Lumbar Herniated Disc

	Jean-Jacques Abitbol, MD, FRCSC Orthopaedic Surgeon California Spine Group, MC San Diego, CA, USA
	Edgar G. Dawson, M.D.
	Regis W. Haid, Jr., MD Neurosurgeon Atlanta Brain and Spine Care Atlanta, GA, USA

Introduction
A common cause of low back and leg pain is a ruptured or herniated disc (sometimes written as herniated disk). Symptoms may include dull or sharp pain, muscle spasm or cramping, sciatica, and leg weakness or loss of leg function. Sneezing, coughing, or bending usually intensifies the pain. Rarely bowel or bladder control is lost, and if this occurs, seek medical attention at once.

Sciatica is a symptom frequently associated with a lumbar herniated disc. Pressure on one or several nerves that contribute to the sciatic nerve can cause pain, burning, tingling, and numbness that extends from the buttock into the leg and sometimes into the foot. Usually one side (left or right) is affected.

Anatomy - Normal Lumbar Disc
In between each of the five lumbar vertebrae (bones) is a disc, a tough fibrous shock-absorbing pad. Endplates line the ends of each vertebra and help hold individual discs in place. Each disc contains a tire-like outer band (called the annulus fibrosus) that encases a gel-like substance (called the nucleus pulposus).

Nerve roots exit the spinal canal through small passageways between the vertebrae and discs. Pain and other symptoms can develop when the damaged disc pushes into the spinal canal or nerve roots.

Disc herniation occurs when the annulus fibrous breaks open or cracks, allowing the nucleus pulposus to escape. This is called a Herniated Nucleus Pulposus (HNP) or herniated disc.

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