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Lumbar disc herniation (LDH)

In Polish literature more, than 20 terms to describe lumbar disc herniation. All of these terms in the meaning of the authors are used to determine one pathology–mechanical damage to the intervertebral disc and moving the disc material beyond the anatomical area 1).


The understanding of lumbar spine pathologies made substantial progress at the turn of the twentieth century.

Stienen et al. reviewed the original publication of Otto Veraguth in 1929 reporting on the successful resection of a lumbar disc herniation, published exclusively in the German language. His early report is put into the historical context, and its impact on the understanding of pathologies of the intervertebral disc (IVD) is estimated. The Swiss surgeon and Nobel Prize laureate Emil Theodor Kocher was among the first physicians to describe the traumatic rupture of the IVD in 1896. As early as 1909 Oppenheim and Krause published 2 case reports on surgery for a herniated lumbar disc. Goldthwait was the first physician to delineate the etiopathogenesis between annulus rupture, symptoms of sciatica, and neurological signs in his publication of 1911. Further publications by Middleton and Teacher in 1911 and Schmorl in 1929 added to the understanding of lumbar spinal pathologies. In 1929, the Swiss neurologist Veraguth (surgery performed by Hans Brun) and the American neurosurgeon Walter Edward Dandy both published their early experiences with the surgical therapy of a herniated lumbar disc. Veraguth's contribution, however, has not been appreciated internationally to date. The causal relationship between lumbar disc pathology and sciatica remained uncertain for some years to come. The causal relationship was not confirmed until Mixter and Barr's landmark paper in 1934 describing the association of sciatica and lumbar disc herniation, after which the surgical treatment became increasingly popular. Veraguth was among the first physicians to report on the clinical course of a patient with successful resection of a herniated lumbar disc. His observations should be acknowledged in view of the limited experience and literature on this ailment at that time 2).




Clinical Features




Case series

Case reports

Lumbar disc herniation in children aged 10 years or less is extremely uncommon and posterior apophyseal ring separation is not a common injury that usually occurs in adolescents or young adults after a sports-related microtraumatism. The authors report an unique case of 10-year-old boy who presented with low back pain and radiating pain on both legs. The boy received conservative treatment, which included anti-inflammatory medication, muscle relaxants, and physical therapy, but symptoms were not improved. Computed tomography and magnetic resonance imaging revealed a huge central disc herniation combined with posterior apophyseal ring separation. Microscopic lumbar discectomy with the removal of apophyseal ring separation was performed due to the intractable pain. At six months after surgery, the child was symptom free 3).


Radło P, Smetkowski A, Tesiorowski M. [Polish nomenclature of lumbar disc disease]. Przegl Lek. 2014;71(7):394-9. Review. Polish. PubMed PMID: 25338336.
Stienen MN, Surbeck W, Tröhler U, Hildebrandt G. Little-known Swiss contributions to the description, diagnosis, and surgery of lumbar disc disease before the Mixter and Barr era. J Neurosurg Spine. 2013 Dec;19(6):767-73. doi: 10.3171/2013.8.SPINE121008. Epub 2013 Sep 27. PubMed PMID: 24074509.
Kim P, Kim SW, Ju CI, Kim HS. Lumbar Disc Herniation Combined with Posterior Apophyseal Ring Separation in a Young Child: A Case Report. Korean J Spine. 2015 Sep;12(3):143-5. doi: 10.14245/kjs.2015.12.3.143. Epub 2015 Sep 30. PubMed PMID: 26512269; PubMed Central PMCID: PMC4623169.
lumbar_disc_herniation.txt · Last modified: 2019/12/09 13:51 by administrador