What is Collapsed Disc?
Written by Neil Badlani, M.D., Chief Medical Officer, North American Spine

Back pain plagues millions of people worldwide, and there is an array of causes that can create persistent pain in the back. One of these is collapsed disc, or degenerated disc. A degenerated disc is a condition that occurs when the discs of the spine lose their normal height through degeneration or loss of the fibrous outer wall. Degeneration can happen as a result of the natural aging process or it can come about as a result of a sudden injury.

Because the intervertebral discs act as a shock absorber in the spine, pain can result when they are not functioning properly. This is because, when the disc collapses, it can cause additional pressure upon the nerve roots which can lead to numbness, tingling, weakness, or pain. However, symptoms This type of diminished disc height is usually common in the cervical and lumbar areas of the spine where the discs are most subject to body weight and a wider range of motion that can induce stress.

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More About Collapsed Disc

lumbar foraminotomy

There are several different factors that can play a part in whether or not a patient develops a degenerated disc. While degenerative disc disease is one of the most common reasons that a disc collapses, it is not the only reason. A patient with a collapsed disc in back or collapsed disc in neck may be experiencing it as a result of a bulging disc or a herniated disc. In all three of these conditions, the integrity of the disc is compromised, and, because of this, the disc can collapse.

If a patient suspects that they have a collapsed disc in back or a collapsed disc in neck, they can receive an MRI and consult with an orthopedic doctor to determine their options. Using an MRI, a doctor can see how the degenerated disc has been broken, and they may even be able to relate it to degenerative disc disease or a number of other disc conditions.

Typically, a degenerated disc is not treated through surgery. In many cases where the disc is caught early enough, physical therapy, as well as medication, can be used to treat symptoms and alleviate pain. In certain cases, however, pain can be long-lasting, and surgery may be necessary in order to restore the quality of life of the patient. This type of treatment can be invasive and medical advice should be sought out before any decisions are made.

What Are the Symptoms?

While a degenerated disc will not exhibit severe symptoms usually. There are circumstances wherein you could experience symptoms. This is normally when the vertebrae become so narrowed that the nerve roots become compressed.

In those cases, patients can be subject to:

  • Weakness of the muscles
  • Numbness or tingling
  • Pain and limited mobility
  • Burning sensation

Given the necessary conditions for a patient to experience symptoms, these signs should be taken seriously. You may be dealing with pinched nerve roots in addition to a degenerated disc. If you begin to notice any of the symptoms above, it may be time to contact your doctor about getting treatment.

How is a Collapsed Disc Diagnosed?

Pain is the first indicator of a bulging disc that needs attention. Once identified, there are typically four steps to the process

Diagnostic Imaging:

A degenerated disc is easily diagnosed with the use of an MRI machine. MRI, or magnetic resonance imaging, is a medical imaging technology that can be used to view the anatomy of the body. When the spine and its vertebrae are viewed in an MRI, the doctor can see the discs and other characteristics that may accompany it. For instance, if the degenerated disc is associated with degenerative disc disease, the doctor may be able to see a darkening of the disc interior and a shrinking of the overall disc space.

In the cases of degenerative disc disease, patients may actually not show any symptoms or signs of the degenerated disc at all. However, in order to see if the degenerated disc is the source of any back pain the patient may be experiencing, a physical exam will need to be performed in addition to a discogram. The discogram, which is an invasive test that uses x-rays to examine the discs of your spine, will help the doctor to determine the disc’s integrity. In this test, a dye is injected into the injured disc, which allows the disc to become visible on the monitor and x-ray film.

What are the Causes of a Collapsed Disc?

low back pain

Degenerated discs can arise as a result of a variety of degenerative conditions. Degenerative conditions are conditions wherein the spine deteriorates as a part of the natural aging process and weakens as time wears on. Examples of these conditions include:

  • Degenerative Disc Disease: This is a condition wherein the discs become weaker and lose water content and, because of this, the discs lose their height and the space that is found between the vertebrae becomes significantly smaller.
  • Herniated Disc: This is a condition that occurs when the interior of the disc pushes through the exterior of the disc. Typically, this happens as a result of aging or injury.
  • Bulging Disc: Bulging discs are similar to herniated discs in that the interior of the disc also pushes out to the exterior. However, in bulging discs, the interior remains contained within the outer layer.

How is a Collapsed Disc Treated?

Conservative Options

Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.

