Lumbar disc herniation (LDH)

• Clinical Characteristics of Minimal Lumbar Disc Herniation and Efficacy of Percutaneous Endoscopic Lumbar Discectomy via Transforaminal Approach: A Retrospective Study
• Effectiveness of Transforaminal, Interlaminar, and Caudal Epidural Injections in Lumbosacral Disc Herniation: A Systematic Review and Network Meta-analysis
• Asymmetric distribution of Modic changes in patients with lumbar disc herniation
• Trend of unplanned reoperation rates after lumbar degenerative surgery from 2011 to 2019: a large patient population study
• A Severe Disc Herniation Mimics Spinal Tumor
• Effects of the administration of Shinbaro 2 in a rat lumbar disk herniation model
• Does Percutaneous Endoscopic Lumbar Discectomy for Adolescent Posterior Ring Apophysis Fracture Accompanied with Lumbar Disc Herniation Have Better Outcome Than Lumbar Disc Herniation Alone?
• Multiple traditional Chinese medicinal approaches in collaboration with conservative conventional medicine for lumbar herniated intervertebral discs: A systematic review and meta-analysis

● 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 health care 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 ¹⁾.

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