Lumbar disk herniation. (Cont...)
Table summarizes the main sÃdromes of lumbar disc herniation. Note that the L5-S1 disk is involved in 45-50% of cases, L4-L5 40-45%, and L3-L4 about 5%. Disc herniation at other lumbar levels is rare. The root compressed is the one below in most cases. However, if the herniation is lateral, into the hole, the compressed root is the one above. This type of hernia is rare and occurs in 3-10% of cases. It is also important to note that although signs are helpful in diagnosis and determining the type of treatment could not be present all the symptoms related to a particular root, and still be symptoms related to multiple roots.
Diagnosis.
The diagnosis should be suspected from clinical history and physical examination. Radiographic studies should be done to make the diagnosis and define the location and configuration. Generally prefer a magnetic resonance imaging and non-invasive (no need to use needles or injections) and provides excellent detail. The CT scan, while inferior to MRI concerning soft tissue detail is superior bone detail, and is faster and cheaper. For this reason, a CT scan is good enough to diagnose a herniated lumbar disc that has no complications. Computed tomography has long been the gold standard because of its excellent definition of the spaces around the nerve roots. The disadvantage is that it requires injection of contrast dye through a lumbar puncture. He has often been supplanted by MRI, but should be considered as a complementary rather than as an alternative, and in many cases is essential.
Herniated cervical disc.
Clinical aspects.
Vn herniated lumbar spine intervertebral disc herniation is a Cando often found weakness in the fibrous ring that surrounds the disk, whereas in the lumbar nerve roots are only at the level of the cervical spine cervical spinal cord there and this can also be compressed by the herniated disk.
The signs and symptoms caused by a herniated disk herniation depend if compress a nerve root, whether directly compresses the spinal cord compression, or both at the time.
The most common complaint is neck pain which restricts movement and is aggravated by neck extension. The pain may also spread to one arm, in a characteristic pattern of the particular root involved (see below). Patients often hold the arm elevated and behind the head, presumably because this maneuver reduces stress on the nerve root and lessens the pain. In many cases, the onset of pain is upon waking, without there having been no trauma or event that caused.