2 Indications and current treatments

2 Indications and current treatments

2.1 Lumbar disc herniation occurs when the nucleus pulposus of an intervertebral disc protrudes through a tear in the surrounding annulus fibrosus. Symptoms include pain in the back or leg, and numbness or weakness in the leg. Serious neurological sequelae may sometimes occur.

2.2 Conservative treatments include analgesics, non‑steroidal anti‑inflammatory medication and physical therapy. Epidural corticosteroid injections can also be used to reduce nerve pain in the short term. Lumbar discectomy is considered if there is evidence of severe nerve compression or persistent symptoms that are unresponsive to conservative treatment. Surgical techniques include open discectomy or minimally invasive alternatives using percutaneous approaches.

2.3 Lumbar discectomy usually leaves a hole in the annulus fibrosus through which the nucleus herniated, which may lead to reherniation and progressive loss in disc height.

  • National Institute for Health and Care Excellence (NICE)