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The majority of spinal disc herniations occur in the lumbar spine (LDH, Lumbar Disc Herniation, 95% at L4–L5 or L5–S1). [21] The second most common site is the cervical region (C5–C6, C6–C7). The thoracic region accounts for only 1–2% of cases.
The sciatic nerve comprises nerve roots L4, L5, S1, S2, and S3 in the spine. [26] These nerve roots merge in the pelvic cavity to form the sacral plexus and the sciatic nerve branches from that. Sciatica symptoms can occur when there is pathology anywhere along the course of these nerves. [27]
This procedure is usually performed when decompression of more than one nerve root is needed. In the lumbar spine it is commonly used to treat spinal claudication caused by spinal stenosis, and is considered the most effective treatment for this condition based on current evidence. [3]
Neurogenic claudication (NC), also known as pseudoclaudication, is the most common symptom of lumbar spinal stenosis (LSS) and describes intermittent leg pain from impingement of the nerves emanating from the spinal cord. [1] [2] Neurogenic means that the problem originates within the nervous system.
However, the pain or other symptoms often radiate to the part of the body served by that nerve. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or lumbar-sacral spine can be manifested with symptoms in the foot.
Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by chronic, direct pressure on a peripheral nerve. [1] It is known colloquially as a trapped nerve , though this may also refer to nerve root compression (by a herniated disc , for example).
The fifth lumbar spinal nerve 5 (L5) [5] originates from the spinal column from below the lumbar vertebra 5 (L5). L5 supplies many muscles, either directly or through nerves originating from L5. They are not innervated with L5 as single origin, but partly by L5 and partly by other spinal nerves. The muscles are: gluteus maximus muscle mainly S1
The biomechanical relationship between the sacroiliac joint, the piriformis muscle (see "piriformis syndrome"), and the sciatic nerve had not yet been discovered. [18] 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]
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