Decompression

Minimally invasive decompression surgery aims to relieve pressure on the nerves of the spine. This pressure is often caused by stenosis, bulging or herniated discs, and more. Relieving this pressure can be achieved by reducing or removing soft tissue (disc material or scar tissue) or bone (bone spurs, a section of the lamina or foramina) to decompress the affected nerve. When the compression is caused by soft tissue material, a surgical laser may be used to shrink the impinging material.

Fusion/Stabilization

Fusion surgeries are similar in goal–to remove damaged disc tissue and fuse the bones together–but differ in approach, including the use of specialized hardware to reinforce stability, and the location used to gain access to the spine. A related procedure is an artificial disc replacement, in which a damaged cervical disc is replaced with a synthetic disc, and the vertebrae are not fused.

How Much Does Treatment Cost?

Treatment cost depends on several factors, especially what insurance you have and how much of your deductible has been met. IN the last two years, 90% of our patients have paid less than $2000 out-of-pocket. Some have paid literally nothing, and other have paid much more than that. It depends. The good news is: our Patient Care Managers will handle as much as they can directly with your insurance company, and all your costs will be known up-front.

Important note: spine surgery often pays for itself within a year or two. Many people actually spend more money trying to live with the pain than they do getting the pain fixed. The following calculator is intended to give you a sense of what you spend on managing—rather than eradicating—your pain.

Calculate how much you've spent on back pain this year.
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This past year you have spent on your pain treatment:

Get surgery now. Getting surgery now is the smartest financial move. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. You’ve spent that much or more this year to manage your back pain than you could to fix it.

Get surgery soon. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. At your current rate, you will spend that much or more within the next two years. The sooner you get treatment, the sooner it will pay for itself.

Keep an eye on your spending. Currently, you are managing your pain efficiently from a financial perspective but over time, your expenses could add up. Surgery should be strongly considered if you start missing more work or spending more on treatment medication.

Great job! You are spending very little on your back pain. Keep it up!

Equipment Used in Diagnosis and Treatment of a Collapsed Disc

In order to treat the pain from a degenerated disc and assist the patient in healing from a debilitating disease such as degenerative disc disease, your doctor may opt for you to receive a spinal fusion. This is a procedure which is meant to stabilize the spine and decrease the mobility of the joint between two vertebrae. Ultimately, this can lessen the pain of the patient and improve their back’s function.

When an interbody fusion is performed, the degenerated disc is replaced with a cage that maintains the proper alignment of the spine to restore the disc to its proper height. The cage also contains harvested bone and additional factors for growth that can stimulate the vertebrae around it to fuse together. The growth factor that is commonly used in these procedures is called bone morphogenetic protein, or BMP.

How Does a Collapsed Disc Compare to Other Spine Conditions?

There are many closely interrelated diseases that affect the vertebrae and discs of the spine. “Collapsed” is one of many terms used to refer to these afflictions. However, there are many others. Among these are:

  • Bulging Disc
  • Herniated Disc
  • Herniated Nucleus Pulposus (HNP)
  • Slipped Disc
  • Disc Extrusion
  • Disc Protrusion
  • Pinched Nerve
  • Compressed Nerve

Many of these terms are interchangeable, but there are some that refer to different conditions altogether. However, one could say that these terms generally deal with the stages of the process of disc herniation. That is, a disc is meant to act as a cushion for the vertebrae by resting between them. It is coated with a protective sac, and when the sac begins to lose its shape, herniation can occur. If the herniation stays with the protective sac that it is found in, it can be called “bulging ” or a “collapsed.” If the disc breaks through its sac, then it is called a “slipped” or “torn” disc.

While a herniated disc that has not broken through the sac is considered to be less severe than those that have broken through, this does not mean that the pain is less significant. Regardless of whether or not the disc has broken through, the disc material itself has the potential to pinch a nerve and cause pain.

Another thing to consider is that many of these different kinds of disc herniations are part of an underlying condition called degenerative disc disease. This means that all of these elements of herniations as well as their causes are all tied together. In other words, degenerative disc disease can lead to a disc that is herniated or a collapsed, and a disc that is collapsed can be a sign of degenerative disc disease.

Analogy: An Old Ladder

Your spinal column is like a ladder, and your intervertebral discs are like rungs. A good ladder must support your body weight at every step. The same is true of the spine. When discs collapse, your ladder—your spine—is not sufficiently supported. The result is pain and, in some cases, instability.

Surgery will focus on removing damaged parts of your disc and restoring the stability of your spine, if possible.

Good Latter

Bad Ladder

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