Low backache
Spine
- symptom of Lumbar disc herniation : acute or gradual
- after trauma or without an inciting event
- most common 3rd and 4th decade
Chief Complaints
- Pain, radiating from the back or buttock into the leg
- Numbness and weakness
- Sharp, lancinating, shooting/radiating pain down the leg posteriorly below the knee
- Coughing 🡪 increase intrathecal pressure 🡪 increase pain
- Sitting position, driving 🡪 increase intra-discal pressure 🡪 increase pain
Evaluation: Involves a thorough clinical evaluation based on patient symptoms, evaluation in the form of MRI of the lower back. Severe symptoms may need further neurological tests.
Management:
- Reports indicate that 40-50% of patients are symptom-free within 1 week
- Initial treatment of lumbar disc disease with pain includes bed-rest, pain medications. Physiotherapy is initiated once intensity of pain reduces.
- Surgery is indicated in patient
- With increasing, unremitting pain even after prolonged treatment.
- Leg weakness
- Symptoms of bladder or bowel involvement
Minimally invasive lumbar discectomy with or without foraminotomy is performed for simple lumbar disc prolapse causing pain along the nerve which is compressed and leading into the leg
Lumbar fusion surgery for lumbar spondylolisthesis
It is performed for spondylitis disease associated with bone instability causing slippage and movement of bone