Lumbar disc herniation, also known as herniated or slipped disc

A herniated disc is caused by the displacement of disc material from its normal position, which can compress the nerve and lead to sciatica or radicular symptoms. This condition is found in 1-3% of the general population, primarily in middle-aged individuals around 40 years old, and is more common in men than women (60%:40%). Several factors can contribute to a herniated disc:
  • Age-related disc degeneration
  • Work-related causes, depending on the nature of work
  • Genetic factors
  • Diabetes
  • Obesity
  • Trauma or back injury
Most patients experience back or hip pain radiating down the legs, which may be accompanied by numbness or weakness. Symptoms often occur suddenly after lifting heavy objects, bending over, or due to a fall.
Some patients may initially experience back pain, followed by hip pain radiating down the leg.
To determine the cause of nerve compression, a Magnetic Resonance Imaging (MRI) scan is typically performed. The MRI can reveal the pathology, location, and severity of the compression. This can be considered in conjunction with a plain X-ray.
The treatment approach includes:
  • Lifestyle modifications, such as avoiding heavy lifting and maintaining a healthy weight
  • Medication
  • Physical therapy
  • Epidural steroid injection
  • Surgery
Approximately one-third of patients with a herniated disc and nerve compression may require surgical intervention. Current surgical options include techniques performed under a magnifying scope, which fall into two categories:
  1. Microscope-assisted surgery: A small incision is made and a microscope is used to aid in the surgery.
  2. Endoscope-assisted surgery: A skin incision of about 1 cm is made, and an endoscope is used to aid in the surgery.

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