Herniation is the medical term used to describe the condition in which a body part escapes its normal anatomic position and occupies an abnormal position. In case of spinal disc the jelly like part of disc escapes the annular covering and encroaches upon the neural canal(space where nerves are normally present) this leads to pressure on nerve roots or the spinal cord leading to varied presentation
1. Lumbar disc herniation – it is the most common type of disc herniation and most commonly presents with pain along back/side of thigh and in back/side of leg. Rarely a lumbar disc herniation may present as anterior thigh pain. – rarely a large central disc herniation in lumbar spine can present with cauda equina syndrome.
2. Dorsal disc herniation – Rarest form of disc herniation. Most dorsal disc herniation remain asymptomatic however the most common symptom caused by a symptomatic dorsal disc herniation is a dorsal myelopathy – patients usually complain of tightness in legs and difficulty in walking.
3. Cervical disc herniation – These disc herniation are unique in the form that the direction of herniation determines the symptoms that the patient would experience. Patients with cervical disc can present in one of two ways.
a) Cervical radiculopathy – this is akin to a sciatica pain but instead of involving the legs the pain travels down the arms and upto the hands.
b)Cervical myelopathy – Typical complains of patient is numbness in hands with difficulty in doing fine motor activity, walking difficulties and urinary issues.
Treatment Options
No weakness and quality of life not affected by symptoms – Careful observation, Medicines, and physiothjerapy, pain management injections. If patient has developed weakness / quality of life is severely affected then surgical options are indicated.
1.Lumbar disc surgery 2.Cervical disc surgery 3.Dorsal disc Surgery