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Williams specified that in most cases the 5th lumbar disc ruptures and the nuclear material of the disc moves into the spinal canal causing pressure on the spinal nerves. In addition to the ruptured disc, irritation of the nerve at the intervertebral foramen where the nerve exits from the spinal canal may result.
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 .
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.
There are three general types of low back pain by cause: mechanical back pain (including nonspecific musculoskeletal strains, herniated discs, compressed nerve roots, degenerative discs or joint disease, and broken vertebra), non-mechanical back pain (tumors, inflammatory conditions such as spondyloarthritis, and infections), and referred pain ...
While neck pain is the second most common cause of disability and cost $100 billion, [2] the NIH budgets only $10 million to the study of neck pain. [3] One of the most common neck pains is between the neck and the shoulder. This is technically over the supraspinatus muscle and not in the neck, but it is still called “neck” pain.
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]
In those who worsen despite conservative treatments surgery leads to improvement in 60–70% of cases. [7] Another procedure using an interspinous distraction device known as X-STOP was less effective and more expensive when more than one spinal levels are repaired. [26] Both surgical procedures are more expensive than medical management. [26]
In 1934, the work of Mixter and Barr shifted all emphasis in research and treatment from the sacroiliac to the herniated intervertebral disc, namely lumbar discs. [30] Medical focus on herniated discs was further forwarded by the invention of the MRI in 1977. [31] Over-diagnosis and attention on herniated discs has led to the SI joint becoming ...
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