Lumbar Disc Herniation

What you need to know

The disc is the material lying between the two bones which acts as a cushion and shock absorber which distributes stress when a compressive force is placed on it. Sometimes as the disc wears out from aging or in severe causes from trauma, the outer part of the disc called the annulus weakens and develops a tear whereby the inner jelly can rupture and pass through placing abnormal pressure on the spinal nerves.

Most often, the herniation produces pain down the legs, and in severe cases can cause numbness and weakness. This is termed a radiculopathy. In seldom cases, the herniation is so big that it compresses the nerves to the bowel and bladder, which causes bowel and bladder incontinence, termed cauda equina syndrome.

The imaging test of choice is a MRI which can directly assess the location and severity of the herniation within the spinal canal. Most herniations can successfully be treated with non-steroidals, rest, and physical therapy. In patients who do not respond to these initial modalities, an epidural can be performed to alleviate leg pain. If in the event all fails or if there is neurological weakness, a lumbar microdiscectomy or lumbar laminectomy can be performed.

Most patients do not need urgent surgery and try numerous non operative treatments to resolve the pain. These include anti-inflammatories, nerve pain pills, muscle relaxants, rest and physical therapy. If these options fail, an epidural steroid injection can be performed to provide relief.

If conservative treatments fail, there are several surgical solutions that can be performed. These include removal of the disc herniation to take the pressure of the nerves and spinal cord, which is commonly either a fusion procedure or a disc replacement.

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Lumbar Microdiscectomy

A lumbar microdiscectomy is an outpatient surgical procedure where a small opening in the spinal canal is made to remove the herniation from the spinal nerves. This provides more room for the nerves to heal.
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Lumbar Laminectomy

A lumbar laminectomy is also known as an open decompression. During this surgery, a small section of the lamina (the bony roof of the spine) is removed to create more space for the nerves and relieve pressure on the spinal cord by widening the spinal canal. This may be performed in conjunction with a lumbar microdiscectomy.

Patrick J. Horan, MD, MBA, FACS

Patrick J. Horan is an orthopaedic surgeon and sports medicine specialist with two decades of experience. He is board-certified in orthopaedic surgery and sports medicine. After receiving his undergraduate degree from Duke University in Durham, N.C., Dr. Horan earned his medical degree from Tufts University School of Medicine in Boston. Residency and Internship were both completed at Walter Reed Army Medical Center in Washington, D.C. He also received an MBA from Auburn University in Auburn, Ala.

Dr. Horan served 10 years on active duty in the US Army as an orthopaedic surgeon before entering into private practice. Dr. Horan is the founder of the Westchase Orthopaedic and Rehabilitation and the official surgeon of the Tampa Bay Rowdies. He maintains professional memberships with the American Academy of Orthopaedic Surgeons, the American Academy of Orthopaedic Sports Medicine and the Arthroscopy Association of North America.

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Dr. Patrick Horan and the other orthopedic surgeons and specialists at Westchase Orthopedics & Rehabilitation have served hundreds of patients in the Tampa Bay area. Our patients choose us because we are able to offer them viable solutions to their pain. We offer hope to patients who have been athletes for years and suddenly find themselves faced with the possibility of never playing again, to elderly patients who want to maintain their independence and do things like drive and grocery shop alone, to parents who aren’t sure what is wrong with their children’s knees or elbows and want answers. Unlike in many other practices, you are not treated like just a number; we take the time to listen to your concerns and symptoms, accurately diagnose the source of the problem, and walk you through what will happen during the course of treatment. Get in touch with our office today to schedule an appointment!

Testimonials

Dr Horan has done a few of my knee surgeries and has always been the best surgeon. Dr Lao has been my physical therapist for every knee surgery and his results are proven and outstanding. I’d be in bad shape if it wasn’t for dr Lao and his staff who go above and beyond to do what’s needed.

Testimonials

Dr. Lao is simply the best! His intense educational training and specialty of the spine are something that you seldom come across these days. When I lived in Bradenton for 9 months I would drive over an hour just to see him because he was the only one I trusted with my physical issues. His assistant Sam is wonderful and Lisa at the front desk is always very helpful! There is another PT there that I have not treated with, but I only hear great things about him! 🙂 I will not go anywhere else.

Testimonials

This review encompasses both Dr Horan's orthopaedic side of the business & Dr Lao's physical therapy side. I have no idea if their practices are actually related, but there's only one street sign & only one Yelp check-in. Luckily, I think both doctors are excellent.

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