Lumbar Disc Herniation
A lumbar (low back) disc herniation is a common problem that often involves a slipped or ruptured disc.
This condition commonly causes low back and leg pain, sciatica or leg weakness. Intervertebral discs, which act as the spine’s shock absorbers, are located in between each vertebra. A tire-like band (annulus fibrosis) encases a gel-like substance, the nucleus pulposus.
How Does a Disc Herniate?
If the disc’s outer band cracks or breaks open, the gel inside the disc can leak out and cause a herniated disc. The disc material may place pressure on nearby nerve roots or the spinal cord. Additionally, nuclear material releases chemical irritants causing nerve inflammation and pain.
Sudden stress, such as from an accident, can cause a lumbar disc herniation. Sometimes, a disc herniation develops gradually over weeks or months.
Age, lack of exercise and poor posture can increase your risk for disc herniation.
Diagnosis & Treatment
Your doctor will ask your medical history and perform a physical exam. Your doctor may also order diagnostic test that include:
- CT scans
- MRI scans
Most lumbar disc herniations do not require surgery. Herniated disc pain often diminishes without surgery within 4-6 months. There are many nonsurgical treatments to help relieve symptoms.
You may require surgery if nonoperative treatment is ineffective or there is evidence of neurological deficit. The goals of surgery are to decompress nerve structures and stabilize the spine.
- A discectomy removes either the entire disc or part of the disc that is compressing nerve structures.
- A laminectomy removes the lamina (vertebral roof) to access disc material from behind that compresses the spinal canal or nerves. If your surgeon only removes part of the lamina, the procedure is known as a decompressive laminotomy.
- Your surgeon may perform instrumentation and fusion to stabilize the spine. This may be combined with discectomy. Instrumentation (i.e. rods, screws, interbody devices) and fusion (bone graft) joins and stabilizes two or more vertebrae.
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Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.