I am an 18 y/o female, about a 1.5 years ago I was involved in a car accident(I was rearended by two cars at a complete stop). And after 1.5 years with no diagnosis I recently found out I have a cerivcal herniation at C5/6, thoracic herniation T9/10,annular injury and protrusion at C6/7, annular bulging at T7/8 and other cervical bulging discs.The doctor told me me they didn't understand how all of that can missed fo so long after seeing more than 10 doctors and having more than 6 MRI'S. The doctor also told me the thoracic region is the risky place to operate because they can accidently puncture my lungs during surgery and it is very uncommon to have thoracic herniations.Since most of the pain is mid back I AM VERY MUCH considering thoracic surgery. I was wondering if there are any new less invasive surgeries available for a thoracic herniated disc? Also what is the difference between an annular injury and protrusion and a regular bulging disc? Will I be at a predisposition for degenerative spine disorders? Any advice will be greatly appreciated.
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to obtain a history from you and examine you, I can not comment on whether or not you need surgery for your disc. however, I will try to provide you with some information regarding this matter.
Our spinal column consist of verebral bones, the body of which are separated by a gelatinous type of substance. When this substance either (slips/squeezes out) between the two bones, this is a herniated disc. When the gelatinous substance sort of breaks down and thins, this is dessication. When only fragments of the material slips out through little fissues in the outer layer called the annular ligament (a surrounding tissue), this is termed a disc protrusion. Finally, spondylosthesis is when the verebtral bones themselves slide past each other.
One of the most important questions to answer when considering back surgery is, are the problems seen ON IMAGING the actual cause of the chronic low back pain. A spine surgeon will help answer this question; one should be aware that even with extensive abnormalities on spine imaging, this does not imply a surgical intervention will be helpful.
Disc buldges are not uncommon and sometimes cause pain but are otherwise of little neurologic consequence; they may not cause problems in the motor or sensory function of our nerves unless they press on them.
A complete trial of non-surgical therapy is always advisable before surgery is entertained as an option. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muslce relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications.
Thoracic disc surgery has traditionally been thought to be of higher risk than disc surgery in other areas, however with newer techniques the complication rate has improved. The operative approach for discectomy in the treatment of thoracic disc disease has changed from standard laminectomy to a variety of different approaches. Some of the complications are related to the age of the patient and pre-existing conditions. For example, spinal instability is more likely if the patient has pre-existing osteoporosis. Certain complications such as infection at the surgical site, lung problems, and CSF leaks (leaking of spinal flui from around the area of surgery) can occur regardless of the technique used but is obviously less with some than others. These are concerns that it would be best for you to discuss with your surgeon.
Spine surgeons can be orthopedic specialists or neurosurgeons. In looking for an opinion from a surgeon, it is obviously important that you select a surgeon specialized in spine surgery. Several larger centers in the USA have dedicated spine centers.
Thank you for using the forum I hope you find this information useful good luck.
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