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Updated: Jul 13, 2026
07:25
Ovine Lumbar Intervertebral Disc Degeneration Model Utilizing a Lateral Retroperitoneal Drill Bit Injury
Published on: May 25, 2017
Herniated lumbar intervertebral disk
R A Deyo1, J D Loeser, S J Bigos
1University of Washington School of Medicine, Seattle.
Annals of Internal Medicine
|April 15, 1990
Summary
Most low back pain isn't caused by herniated discs. Conservative treatments often resolve symptoms, with surgery reserved for persistent cases with clear imaging and neurological deficits after six weeks.
Area of Science:
- Orthopedics
- Neurology
- Radiology
Background:
- Low back pain is prevalent, but herniated intervertebral discs (HIDs) are an infrequent cause.
- Most HIDs resolve with conservative management, necessitating surgery in only 5-10% of cases.
Purpose of the Study:
- To outline diagnostic and treatment strategies for suspected lumbar disc herniation.
- To differentiate HID from other causes of radiating leg pain.
Main Methods:
- Focused physical examination on L5 and S1 nerve roots due to common herniation locations (L4-L5, L5-S1).
- Utilized advanced imaging (CT, MRI) selectively for surgical candidates.
- Emphasized conservative therapies including NSAIDs, limited bed rest, and early ambulation.
Main Results:
- Sciatica is a key indicator but can be mimicked by other conditions.
- Plain radiography lacks diagnostic utility for HIDs.
- Conservative therapy is generally effective, with limited roles for muscle relaxants and narcotics.
Conclusions:
- Surgery is indicated for HIDs only when conservative treatment fails for six weeks and is confirmed by imaging with corresponding sciatic pain and neurological deficits.
- Cauda equina syndrome is a surgical emergency requiring immediate intervention.
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