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Updated: Apr 4 2025

Lumbar Disc Herniation

Images
  • summary
  • Epidemiology
  • Etiology
  • Anatomy
  • Classification
    • Location Classification
      • central prolapse
        • often associated with back pain only
        • may present with cauda equina syndrome which is a surgical emergency
      • posterolateral (paracentral)
        • most common (90-95%)
        • PLL is weakest here
      • foraminal (far lateral, extraforaminal)
        • less common (5-10%)
        • herniated disc material directly compresses dorsal root ganglion
          • can manifest with more severe pain than traditional posterolateral disc herniation
      • axillary
        • can affect both exiting and descending nerve roots
    • Morphology classification
      • protrusion
        • eccentric bulging with an intact annulus
      • extrusion
        • disc material herniates through annulus but remains continuous with disc space
      • sequestered fragment (free)
        • disc material herniates through annulus and is no longer continuous with disc space
        • prone to proximal or distal migration
    • Containment classification
      • contained 
        • disc material is contained beneath the posterior longitudinal ligament
      • uncontained
        • disc material passes dorsal to the posterior longitudinal ligament
    • Timing classification
      • acute
        • herniations present < 3-6 months
          • important consideration given surgical outcomes are associated with chronicity 
      • chronic
        • herniations present >6 months
  • Presentation
  • Imaging
  • Treatment
  • Techniques
  • Complications 
  • Prognosis
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Spine | Lumbar Disc Herniation
  • Spine
  • - Lumbar Disc Herniation
21:28 min
10/24/2019
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