Breakdown of Herniated Disks

[JPM]

Owner Jerry Jones isn’t ready to give up hope, either.

“All I’m saying is he has back spasms, symptoms that we’re treating as we go along in the week to see if he will play,” Jones said late Monday evening. “There is nothing structurally that will rule him out if he feels good and is cleared to play. Nothing.”

I'm holding out hope too.

 

[Tabascocat]

Thanks for this post, dexter.
I'm curious why you didn't complete medical school? If it's not too private, do you mind sharing? If not, I understand.
Thanks.

Passion wasn't there for it. I liked the research aspect more, i.e. genetic or chemistry. I still had about 8-10 more years until I could do my own thing after residency, internship and specialization training.

Since my wife is in the field, I constantly heard docs complain and moan on the state of medicine and how it will get worse. More work, less pay, brink of socialization, etc. Several MD's that we knew quit and went on to do other ventures. If I was going to quit, that was the time since I wasn't in too far yet.

Looking back, should have just went the RN route. They will always have work and make good money.

 

[SDCowboy]

The doctor they had on ESPN essentially said Romo will in all likelihood be 100% in 3-4 months.

 

[Tabascocat]

Several points in this post are erroneous.

Herniation is rupture of the outer fibrous ring (annulus fibrosus) which then causes extrusion of the inner gelatinous material (nucleus pulposus).
Rupture and herniation are identical, and this is not caused by swelling, but by degeneration or trauma.

Herniation certainly distorts the anatomy locally, but there is not necessarily nerve root entrapment. The gelatinous material eventually reabsorbs, and discomfort from that pressure resolves. Steroids and non-steroidal anti-inflammatory medication help to resolve the swelling and subsequent pressure, but do not bring about healing. Steroid injections are likely to reduce swelling and pressure rapidly - within hours to days, and local anesthetic injections are effective immediately.

The serious consequence of of a tear (or herniation) of the outer fibrous ring is displacement of the fibrous material in such a way to cause direct entrapment of a spinal nerve, which results in significant pain and and dysfunction along the entire path of the nerve. If there are no radiating neurological symptoms, then there is no nerve entrapment, and the injury is not serious and requires no surgery. Furthermore, even passive range of motion may displace a fibrous component which is compressing a nerve, causing the nerve to then be decompressed and relieving the neuropathy.

An MRI shows the details of this anatomy, and no further testing is needed if there are no significant distal nerve symptoms (radiculopathy).

So, it is feasible that such an injury may NOT require surgery or even be very limiting within a few days of its occurrence. You or your quarterback may be able to carefully go back to work.

Cliff notes Doc, cliff notes. Like I said, I only have book experience in this area with minimal clinical exposure. Was trying to not get too technical with terms.

As for the MRI, it is sufficient and I mentioned some other tests that can be done(if needed). Just outlying options here for anyone with this injury, not just in Romo's case.

 

[xwalker]

Several points in this post are erroneous.

Herniation is rupture of the outer fibrous ring (annulus fibrosus) which then causes extrusion of the inner gelatinous material (nucleus pulposus).
Rupture and herniation are identical, and this is not caused by swelling, but by degeneration or trauma.

Herniation certainly distorts the anatomy locally, but there is not necessarily nerve root entrapment. The gelatinous material eventually reabsorbs, and discomfort from that pressure resolves. Steroids and non-steroidal anti-inflammatory medication help to resolve the swelling and subsequent pressure, but do not bring about healing. Steroid injections are likely to reduce swelling and pressure rapidly - within hours to days, and local anesthetic injections are effective immediately.

The serious consequence of of a tear (or herniation) of the outer fibrous ring is displacement of the fibrous material in such a way to cause direct entrapment of a spinal nerve, which results in significant pain and and dysfunction along the entire path of the nerve. If there are no radiating neurological symptoms, then there is no nerve entrapment, and the injury is not serious and requires no surgery. Furthermore, even passive range of motion may displace a fibrous component which is compressing a nerve, causing the nerve to then be decompressed and relieving the neuropathy.

An MRI shows the details of this anatomy, and no further testing is needed if there are no significant distal nerve symptoms (radiculopathy).

