One painful and sometimes debilitating back injury that may result when you’ve been rear-ended in a car accident is a herniated disc. The most common location for a disc herniation is the lower back (lumbar spine).
What is a Herniated Disc?
The bones, or vertebrae, that form the spine are cushioned by small discs of spongy material. The purpose of the disc is to act as a shock absorber for the spine and keep it flexible. When a disc is damaged when you are hit in an accident, it may bulge or rupture. This commonly happens when the car you are in is hit from the rear. This is called a herniated disc or ruptured disc.
Symptoms of a Herniated Disc
A herniated disc often presses on a nerve, causing pain, numbness, and weakness along the path of the nerve. A herniated disc in the lower back can cause pain and numbness in the buttock and down the leg along the sciatic nerve. This is called sciatica and is the most common symptom of a herniated disc in the lumbar or lower spine.
Sometimes, though not commonly, a person may experience weakness or numbness in both legs along with loss of bladder or bowel control. This could be a sign of a rare but serious problem called cauda equina syndrome, which requires immediate medical attention.
Treatment for a Herniated Disc
Usually your doctor will start with conservative treatments for a herniated disc in the lumbar spine, including icing, hot compresses, NSAIDS, steroid injections, and physical therapy. Unfortunately these treatments do not always work, and surgery may be necessary, usually a lumbar fusion.
What is a Lumbar Fusion Surgery?
Lumbar spinal fusion surgery is designed to stop pain in the segment of the lower back where the herniation is by eliminating motion in that area. Lumbar spinal fusion surgery, involves adding bone graft to the damaged area of the spine. The graft can be taken from the hip during the spine fusion surgery, harvested from cadaver bone, or the surgeon can use a manufactured synthetic bone graft substitute.
This sets up a biological response that stimulates the bone graft to grow between the two vertebrae, fusing them together to prevent movement at that part of the spine.
Lumbar spinal fusion surgery is most effective when only one vertebral segment is involved. A one-level spinal fusion usually doesn’t cause a noticeable limitation of motion. Sometimes two-level fusion involving fusing two vertebrae may be required. In the most serious cases a three level fusion may be necessary, but this is generally avoided.
What Comes After Surgery?
Following the surgery you’ll need to rest and take anti-inflammatory medications. After several days, you’ll get out of bed and walk for short periods. From there you’ll progress to light stretching exercises and then to a course of physical therapy to help restore your range of motion and strengthen the muscles that support the back.
Lumbar fusion is major surgery and you should expect to be out of commission for a while. Your commitment to working with your physical therapist will be important in determining how quickly you will recover from the surgery.