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When a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out beyond the damaged outer rings, the disc is said to be herniated. Disc herniation is frequently associated with age-related degeneration of the outer ring, known as the annulus fibrosus, but is normally triggered by trauma or straining ...
A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. When doctors and patients refer to "torn cartilage" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Menisci can be torn during innocuous activities such as walking or squatting.
Articular cartilage does not usually regenerate (the process of repair by formation of the same type of tissue) after injury or disease leading to loss of tissue and formation of a defect. This fact was first described by William Hunter in 1743. [1] Several surgical techniques have been developed in the effort to repair articular cartilage defects.
CT scan image of large herniated disc in the lumbar spine. Removal of a disc at one level can lead to disc herniation at a different level at a later time. Even the most complete surgical excision of the disc still leaves 30–40% of the disc, which cannot be safely removed. This retained disc can re-herniate sometime after surgery.
The second disc replacement to achieve wide clinical use was the prodisc total disc replacement; it continues to have worldwide use today. Designed by French orthopedic spine surgeon Thiery Marnay, M.D., in the late 1980s, early implantations of the prodisc device began in 1990, with a 7-11 year follow-up published in 2005.
The MSU Classification for herniated discs uses the proximity of the disc to the facet joint when measuring the size of a herniated disc. [7] Using the MSU Classification, a grade of 1, 2 or 3 can be used to describe the size of a herniated disc with 1 being the least severe and 3 being the most severe.
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A herniated disc can compress spinal nerves and cause intense pain and impaired sensation. [4] Removing a portion of the lamina allows physicians to be able to access and repair the herniated disc. Laminotomies may also be used to treat intraspinal lesions such as spinal tumor or problems with the blood vessels supplying the spinal cord. [4]
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