Intervertebral discs: what they are and what are the most common injuries

The spine is one of the most important structures in the human body. The intervertebral discs play a fundamental role in it, as they allow the spine to move and absorb the impact between the vertebrae. Therefore, it is crucial to take conscious care of your back to avoid injuries and maintain its health.

What are intervertebral discs?

Intervertebral discs are flexible, gelatinous cushions that separate the vertebrae of the spine. In total, humans have 23 intervertebral discs, which are flexible and resistant in structure.

Composed of 95% water, these discs require proper hydration to function, as water allows the disc to swell and become a stable structure to support any load. As they do not have their own vascular system, they are nourished through the entry and exit of fluids from nearby tissues.

They are composed of three parts: the nucleus pulposus, which is located inside and has a gelatinous consistency; the fibrous ring, formed by collagen fibers, whose function is to protect the nucleus; and the basal plate, which functions as a separation between the disc and the vertebra.

Function of the intervertebral discs

The intervertebral discs play a fundamental role in the functioning of the spine. Their main function is to act as shock absorbers between the vertebrae, absorbing the impact generated by everyday movement, such as walking, running or lifting objects, thus protecting the vertebrae from possible damage.

They also function as ligaments that hold the vertebrae together, stabilising the spine at all times. They also contribute to its mobility, allowing flexion, extension and smooth lateral movements between the vertebrae, which provides flexibility and freedom of movement.

Risk factors for intervertebral disc injuries

There are several factors that can increase the risk of suffering injuries to the intervertebral discs. Some of the most common factors include:

• Natural aging.
• Repetitive overload activities.
• Inadequate postures for long periods.
• Lack of physical activity and sedentary lifestyle.
• Excess body weight.
• Genetic predisposition.
• Accidents or falls that affect the spine.
• Smoking.

Pathologies in the intervertebral discs

Back injuries affect a large percentage of the population, and their causes can be very varied. Often, these pathologies are related to daily wear and tear or natural aging.

The most common are the appearance of osteoarthritis, due to general wear and tear of the intervertebral discs, and hernias, which appear due to the displacement of the intervertebral discs.

Osteoarthritis of intervertebral discs

Osteoarthritis of the intervertebral discs is a degenerative pathology that occurs due to the wear and tear of the structures that form the spine. The most common symptoms include chronic back pain, stiffness and, in some cases, a reduction in spinal mobility. Although wear and tear is a natural process that occurs with age, certain factors such as a sedentary lifestyle, poor posture or activity that generates repetitive overload can accelerate this deterioration.

herniated disc

A herniated disc is one of the most common spinal pathologies. It occurs when the nucleus pulposus of the disc is displaced due to wear or tear of the fibrous ring that surrounds it. This can cause irritation of nearby nerves, generating pain in the affected area, which can significantly limit the patient's mobility.

lumbar hernia

Lumbar hernias commonly occur between the fourth and fifth lumbar vertebrae, or between the fifth lumbar vertebra and the sacrum. In this condition, the nucleus pulposus of the disc is displaced by the rupture of the annulus fibrosus, putting pressure on the nerve root, causing pain or sciatica in the lumbar area.

In severe cases, where the hernia compresses multiple nerves, the hernia may develop. cauda equina syndrome, a medical emergency that requires urgent surgical intervention.

Vertebral fractures

This type of pathology occurs when a vertebral fracture occurs, affecting the intervertebral discs (as is the case of L1 fracture). In our specialized traumatology center, patients usually undergo spinal reconstructive surgery to treat this condition.

The most common types include thoracic vertebral fracture and lumbar vertebral fracture, for which innovative techniques such as kyphoplastyThe recovery time for a dorsal and lumbar fracture is 24 to 48 hours for medical discharge, while the consolidation time for vertebral fractures is 8 or 10 weeks, depending on the severity of the patient's condition.

Causes of herniated discs

The most common cause of herniated discs is the natural aging process. As a person ages, the discs tend to dehydrate and weaken, which reduces the space between the vertebrae. For this reason, hernias are common in people over 50 years of age.

