Lumbar Disc Herniation
Herniation of intervertebral discs is a common condition with up to 5% of the population experiencing symptoms of nerve irritation (sciatica) as a consequence of lumbar disc herniation.
Definition
Lumbar disc herniation is a condition where the tears in the outer fibrous ring of the intervertebral disc (annulus fibrosis) allows the central portion to herniate through, compressing the nerve root .
Clinical Presentation
The ubiquitous symptom of a lumbar disc herniation is pain radiating down the lower extremity (scitica). The are sometimes symptoms and signs of a neurological deficit : weakness, numbness and loss of reflexes.
Radiographic Presentation
A disc heniation can be diagnosed clinically with a focused clinical assessment but an MRI is often used to corroborate the diagnosis and as a preoperative tool should surgery be contemplated.
Treatment
4This includes non-operative measures including: pain-killers, physical therapy and occasionally corticosteroid injections. Operative indications include: intractable pain, protracted symptoms and precipitous decline in function as a consequence of a worsening neurological deficit.