4. Prolapsed disc Flashcards
1
Q
How common is it?
A
Common
5-20 per 1000
Underlying aetiology of 5% of back pain
2
Q
Who does it affect?
A
M:F = 2:1
30-50 y/os
3
Q
What causes it?
A
Nucleus pulposus protrudes through annulus fibrosis of intervertebral disc Mechanical compression of nerve Degeneration is most common cause Trauma is 2nd most common Lumbar and cervical spine
4
Q
What risk factors are there?
A
Obesity
Family history
Smoking
Labourers
5
Q
How does it present?
A
Pain (lower back / neck most common) Numbness, tingling Limited range of motion Muscle weakness Sciatica
6
Q
What other conditions might present similarly?
A
Discal cyst Mechanical back pain Malignancy / metastasis Epidural abscess / haematoma Cauda equina Synovial cyst Proximal diabetic neuropathy
7
Q
How would you investigate?
A
X-ray
CT / MRI for further investigation
8
Q
What treatments are there?
A
NSAIDs (and physical therapy if >3 weeks)
Surgery if no improvement / neurological deficits
9
Q
What complications are there?
A
Chronic back pain
Severe root compression –> lasting nerve damage
