Paracentral Disc Extrusion: Causes, Symptoms, Treatment
What is Paracentral Disc Extrusion?
Paracentral Disc Extrusion is a pathological condition in which there is seepage of the nucleus material of a herniated disc on right or left side of the middle portion of the disc. The disc herniation often protrudes into foramina and causes foraminal stenosis. This condition occurs when the nucleus pulposus infiltrates into the spinal canal from a tear in the outer fibrous wall of the disc, but in contact with the material still remaining inside the wall of the disc. This can result in irritation of the nerve roots causing pain and difficulty with range of motion depending on the severity of the disc herniation
What Causes Paracentral Disc Extrusion?
The spinal vertebrae are separated from each other through cushions which are called as intervertebral discs.1 These intervertebral discs have what is called as nucleus pulposus and an outer fibrous layer. During normal wear and tear of the body and due to aging, the elasticity of these intervertebral discs goes down considerably. This along with increased pressure from the disc material present inside or the nucleus pulposus weakens the outer fibrous walls of the intervertebral discs due to which some of this disc material seeps out of its confinement and encroaches the spine. This leads to impinging of the nerve roots and hence symptoms are experienced by the affected individual. Apart from the natural process of aging, Paracentral Disc Extrusion can also be caused due to certain traumatic injuries to the spine like a motor vehicle crash, an injury to the spine while playing contact sports like football or rugby endangering the neural activities performed by the spinal cord and nearby nerve roots.
What are the Symptoms of Paracentral Disc Extrusion?
A Paracentral Disc Extrusion can cause the following symptoms:
- Severe pain in the back or the neck depending on which area of the spine the extrusion has occurred
- Radiating pain through the course of the affected nerve
- Tingling and numbness in those regions of the body where the affected nerve traverses
- Weakness of the muscles which are innervated by the affected nerve
How is Paracentral Disc Extrusion Diagnosed?
The best way to diagnose Paracentral Disc Extrusion is by way of radiologic studies in the form of a CT scan or an MRI. This will give the accurate picture of the internal structures of the spine and will clearly show the disc herniation and the nucleus pulposus impinging the nerve root.
How is Paracentral Disc Extrusion Treated?
Paracentral Disc Extrusion can be treated conservatively with pain medications, exercise to strengthen the spine through diligent physical therapy, and behavior modification in the form of not doing activities which may aggravate the condition like heavy lifting, avoiding playing contact sports, sitting in front of the computer for long periods of time. This will have to be done till the process of resorption occurs and the condition improves.
If the patient exhausts all considerable conservative options without improvement of the condition then surgery in the form of spinal decompression may be done to decompress the nerves affected by Paracentral Disc Extrusion.