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Disc Herniation and Radiculopathy

  • Brent Earls
  • M. Alexander Kiefer
Chapter

Abstract

Intervertebral discs are pads of fibrocartilage that lie between the vertebral bodies of the spine. The function of the intervertebral disc is to provide articulation between the vertebral bodies and stability to the spine. In addition to allowing complex range of motion, the discs transmit and withstand mechanical loads such as axial loading, bending, and twisting. The central nucleus pulposus is surrounded by the annulus fibrosus (AF). Both these structures are bound on top and bottom by the cartilaginous end plates. The state of the intervertebral disc is dynamic over its lifetime, and degenerative processes change the intervertebral disc at the cellular level, making it more susceptible to overload during strained physical activity. Herniation describes displacement of disc material beyond the limits of the intervertebral disc space. This is the most common cause of disruption of the nerve roots as they exit the spine. This condition, called radiculopathy, presents as pain and/or a neurologic deficit along the territory of the affected nerve(s). While no gold standard for diagnosis is universally accepted, diagnosis can be aided by physical exam maneuvers, electrodiagnostic studies, and imaging. Early prognosis is favorable with most patients having significant improvement or complete resolution of symptoms within 3 months. In circumstances where pain persists beyond 3 months, there are many effective treatment options to assist with pain recovery and resuming normal activity for the patient.

Keywords

Herniated disc Lumbosacral radiculopathy Cervical radiculopathy Root compression Sciatica Low back pain Radiculitis Radicular pain Electromyography Somatosensory evoked potentials Discectomy Spinal fusion 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Brent Earls
    • 1
  • M. Alexander Kiefer
    • 2
  1. 1.Department of AnesthesiologyGeorgetown University HospitalWashington, DCUSA
  2. 2.Georgetown Pain Management and Georgetown University School of MedicineWashington, DCUSA

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