What is a Fragmented Disc and how is it Different from Disc bulge, herniation, Protrusions or prolapse?
A fragmented disc is a serious spine condition where a portion of the spinal disc is torn and separated. A fragmented disc is also called a sequestered disc or a chipped disc. There are two types: partially fragmented disc or fully fragmented disc. With the full fragmentation, the isolated or broken part migrates or becomes a free-floating tissue within the spinal canal.
The fragmented disc also called sequestered disc, or free-disc fragment is a description of pre-existing milder forms spinal disc issues that have progressed. In other words, fragmented discs are neglected spinal disc issues. Typically a neglected disc bulge or disc herniation progresses to the fragmented stage. For better understating we have listed the order or spinal disc disorders from the initial stage to the fragmented or sequestered stage for your review below:
What Are the Root-Causes of Spinal Disc Damage and Disorders as seen in Disc Fragmentations?
The root-cause of spinal a disc disorder is an increased intradiscal pressure. Spinal discs must be pressurized structures that provide weight-bearing and movement functions. Published research by Dr. Nachemson and Dr. Elfstrom reported an intradiscal pressure range of 25-275mmgh. A higher level of intradiscal pressure is the leading cause of degenerative disc disease. Prolonged sitting, excessive bending or twisting all increase the intradiscal pressure. With an increase in the intradiscal pressure, the spinal disc loses or leaches out nutrients. In short, the increase in intradiscal pressure stops the process of disc hydration. Continued loadbearing activities lead to degenerative changes in the spinal disc.
What are the Main Structures of a Spinal Disc?
The human spinal disc has two main structures: the Nucleus Pulposus and the Annulus Fibrosus. The Annulus Fibrosus is the outer fibers that maintain the Nucleus Pulposus in the center. The Annulus Fibrosus (AKA Annuls Ligament) further forms to spinal-bone-to-spinal-bone connections. On the average, a spinal disc contains 15-25 concentric rings of annulus fibrosus. Each ring is securely attached to the adjacent annular ring through chemical bonds made possible with Elastin. The Elastin bond renders the Annulus Fibrosus (as a whole) strong and durable enough to last a lifetime. However, our modern lifestyles have placed enormous burdens on the annulus fibrosus, causing them to crack or tear apart from one another. In some cases, the annular ring thoroughly rips, giving up its ring-like orientation.
In spinal disc bulge, tears of the bonds between the annular ligament and the annulus fibrosus are common. But, still maintaining the ring-like composition. The tearing apart of the intra-annulus bonds (Elastin bonds) leads to buckling or bulging of the disc. With continued abuse, poor posture or repeated traumatic events one or more fibers of the annulus ligaments tear. Once the threads of the annulus fibrosus (annular ligament) are torn or broken the Nucleus Pulposus migrates (herniates, protrudes or prolapses) through the torn annular ligaments.
Which is More Important: Annuls Fibrosis or Nucleus Pulposus?
It is nearly impossible to relate the importance of Nucleus Pulposus over the Annuals Fibrosus or vice-versa. Simply put, it is similar to the chicken or the egg. In other words, one is not possible without the other. The Nucleus cannot function without the Annulus and the same holds true for the Annulus Fibrosus. We have already discussed the roles of the Annulus Fibrosus, now let’s take a closer look at the Nucleus Pulposus.
The Nucleus Pulposus is the heart of the disc. It functions as a fulcrum point, allowing motion and mobility. It is a cushion that provides shock absorbance to the encountered stresses of daily life. Aside from functional characteristic, it produces and manufacturers the building material needed for repair and maintenance of the Nucleus Pulposus and the Annulus Fibrosus. There are chondrocyte-like cells within the Nucleus Pulposus that manufactures proteoglycans: a needed compound for repair when the spinal disc is damaged or under stress.
What is the Role of the Nucleus Pulposus in disc Bulge, Disc Herniation, Disc Protrusion or Disc Prolapse?
Disc bulges, disc herniation, disc prolapse, disc protrusions, disc extrusion and disc fragmentation, is not possible unless there are some degenerative changes within the disc. Spinal disc degeneration occurs when the encountered daily stresses increase the intradiscal pressure. Intradiscal pressure refers to the influences present in the Nucleus Pulposus. The average healthy intradiscal pressure of an adult spinal disc is between 25-90mmgh. Supine position or lying on the back is when the pressure is decreased the most (25mmgh). Repetitive movements, poor postures, and bending at waist increase the intradiscal pressure. Intradiscal pressure exceeding 100mmgh leads to disc damage and disc degeneration. Let’s take a look.
What is the Normal Intradiscal Pressure at Rest?
Researchers have reported the pressure within the disc of normal healthy adults in supine positions as low as 25mmgh. On the other hand, sitting can increase the pressure to 140mmgh, while bending forward at the waist can propel the intradiscal pressure over 220mmgh. The most dramatic increase occurs in sitting positions that require leaning forward. Leaning forward from a seated position can the increase intradiscal pressure beyond 250mmgh.
Increased intradiscal pressure prevents nutrients such as oxygen, amino acids, sugars, and water from entering the disc. Lack of the inward flow of nutrients leads to decreased production of the proteoglycans in the Nucleus Pulposus. With the decreased production of the proteoglycan molecules; the disc dehydrates. A dehydrated disc is a weak disc; unable to maintain and repair the damage caused by daily activities or traumatic events. As such, spinal disc degeneration is the leading factors in disc bulges, disc herniation, disc protrusions, disc prolapse, disc extrusion or disc fragmentations.
