27 Jun 2014

Inter vertebral disc prolapse - Clinical features

Functions of Inter vertebral disc
1)     To separate two vertebral bodies and increases available motion.
2)     To transmit load from one vertebral body to the next.
3)     The disc makes up to 20% to 33% of the length of the vertebral column.
4)     Disc increase in size from cervical ( neck) to lumbar region (lower back).
Disc thickness is 3mm in cervical region (neck region) where weight bearing loads are minimum.
Disc thickness is 9mm in lumbar region (low back)

Risk factors for disc herniation are the following
1)     Job requiring heavy and repetitive weight  lifting.
2)     Use of machine tools.
3)     Operation of motor vehicles.
4)     Cigarette smokers and tobacco consumers.
5)     Overtime heavy work,  poor postural habits.
6)     Degenerative changes make the disc susceptible to trauma.

Any trauma which suddenly increases the pressure will result in rupture of posterior fibres of annulus.

Repeated stresses over time cause
1)     Fatigue breakdown
2)     Traumatic rupture

Clinical features of disc prolapse
Patient is usually an adult between 20 -40 age group. Commonest complaint is low backache. It can be acute or chronic sometime pain radiate to the buttock and leg. The pain is increased by flex-ion (stooping forward) episode, straining, sneezing, coughing and relieved by rest. If there is associated, nerve root compression there will be numbness or weakness in lower limb.

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