Lumbar Disc Herniation
What is a lumbar disc herniation?
Between each vertebra there are gel-like discs that permit movement between the vertebra, cushion and absorb shock and transmit loads through the spinal column. The outside of the disc is a tougher, fibrous material called the annulus fibrosus. The center of each disc has a softer, jelly-like center called the nucleus pulposus. Sometimes, this material in the middle can leak out or push on its tough outer sheath as it dries out with age and after repetitive stress or a sudden injury. The leaked disc can then compress lumbar nerve roots, causing symptoms into the leg. This is called a lumbar (low back) disc herniation.
A lumbar disc herniation is a common cause of low back pain and leg pain that causes radiculopathy also referred to as sciatica (sharp or searing pain down the leg).
Lumbar disc herniation can happen suddenly, or progressively over time.
- Acute (sudden) lumbar disc herniation can be caused by an injury, oftentimes by lifting something heavy using back muscles instead of leg muscles. This is how younger patients with healthy discs may develop a lumbar disc herniation.
- Degenerative lumbar disc herniation can happen over time due to the repetitive stresses put on the disc. Factors that can put extra stress on the disc and speed up the process are aging, smoking and obesity. With age, discs naturally degenerate losing moisture and flattening over time, putting more strain on the tough outer layer, making it more likely that the disc will herniate.
Symptoms of a lumbar disc herniation may vary depending on the severity and cause of the herniation, but may include:
- Low back pain, sometimes worse with coughing, sneezing or straining or sitting
- Sharp, shooting, burning pain down the leg
- Numbness or tingling in the leg
- Weakness in the legs
- Cauda Equina Syndrome. The Cauda Equina is a bundle of nerves at the end of the spinal cord that provide motor and sensory function to the legs, bowel and bladder. When the discs herniate in this area it can cause bowel and bladder incontinence, numbness in the groin or genital area, or sudden weakness in both legs. Cauda Equina Syndrome is a serious condition that requires immediate surgical evaluation by a spine surgeon.
Dr. Singh will review your medical history, ask about your symptoms and perform a thorough physical exam can help identify areas of numbness, weakness and pain that may point to compression of a specific nerve in the lumbar spine.
An CT scan of the lumbar spine may be done to check for fractures and degenerative changes of the spine. The best imaging to check for a lumbar disc herniation is an MRI, which can show details of soft tissues like discs and nerves as well. If the patient has red flag symptoms and Cauda Equina Syndrome confirmed, expedited surgery after diagnosis is necessary to prevent permanent damage.
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If you or a loved has symptoms related to a spinal condition, contact Chicago spine surgeon Dr. Kern Singh who can assess your situation, provide an accurate diagnosis and guide you on the most suitable treatment options.
Dr. Kern Singh, MD is an internationally renowned spine surgeon specializing in outpatient minimally invasive and motion-preserving techniques and endoscopic spine surgery at Midwest Orthopaedics at Rush and Professor in the Department of Orthopaedic Surgery at Rush University Medical Center in Chicago, Illinois. Dr. Kern is one of the nation’s Top 100 spine surgeons and beloved by his patients for his compassionate care and excellent outcomes. He welcomes nationally and internationally-based patients.
- Journal of Orthopaedic & Sports Physical Therapy 2001;31(6) :291-306
At A Glance
Dr. Kern Singh
- Minimally invasive and endoscopic spine surgeon
- Inventor and surgeon innovator with multiple patents in spinal surgery and instrumentation
- Author of more than 10 textbooks in minimally invasive spinal surgery
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