Lumbar Prolapsed Intervertebral Disc

  • Represents a “rapid model” of nerve compression. The commonest age group is 25 to 40 when the disc starts degenerating (weakening) and the activity levels are high. The profile of patient at risk is an obese, sedentary individual that occasionally indulges in unaccustomed strenuous activity at one end of the spectrum versus an individual who indulges who challenges the mechanical endurance of the back with very strenuous activity.
  • PID represents acute or repetitive failure of the disc due to abnormal forces transferred to it due to inefficiency of the supporting muscles.
  • The protrusion in the disc causes a mechanical compression of the nerve. Also the nucleus pulposus (disc gel) causes severe inflammation of the nerve enhancing the pain.
  • Enforced complete bed rest reduces the force on the injured disc allowing it to heal over 3-6weeks. Pain control is improved with medications, steroids, injections and physiotherapy. Once pain control reaches tolerable limits, early resumption of graduated activity and exercise is necessary.
  • Removing the fragment through minimally invasive (key-hole) surgery is the mainstay of surgical treatment. The aim is remove loose fragments enough to free the nerve and cause relief of pain. The annulus (disc covering) heals naturally allowing normal activity.