Slipped disc

Slipped disc (medical term: prolapsed or herniated intervertebral disc) is a conditionin which, due to a tear in the outer fibrous ring (annulus), the central part (nucleus pulposis) of the intervertebral discmay extend into the spinal canal.

Most commonly this occurs in the lowermost part of the spine, especially between the fourth and fifth lumbar vertebral bodies and between the fifth lumbar vetrebral body and the sacrum. This protrusion usually occurs to one side of the spinal canal, at the point where a nerveroot leaves the canal. Impingement on the nerve causes pain, numbness and/or weakness in the part of the skin (dermatome) and muscle that are taken care of by the particular nerve root. The pressure on the nerve is not the only cause of the pain. The leaking of chemical substances from the disc lead to an inflammation of the root, also causing pain.

Types

Image:Slipped Discs.jpg

• Spondylolisthesis is a condition in which one vertebraslips forward onto the one below it.
• Retrolisthesis is when one vertebra slips backwards on the one below.

Causes

This most often occurs because the facet joints at on the posterior part of the spine have degenerated (worn away) and fail to prevent excessive vertebral slippage. In adults, the most common cause is a degenerative disc diseasewhich leads to excessive stress on the facet joints and causes degeneration (such as arthritis) and the slip usually occurs between the fourth and fifth lumbarvertebrae (L4 and L5) or the one below that level.

Other causes of spondylolisthesis include stress fractures(caused by repetitive hyper-extension of the back, commonly seen in gymnasts) and traumatic fractures.

Symptoms

Symptoms can include lower back pain, painin the thighsand buttocksor tenderness in the slipped area. Legweakness or numbness can result from pressure on nerveroots and can cause pain to radiate down the legs.

Treatment

Generally, slipped discs are treated conservatively. Bed-rest and painkillersis still advocated by some, but a more functional approach tends to give better results. When the pain persists surgery can be considered. When there are symptoms of pressure on the spinal cordor on the cauda equina, an operation should be performed immediately.

External links

• Herniated Disc: How it Causes Lower Back Pain
• Understand Slipped Discs
• Herniated Discs
• Cervical Herniated Discs
• Lumbar Herniated Discs
• NIH/Medline on "Herniated Disc"
• eMedicine on "Herniated Nucleus Pulposus"de:Bandscheibenvorfall

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This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Slipped+disc Wikipedia article Slipped disc.