Lumbar Disc Herniation Flashcards
What is lumbar disc herniation usually due to?
Bending or heavy lifting with the back in flexion, causing herniation or extrusion of disc contents into the spinal cord area
What do disc herniations usually occur from?
degenerative disc disease (desiccation of the annulus fibrosis)
Lumbar disc herniation is most common between ages __-__
30-50
What spinal level is affected 90% of the time?
L5-S1
Describe typical symptoms associated with discogenic pain
Localized in the low back at the level of the affected disc and is worse with activity
Describe sciatica
Electric “shock-like” pain radiating down the posterior aspect of the leg often to below the knee
What motions worsen symptoms?
Back flexion such as bending or sitting for long periods
What can a severe disc herniation cause?
Numbness and weakness, including weakness with plantar flexion of the foot (L5/S1) or dorsiflexion of the toes (L4/L5)
What syndrome should be ruled out if the patient complains of perianal numbness or bowel or bladder incontinence?
cauda equina syndrome
What is the best method to assess the level and morphology of a disc herniation?
MRI
What is the treatment protocol for an acute exacerbation?
- bed rest for up to 48 hours
- modified activities
- NSAIDs
- PT (core stabilization and McKenzie exercises)
Following nonsurgical treatment for a lumbar disc for over 1 year, the incidence of LBP recurrence is __%
40
How long do the benefits of epidural and tranforaminal corticosteroid injections tend to last?
3 months
What medication can reduce inflammation and is useful in reducing symptoms of acute sciatica?
oral prednisone
True or False
In general patients who undergo surgery for lumbar disc herniation achieve greater improvement than conservatively treated patients.
True
