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What is disc prolapse?

The human spine has soft tissue / non bony structures called discs in between the vertebrae. Prolapse of this structure beyond its normal confines is called a disc prolapse. It can occur in any direction but is problematic when it occurs into the spinal canal or neural foramen (region from which nerves come out of spine). Disc prolapse can occur due to acute trauma or following chronic stress due to a particular physical activity. With ageing degenerative changes take place in the disc which makes it more susceptible to prolapse without any precipitating event.The symptoms depend on the site, degree and direction of disc prolapse. It commonly occurs in the lumbar or cervical (neck) region and can cause low back ache or neck pain. If the prolapsed disc causes compression of a particular nerve supplying the limb then there will be radiation of pain to that limb. The best imaging modality available today is MRI. It can directly show the site and degree / type of prolapse and also whether any neural compression is present or not. This helps decide the line of treatment- conservative or surgical. It also helps in planning the type of surgical approach needed.

1. Slipped disc pain management through ozone injections

The inter-vertebral discs are protective cushion-like shock-absorbing pads between the two bones of the spine called vertebrae. These discs are soft gel filled pads bounded by few layers of membrane called lamella. These discs do not actually "slip," they may split or rupture. Following this rupture the gel escape into the surrounding tissue. The leaking jellylike substance can produce pressure on the spinal cord or on a single nerve root and cause pain either around the damaged disc or anywhere along the area controlled by that nerve. This condition is also known as a herniated disc, ruptured disc, prolapsed disc, or, more commonly, slip disc or slipped disc. Injection of ozone for slipped disc or discogenic radiculopathy (low back pain with radiation to legs) has developed as a nonoperative treatment of slipped disc/ slip disc (or called ozone therapy for slip disc) which is an alternative to chemonucleolysis and disc surgery. Owing to its high success rate, less invasiveness, fewer chances of recurrences and remarkably fewer side effects, ozone therapy for slip disc is becoming popular day by day in the whole world. This is called ozone nucleolysis or ozone discectomy.

Percutaneous discectomy is another less invasive nonoperative treatment of slipped disc where disc material is taken out with motorized probe that is introduced through a 17 G needle.

These nonoperative treatment of slipped disc have revolutionized the treatment of slipped disc/ slip disc. There is quick recovery, less hospital stay, more economical, very little chance of side effects, and no chance of failed back surgery syndrome- the most fearsome complication of open surgery.

2. Radiofrequency abalation

RFA, or rhizotomy, is sometimes used to treat severe chronic pain in the lower (lumbar) back, where radio frequency waves are used to produce heat on specifically identified nerves surrounding the facet joints on either side of the lumbar spine. By generating heat around the nerve, its ability to transmit pain signals to the brain is destroyed, thus ablating the nerve. The nerves to be ablated are identified through injections of local anesthesia (such as lidocaine) prior to the RFA procedure. If the local anesthesia injections provide temporary pain relief, then RFA is performed on the nerve(s) that responded well to the injections. RFA is a minimally invasive procedure which can usually be done in day-surgery clinics, where the patient is sent home shortly after completion of the procedure. The patient is awake during the procedure, so risks associated with general anesthesia are avoided. An intravenous line may be inserted so that mild sedatives can be administered. The major drawback for this procedure is that nerves regenerate over time, so the pain relief achieved lasts for only a short duration.


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