Preamble

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. 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 .

Indications

Operative indications include: intractable pain, protracted symptoms and precipitous decline in function as a consequence of a worsening neurological deficit.

Diagnosis

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.

Non -Operative Treatment

This includes non-operative measures including: pain-killers, physical therapy and occasionally corticosteroid injections.

Risks

These include dural injury (fluid sac injury), infection, instability of the vertebral column and recurrence.

OPERATIVE TECHNIQUE