What is Lumbar Disc Displacement?
Lumbar Disc Displacement is a pathological condition of the lumbar spine in which one of the discs which forms the lumbar spine moves out of its normal alignment. The lumbar disc acts as a shock absorber for the lumbar spine and protects it from the stresses of everyday life and keeps the lumbar vertebrae separated from each other.
In cases of Lumbar Disc Displacement, the disc is no longer able to provide that cushioning to the bones of the lumbar vertebra and thus even performing daily tasks becomes difficult for an individual. Lumbar Disc Displacement leads to chronic low back pain and if not treated appropriately may lead to disabling pain where the individual may not be able to work or perform day to day activities due to severe pain as a result of Lumbar Disc Displacement.
What Causes Lumbar Disc Displacement?
In majority of the cases, Lumbar Disc Displacement occurs due to the natural process of aging with degeneration of the lumbar spine. With age, the water content in the lumbar discs gets reduced making the disc weak. This is medically termed as disc degeneration. Apart from disc degeneration, there are also various factors that may cause a Lumbar Disc Displacement.
Gender is one of the factors and it is seen that males between the age of 35 and 50 are more prone to have Lumbar Disc Displacement than females in the same age group. Obesity also plays a key role and people who are overweight are at greater risk for Lumbar Disc Displacement due to the stress that they put on the spine as a result of their weight. People who do not have an active lifestyle are remain sedentary may also suffer from Lumbar Disc Displacement.
People working in construction and other areas where they have to do heavy lifting of items are also at greater risk for having Lumbar Disc Displacement. All these things put a lot of strain on the discs of the lumbar spine which eventually starts degenerating and ultimately moves out of alignment causing Lumbar Disc Displacement.
What are the Symptoms of Lumbar Disc Displacement?
The classic presenting feature of Lumbar Disc Displacement is pain on the low back. This pain tends to worsen gradually with time and becomes severe depending on the level of activity. The pain may also impair the sleep of an individual at night as a result of Lumbar Disc Displacement. The pain may also worsen with sneezing, coughing, or even laughing. Some of the other symptoms of Lumbar Disc Displacement are:
- Back pain radiating to one side of the leg, hip, and buttocks
- Numbness behind the calf and sole of the foot
- Weakness of the muscles of the lower extremities
- Bowel and bladder incontinence in some severe cases of Lumbar Disc Displacement.
How is Lumbar Disc Displacement Diagnosed?
In order to diagnose Lumbar Disc Displacement, the physician will first perform a detailed physical examination to inspect the area of concern which is the lower back, hips, and legs. The physician will look for areas of numbness in the calf or sole of the foot. Physician will also test the muscle strength of the lower extremities.
A straight leg raise test may also be performed to see if it reproduces the pain or not. If the patient experiences pain then it is a pointer towards a Lumbar Disc Displacement. For further investigation, radiological studies will be performed with an x-ray of the lumbar spine along with advanced imaging like MRI and CT scan. These studies will clearly delineate and confirm the diagnosis of Lumbar Disc Displacement.
How is Lumbar Disc Displacement Treated?
Lumbar Disc Displacement may be treated both conservatively as well as surgically, although surgical procedures are reserved only if all conservative measures to treat the condition fail. To begin with, the patient will be asked to refrain from activity that may aggravate the symptoms, rest for a period of time, and antiinflammatory medications and NSAIDs in the form of Tylenol or ibuprofen to calm down the inflammation.
Minor cases of Lumbar Disc Displacement can be effectively treated by these measures along with spine specific physical therapy. In most of the cases, these measures are enough to successfully treat Lumbar Disc Displacement and allow the patient to lead a normal life in a few months. In some cases, if significant relief is not obtained by these measures, then steroid injections are recommended for pain relief.
Controlled use of narcotics is also one way to treat pain due to Lumbar Disc Displacement but this is only for a short period of time. Additionally, the patient will also be advised lifestyle modifications to include a balanced diet and exercise. Losing weight for obese patient is also advised for patients with Lumbar Disc Displacement.
Surgery to Treat Lumbar Disc Displacement
Surgery is recommended for all the patients who do not get any relief from any of the above mentioned measures. The surgical procedures done for Lumbar Disc Displacement are microdiscectomy and percutaneous discectomy.
Microdiscectomy to Treat Lumbar Disc Displacement
In this procedure, a small segment of the disc in the lumbar spine that is impinging the spinal root is excised. Using fluoroscopic guidance for the procedure reduces the length of the incision made for the procedure and also gives a direct view of the lumbar disc displacement.
Percutaneous Discectomy to Treat Lumbar Disc Displacement
It is a minimally invasive procedure which involves insertion of a thin tube or tubes into the lumbar spine. This creates a pathway for the surgeon to access the displaced disc. A guide wire is then placed in the disc. Over this central guide wire, tubes are placed sequentially to push the surrounding soft tissues away from the displaced disc provide a pathway for the surgeon to excise the displaced disc and thus treat lumbar disc displacement.