Lumbar Disc Herniation: Diagnosis and Management - 20/06/23

Doi : 10.1016/j.amjmed.2023.03.024

Andrew S. Zhang, MD ^a,^b, Andrew Xu ^c, Kashif Ansari ^c, Kyle Hardacker, MD ^a, George Anderson, BS ^c, Daniel Alsoof, MBBS ^a, Alan H. Daniels, MD ^a,^⁎
^a Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI
^b Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, Shreveport
^c Warren Alpert Medical School, Brown University, Providence, RI

^⁎Requests for reprints should be addressed to Alan H. Daniels, MD, Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI 02906.Department of Orthopaedic SurgeryWarren Alpert Medical School, Brown University1 Kettle Point AveEast ProvidenceRI02906

Abstract

Lumbar disc herniations are common causes of lower back pain, neurological dysfunction, and buttock/leg pain. Herniation refers to the displacement of the nucleus pulposus of the intervertebral disc through the annulus fibrosus, thereby causing pressure on the neural elements. The sequalae of lumbar disc herniations range in severity from mild low back and buttock pain to severe cases of inability to ambulate and cauda equina syndrome. Diagnosis is achieved with a thorough history and physical examination along with advanced imaging. Treatment plans are dictated by corresponding patient symptoms and examination findings with their imaging. Most patients can experience relief with nonsurgical measures. However, if symptoms persist or worsen, surgery may be appropriate.

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Keywords : Diagnosis, Herniated disc, Imaging, Management