The Link between Degenerative Disc Disease, Disc Bulge, Disc Herniation, Disc Extrusion and Spinal Disc Fragmentations
Degenerated disc are damaged discs. Damaged discs are weak discs the buckle under load. Before a disc can bulge, herniates, protrude or rupture through there must be some degree of degenerative disc changes present. Healthy discs do not herniate, bulge, protrude or rupture through. It is just that simple.
A disc bulge is one where the bonds between the annulus fibrosus have weakened to a point where the disc buckles under load. The breaks present in bulging discs are weakness or tears in the Elastin bonds that attach the 15-25 rings of the annulus fibrosus. If the continued stresses accumulate, disc damage progresses to the point where the annulus fibres snap; breaking apart. The tearing of the annulus fibres is the leading factor in disc herniation, protrusion, prolapse, and ruptures.
Herniated discs, prolapsed discs, protruded disc, and discs that have ruptured through are the results of continued progression of the pre-existing disc bulge. The snapping of the annulus fibrosus leads to weakening of the annulus’s ability to maintain the Nucleus Pulposus in the center. As such, the Nucleus Pulposus shifts from the center towards the weakened portions of the annulus fibrosus. This migration or shifting in the natural central position further damages the already weekend annular ligaments. Disc herniations, prolapse, protrusions, and ruptures are conditions that can rapidly progress. Care must be taken to prevent progression. An appropriate targeted therapeutic measure such as NSD Therapy®, as provided by our clinical staff is your best hopes of recovery without spine surgery.
What are the Differences between Disc Herniation, Disc Extrusion, and Disc Fragmentation?
As mentioned earlier, tears of the Annulus Fibrosus lead to migration of the Nucleus Pulposus from the center to the periphery. The movement of Nucleus Pulposus to the edge pushes the Annular Ligaments outwards towards the spinal canal or neural foramina. The continual flow of the Nucleus Pulposus to the periphery leads to massive tears of the Annular Ligament (Annular Fibrosus).
When the integrity of the annular ligaments is compromised: the Nucleus Pulposus squeezes beyond the boundaries of the spinal disc. And as such, it is termed as an extruded disc. In short, extruded discs are the result of neglect of a smaller issue. But, worse yet is the neglect of an extruded disc. When an extruded disc is neglected or improperly treated, it leads to disc fragmentation or sequestration. A disc fragment occurs when portions of the Nucleus Pulposus break off.
Which is Better Surgery or Therapy?
So, while cutting away at the annular ligaments may provide some short-term relief; it leads to greater issues later. Most have to go through additional spine surgeries. Therefore, even the mildest and least invasive spine surgery should be approached with great caution. Most surgical intervention fails to relieve pain and symptoms. Published research reported failures of spine surgery at 75%. The authors studied 750 injured workers who received spine surgery through fusion. 75% of these patients were classified as disabled workers because they could not return to work two years after their spine surgery. Other researchers have related that even the most minimal spine surgery leads to additional surgical interventions in the future. The most common recommendation that all researchers have made in regards to spine surgery is for patients to thoroughly exhaust a non-surgical treatment option before opting for spine surgery.
So, while cutting away at the annular ligaments may provide some short-term relief; it leads to greater issues later. Most have to go through additional spinal surgeries. Therefore, even the mildest and least invasive spine surgery should be approached with great caution. If you have been told to opt for spine surgery, visit us and discover the non-surgical solutions your surgeon may not be aware of. The best non-surgical spine treatment is NSD Therapy®. NSD Therapy® will provide you with spinal decompression without injections or surgery. it is the most comprehensive means of treating the spine.
Chiropractic Specialty Center® is the only center that offers NSD Therapy®.
We are Malaysia’s top chiropractic and physiotherapy center. Call us now for combined (integrative) care that fix and repairs the cause of your spinal disc issues.
What is the BEST Non-Surgical Treatment Option for Herniated Discs, Extruded Discs, and Disc Fragmentation?
NSD Therapy® is the best therapeutic options for those diagnosed with disc degeneration, disc bulge, disc herniation, extruded discs and even partially fragmented disc. The ONLY time you should consider spinal surgery is if NSD Therapy® fails to produce desirable results. We have utilized NSD Therapy® methods of treatments for almost 10-years. Our clinical successes in treating difficult and challenging spinal disc conditions through NSD Therapy® is greater than 90%. However, if you have experienced bowl and bladder issues or have been diagnosed with a fully fragmented disc, you may consider a surgical option. But, even then, visit us to seek our advice.
NSD Therapy® works better than surgery. There is no cutting and throwing away important body parts. NSD Therapy® can fix, repair and reverse extruded discs and even partially fragmented discs. Don’t take our word for it, read our proven methods of reversing severe slipped discs without injections or surgery.
Perhaps the worse of these surgical interventions is the nucleoplasty. Nucleoplasty is on the rise because it is quick and easy. The long-term impact always ends in failures. Therefore, we encourage all spinal disc patients to consult our doctors of chiropractic before they even contemplate on a surgical intervention. To conclude, our clinical teams have successfully treated and reversed herniated discs, extruded discs, and even partially fragmented disc. Visit one of our centers to learn more about the best non-surgical treatments (NSD Therapy®) for a slipped disc, extruded disc and fragmented disc without injections or surgery.