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Disc Herniation

  • Antonio Gonzalez FiolEmail author
Chapter

Abstract

  1. 1.

    Herniated disc disease refers to a condition in which the intervertebral disc may herniate or rupture, allowing some of the nucleus pulposus to escape through the outer layer of the disc, the annulus fibrosus. This is typically caused by excessive tension on the disc and may be due to trauma or aging.

     
  2. 2.
    Sometimes there is merely an annular tear in the outer layer of the disc, in the annulus fibrosus.
    1. (a)

      This may be due to high impact sports such as gymnastics, football, and lifting or may be due to natural aging. Annular tears typically heal with scar tissue but are more prone to future tears and injury.

       
    2. (b)

      Degenerative disc disease (DDD) may result from trauma and aging and may begin as annular tears. Eventually this leads to the loss of the nucleus pulposus such that the vertebrae above and below approximate each other.

       
     

Keywords

Back pain Disc herniation Cauda equina syndrome MRI Neurologic exam 

References

  1. 1.
    Abou-Shameh MA, Dosani D, Gopal S, McLaren AG. Lumbar discectomy in pregnancy. Int J Gynecol Obstet. 2006;92(2):167–9.CrossRefGoogle Scholar
  2. 2.
    Al-areibi A, Coveney L, Singh S, Katsiris S. Case report: anesthetic management for sequential Cesarean delivery and laminectomy. Can J Anesth. 2007;54(6):471–4.CrossRefGoogle Scholar
  3. 3.
    Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72(3):403–8.CrossRefGoogle Scholar
  4. 4.
    Brown MD, Levi AD. Surgery for lumbar disc herniation during pregnancy. Spine (Phila Pa 1976). 2001;26(4):440–3.CrossRefGoogle Scholar
  5. 5.
    Brown MD, Brookfield KF. Lumbar disc excision and cesarean delivery during the same anesthesia. A case report. J Bone Joint Surg Am. 2004;86-A(9):2030–2.CrossRefGoogle Scholar
  6. 6.
    Chow J, Chen K, Sen R, Stanford R, Lowe S. Cauda equina syndrome post-caesarean section. Aust N Z J Obstet Gynaecol. 2008;48(2):218–20.CrossRefGoogle Scholar
  7. 7.
    Darwich AA, Diwan SA, Ostgaard HC, Anderson GB, Karlson K, Morgan IM, et al. Management of back pain in pregnancy. Tech Reg Anesth Pain Manag. 2009;13(4):251–4.CrossRefGoogle Scholar
  8. 8.
    Garmel SH, Guzelian GA, D’Alton JG, D’Alton ME. Lumbar disk disease in pregnancy. Obstet Gynecol. 1997;89(5 Pt 2):821–2.CrossRefGoogle Scholar
  9. 9.
    Geftler A, Sasson A, Shelef I, Perry ZH, Atar D. Cauda equina syndrome in a 36 week gravida patient. Israel Med Assoc J. 2015;17:522.Google Scholar
  10. 10.
    Hakan T. Lumbar disk herniation presented with cauda equina syndrome in a pregnant woman. J Neurosci Rural Pract. 2012;3(2):197–9.CrossRefGoogle Scholar
  11. 11.
    Han I-H. Pregnancy and spinal problems. Curr Opin Obstet Gynecol. 2010;22(6):477–81.CrossRefGoogle Scholar
  12. 12.
    Hebl JR, Horlocker TT, Kopp SL, Schroeder DR. Neuraxial blockade in patients with preexisting spinal stenosis, lumbar disk disease, or prior spine surgery. Anesth Analg. 2010;111(6):1511–9.CrossRefGoogle Scholar
  13. 13.
    Kim HS, Kim SW, Lee SM, Shin H. Endoscopic discectomy for the cauda equina syndrome during third trimester of pregnancy. J Korean Neurosurg Soc. 2007;42(5):419.CrossRefGoogle Scholar
  14. 14.
    LaBan MM, Rapp NS, von Oeyen P, Meerschaert JR. The lumbar herniated disk of pregnancy: a report of six cases identified by magnetic resonance imaging. Arch Phys Med Rehabil. 1995;76(5):476–9.CrossRefGoogle Scholar
  15. 15.
    Powell MC, Wilson M, Szypryt P, Symonds EM, Worthington BS. Prevalence of lumbar disc degeneration observed by magnetic resonance in symptomless women. Lancet. 1986;2(8520):1366–7.CrossRefGoogle Scholar
  16. 16.
    Vercauteren M, Waets P, Pitkänen M, Förster J. Neuraxial techniques in patients with pre-existing back impairment or prior spine interventions: a topical review with special reference to obstetrics. Acta Anaesthesiol Scand. 2011;55(8):910–7.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyYale University School of MedicineNew HavenUSA

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