Herniated Disc
A herniated disc is the displacement of nucleus pulposus material through a tear in the annulus fibrosus of an intervertebral disc. The extruded material may impinge on spinal nerve roots or the spinal cord itself, producing radicular pain, sensory disturbance, and motor deficits corresponding to the compressed neural structures.
Understanding Herniated Discs
Intervertebral discs serve as the spine's shock absorbers — gel-filled cushions between the vertebral bodies that distribute load and permit motion. Each disc has a tough outer ring (annulus fibrosus) and a soft gelatinous centre (nucleus pulposus). When the annulus tears — typically from a combination of age-related degeneration and acute loading — the nuclear material can extrude through the defect. The extruded fragment may lie directly under or migrate away from the disc space, compressing the nerve root or cauda equina. Lumbar disc herniations most commonly occur at L4–L5 and L5–S1, affecting the L5 and S1 nerve roots respectively. Cervical disc herniations typically involve C5–C6 and C6–C7, affecting the C6 and C7 nerve roots.
While many disc herniations resolve with conservative management, persistent or severe radicular symptoms, motor weakness, or cauda equina syndrome require surgical intervention. Istanbul's spine surgeons perform high-volume microdiscectomy procedures with outcomes comparable to leading Western centres at a fraction of the cost.
Treatment Options for Herniated Disc
View All ProceduresSymptoms of Herniated Disc
The cardinal symptom of lumbar disc herniation is sciatica — a sharp, shooting pain radiating from the buttock down the posterior or posterolateral thigh and leg, following the dermatomal distribution of the compressed nerve root. L4 compression produces pain in the anterior thigh and medial leg; L5 compression radiates to the great toe; S1 compression radiates to the lateral foot. Sensory changes (numbness, tingling) and motor weakness (foot drop for L5, plantar flexion weakness for S1) accompany the pain. Cauda equina syndrome — a surgical emergency — presents with bilateral leg pain and numbness, saddle anaesthesia, urinary retention or incontinence, and loss of anal sphincter tone. Cervical disc herniation produces neck pain with radiation down the arm (brachialgia), with corresponding dermatomal sensory and myotomal motor deficits.
Diagnostic Pathways
MRI of the spine is the definitive imaging study, demonstrating the level and type of disc herniation (protrusion, extrusion, sequestration), the degree of spinal canal or neural foraminal compromise, and the relationship of the herniated fragment to the affected nerve root. CT myelography is an alternative for patients with MRI contraindications. Electromyography and nerve conduction studies (EMG/NCS) can confirm the affected nerve root level and exclude peripheral neuropathy or other mimics. Plain radiographs are not diagnostic for disc herniation but are useful for assessing spinal alignment and stability.
Advanced Treatment Options at Vellum Select
Microdiscectomy
For patients who fail 6–8 weeks of conservative treatment, Spinal Surgery in Turkey offers microdiscectomy — the gold-standard surgical treatment. Under microscopic magnification, the herniated fragment is removed through a small incision with minimal disruption of the paraspinal muscles. The procedure is performed under general anaesthesia with typical hospital stay of 24 hours. Immediate relief of radicular pain is achieved in over 90 per cent of patients. Cervical disc herniations are treated with anterior cervical discectomy and fusion (ACDF) or cervical disc replacement.
To discuss your herniated disc with a Vellum Select spine specialist, contact us to arrange a consultation.