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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...

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Updated: Jun 28, 2026

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
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Team Approach: Management of an Acute L4-L5 Disc Herniation.

Zorica Buser1, Gene Tekmyster1, Hannah Licari1

  • 1Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

JBJS Reviews
|October 12, 2021
PubMed
Summary

Lumbar disc herniation, a common spinal condition, is effectively managed through a stepwise, multidisciplinary approach. This strategy integrates various specialists to tailor treatments from conservative care to surgery for optimal patient outcomes.

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Area of Science:

  • Spinal pathology and treatment algorithms.
  • Multidisciplinary healthcare models.
  • Interventional pain management.

Background:

  • Lumbar disc herniation is a prevalent spinal condition, frequently affecting L4-L5 and L5-S1 levels, with peak incidence in the fourth to sixth decades of life.
  • Symptom severity is contingent upon patient risk factors, herniation location, extent, and type.
  • Treatment options range from conservative measures to surgical interventions.

Observation:

  • A case review details the management of acute L4-L5 disc herniation in a young adult.
  • The case highlights the application of a multidisciplinary team approach.
  • The patient had no significant pre-existing comorbidities.

Findings:

  • Nonoperative treatments, including medication, activity modification, and physical therapy, are typically first-line interventions.
  • Epidural steroid injections may be considered if conservative methods fail.
  • Surgery, such as discectomy, is reserved for refractory cases.

Implications:

  • A stepwise, multidisciplinary team approach is crucial for managing symptomatic lumbar disc herniation.
  • Effective treatment necessitates collaboration among interventional physiatrists, orthopedic surgeons, physician assistants, and physical therapists.
  • This integrated model ensures comprehensive care and optimizes treatment pathways for patients with lumbar disc herniation.