A herniated phonograph recording , also know as slipped disc or prolapsed disc , can occur in any part of the spine , but most commonly occurs in the lower back .
The intervertebral discs are pads of gristle site between each vertebra . Their function is daze engrossment and allowing devoid movement of the back such as flexion , extension , side deflexion , and revolution . Disc herniations can pass anywhere in the spine , but commonly come in the lumbar region . Lumbar spine has 5 vertebra , which are separated by 5 intervertebral phonograph record . The intervertebral disc comprises of three part : The vertebral end plate , the annulus fibrosus , and the nucleus pulposus . The nucleus pulposus is present in the eye and this is the part , which herniates due to a debile and degenerated wall ( skirt fibrosus ) .
If the disc hernia is wicked , then it contract the spinal column . The pressure on the spinal electric cord from the herniated magnetic disc causes pain and other symptom in an someone .
Causes of Herniated Disc
Symptoms of Herniated Disc
About 90 % of the lumbar spine herniations happen at either L4 / L5 or L5 / S1 . The symptoms depend on the location of the hernia and the degree of spinal cord densification . Most common symptoms are depleted back pain along with the following :
Leg Pain :
Neural Symptoms : These symptom are produced due to nerve injury or nerve compaction . symptom are numbness , tingling and weakness . helplessness is present especially in the invertebrate foot along with difficulty in lifting the fundament ( pes drop-off ) . This often occurs in L4 / L5 herniation .
Pain pattern : Pain usually occurs after simple drive , such as bending over . The pain is worsened by sit , bending , lifting and coughing or sneeze and is ease by lie down down , especially on the unaffected side . The pain is least felt in the morning .
Bladder / Bowel symptom : If a patient has exit of vesica or bowel ascendancy then quick medical attention should be sought , as this is a serious condition . It may be cauda equina syndrome and can cause lasting personnel casualty of vesica or bowel control and palsy in the lower body .
Diagnosis of Herniated Disc
Treatment of Herniated Disc
Surgery For Herniated Disc
Surgery is required if the affected role does not benefit from button-down treatment and if the symptom do not amend .
It comprises of surgically removing the portion of the disc , which has herniated . This is successful in majority of the patients . In some patients , there may be duplicate episodes of disc hernia . Microdiscectomy is often performed on an out - patient basis and does not require an overnight stay . The patient can regress to day-after-day activeness within 1 to 3 weeks .
In case of severe hernia or perennial hernia , a full discectomy may be done where the entire disc is removed and the vertebra located above and below the disc are fused .
Prognosis and Recovery of Herniated Disc
Prognosis and convalescence following lumbar disc herniation count on size of herniated platter .
Prognosis and Recovery of Small Symptomatic Lumbar Herniated Disc-
Small herniated phonograph recording often shrinks in 2 to 4 weeks . The symptoms like painfulness , tingle , spiritlessness and weakness in muscle may last for 1 to 4 weeks . symptom may subside with rest and pain medicine . If symptoms persist in after 1 to 2 week , forcible therapy is advise . strong-arm therapy for 2 to 4 weeks may eliminate the symptoms , if not , then patient is advise extradural injection . Series of extradural shot may help to reduce symptoms to adequate level or symptom may disappear . retrieval time could be 2 to 6 weeks and prognosis is very good .
Prognosis and Recovery of Moderate Symptomatic Lumbar Herniated Disc-
restrained sized disc herniation occupies 1/3rd of the spinal channel or foramen . The pain and indifference become predominant symptoms . bother is restrained to severe at rest and knockout to very severe with activities . Pain never subsides with buttoned-down intervention . Physical therapy for 4 to 6 calendar week followed by series of extradural steroid hormone injection may help to reduce or eliminate the pain get up from moderate symptomatic lumbar record hernia . The recovery time for temperate symptomatic lumbar record herniation could be 4 to 8 week . Prognosis ; botheration may subside after series of epidural injection and physical therapy . annoyance may continue and patient may need surgery .
Prognosis and Recovery of Large Symptomatic Lumbar Herniated Disc –
The hernia of lumbar disc of gravid size of it do significant symptoms , which often does not respond to physical therapy and extradural injection . Patient often refuse surgical treatment and surgical treatment is delayed by 4 to 6 weeks for test of physical therapy and epidural steroid shot . Patient may postulate hospitalization for severe pain , which is not responding to oral opioids . Overall patient may not be considered for operating room for several week unless numbness and weakness become significant . Patient is often considered for emergency surgery . recuperation after surgery for large symptomatic lumbar platter herniation may take 4 to 6 weeks . Overall recovery period can last for 6 to 12 weeks depending on when patient decided to consider operating theater . Prognosis after operating theatre for large symptomatic lumbar disc hernia depends on operative procedure . Overall lit suggests 60 to 78 % of patients gets tolerable pain relief after first surgery for large lumbar disc herniation and may not need follow up intervention except physical therapy . But 20 to 30 % of the patient may ask second surgery , which could be spinal fusion surgery . Recovery after spinal unification operating room could be 4 to 6 months or longer depending on residuary symptom and surgical complications .
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