prolapsed disc

Question 1

what are features of prolapsed disc?

Answer 1

produces clear dermatomal leg pain associated with neurological deficits

leg pain usually worse than back
pain worse when sitting

Question 2

what are the features of L3 nerve root compression?

Answer 2

Sensory loss over anterior thigh
Weak hip flexion, knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

Question 3

what are the features of L4 nerve root compression?

Answer 3

Sensory loss anterior aspect of knee and medial malleolus
Weak knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

Question 4

what are the features of L5 nerve root compression?

Answer 4

Sensory loss dorsum of foot
Weakness in foot and big toe dorsiflexion
Reflexes intact
Positive sciatic nerve stretch test

Question 5

what are the features of S1 nerve root compression?

Answer 5

Sensory loss posterolateral aspect of leg and lateral aspect of foot
Weakness in plantar flexion of foot
Reduced ankle reflex
Positive sciatic nerve stretch test

Question 6

what is the management of prolapsed disc?

Answer 6

analgesia, physio, exercises
1st line- NSAIDs +/- PPI

if symptoms persist after 4-6 weeks then refer to consider MRI