DISC EXTRUSION SYMPTOMS

March 18, 2021 Nicholas Lancaster

Disc Extrusion – Symptoms

When the outer wall of an intervertebral disc becomes torn, or if the layers within the wall begin to separate because of external pressure or general deterioration, the small nerves located within the outer layers of the disc can begin to send pain signals to the brain. This is known as discogenic pain, and it can accompany any of the three main types of outer wall rupture:

Rim lesion – a tearing of the outer wall fibers near the vertebral endplates, potentially the result of the disc being punctured by a bone spur on the edge of a vertebra
Concentric tear – a splitting apart of the lamella, or layers, of the outer wall
Radial tear – a horizontal rupture that typically originates on the inside of the disc and proceeds outward through the many layers of the disc wall

Discogenic pain might only be an early sign of more serious problems to come. If the nucleus material begins to leak into the epidural space surrounding the spinal cord and nerve roots, it can produce symptoms that can potentially have a much more adverse effect on the quality of life. This phenomenon is known as nerve compression if nerve roots are involved, and cord compression if the spinal cord is “pinched” by the extruded or sequestered nucleus material. The symptoms produced by nerve compression are known as radiculopathy, or neurogenic symptoms. They can include:

Localized pain at the site of the compression
Pain that radiates along the length of a compressed nerve
Tingling or numbness in an area of the body innervated by the compressed nerve
Weakness or a loss of functionality in a muscle group innervated by the affected nerve

These symptoms might be constant, or they might only occur when the spine moves in a particular direction, or the body is held in a particular posture. In most cases, radiculopathic symptoms are felt only on one side of the body or the other – rarely on both sides. This is based on which side of the disc the extruded nucleus material makes contact with the adjacent nerve root.

Another factor that determines which areas of the body experience symptoms are the location of the nerve or cord compression on the vertical axis of the spine. In general, compression that occurs in the neck region will affect the head, upper back, neck, shoulders, arms, hands, and fingers. When a nerve within the lumbar region is compressed, symptoms may be experienced in the lower back, buttocks, upper and lower legs, feet, and toes.

In very rare cases, spinal cord or nerve root compression can constitute a medical emergency that requires immediate treatment due to these severe symptoms:

Loss of motor skills in the hands, a stumbling gate, or paralysis if the spinal cord is compressed by a cervical (neck) disc extrusion
Bowel and/or bladder dysfunction or numbness in the groin area if the cauda equina nerve root bundle is compressed by a disc extrusion in the lower back

Back or neck pain is typically classified as either acute or chronic. Acute symptoms are those that are sudden, but may last a defined period of time – usually less than a month. Chronic symptoms might arise gradually, but lasts longer (more than a month) and are more likely to become debilitating over time. The time to see a doctor about symptoms that potentially could be related to a disc extrusion is as soon as possible after the first instance of pain or other discomforts.

At AOMSI diagnostics, we provide the most accurate spinal imaging available in the healthcare marketplace. This imaging has been proven in peer-reviewed medical journals to be the most accurate, reliable, and specific spinal imaging when compared to traditional spinal imaging modalities. Often times we are able to expedite pre-authorizations for surgery or even overturn denials for spinal surgery after the VMA study is presented to insurance.