Herniated disc of the lumbar spine
In a herniated disc of the lumbar spine, the intervertebral disc’s outer fibrous ring is ruptured, allowing parts of the disc to become pushed into the vertebral canal. The herniated disc then presses against the nearest nerve root, which then makes itself felt with the typical symptoms such as pain that spreads out into the leg. This is often accompanied by paraesthesia such as a feeling of “pins and needles” or numbness, or sometimes even paralysis. The paralysis is noticeable during walking (e.g. tripping over the foot) or walking up stairs. Using the radiation of pain and the localisation of the numbness in the leg, the physician is able to diagnose the height of the herniated disc very precisely in the neurological examination. This is complemented by an imaging, mostly using an MRI (Figure 1).
As a rule, a herniated disc is initially treated by protecting the body and using painkillers and physiotherapy. In some cases, pain relief can be achieved using targeted cortisone infiltrations in the vertebral canal (epidural anaesthesia). If this does not result in a significant improvement of the symptoms or if there is a paralysis, then an operation is indicated. This involves the herniated disc being found and removed under the microscope through a small incision in the back, providing the nerve root with enough room again and it can recover.
Fig. 1: large herniated disc
Fig. 2: Herniated disc in the lumbar spine region
herniated disc of the cervical spine
constricted vertebral canal of the cervical spine
constricted vertebral canal of the lumbar spine