Published May 5th, 2o16 in the New England Journal of Medicine 1 is a review paper on herniated lumbar disk. Dr. Deyo opens the manuscript with a case presentation of 41-yr-old man. He develops progressive increasing lower back and leg pain from doing yard work. This involved pulling out large bushes. With a positive straight leg raise at 40 degrees, the most probable diagnosis is herniated lumbar disk.
About two-thirds of adults experience back pain some time in their life. Sciatica is often used to describe the result of a disk herniation as the sciatic nerve is the downstream nerve effected. A more appropriate term is lumbar radiculopathy. This is due to the proximal origin of the issue and the sensory and motor findings that presents along the sciatic nerve distribution.
Herniated Lumbar Disk
To help with patient education of a herniated lumbar disk, accurate modeling of the nucleus pulposus and annulus fibrosus is developed by Dynamic Disc Designs Corp. Now, a patient can understand the geometry and forces involved to create a disk herniation and may think twice about repeating the activity that causes the problem initially. Accurate patient education of herniated lumbar disk to reveal the mechanism of the injury is very helpful in the management of the condition. This is both in onset and rehabilitation as load with flexion causes the nucleus to push posteriorly.
It is important for patients to understand what caused their symptoms as to change future behaviours. It is known that a herniated lumbar disk is caused by hydraulic compression of overloading the spine into a flexion moment as the posterior annulus is compromised causing radial fissures 2. And now, this never before seen event can be shown with a knowledge transfer to the patient in an easily understandable dynamic model to help improve outcomes.
- Richard A. Deyo, M.D., M.P.H., and Sohail K. Mirza, M.D., M.P.H. Herniated Lumbar Intervertebral Disk. The New England Journal of Medicine. May 5, 2016 1763-72 ↩
- Samuel P. Veres, BEng, Peter A. Robertson, MD, Neil D. Broom, PhD The Morphology of Acute Disc Herniation. A Clinically Relevant Model Defining the Role of Flexion. SPINE 2009 Volume 34, Number 21, pp 2288–2296 ↩