41. Revista Do Hospital Das Clínicas - Extruded disk herniation is the main differential diagnosis with lumbar The fragments of the herniated disk show a low intensity signal in the T1 and http://www.scielo.br/scielo.php?pid=S0041-87811999000100006&script=sci_arttext&t

42. Clinical Evaluation And Treatment Options For Herniated Lumbar Disc - February 1 Illustrated discussion of causes of disc herniation, assessment, imaging procedures and both surgical and nonsurgical treatment. http://www.aafp.org/afp/990201ap/575.html

Advanced Search AAFP Home Page Journals Vol. 59/No. 3 (February 1, 1999) Clinical Evaluation and Treatment Options for Herniated Lumbar Disc S. CRAIG HUMPHREYS, M.D., and JASON C. ECK, M.S. Chattanooga, Tennessee A patient information handout on herniated lumbar disc, written by the authors, is provided on page 587. Degeneration of the intervertebral disc from a combination of factors can result in herniation, particularly at the L4-5 and L5-S1 levels. The presence of pain, radiculopathy and other symptoms depends on the site and degree of herniation. A detailed history and careful physical examination, supplemented if necessary by magnetic resonance imaging, can differentiate a herniated lumbar disc from low back strain and other possible causes of similar symptoms. Most patients recover within four weeks of symptom onset. Many treatment modalities have been suggested for lumbar disc herniation, but studies often provide conflicting results. Initial screening for serious pathology and monitoring for the development of significant complications (such as neurologic defects, cauda equina syndrome or refractory pain) are essential in the management of lumbar disc herniation. T he intervertebral disc is responsible for the attachment of vertebral bodies to each other, providing flexibility and absorbing and distributing the loads applied to the spinal column. With aging, the disc undergoes significant changes in volume and shape as well as in biochemical composition and biomechanical properties. Lumbar disc herniations are believed to result from anular degeneration that leads to a weakening of the anulus fibrosus, leaving the disc susceptible to anular fissuring and tearing.

43. Lumbar Spine Stenosis: A Common Cause Of Back And Leg Pain - April 15, 1998 - Am radicular pain secondary to nerve root compression by a herniated lumbar disc, It should be noted that herniation of disc material and subsequent http://www.aafp.org/afp/980415ap/alvarez.html

Advanced Search AAFP Home Page Journals Vol. 57/No. 8 (April 15, 1998) ... Patient Information Lumbar Spine Stenosis: A Common Cause of Back and Leg Pain JAMIE A. ALVAREZ, M.D., and RUSSELL H. HARDY, JR., M.D. University Hospitals of Cleveland/Case Western Reserve University, Cleveland, Ohio A patient information handout on lumbar spinal canal stenosis , written by the authors of this article, is provided on page 1839. L ow back pain resulting from degenerative disease of the lumbosacral spine is a major cause of morbidity, disability and lost productivity. Up to 90 percent of the U.S. population may have significant low back pain at some point. In 1984, it was estimated that over 5 million persons were incapacitated as a result of lower back pain. The financial impact in terms of health care dollars and lost work hours reaches billions of dollars each year in this country. With the increasing longevity of our population and a continually climbing proportion of middle-aged and elderly persons, the problem of lumbosacral pain is a significant health care issue. A ubiquitous and potentially disabling cause of osteoarthritic pain of the lower back and legs is stenosis of the lumbar spinal canal. This treatable condition is often a major cause of inactivity, loss of productivity and, potentially, loss of independence in many persons, particularly older persons. Because of the slow progression of the disease, the diagnosis may be significantly delayed. Given the potentially devastating effects of this condition, rapid diagnosis and treatment are essential if patients are to be returned to their previous levels of activity.

