Bulging Disc

Bulging = swollen, protruding
Disc = the disk-shaped cushions between the bones of the spine

Between each set of vertebrae, or bones of the spine, is a fibrous disc with a jelly-like core. These discs cushion the vertebrae and promote flexibility of the spine, which is required for performing normal activities of daily living.

A bulging disc is a condition in which the outer layer of the disc forms a bubble that “bulges” outward. This bulge may compress the spinal cord and nearby nerves.

A bulging disc can occur at any spinal level: cervical (neck), thoracic (upper and mid-back), and lumbar (lower back).

Under continued pressure, the outer wall of the disc may rupture. This is a condition known as a herniated disc

.

A bulging disc that compresses the spinal cord or nearby nerves may cause pain, numbness or tingling in the arms, hands, legs or feet. Exact symptoms depend on the exact location of the problem.

Bulging discs are usually a result of degenerative disc disease. Disc degeneration is a natural process in which spinal discs gradually thin and dry out. The fibrous outer layer loses some of its strength and flexibility.

In many cases, a diagnosis can be made on the basis of a thorough medical examination. However, the following imaging studies can help rule out other problems or provide more information about the disc’s effects on the spinal cord or nearby spinal nerves:

• X-rays: Produce pictures of bones, so cannot show bulging discs. May be useful for ruling out other problems.
• Magnetic resonance (MR) scans: Clearly show soft tissues like discs, spinal cord, and nerves.
• Computed tomography (CT) scans: Use X-rays and a computer to create detailed images of the spine and nearby structures.
• CT plus myelogram (myelo-CT): Uses an injectable dye and CT scan to measure nerve function. Can be especially useful in pinpointing the nerve or nerves affected by a bulging disc.

Bulging discs are often treated with nonoperative measures such as pain medications and physical therapy. However, if the bulging disc compresses the spinal cord, surgical treatment may be necessary.

A microdiscectomy is one surgical option. This is a minimally invasive procedure in which a neurosurgeon removes part of a damaged disc through a very small incision. This procedure is usually performed in the neck or low back. A microdiscectomy in the neck is called a cervical microdiscectomy, while the same procedure in the low back is called a lumbar microdiscectomy.

If a disc is so damaged that it must be replaced, the surgeon may perform an artificial disc replacement, also known as arthroplasty.

Drs. Paul C. McCormick, Michael G. Kaiser, Peter D. Angevine, Alfred T. Ogden and Christopher E. Mandigo are experts in treating bulging discs. Each can also offer you a second opinion.

[request-button]