Lumbar disc herniation (LDH)

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• Safety and efficacy of Yaobitong capsules for lumbar disc herniation: A multicenter, randomized, double-blinded, parallel, positive-controlled clinical trial
• Epidemiological investigation and diagnostic analysis of osteonecrosis of the femoral head in three northeastern provinces of China
• Cauda equina syndrome with surgical intervention in pregnancy during the periviable period
• The magnetic resonance imaging-based vertebral bone quality scoring system: A novel method to evaluate endplate changes in patients with primary single-level disk herniation and Modic changes

Lumbar disc herniation (LDH) is a degenerative disease of the lumbar spine and a common cause of low back and leg pain ^{1) 2)}

● Radiculopathy: pain and/or subjective sensory changes (numbness, tingling…) in the distribution of a nerve root dermatome, possibly accompanied by weakness and reflex changes of muscles innervated by that nerve root

● typical disc herniation → radiculopathy in the nerve exiting at the level below

● massive disc herniations can → cauda equina syndrome (a medical emergency). Typical symptoms: saddle anesthesia, urinary retention, LE weakness.

● most patients do as well with conservative treatment as with surgery, ∴ initial nonsurgical (conservative) treatment should be attempted for the vast majority

● surgery indications: cauda equina syndrome, progressive symptoms or neurologic deficits despite conservative treatment, or severe radicular pain > ≈ 6 weeks

Lumbar disc herniation definition.

Lumbar disc herniation history.

see Lumbar disc herniation epidemiology.

see Lumbar Disc Herniation Classification.

Lumbar disc herniation (LDH) occurs owing to the inability of the posterior longitudinal ligament (PLL) to preserve the disc material within the intervertebral space. There is apparently no study that has investigated the histopathological changes occurring in both PLL and disc material in patients with LDH.

Kilitci et al. investigated and compared the histopathological changes occurring in PLL and disc material of the patients who underwent a surgical operation for LDH.

Pathology and neurosurgery departments of a tertiary Healthcare institution. The study included patients who underwent surgical operation for LDH from January 2018 to May 2019 and whose PLL and disc material was removed together, and had disc degeneration findings that were radiologically and histologically concordant.

PLL degeneration scores according to the histopathological findings, changes in disc materials according to the MRI findings, disc degeneration scores according to the histopathological findings.

Sample size: 50.

MRI and histological examinations showed fully degenerated black discs (Grade 2) in 12 patients, partially degenerated discs (Grade 1) in 29 patients, and fresh/acute discs (Grade 0) in 9 patients. The PLL showed grade 0 degeneration in 2 patients, grade 1 degeneration in 23 patients, and grade 2 degeneration in 25 patients. PLL degeneration grades were higher than the disc degeneration grades (P=.002).

Longitudinal ligament degeneration can play a significant role in the pathogenesis of LDH. This study represents the first to focus on the histopathological changes occurring in both the PLL and disc material in patients with LDH ³⁾.

Lumbar disc herniation pathophysiology

see Lumbar disc herniation clinical features.

see Lumbar disc herniation diagnosis.

see Lumbar disc herniation treatment.

Recurrent lumbar disc herniation.

see Lumbar disc herniation case series.

Lumbar disc herniation case reports.

Gender

Age

Smoking status

Pfirrmann grading system grade

Analgesic use

Leg pain duration