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Orlando Magic Center Dwight Howard’s Season Is Over

The Orlando Magic received devastating news today: center Dwight Howard will be undergoing back surgery for a herniated disc.  When will he be back?

ANATOMY

The spine is made up of vertebral bodies that make the vertebral column.  In the neck (cervical) region, there are 7 bones, in the back (thorax) region, there are 12 bones, and in the lower back (lumbar) region there are 5 bones.

Each bone interacts in a complex manner with the bone above and beneath it. Furthermore, the spinal canal is home to the spinal cord.  Throughout the length of the spinal cord, nerves (known as nerve roots) come off the cord to provide function to that level of the body.

In addition, between the bones are cushioned disks, known as vertebral discs, which act as shock absorbers along the length of the vertebral column. The intervertebral disc acts as a shock absorber for the spine.  It is made of two parts: a soft inner core and a tougher fibrous outer wall.  Finally a series of ligaments and muscles attach to the bones to provide stability and flexibility to the spine.

CAUSES

Herniated discs can occur for a number of reasons.  Most disc herniations occurring in the lower back occur with the normal aging process.  People who perform a lot of bending and twisting activities are at particular risk.  However, traumatic herniations are also possible.

In a disc herniation, small tears develop in the tough outer wall of the disc.  Damaged pieces of the soft inner core bulge through the tear and out of the disc wall.  This part of the disc bulges into the spinal canal.  It can then push on the nerves.

SYMPTOMS

In the lower back, depending on the location of the herniation, the pressure on the nerve can cause pain, numbness, tingling, and loss of strength into one or both legs and feet, or even the buttocks region.  Some time bowel and bladder incontinence can develop, in a condition called cauda equina syndrome.

WHEN TO SEEK MEDICAL CARE

If you have pain shooting in to the legs or feet with associated weakness that does not improve, you should seek the care of a health care provider.  If you develop symptoms of cauda equina syndrome, you should seek help emergently.

A thorough physical exam, xrays, and often an MRI is needed to evaluate the spine.

 

TREATMENT

Most disc herniations are minor and can often be treated without surgery.  Anti-inflammatories, steroids, physical therapy, back supports, and epidurals can help relieve symptoms.

Surgery is considered for larger herniations, for patients whose pain does not improve or worsens.  In surgery, the herniated part of the disc is removed to decompress the nerve (discectomy).  If this is done through a small incision, it is known as a microdiscectomy.  Sometimes, a part of the vertebral bone, known as the lamina, may need to be removed as well.

OUTCOMES

Most individuals are able to return to activities with associated pain relief.  This can take up to two years to occur.  Furthermore, at times, the disc can herniate again.

RETURN TO ACTIVITIES

With a microdiscectomy, Howard can take up to 4 to 6 months to return to sporting activities.

Dr. P

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All material published through this blog/website is for informational and entertainment purposes only. Readers are encouraged to confirm the information contained herein with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by physicians. Dr. Parekh and Duke University will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising from the discussions in this blog.   For more information on the North Carolina Orthopaedic Clinic, go to: http://www.ncorthoclinic.com/  For more information on Duke Orthopaedics, go to: http://www.dukehealth.org/orthopaedics

Locations

  • N.C. Orthopaedic Clinic
  • Durham Regional Hospital
  • Davis Ambulatory Surgery Center
  • Duke Hospital North
  • Duke Ambulatory Surgery Center

(919) 471-9622

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