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Disc herniation can occur in any disc in the spine, but the two most common forms are lumbar disc herniation and cervical disc herniation. The former is the most common, causing low back pain (lumbago) and often leg pain as well, in which case it is commonly referred to as sciatica .
Degenerative disc disease occurs over time when the discs within each vertebra in the neck begin to fall apart and begin to disintegrate. Because each vertebra can cause pain in different areas of the body, the pain from the disease can be sensed in the back, leg, neck area, or even the arms.
Lumbar disc disease is the drying out of the spongy interior matrix of an intervertebral disc in the spine. Many physicians and patients use the term lumbar disc disease to encompass several different causes of back pain or sciatica. In this article, the term is used to describe a lumbar herniated disc.
Microdiscectomy (or microdecompression) is a minimally invasive surgical procedure in which a portion of a herniated nucleus pulposus is removed by way of a surgical instrument. [2] The purpose of this procedure is to relieve the pressure and reduce the local inflammatory reaction around a nerve root, caused by the herniated nucleus pulposus.
Spinal disc herniation pressing on one of the lumbar or sacral nerve roots is the most frequent cause of sciatica, being present in about 90% of cases. [4] This is particularly true in those under age 50. [13] Disc herniation most often occurs during heavy lifting. [14]
The straight leg raise test is almost always positive in those with disc herniation, [5] and lumbar provocative discography may be useful to identify a specific disc causing pain in those with chronic high levels of low back pain. [47] Therapeutic procedures such as nerve blocks can also be used to determine a specific source of pain. [5]
CT scan image of large herniated disc in the lumbar spine. Removal of a disc at one level can lead to disc herniation at a different level at a later time. Even the most complete surgical excision of the disc still leaves 30–40% of the disc, which cannot be safely removed. This retained disc can re-herniate sometime after surgery.
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. [6] Symptoms may include pain, numbness, or weakness in the arms or legs. [1]