44. Herniated Lumbar Disc A herniated lumbar disc can press on the nerves in the spine and may cause A herniated lumbar disc may also cause back pain, although back pain alone http://www.spine.org/articles/herniatedlumbardisc.cfm

Herniated Lumbar Disc While a disc herniation may sound serious, most people recover and return to their normal lifestyle within several weeks or months without having surgery. There may still be some symptoms, but most patients can function well. What is it? Available Treatments Medical Treatments Surgical Treatments Get professional supervision early to so your doctor can prescribe the right regimen of medication, physical therapy, exercise, posture modification and physical activity. Accurate diagnosis and early management may help you recover faster. Keep the use of pain medications to a minimum. All medications should be taken as directed. Tell your doctor of any changes in your symptoms so treatment can be changed if necessary. Call your doctor immediately if you have loss of bladder or bowel control or numbness in the genital area in addition to your pain. What Is A Herniated Disc? The spine is made up of a series of connected bones called "vertebrae". The disc is a combination of strong connective tissues which hold one vertebra to the next, and acts as a cushion between the vertebrae. The disc is made of a tough outer layer called the "annulus fibrosus" and a gel-like center called the "nucleus pulposus." As you get older, the center of the disc may start to lose water content, making the disc less effective as a cushion. This may cause a displacement of the disc’s center (called a herniated or ruptured disc) through a crack in the outer layer. Most disc herniations occur in the bottom two discs of the lumbar spine, at and just below the waist.

45. Lumbar Herniated Disc lumbar herniated disc overview of causes and treatments, by SpineHealth. http://www.spine-health.com/topics/cd/overview/lumbar/young/lum01.html

Introduction Common causes Conservative care Surgery ... Anatomy Search Common causes of back pain and neck pain Back pain introduction Lumbar spine: Young adult causes: Lumbar herniated disc Degenerative disc disease Isthmic spondylolisthesis Older adult causes: Facet joint osteoarthritis Lumbar spinal stenosis Degenerative spondylolisthesis Miscellaneous causes Figures Fig. 1: Lumbar Disc Herniation larger view Fig. 2: MRI of Lumbar Disc Herniation) larger view Spine animations Lumbar herniated disc Lumbar microdecompression (microdiscectomy) back surgery Related information Insights and advice about herniated discs Treatment options for a lumbar herniated disk Lumbar artificial disc surgery for chronic back pain Multi-specialy caseherniated disc ... The doctor is in! - Lumbar herniated disc surgery

46. Lumbar Herniated Disc Animation Animation of a lumbar herniated disc and how disc herniation causes low back pain and leg pain, by SpineHealth. http://www.spine-health.com/dir/hern.html

Interactive Spine Animations Search Related information Insights and advice about herniated discs Lumbar disc herniation What you need to know about sciatica What is a herniated disc, pinched nerve, bulging disc...? Find a Doctor Choose a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Germany United Kingdom Lumbar herniated disc animation This animation allows you to see what a typical lumbar herniated disc looks like. A herniated disc in the lower back can cause lower back pain and/or leg pain (sciatica) by putting pressure on the nerve root.

47. Clinical Evidence Musculoskeletal Disorders Herniated Disc herniated lumbar disc is a displacement of disc material (nucleus pulposus The prevalence of symptomatic herniated lumbar disc is about 1–3% in Finland http://www.clinicalevidence.com/ceweb/conditions/msd/1118/1118_background.jsp

48. Clinical Evidence Musculoskeletal Disorders Herniated Disc Musculoskeletal disorders. herniated lumbar disc. Search date May 2004. Jo Jordan, Tamara Shawver Morgan, and James Weinstein http://www.clinicalevidence.com/ceweb/conditions/msd/1118/1118.jsp

49. Herniated Lumbar Disc | Mayfield Clinic A herniated disc occurs when the gel inside the disc ruptures through a weak area in the disc wall, similar to the filling being squeezed out of a jelly http://www.mayfieldclinic.com/PE-HLDisc.htm

