Disc Prolapse

About Prolapsed Discs

A disc prolapse is essentially the same thing as a bulging disc, and occurs when the outer wall of the disc becomes weak and the internal disc contents projects beyond the usual border. This condition commonly occurs due to the normal aging process, but can also occur after a back or neck injury.

It is common that a prolapsed disc will be confused with a herniated disc. A disc prolapse can develop into a herniated disc if the outer layer of the disc cracks, causing the inner disc matter to protrude into the nerve channel.

Common Symptoms of Prolapsed Discs

Prolapsed discs are often asymptomatic, but symptoms can vary depending on the severity of the condition. If pressure is being applied to a nerve root or the spinal cord, pain and other symptoms can arise.  When the disc presses against your spinal cord include symptoms can include:

  • Loss of hand coordination or strength
  • Numbness
  • Problems with bladder or bowel control
  • Spastic movement
  • Tingling in the hands

When the disc is pressing on an individual nerve include, symptoms can include:

  • Pain radiating into an extremity, in the area supplied by the nerve
  • Numbness/weakness in an extremity, in the area supplied by the nerve

A disc prolapse can also lead to neck or back pain, with radiation into the shoulders or buttocks, without compression of a nerve. This pain may get worse over time or while participating in certain activities.

Diagnosis of Prolapsed Disc

A slipped disc can be diagnosed by description of symptoms and a physical examination. X-rays will not show signs of a prolapsed disc, but can be used to rule out conditions that produce similar symptoms. Other scans including MRI scans, CT scans and myelogram can be used to determine the size and location of a prolapsed disc.

Treatment Options for a Prolapsed Disc

Conservative treatments are usually encouraged once symptoms develop. Over time, the inflammation associated with the disc prolapse can subside, leading to improvement in pain or other symptoms. Some nonsurgical treatments include:

  • Activity modification
  • Cortisone shots
  • Physical therapy
  • Pain medications
  • Strengthening exercises

Surgical options will be considered during weeks 4 to 12 of failed attempts at conservative treatments, or if neurological deficits are progressing or prominent. Some options include:

  • Anterior cervical decompression- removal of disc material through the front of the neck
    • This requires either a fusion or arthroplasty to be performed in addition to disc removal
  • Minimally-invasive microdiscectomy – removal of the herniated portion of the disc
  • Posterior cervical laminectomy – removal of the nerve channel roof to provide more space