Prolapsed Disc and SCIATICA Flashcards
What causes discogenic back pain?
Acute tear in outer annulus of an intervertebral disc.
What is sciatica?
Buttock and/or leg pain in a specific dermatomal distribution caused by compression of the sciatic nerve roots.
What is a disc prolapse?
When a disc tear occurs and the gelatinous nucleous herniates through the tear and impinges on exiting nerve roots.
How does disc prolapse result in sciatica?
Disc prolapse affects (most commonly) L4, L5 and S1 nerve roots (contributes to sciatic nerve) causing pain to radiate to the sensorydistribution of the sciatic nerve.
TRUE or FALSE:
The nerve root corresponding to the LOWER of the two vertebra in a segment affcected by sciatica is compressed?
TRUE
L4/5 prolapse causes which root entrapment?
L5
Which kind of prolapse will lead to cauda equina?
Central
What is cauda equina?
Bilateral sciatica with loss of bowel and bladder control
Management of Sciatica?
Analgesia, maintaining mobility and physio.
Drug given if neurological pain?
Gabapentin.
Indications for discectomy?
- pain not resolving
- ocalising signs suggesting a specific nerve root involvement
- +ve MRI evidence of nerve root compression.
Investigations for Sciatica?
MRI and CT
What, other than disc prolapse, can cause sciatica?
Osteophytes (as a result of OA of facet joints) impinging on nerve roots.
Do acute tears usually resolve themselves?
YES. analgesia and physio = main treatment
Characteristic of acute IV disc tear?
Worse on coughing.
