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Abstract
The patient of lumbar disc herniation complains low back pain and sciatica. The intervertebral disc was degenerated by aging, the lifetime incidence of low back pain ranges from 80 to 90%, as determined by epidemiologic studies, whereas the incidence of sciatica is only 2~40%. This article was made with review of the natural history, clinical manifestations and physical examinations of lumbar disc herniation. In conclusion, a careful history and physical examination remain the key to accurate diagnosis of the cause of low back pain and /or sciatica, and very helpful adjuncts to make a diagnosis of lumbar disc herniations.
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Figures and Tables%
Fig. 1.
Root compression according to type of herniated disc Fig. 1-A. Posterior herniated disc Fig. 1-B. Extraforaminal herniated disc
Fig. 2-A.
Herniated disc lateral to the nerve root. This usually produces a sciatic list away from the side of irritated nerve root. Fig. 2-B. Herniated disc medial to the nerve root and in an axillary position. This may produce a sciatic list toward the side of irritated nerve root.
Fig. 3.
The dynamics of SLR : Observations on straight leg raising, with special reference to nerve root adhesion.
Fig. 4.
Movement of nerve roots when the leg on the opposite side is raised. Fig. 4-A. When the leg is raised on the unaffected side, the roots on the opposite side slide slightly downward and toward the midline. Fig. 4-B. In the presence of a disc lesion, particularly in an axillary locatin, this movement. Fig. 4-C. Increases the root tension.
Table 1.
neurologic test according to location of herniated disc
Table 2.
sensory test
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