In the first two stages, the herniated nucleus pulposus hasn't yet broken through the outer wall of the lumbar disc which means the nucleus pulposus, or gel-like material, remains contained within the annulus. This type of disc herniation is often referred to as a "contained herniation" because the bulge is still within the disc and below the posterior longitudinal ligament.

The third and fourth stages are often referred to as non-contained herniations or ruptured discs. In this stage, the nucleus pulposus has either partially or completely broken through the outer wall of the intervertebral disc and can leak into the spinal canal.

A bulging contained herniation may be a precursor to a non-contained disk herniation, also called a disk extrusion. The disc may initially bulge into the spinal canal without the gel-like material leaking out of the disc.

In the final stages, fragments of the annulus or tough outer disc wall may break away from the disc allowing the herniated nucleus pulposus to leak out and drift into the spinal canal.

It is important that an accurate diagnosis is made regarding the type of nucleus displacement a patient may have. The type of degeneration will dictate the type of treatment needed and whether a patient requires spine surgery or a less invasive procedure.

The Hydrodiscectomy procedure is an effective, minimally invasive procedure for patients experiencing symptomatic back pain and radicular (leg) pain or sciatica caused by a contained herniated or bulging disc that is compressing against a nerve root, especially when there is limited deterioration of the disc and the nucleus is still largely intact and within the disc itself.

Patient Education Video