Herniated Disc Video Series

In this video, Dr. Timothy Kuklo, a spine surgeon, gives a brief overview of herniated disc. In simple, easy-to-understand language, Dr. Kuklo will help you understand why some discs herniate.

To understand herniated discs, it helps to imagine your intervertebral discs—the cushions in between your vertebrae that help you move—as jelly donuts. In a jelly donut, there’s the jelly in the middle: That’s the nucleus pulposus. The tougher, more solid part of the donut holds in the jelly: That’s the annulus fibrosus in your intervertebral disc. When a disc herniates, it’s just like when you squeeze the jelly donut.  The jelly can come squirting out through the donut.

When a disc herniates, the nucleus pulposus pushes out of the central part and into the annulus fibrosus, as Dr. Kuklo explains in the video.

To learn more, you can read this informative summary article on herniated discs.

Dr. Timothy Kuklo, a spine surgeon, explains the typical symptoms associated with a herniated disc.

If the herniation is in your low back (lumbar spine), you’ll have low back pain. (Dr. Kuklo focuses on low back disc herniations, although you can also herniate or rupture a disc in your neck, which is called your cervical spine.) A herniated disc can also cause pain in your legs, in addition to other leg symptoms, such as numbness or tingling.

To learn more, you can look over this helpful article about symptoms of a herniated disc.

To help you understand the causes of sciatic pain, SpineUniverse brought in Dr. Timothy Kuklo, a spine surgeon.  In this video, he goes over the typical causes of a herniated disc.

Sometimes, you can't pinpoint an exact moment when you herniate a disc.  You don't remember any sudden movements that instantly caused pain, but still—you quite clearly have pain from a herniated disc.  Dr. Kuklo points out that most often, a herniated disc has been going through a degenerative process.  He means that as we age, our bodies inevitably change and age with us, and that includes our spines.  As we grow older, our intervertebral discs can become thinner and more likely to herniate.

If you want to read more, try this article about the causes of a herniated disc.

Before your doctor can diagnose a herniated disc and develop a treatment plan, he or she will have to run a series of exams and tests.  In this video, Dr. Timothy Kuklo, a spine surgeon, explains those exams and tests in clear-cut language.  He'll help you really understand what is going to happen to you during the diagnosis process (or maybe you’ve already been through that process but still don't entirely understand what happened).

Dr. Kuklo explains what the doctor is looking for when he or she does a physical exam, plus he talks about why a tension sign helps diagnose a herniated disc.  He says if you experience a sudden onset of pain in an extension position (arching your back), that's a good indication that you have a herniated disc—and that tugging sensation of sudden pain is called the tension sign.  (The tension sign is also called the straight leg raising sign because while seated or standing, the doctor will have you bend backwards slightly while trying to raise your leg.)

Finally, he discusses imaging tests the doctor may do.  He mentions x-rays and says that they'll probably be taken from the anterior and lateral views; that means they doctor will get a front view (anterior) and a side view (lateral).  Dr. Kuklo also talks about MRIs and myelograms.

You can also read an article on herniated disc exams and tests.

Dr. Timothy Kuklo, a spine surgeon, talks about the non-surgical treatment options for a herniated or bulging disc.  Conservative treatments are always tried first, except in the most severe cases (where you develop, for example, cauda equina syndrome, which is a surgical emergency.  With cauda equine syndrome, the bundle of nerve roots at the end of your spinal cord is compressed, cutting off sensation and movement below that point.).

Dr. Kuklo says that he likes to think of non-surgical treatments as a graduation of modalities:  you work your way through the treatments, seeing what works and going to the “next level” is your symptoms aren’t reduced.  He discusses rest, anti-imflammatories, physical therapy, and injections.

He also notes that time can help reduce the pain from a herniated disc.  Over time, the herniation won’t heal itself (the nucleus pulposus won’t pull entirely back into the center of the annulus fibrosus), but the symptoms can lessen.

As a top spine surgeon, Dr. Timothy Kuklo is a trustworthy source when it comes to reviewing your surgical options for a herniated or bulging disc.

In this video, Dr. Kuklo mentions that the most common surgery is a discectomy, which is a removal of the disc material that’s pushing on your nerve.  This can be done with a minimally invasive procedure, and Dr. Kuklo explains some of the techniques surgeons use in those procedures.

Sometimes—but not very often, according to Dr. Kuklo—a patient will need a spinal fusion along with a discectomy.  The fusion will help stabilize your spine, and it’s used for large disc herniations where a major portion of the disc has to be removed.

You can also read this article about other surgical options for herniated discs.

Dr. Timothy Kuklo, a spine surgeon, goes over some terms you may hear your doctor use as he or she talks about herniated or bulging discs.  Use this video as a quick reference or refresher to help you more fully understand your condition.

Dr. Kuklo reviews:

• Annulus fibrosus
• Nucleus pulposus
• Prolapsed disc / Bulging disc / Slipped disc / Herniated disc
• Discectomy
• Microdiscectomy
• Radiculopathy