would notice that apart from one big large disc there are multiple small disc bulges or small protrusion which is there at the above and the below level above. in those cases do we need to do something for that, in fact the answer is no. you don’t have to deal with each and every disc bulge or disc protrusion is there. you deal with exactly the one which is causing problem at that point of time. if there are disc bulges but somehow it does not correspondent to the clinical findings that we have on the patient. then again i would prefer the conservative management in such patients. so it is very important to match the clinical findings with what we see with the MRI and then may be if we need to further corroborate it we can do an EMG and nerve conduction study. all when these three things are put together, will give us an idea about which are those candidates in whom surgical procedure will be extremely beneficial.
Majority of that patients fall in that bracket where surgical intervention is not required or will never be needed, these are the patient with mild disc bulges. these disc bulges are indicative of possible problem in the future so what can be done for that, what can be done is extremely simple which is advocated by everybody, not specifically for the back but generally for good health. but when we look at the back percept this becomes extremely important that is keeping your weight in the correct range, that’s something which is extremely important. Regular exercise – Regular exercise not just helps you reduce weight but it also keeps your muscles healthy your bones stronger so all these things are going to happen , and once we realize the back muscles are working well and are strong enough the possibility of a disc prolapsing obviously goes down because it is able to bear the impact that much better the weight is distributed along the muscles better your postures gets better so the possibility of these occurrence goes down so the key here over would be regular exercise , perfect diet to keep under control and over these things happen and you are in terms of maintaining your back alignment the shape of the back and preventing problems regarding the back in the future. so even if they don’t have back problems i would suggest that you actually start doing regular exercise for strengthening your back muscles. Thank you.