Lumbar Disc Herniation: Diagnosis and Management

Am J Med. 2023 Jul;136(7):645-651. doi: 10.1016/j.amjmed.2023.03.024. Epub 2023 Apr 17.

Abstract

Lumbar disc herniations are common causes of lower back pain, neurological dysfunction, and buttock/leg pain. Herniation refers to the displacement of the nucleus pulposus of the intervertebral disc through the annulus fibrosus, thereby causing pressure on the neural elements. The sequalae of lumbar disc herniations range in severity from mild low back and buttock pain to severe cases of inability to ambulate and cauda equina syndrome. Diagnosis is achieved with a thorough history and physical examination along with advanced imaging. Treatment plans are dictated by corresponding patient symptoms and examination findings with their imaging. Most patients can experience relief with nonsurgical measures. However, if symptoms persist or worsen, surgery may be appropriate.

Keywords: Diagnosis; Herniated disc; Imaging; Management.

Publication types

  • Review

MeSH terms

  • Cauda Equina Syndrome* / etiology
  • Humans
  • Intervertebral Disc Displacement* / diagnosis
  • Intervertebral Disc Displacement* / therapy
  • Low Back Pain* / etiology
  • Lumbar Vertebrae
  • Magnetic Resonance Imaging
  • Physical Examination