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A disc herniation or spinal disc herniation is an injury to the intervertebral disc between two vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain , pain or sensation in different parts of the body, and physical disability .
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 MSU Classification for herniated discs uses the proximity of the disc to the facet joint when measuring the size of a herniated disc. [7] Using the MSU Classification, a grade of 1, 2 or 3 can be used to describe the size of a herniated disc with 1 being the least severe and 3 being the most severe.
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Disc replacement is also an alternative intervention for symptomatic disc herniation with associated arm and hand, or leg symptoms (radicular pain). TDR has been developed as an alternative to spinal fusion , with the goal of pain reduction or elimination, while still allowing motion throughout the spine.
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.
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]
Spinal cord compression is a form of myelopathy in which the spinal cord is compressed. Causes can be bone fragments from a vertebral fracture, a tumor , abscess , ruptured intervertebral disc or other lesion.