Lumbar hernias have increased their incidence significantly in recent years, with low back pain being one of the largest cases of work absenteeism in the world. A lumbar hernia occurs when a part of the intervertebral disc moves into the spinal canal, compromising the thecal sac and/or nerve roots.
66% of lumbar hernias end up being reabsorbed in less than 12 months with conservative treatment. The symptoms of a herniated disc (increased pain) will depend more on the composition of the disc than on its size.
In general, lumbar hernias manifest as lumbar pain radiating to the lower limb with an area of distribution corresponding to the dermatomes of the nerve roots involved.
The usual clinical manifestation of lumbar hernia is sciatica or lumbosciatica. Sciatica is defined as pain that begins in the gluteal area and radiates along the path of the sciatic nerve. The typical case of sciatica caused by a hernia is unilateral pain that begins in the medial posterior gluteal area or lumbar area that radiates through the lateral aspect of the leg. It usually resolves or improves substantially in the first 2 weeks so that less than 25% of patients remain with pain after 3 months.
In patients with greater symptoms, greater vascularization has been found, in addition to a greater composition of hyaline cartilage.
It can be stated that 85% of sciatica cases are caused by conditions of the intervertebral disc. The origin of the pain is not completely known, but it is assumed that it may appear due to direct involvement of the root or spinal ganglion in addition to the effect of local inflammatory cytokines.
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