So, it is feasible that such an injury may NOT require surgery or even be very limiting within a few days of its occurrence. You or your quarterback may be able to carefully go back to work.

Thanks.

I've seen some MRI studies of this issue when I was designing medical imaging equipment. In layman's terms, I would describe it as a jelly doughnut (donut) where the jelly is coming out at some spot.

My understanding is that the location on the doughnut is significant. If it is more on the inside of the doughnut, then there is a good chance that it is pushing against something; whereas, if it is more on the outside of the doughnut, then there might not be anything (nerve, etc.) to push against.

 

[khiladi]

Herniated disks can easily heal, provided one maintains proper posture and doesn't resort to bad habits that caused it in the first place.

 

[Doc50]

Thanks.

I've seen some MRI studies of this issue when I was designing medical imaging equipment. In layman's terms, I would describe it as a jelly doughnut (donut) where the jelly is coming out at some spot.

My understanding is that the location on the doughnut is significant. If it is more on the inside of the doughnut, then there is a good chance that it is pushing against something; whereas, if it is more on the outside of the doughnut, then there might not be anything (nerve, etc.) to push against.

The nerve roots are located bilaterally, so a lateral herniation would be more likely to be problematic, as opposed to an anterior or posterior herniation.

 

[SportsGuru80]

I don't want to see Romo get further injured. For the long term success of this team they need to put him on the shelf and wait for next season. Kyle Orton it's your turn bruh!

 

[Smith22]

According to multiple sites, he got an epidural. Will evaluate in a few days.

 

[TheDude]

Herniated disks can easily heal, provided one maintains proper posture and doesn't resort to bad habits that caused it in the first place.

Like sports

Core training is inportant

 

[tyke1doe]

Passion wasn't there for it. I liked the research aspect more, i.e. genetic or chemistry. I still had about 8-10 more years until I could do my own thing after residency, internship and specialization training.

Since my wife is in the field, I constantly heard docs complain and moan on the state of medicine and how it will get worse. More work, less pay, brink of socialization, etc. Several MD's that we knew quit and went on to do other ventures. If I was going to quit, that was the time since I wasn't in too far yet.

Looking back, should have just went the RN route. They will always have work and make good money.

Thanks, Dexter. Yeah, I hear RNs are in short supply and heavy demand. My son's baseball coach is a critical care RN, and he ranks in the dough, from what I've heard.

 

[tyke1doe]

Thanks.

I've seen some MRI studies of this issue when I was designing medical imaging equipment. In layman's terms, I would describe it as a jelly doughnut (donut) where the jelly is coming out at some spot.

My understanding is that the location on the doughnut is significant. If it is more on the inside of the doughnut, then there is a good chance that it is pushing against something; whereas, if it is more on the outside of the doughnut, then there might not be anything (nerve, etc.) to push against.

That was a very good analogy. I wish more medical people would break stuff down in regular, everyday language when they explain to non-medical people.

 

[Dodger12]

According to multiple sites, he got an epidural. Will evaluate in a few days.

He's having a baby? This thing is worse than we all thought.......

 

[sureletsrace]

My L4/L5 is ruptured. It's misery. Without heavy painkillers, I can barely move or breathe. And I'm too young of any neurosurgeon to be willing to do surgery. I'm basically stuck with pain management. I feel for the guy.

 

[bark]

I don't know how many more yrs tony had before this back injury... I see Brady and manning still doing it and both are a few yrs older.
I am a bit concerned about his future. His escape ability has been a big part of his game all these yrs.
I don't remember exactly what issue Larry bird had with his back, but I remember he injured it working on his mothers driveway and it worsened quickly thru the yrs and eventually caused him to hang it up.... Not saying they are the same injury but that's what came to mind.....

 

[BoysFan4ever]

My L4/L5 is ruptured. It's misery. Without heavy painkillers, I can barely move or breathe. And I'm too young of any neurosurgeon to be willing to do surgery. I'm basically stuck with pain management. I feel for the guy.

Wow. So sorry.

 

[CT Dal Fan]

If I recall correctly, didn't Troy Aikman have some kind of back procedure done in 1993 after his first Super Bowl win? He came back fine from that, and his back didn't really give him any more problems until his final season in 2000.