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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]
Intradural disc herniation occurs when the disc material crosses the dura mater and enters the thecal sac. It is a rare form of disc herniation with an incidence of 0.2–2.2%. Pre-operative imaging can be helpful for diagnosis, but intra-operative findings are required for confirmation. [26]
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.
The cause is usually a disc herniation in the lower region of the back. [1] Other causes include spinal stenosis, cancer, trauma, epidural abscess, and epidural hematoma. [1] [2] The diagnosis is suspected based on symptoms and confirmed by medical imaging such as MRI or CT scan. [1] [3] CES is generally treated surgically via laminectomy. [1]
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.
Diagnosis of neurogenic claudication is based on typical clinical features, the physical exam, and findings of spinal stenosis on computer tomography (CT) or X-ray imaging. [1] In addition to vascular claudication, diseases affecting the spine and musculoskeletal system should be considered in the differential diagnosis .
Non-radicular back pain is most commonly caused by injury to the spinal muscles or ligaments, degenerative spinal disease or a herniated disc. [11] Disc herniation and foraminal stenosis are the most common causes of radiculopathy. [11] Imaging of the spine and laboratory tests is not recommended during the acute phase. [19]
Imaging modalities such as computerised tomography or magnetic resonance imaging can help with the diagnosis of lumbar disc herniation. [40] Both are equally effective at diagnosing lumbar disk herniation, but computerized tomography has a higher radiation dose. [6] Radiography is not recommended because disks cannot be visualized by X-rays. [6]
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