week 4 disc injuries

Question 1

What is the definition of a disc herniation?

Answer 1

Localized or focal displacement of disc material beyond the limits of the intervertebral disc (IVD) space.

Question 2

What materials can be involved in a disc herniation?

Answer 2

Nucleus pulposus, cartilage, fragmented apophyseal bone, annular tissue, or a combination.

Question 3

What is required for a disc herniation to occur?

Answer 3

Disruption of the annulus fibrosus.

Question 4

How is a disc herniation classified as “contained” or “non-contained”?

Answer 4

If the displaced disc material remains within the intact outer annulus and/or posterior longitudinal ligament, it is contained.

Question 5

What can happen when the disc material passes through the annulus fibrosus?

Answer 5

It can affect a nerve root, leading to pain and neurological symptoms.

Question 6

What are the four main types of disc injuries?

Answer 6

1. Disc Bulge
2. Disc Protrusion/Prolapse (Contained)
3. Disc Extrusion (Non-contained)
4. Sequestration

Question 7

What is a disc bulge?

Answer 7

Concentric outward overhang of the annulus fibrosus beyond the vertebral endplate margins involving 50% (180 degrees) of the disc.

Question 8

Is a disc bulge considered a herniation?

Answer 8

No, a bulge is a form of disc displacement but not a disc herniation.

Question 9

Who commonly has disc bulges?

Answer 9

Individuals over 40 years old.

Question 10

What defines a disc protrusion?

Answer 10

displacement of nuclear, annular, or endplate material beyond the IVD margin while remaining contained within the annulus.

Question 11

Does the nuclear material completely penetrate the annulus in a protrusion?

Answer 11

No, it remains contained within the annulus fibrosus.

Question 12

What is disc extrusion?

Answer 12

displacement of nuclear, annular, or endplate material beyond the IVD margin with complete disruption of all annular layers.

Question 13

Where can the displaced nuclear material go in disc extrusion?

Answer 13

It can enter the spinal canal.

Question 14

What is sequestration?

Answer 14

Migration of a free fragment of herniated material with no connection to the IVD.

Question 15

What are the most common migration patterns of a sequestered fragment?

Answer 15

Laterally, superiorly, inferiorly, staying midline, or dispersing in multiple directions.

Question 16

What are the four main classifications of disc herniations?

Answer 16

1. Postero-lateral
2. Far Lateral
3. Central (Medial)
4. Broad-based (Bilateral signs & symptoms)