Overview Your spine is made of 24 moveable bones called vertebrae, which are separated and cushioned by gel-filled discs that act as shock absorbers, keeping your vertebrae from rubbing together. A herniated disc occurs when the gel inside the disc ruptures through a weak area in the disc wall, similar to the filling being squeezed out of a jelly doughnut. Pain results when the disc material touches a nearby nerve. Conservative nonsurgical treatment is the first step to recovery. With a team approach to treatment, 80% of people with back pain improve in about 6 weeks and return to normal activity. If your body doesn't respond to conservative treatment, your doctor may recommend surgery. To understand a herniated disc, it is helpful to understand a little about how your spine works (see Anatomy of the Spine The lumbar (lower back) section of your spine bears most of the weight of the body and provides the most movement. It is made up of 5 bony vertebrae stacked on top of one another. These vertebrae are separated by cushiony discs, which act as shock absorbers, preventing the vertebrae from rubbing together. Each disc has a gel-filled center called the nucleus and a tough fibrous outer ring called the annulus (Fig. 1A). At each disc level, a pair of spinal nerves exit from the spinal cord and branch out to your body. Your spinal cord (which runs through the middle of the vertebrae) and your spinal nerves act as a "telephone," allowing messages, or impulses, to travel back and forth between your brain and your body to relay sensation and to control movement.

50. UCLA NEUROSURGERY | Spinal Disorders & Diseases The symptoms of a herniated lumbar disc are dependent upon the nerve roots that are The mainstay of therapy for herniated lumbar disc is conservative http://neurosurgery.ucla.edu/Diagnoses/Spinal/SpinalDis_3.html

Lumbar Disc Disease COMPREHENSIVE SPINE PROGRAM COMPREHENSIVE SPINE DIAGNOSES INDEX What is lumbar disc disease? Degeneration, dehydration and collapse of a disc can occur with or without herniation. The failure of the disc to act as a cushion can cause instability and mechanical low back pain upon weight bearing such as sitting, standing, and walking, that is improved by reclining or laying down. Fusion surgery may be necessary to relieve back pain in this condition. The intervertebral discs are cartilaginous plates surrounded by a fibrous enclosure which lie between the vertebral bodies and serve to cushion the spine. Through degeneration, wear and tear, or trauma, the fibrous tissue (annulus fibrosus) constraining the soft disc material (nucleus pulposus) may tear. This results in protrusion of the disc or even extrusion of disc material into the spinal canal or neural foramen. This has been called herniated disc, ruptured disc, herniated nucleus pulposus, or prolapsed disc. What causes the symptoms of lumbar disc herniation?

51. Lumbar Herniated Disc Sciatica is a symptom frequently associated with a lumbar herniated disc. http://www.spineuniverse.com/displayarticle.php/article28.html

The World Leader in Back Pain Care Home Patients Professionals Find a Doctor ... Pain Management SEARCH Make SpineUniverse my Home Page patient>conditions>slipped disc Use FREE SpineUniverse Tools. Enter your Zipcode and we'll show you the best doctors and treatments in your area. Lumbar Herniated Disc Part 1 of 3 Jean-Jacques Abitbol, M.D., FRCSC Orthopaedic Surgeon California Spine Group, MC San Diego, CA, USA Edgar G. Dawson, M.D. Regis W. Haid, Jr., M.D. Neurosurgeon Atlanta Brain and Spine Care Atlanta, GA, USA Introduction A common cause of low back and leg pain is a herniated or ruptured disc. Symptoms may include dull or sharp pain, muscle spasm or cramping, sciatica , and leg weakness or loss of leg function. Sneezing, coughing, or bending usually intensifies the pain. Rarely bowel or bladder control is lost, and if this occurs, seek medical attention at once. Sciatica is a symptom frequently associated with a lumbar herniated disc. Pressure on one or several nerves that contribute to the sciatic nerve can cause pain, burning, tingling, and numbness that extends from the buttock into the leg and sometimes into the foot. Usually one side (left or right) is affected.

