Dr. Robert Berkowitz, Lorain County, Ohio’s only orthopedic spine surgeon, specializes in treating conditions involving the neck and back—especially patients who have symptoms in their arms and legs as a result of spine conditions.
Statistics show that about one in four people with back pain is suffering from a herniated disc. Your spinal discs are essentially shock absorbers between the vertebrae in your neck and back. When one of these discs ruptures and its filling starts to leak, it can lead to chronic pain, not only in your back, but radiating down your arms or legs.
Dr. Robert Berkowitz answers questions about herniated discs
What is a herniated disc?
“A herniated disc—also known as a slipped, ruptured or prolapsed disc—is a rupturing of the tissue that separates the vertebral bones in your spine. This occurs when the outer layer of the disc, or annulus, ruptures, allowing the crabmeat-like filling or nucleus of the disc to leak out.
“If the disc is not pressing on a nerve, you might have pain in your neck or back. But often, the disc filling impinges on sensitive nerves in the neck or back, causing pain, weakness or numbness that can radiate down your arms or legs. When the disc’s filling irritates the sciatic nerve that runs down the back of the leg, the condition is known as sciatica.”
How do you diagnose a herniated disc?
“Sometimes the symptoms of a herniated disc are hard to distinguish from those of other back problems. That’s why I will give you a head-to-toe, complete musculo-skeletal, neurologic exam.
“I’ll also ask you questions about your pain—when it started, what makes it feel worse, what makes it feel better, whether you have numbness, pain or tingling down your arms or legs. I’ll want to know whether you’ve had this problem before—and if so, which types of treatment you had and how well they worked for you.
“Then we’ll use imaging—X-rays and possibly an MRI. I’ll review your images and come up with a diagnosis and treatment plan.”
How do you typically treat a herniated disc?
“I will do everything I can to try to treat your condition non-surgically. Almost always, my recommendation is a non-operative treatment plan involving physical therapy, injections, chiropractic care, acupuncture and other non-surgical treatments to try before considering surgery. Most people get better with the non-operative treatment plan.
“If non-surgical treatments don’t work for you and you need surgery, you can be assured I will use the latest operative techniques and technology to help you.”
Can a herniated disc get better without surgery?
“Yes. Without treatment, 90% of herniated discs get better over the course of two years. What we’re trying to do with chiropractic care, acupuncture, or injections or even physical therapy is to try to buy time, which might help the body fix the problem without surgery. These conservative treatments can help make you comfortable while the body is healing itself.”
So why operate on a herniated disc?
“We operate on herniated discs when patients are in excruciating pain and can’t wait two years for the body to heal itself. They have terrible, burning, searing pain down their arm or leg, and they want to get back to work. These patients are not willing to wait a year or two, so we operate on them and take the pain away immediately.
“I tell my patients, ‘You might be one of the 90% whose herniated disc heals by itself in two years—or you could be one of the other 10%. So if we wait two years and you’re not any better and still need surgery, we will have wasted two years of your life.’”
Can a herniated disc lead to more serious problems?
“Yes. In extremely rare cases, the ruptured disc filing can squeeze a bundle of nerve roots at the base of the spine. When this happens—resulting in a condition known as cauda equina syndrome—patients may experience bowel and bladder problems as well as a loss of sensation in the lower pelvic area and legs. Surgery is necessary to relieve cauda equina syndrome in an effort to regain normal nerve function.”
What kind of neck disc surgery do you perform?
“I perform two neck disc procedures. They’re both essentially the same surgery—the difference is what we’re putting in the disc space.
- The conventional operation is called an anterior cervical discectomy and fusion. This procedure puts a new piece of bone in the space where the disc used to be and fuses that level of the spine.
- Neck disc replacement surgery is a state-of-the-art procedure that puts a new, artificial disc in to replace the damaged disc. There is no need for spinal fusion with this surgery, which helps preserve the range of motion in your neck.
“Everything else about the two procedures is identical.”
What kind of back disc surgery do you perform?
“I perform microdiscectomy—a state-of-the-art, minimally invasive surgical technique to alleviate the symptoms of a herniated disc.”
How is a microdiscetomy performed?
“When a patient has a herniated disc, microdiscectomy takes away a small portion of the lamina—the bone that covers the back of the spinal canal. This allows us to get down to the disc and remove the part that’s herniated. After a microdiscectomy, patients typically experience rapid relief of their arm or leg symptoms.”
How fast is the recovery from a microdiscectomy?
“Each patient’s recovery is unique and depends on a number of factors. The typical person with a sedentary job can expect to return to work a week or two after microdiscetomy. If you have a more active profession, you will probably need more time off work.”
Call 440.329.2800 for an appointment today.