The appearance of hernias is usually related to the degeneration of the fibrous ring, which is why it is more frequent in adults. When the fibrous ring deteriorates, the nucleus pulposus of the intervertebral disc can partially or completely come out, causing a herniated disc.

Herniated disc symptoms

Symptoms of herniated discs often manifest as pain in the neck, which may radiate to the back and other areas of the body. This pain is often worsened by coughing, sitting, or standing for long periods of time. It is common to experience tingling or weakness in the leg or foot.

If you suffer from the aforementioned cauda equina syndrome, the symptoms are more severe and can cause loss of bladder or bowel control, leading to incontinence.

In addition, in some cases, a herniated disc can cause myelopathy, which is a compression of the spinal cord that can cause tingling and weakness in various parts of the body.

Diagnosis of intervertebral hernias

There are various tests that can confirm the presence of a herniated disc. Initially, when the patient goes to the doctor, an X-ray is usually performed to rule out other pathologies such as infections, tumors or bone fractures.

Once other types of injuries have been ruled out, an MRI is usually performed, which uses radio waves to provide information about the location of the hernia and whether nerves are affected. A CT scan can also be performed, which uses X-rays to create cross-sectional images of the spine and surrounding structures.

In cases where it is suspected that the hernia may be affecting the nervous system, more complex and specialized tests are performed. One of them is the electromyogram, which, through electrical impulses, assesses the response of the nerves. In this way, it is possible to know if the injury is neurological or not. Another test performed in these cases is a myelogram, in this case, a contrast substance is injected into the cerebrospinal fluid, and then X-rays are performed, which show whether the herniated disc is causing pressure on the nerves or spinal cord.

Herniated disc treatments

When a herniated disc is diagnosed, some patients require surgery. Herniated disc surgery is usually considered after other conservative treatments, such as physical therapy, have been tried without positive results.

In recent years, minimally invasive surgeries have been developed to treat herniated discs. The most common is discectomy, in which part or all of the damaged intervertebral disc is removed. Another intervention is anterior cervical arthrodesis, in which two or more bones of the spine are fused to prevent movement between them and correct certain pathologies such as cervical degenerative disc disease (damaged intervertebral disc), spondylolisthesis or herniated discs with intervertebral degeneration. The anterior cervical arthrodesis operation does not cause sequelae in the patient, and the postoperative period is not painful.

Another procedure is the laminectomy, a procedure in which a part of the vertebra called the lamina is removed. This procedure is usually performed when there is compression of the nerves or spinal cord.

At ICAC, an innovative technique has been launched, called advanced spinal endoscopyA one-centimeter incision is made in the skin through which a high-definition lens is introduced to obtain a high-resolution image of the spinal canal. Using this technique, the damaged disc can be removed and a prosthetic intervertebral disc can be placed.

How to prevent herniated discs

Although herniated discs may have a hereditary component, there are several measures that can be taken to reduce the risk of their occurrence:

• Good postural hygiene:Exertions that put excessive pressure on the spine should be avoided. It is important to try not to adopt postures that force or strain the spine during daily activities, especially when sitting, lifting objects or sleeping.
• Body weight control: Being overweight increases pressure on your lower back, which can weaken your muscles and increase your risk of herniated discs.
• Moderate physical activity: Exercising regularly strengthens the muscles around the spine, especially those in the abdomen and back, which act as support. It is important that the exercises are performed with the correct technique to avoid injuries.
• Regular stretchingStretching helps maintain flexibility and relieve tension in the spine. Incorporating stretching into your routine can improve mobility and reduce the risk of injury.
• Avoid smoking: Smoking negatively affects the health of the intervertebral discs by reducing blood flow to the spine, which can accelerate disc deterioration and increase the risk of herniated discs.

As you can see, it is essential to maintain good posture to avoid back injuries, as well as to go to a specialist if you experience pain. An early diagnosis can be key to avoiding more complex injuries, which require more aggressive treatments. In our clinic specializing in spinal surgery in Madrid we apply minimally invasive microsurgery of the spine. Do not hesitate to contact us. ask for a date so that our specialists can treat your back in the best way.