52. Treatment Options For Ruptured Discs In The Low Back One of the more common problems of the lumbar spine is a herniated disc. Accordingly, a herniated lumbar disc characteristically produces buttock and http://www.spineuniverse.com/displayarticle.php/article510.html

The World Leader in Back Pain Care Home Patients Professionals Find a Doctor ... Pain Management SEARCH Make SpineUniverse my Home Page patient>treatments>low back pain>non-surgical Use FREE SpineUniverse Tools. Enter your Zipcode and we'll show you the best doctors and treatments in your area. Treatment Options for Ruptured Discs in the Low Back Kevin T. Foley, M.D. Associate Professor University of Tennessee Memphis, TN, USA A shooting, stabbing pain that shoots from your back or buttocks into your leg is called sciatica or radiculopathy. It can be associated with numbness or weakness of your leg and foot. The most frequent cause of this condition is a ruptured disc in the lower back. In this article, we review disc problems of the lower back, also known as lumbar disc disease. Most ruptured discs respond to nonsurgical treatment. When this does not work, back surgery may be necessary. The content of this article addresses the anatomy, pathology, diagnosis, treatment options, and care for the patient who suffers from pain secondary to lumbar disc herniation.

53. American Family Physician: Clinical Evaluation And Treatment Options For Herniat Many treatment modalities have been suggested for lumbar disc herniation, Symptoms of a herniated lumbar disc may often be difficult to distinguish from http://www.findarticles.com/p/articles/mi_m3225/is_3_59/ai_53979624

@import url(/css/us/style1.css); @import url(/css/us/searchResult1.css); @import url(/css/us/articles.css); @import url(/css/us/artHome1.css); Advanced Search Home Help IN free articles only all articles this publication Automotive Sports 10,000,000 articles - not found on any other search engine. FindArticles American Family Physician Feb 1, 1999 Content provided in partnership with 10,000,000 articles Not found on any other search engine. Related Searches Intervertebral disk / Hernia Vertebrae, Lumbar / Medical examination Featured Titles for AAACN Viewpoint ABNF Journal, The AIDS Treatment News AMAA Journal ... View all titles in this topic Hot New Articles by Topic Automotive Sports Top Articles Ever by Topic Automotive Sports Clinical Evaluation and Treatment Options for Herniated Lumbar Disc American Family Physician Feb 1, 1999 by S. Craig Humphreys Jason C. Eck Save a personal copy of this article and quickly find it again with Furl.net. It's free! Save it. Degeneration of the intervertebral disc from a combination of factors can result in herniation, particularly at the L4-5 and L5-S1 levels. The presence of pain, radiculopathy and other symptoms depends on the site and degree of herniation. A detailed history and careful physical examination, supplemented if necessary by magnetic resonance imaging, can differentiate a herniated lumbar disc from low back strain and other possible causes of similar symptoms. Most patients recover within four weeks of symptom onset. Many treatment modalities have been suggested for lumbar disc herniation, but studies often provide conflicting results. Initial screening for serious pathology and monitoring for the development of significant complications (such as neurologic defects, cauda equina syndrome or refractory pain) are essential in the management of lumbar disc herniation.

54. Herniated Disc - New Treatments, January 22, 2005 Symptoms of a herniated lumbar disc may often be difficult to distinguish from The most common sites for a herniated lumbar disc are L45 and L5-S1, http://www.medical-library.org/journals2a/herniated_lumbar.htm

Click here to view next page of this article New Treatments for Herniated Lumbar Disc Symptoms of a herniated lumbar disc may often be difficult to distinguish from those of other spinal disorders or simple back strain. Clinical evaluation The most common levels for a herniated disc are L4-5 and L5-S1. The onset of symptoms is characterized by a sharp, burning, stabbing pain radiating down the posterior or lateral aspect of the leg, to below the knee. Pain is generally superficial and localized, and is often associated with numbness or tingling. In more advanced cases, motor deficit, diminished reflexes or weakness may occur in herniated disc and sciatica. If a disc herniation is responsible for the back pain, the patient can usually recall the time of onset and contributing factors, whereas if the pain is of a gradual onset, other degenerative diseases are more probable than disc herniation. Rheumatoid arthritis often begins in the appendicular skeleton before progressing to the spine. Inflammatory arthritides, such as ankylosing spondylitis, cause generalized pain and stiffness that are worse in the morning and relieved somewhat throughout the day. "Red Flags" for Potentially Serious Conditions

