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Lumbar– lower back, prolapsed– slipped from usual position, intervertebral– between vertebral [spinal] bones, disc– gelatinous structure between bones
Prolapsed intervertebral disc is commonly known as ‘Slipped Disc’ or ‘Sciatica’ in lay man’s terms. This is one of the most common conditions affecting young and old alike. This can occur in the neck [Cervical Disc Herniation] or in the lower back. The human spine contains 33 bones known as vertebrae stacked upon each other and separated by a gelatinous structure known as intervertebral disc which acts as a shock absorber.
With aging as early as 2nd or 3rd decade, the disc starts losing its water content and becomes prone to displace. Compounded by daily exertional activities the disc may slip and cause compression of neural structures around. These neural structures give rise to one of largest nerves of the body- the sciatic nerve, hence the name ‘sciatica’. It causes severe pain radiating to lower limbs, paraesthesia and occasionally weakness or bowel/bladder incontinence [Cauda Equina Syndrome].
The prolapsed disc is diagnosed on MRI. Usually, the slipped disc resolves in 3 weeks- 3 months time with adequate conservative treatment– rest and medications. In certain conditions- non- resolving discs, severely painful discs or weakness of lower limbs/ bowel/bladder incontinence- surgical treatment is advised. The surgery in most cases entails removal of the fragment of disc compressing the nerve through a small incision. This can be done with Conventional or Minimally Invasive techniques– Microdiscectomy/ Micro Endoscopic Discectomy. Based on patient’s symptoms and X-rays/MRI, it may be necessary to install surgical implants in some- Stabilization/ Fusion Surgery.