Neurologists treat disc sequestration based on the symptoms the patient is experiencing and the results of imaging studies. This type of disc herniation commonly occurs in the neck (cervical) or the lower region of the back (lumbar). Physicians may suggest non-surgical treatments and therapy. The severity of this type of disc herniation and the likelihood that the condition will not be reversed, often results in surgical intervention. Modern technology provides surgeons with the equipment necessary for performing disc correcting procedures that are less invasive than those in the past.
Left untreated, herniated discs deteriorate, progressing to a torn or ruptured state in which the disc loses some of the internal gel-like substance known as the nucleus pulposus. This advanced condition is what is known as disc sequestration. The rupture not only reduces the much needed cushion between vertebrae, but can cause the gel to disperse into the space between the vertebra and the sensitive nerves of the spinal column. This can cause a variety of symptoms that may include numbness and tingling, varying degrees of pain, limb weakness or loss of reflexes. Inflammation and swelling commonly follow the original irritation.
Non-surgical treatments for this condition may include alternating cold and hot applications, taking over-the-counter or prescription non-steroidal anti-inflammatory (NSAID) medications. Neurologists might also administer anesthetic/corticosteroid injections directly into the affected area. The anesthesia provides immediate pain relief while the steroid produces long term anti-inflammatory effects. Physicians sometimes suggest physical therapy to improve muscle strength around the affected region. Strengthening the weaker muscles allows the tighter muscles to relax, which improves spinal alignment and reduces pressure on the herniated disc.
When non-surgical treatment or lifestyle changes do not provide sufficient improvement of disc sequestration symptoms, physicians often recommend some type of decompression surgery. Common surgical procedures used to treat disc sequestration correction include disectomy or microdisectomy. Surgeons typically perform disectomy procedures with the patient under general anesthesia. After making a small incision of around 3 centimeters in length, they access the affected area by dissecting the muscle and tissue until arriving at the specific location. They then remove the exposed nucleus pulposus and perhaps part of or the entire ruptured disc, after which they fuse the two vertebrae together. Spinal fusion causes immobility in the area of the fusion, which may later prove stressful to other areas of the spine.
Another treatment for disc sequestration includes the minimally invasive procedure known as a microdiscectomy. Through a smaller incision than is used for disectomy and using microscopic or fluoroscopic instruments, surgeons remove the displaced gelatinous mass and part of, or the entire ruptured disc. Physicians may perform this procedure using either local or general anesthetic.