55. Herniated Disc Often people who experience a herniated disc already have lumbar spinal stenosis, a problem that causes bone spurs and inflammatory tissue to take up some http://orthopedics.about.com/cs/herniateddisk/a/ruptureddisk.htm

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56. Lumbar Disc Disease (Herniated Disc) Detailed information on lumbar disc disease, including cause, symptom, diagnosis, and treatment. http://www.healthsystem.virginia.edu/uvahealth/adult_neuro/hdisc.cfm

[ Skip Navigation ] Health System Home For Health Answers Healthcare Professionals ... Advanced Search Health System Search Search for Information People UVa Home Health System News Health System Events (all) Health System Publications ... Making a Gift Topics All About Cancer Blood Disorders Bone Disorders Breast Health Cancer Cardiovascular Disease Dermatology Diabetes Digestive Disorders Endocrinology Environmental Medicine Eye Care Glossary Gynecological Health Infectious Diseases Kidney Disease Men's Health Mental Health Nervous System Disorders Non-Trauma Emergency Oral Health Orthopaedics Otolaryngology Pathology Pediatrics, General Health Prostate Health Radiology Respiratory Disorders Skin Cancer Surgical Care Urology Women's Health UVa Health Topics A to Z FIND A DOCTOR Brain Cancer: Medical Oncology Brain Tumors Epilepsy ... WHY CHOOSE UVA Search This Site Lumbar Disc Disease (Herniated Disc) Anatomy of the lumbar spine: The vertebral column, also called the backbone, is made up of 33 vertebrae that are separated by spongy disks and classified into four distinct areas. The cervical area consists of seven bony parts in the neck; the thoracic spine consists of 12 bony parts in the back area; the lumbar spine consists of five bony segments in the lower back area; five sacral bones (fused into one bone, the sacrum); and four coccygeal bones (fused into one bone, the coccyx). Lumbar disc disease occurs in the lumbar area of the spine. The lumbar area of the spine (and other areas of the spine) is made up of two parts, including the following:

57. Back Institute : Herniated Disc, Microdiscectomy, Herniated Disc, Back Surgery, A New and Superior Technique for Removal of herniated lumbar Disc Endoscope and Nucleotome Combination. Abstract. A New and Superior Technique for Removal http://www.backinstitute.com/article.htm

OutPatient Spine Surgery Specialist since 1986 (Alternatives to Major Surgery) ABSTRACT Endoscopic Transforaminal Disc Removal and Reconfiguration Abstract Endoscopic Transforaminal Disc Removal and Reconfiguration . . .. . .Endoscopic Transforaminal Disc Removal and Reconfiguration .Source: Spine Disorders 1996 Annual Meeting .Publisher: The Joint Section on Spine and Peripheral Nerves .Major subject: Spine and Peripheral Nerve .Publication type: Paper .Date of publication: Feb 1996.ISSN: .Author: Ditsworth DA .Abstract:. Over the... A New and Superior Technique for Removal of Herniated Lumbar Disc: Endoscope and Nucleotome Combination Abstract A New and Superior Technique for Removal of Herniated Lumbar Disc: Endoscope and Nucleotome Combination . . .. . .A New and Superior Technique for Removal of Herniated Lumbar Disc: Endoscope and Nucleotome Combination .Source: Spine Disorders 1995 Annual Meeting .Publisher: The Joint Section on Spine and Peripheral Nerves . Major subject: Spine and Peripheral Nerve .Publication typ... Comprehensive Percutaneous Endoscopic Spinal Surgery Abstract Comprehensive Percutaneous Endoscopic Spinal Surgery . . .. . .Comprehensive Percutaneous Endoscopic Spinal Surgery .Source: AANS 1995 Annual Meeting .Publisher: The American Association of Neurological Surgeons .Major subject: Spine and Peripheral Nerve .Publication type: Paper .Date of publication: Apr 1995 .ISSN: .Author: Ditsworth D .Abstract:. Over 4 years, 450 outpatient pe...

