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 (sciatica). There are sometimes symptoms and signs of a neurological deficit: weakness, numbness and loss of reflexes.
Radiographic Presentation
A disc herniation 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.