The vertebrae in our spines are situated so that the rounded platform called the vertebral body is in the anterior position (facing the front of the body), the spinal cord runs through the middle of the bone, and the spiny processes or projections – what you can feel through your skin when you run your hand down your back – are facing the back, or posterior side. The spinal cord may be impinged upon by a central disc extrusion if an intervertebral disc’s material is forced outward centrally and posteriorly toward the spinal canal.
Causes
While a central disc extrusion may be caused by sudden traumatic force to the back or neck, or by lifting or twisting incorrectly, most cases develop due to age and natural disc degeneration. The intervertebral discs of the spine act as shock absorbers and are made of pliable, sturdy cartilage saturated with water. Each disc has a strong outer layer, known as the annulus fibrosus. The nucleus pulposus is the disc’s gel-like interior. As we age, the discs begin to dehydrate, or lose water. This process leaves the discs weakened and susceptible to bulging or herniating under the weight of the surrounding vertebrae. A bulging disc occurs when the nucleus pulposus pushes outward against the weakened outer wall without breaching it. A disc extrusion occurs if the annulus fibrosus tears and the interior material leaks out of the disc and into the spinal canal.
Symptoms
A central disc extrusion may impinge upon the spinal cord due to the direction that the disc material is pressing, which could cause shooting or burning pain at the site of compression. If the disc extrusion is located in the cervical (neck) region of the spine, radiating symptoms of pain, weakness, tingling, cramping, and numbness in the arms and hands may occur. A thoracic (mid-back) central disc extrusion, while rare, could produce pain in the upper back and chest. Severe thoracic extrusion cases may lead to paralysis in the lower body. The spinal cord tapers off into a bundle of nerve roots called the cauda equina, or “horse’s tail,” in the lumbar (lower back) region of the spine. If a central disc extrusion occurs in this area, pain, numbness, tingling, and weakness could manifest in one or both legs and feet. Serious symptoms such as the loss of bladder and bowel control and leg paralysis indicate a rare but serious medical emergency known as cauda equina syndrome. Anyone with these symptoms should be rushed to a hospital immediately as it can be life-threatening.
Treatment
Cases of central and paracentral disc extrusion may need immediate attention due to their proximity to the spinal cord. Conservative non-surgical treatments such as pain medication and physical therapy might not be enough to treat this condition. Patients may also want to consider an alternative option to treat back or neck pain by learning more about the minimally invasive procedures offered at Laser Spine Institute. Our orthopedic specialists use safe and effective endoscopic techniques to perform these procedures on an outpatient basis. Contact Laser Spine Institute today and schedule a complimentary review of your MRI or CT scan.
