![]() ![]() The best way to diagnose a bulging disc is with an MRI. ![]() Because the discs are soft tissue, they can not be seen effectively on an X-ray. Thus the incompetent disc and the bulging herniated disc accompanied with severe enough osteoarthritic changes, will require surgery to correct.Ĭompare to the fully Ruptured or Free-Fragmented Disk.Ĭlick here to Learn more about Spinal Stenosis. This MRI shows a disc bulge at the L4-L5 spinal level. Thus a person with stenosis is more likely to be symptomatic from even mild disk herniations. In the above illustration, the foramina was tight (i.e., stenotic!) prior to the disc herniation. Stenosis occurs whenever the spinal canal or the hole a nerve root exits (foramina) the spinal canal is narrowed. Now the nerve no longer has enough room to exit the spinal canal, and sciatica with varying degrees of pain, numbness, and weakness will be present. (This is to be distinguished from Osteoporosis, which is the thinning of bones due to loss of calcium, and which usually occurs in genetically predisposed post-menopausal women.) In the illustration below, the facet joint has become large (hypertrophied) and developed bony spurs, i.e. ![]() Often a disc bulge occurs in a patient with “degenerative arthritis” known as Osteoarthritis. The traditional test for this is the myelogram. This type of disc bulge is described as an incompetent disc. Often the only way to demonstrate this condition is with a dynamic or motion study of the spine with X-rays. Often in this latter case, the disc moves in and out compressing the nerve and thus causing sciatica. If the nerve has enough space to exit the spinal canal, then there will be minimal or no pain, thus obviating the need for surgery.īut what if the disc annulus is too weak to repair itself, despite time, medications, and therapy? This may result in continued pain, or intermittent pain which only interferes with specific activities. If given enough time and appropriate therapy, these will–more often than not–get better! This is attributed the the disc “going back in,” or with time drying out and shrinking. This is an important distinction to make. As can be seen in the above illustration, a bulging disc is a herniated disc which is still contained by it’s annulus. ![]()
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