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12 non-surgical techniques for Disc Prolaps with Dr. Koura

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12 non-surgical techniques for Disc Prolaps with Dr. Koura


Disc herniation is one of the most common modern-day conditions affecting various age groups and is one of the leading causes of back pain. Traditionally, surgery was considered the only treatment for disc herniation. However, modern advanced techniques, known as interventional techniques, provide non-surgical solutions. Dr. Mohamed Koura specializes in these techniques. In this article, we will learn more about disc herniation, its types, diagnosis, and treatment.

What is Disc Herniation?
Disc herniation occurs when the soft discs between the vertebrae in the spine, responsible for reducing friction between them, protrude or rupture. This condition is also known as disc protrusion or herniated disc. It happens when the soft inner core of the disc presses on the weak part of the surrounding fibrous ring, causing it to bulge. This can compress the nerve roots branching from the spinal cord, leading to pain and eventually resulting in disc herniation.

What Are the Types of Disc Herniation?
Disc herniation is classified based on its location:

- Lumbar Disc Herniation: This is the most common type and occurs in the lumbar spine. It often causes lower back pain that may radiate into one or both legs, accompanied by numbness and tingling.

- Cervical Disc Herniation: The disc protrudes between the cervical vertebrae in the neck. Symptoms may include neck pain, radiating arm pain, and numbness.

- Thoracic Disc Herniation: This type is less common and affects the thoracic spine. It leads to mid-back pain.

What Causes Disc Herniation?
Disc herniation usually occurs due to the deterioration of spinal discs. When the nucleus loses its water content, it becomes less able to absorb shocks, and the fibrous ring weakens, making it more prone to protrusion or rupture. Factors that increase the risk of disc herniation include:

- Improper heavy lifting techniques that put excessive pressure on the back muscles and discs.
- Obesity, as it increases the load on the spine.
- Aging, which can lead to the weakening of neck or back muscles, whether genetically or due to acquired factors.

What Are the Symptoms of Disc Herniation?
Symptoms of disc herniation vary depending on its location:

- Lumbar Disc Herniation: Symptoms include lower back pain, which can radiate to the buttocks, legs, or feet, often accompanied by numbness and tingling. Walking or standing for extended periods may be difficult.

- Cervical Disc Herniation: This may cause neck pain, arm pain, and numbness. Severe cases can lead to urinary incontinence due to nerve dysfunction.

What Are the Treatment Options for Disc Herniation?
There are several treatment options for disc herniation, and Dr. Mohamed Koura employs more than twelve different techniques to treat it effectively. Some of these techniques include:

- Nerve Root Injections: Injecting anti-inflammatory substances directly into the nerve roots to relieve inflammation and pain.

- Thermal Ablation of Nerve Roots: Using a modern technique that employs thermal frequencies to treat nerve root inflammation.

- Laser Disc Decompression: A minimally invasive procedure involving the insertion of a small laser fiber to vaporize the herniated disc part.

Dr. Mohamed Koura specializes in these innovative techniques to provide effective treatment for disc herniation, helping patients avoid traditional surgery and its associated risks and recovery times.

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- Microscope (Endoscopy):
Microscopic endoscopy is one of the latest techniques used in the treatment of disc herniation and spinal pain. It involves a thin needle, less than half a millimeter thick, that is inserted through the skin under local anesthesia. A fluoroscopy camera guides the procedure in the operating room until the needle reaches the herniated disc, which is then removed.

- Disc FX Technique:
The miniature endoscope is used inside the operating room to ensure complete sterility. Local anesthesia is used, unlike general anesthesia, which distinguishes it from surgical endoscopy. A small needle is inserted through the locally anesthetized skin, and fluoroscopy guidance ensures precision. The miniature endoscope channel is inserted through this needle with fluoroscopy guidance to reach the part of the disc that needs removal. Using a precise instrument and under fluoroscopy guidance, the protruding part of the disc causing the problem is removed safely. The patient can walk within 30 minutes of the procedure and return to their normal life within 48 hours without any pain.

- Hydrocision for the Disc:
Hydrocision is a technique for removing a portion of the disc. It is not a modern technique but one of the first methods invented for treating this condition. It involves a fine needle inserted into the disc through a cycle that introduces a saline solution. This cycle exerts specific pressure on the disc, and the needle then removes the protruding disc part due to this pressure. One drawback of this technique is the possibility of infection due to the saline solution, so it is preferred to use it only when necessary.

- Laser Disc Suction:
This procedure is performed using a device that enters through the skin under local anesthesia. It suctions the protruding part of the disc, reducing its internal size and thus reducing the extent of external herniation. This procedure is characterized by its safety and effectiveness.

- Minimally Invasive Microscopic Surgery for Disc Removal:
Disc removal is performed using an advanced surgical microscope or an optical magnifier equipped with LED lighting. Spacers are used under a surgical microscope to ensure the procedure's precision. A small surgical incision, no longer than the length of a fingertip, is made, and it may be closed with cosmetic surgical sutures and covered with adhesive strips to ensure optimal healing. The wound may require dressing changes once or twice during the first week, and the surgery takes about an hour.

- Clodhiker:
This technique is performed through a small skin opening at the level to be treated. A channel is inserted that reaches the nerve canal, and through it, a tool removes the excess part of the ligament.

- Mild Technique:
This is a non-surgical technique used in cases of central nerve canal stenosis, which results from an enlargement of the internal ligaments that can block the nerve canal. The intervention is done through a fine needle for removal.

- Nerve Canal Dilation with Catheter:
This technique involves inserting a catheter from the outside through the canal's stenotic area, and the doctor controls it externally to dilate the nerve canal on both sides. The catheter is one of the techniques used to treat nerve canal stenosis, along with clodhiker, which is used to expand the nerve canal.

Please note that these techniques are advanced methods for treating disc herniation and spinal pain, offering alternatives to traditional surgery with reduced recovery times and risks.