58. Back Institute : Herniated Disc, Microdiscectomy, Herniated Disc, Back Surgery, Until a few years ago, the only surgical treatment for herniated lumbar discs was the open removal of a part of the herniated disc, an often effective but http://www.backinstitute.com/faq/treatments.html

OutPatient Spine Surgery Specialist since 1986 (Alternatives to Major Surgery) Treatments for herniated lumbar discs Depending upon the results of the physical examination and the severity of your condition, your doctor may offer you two forms of treatment. The first common treatment is the aforementioned "Conservative Therapy," bed rest, pain medication, and physiotherapy . If conservative therapy does not bring enough pain relief, surgical procedures may be considered. Until a few years ago, the only surgical treatment for herniated lumbar discs was the open removal of a part of the herniated disc, an often effective but major operation that requires general anesthesia, the dissection of muscle, removal of bone, and at times, bone fusion. In recent years, techniques employing the use of endoscopy have been incorporated into lumbar spine surgery making minimally invasive spine surgery possible while overcoming disadvantages of traditional techniques. Endoscopic Discectomy can provide an effective way to decompress and repair damages discs without open surgery An Endoscope provides clear visualization and magnification of deep structures. First used in knee surgery, endoscopy, (arthroscopy,) with its advanced miniaturization and video imaging technology has made it possible for a less invasive and less traumatic discectomy procedure for some disc patients.

59. The Physician And Sportsmedicine: Acute Lumbar Disk Injuries In Active Patients Nonoperative and Operative Treatment Options for lumbar disk Herniation. Technique, Advantage, Disadvantage, or Indication. Nonoperative http://www.physsportsmed.com/issues/2005/0405/lively.htm

Acute Lumbar Disk Injuries in Active Patients Making Optimal Management Decisions Mathew W. Lively, DO; Julian E. Bailes, Jr, MD THE PHYSICIAN AND SPORTSMEDICINE - VOL 33 - NO. 4 - APRIL 2005 For CME accreditation information, instructions and learning objectives, click here In Brief: Managing acute lumbar disk herniations in active patients can be challenging for physicians, especially when controversies surrounding treatment options make choosing the right care more difficult. The prognosis for lumbar disk herniations is generally favorable, and most patients will improve with conservative measures, such as early activity and avoiding bed rest. Minimally invasive techniques, such as percutaneous diskectomy, laser diskectomy, and epidural corticosteroid injection, may help control sciatic pain. Athletes who sustain late-season disk injuries should receive conservative treatment before considering surgery. Those who have early-season injuries may be able to return to competition sooner by having a microdiskectomy before a full course of conservative therapy is completed, but data supporting this approach are currently lacking. T he incidence of low-back pain in college athletes ranges from 6.9% to 64.8%

60. Lower-extremity Sensibility Testing In Pts W/ Herniated Lumbar Intervertebral Di touch in individuals with a herniated lumbar disc has been questioned. by a herniated lumbar disc was accurate in only 50 per cent of patients. http://www.wheelessonline.com/ortho/lower_extremity_sensibility_testing_in_pts_w

Duke Orthopaedics presents Wheeless' Textbook of Orthopaedics Site Index A - Z Search Site by Word Home Contact Us My Account Lower-extremity sensibility testing in pts w/ herniated lumbar intervertebral discs Steve Rowlands website graphic design at www.steverowlands.com http://www.DiamondSea.com

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