Lumbar disc herniation

Abstract

Lumbar disc hernia represents one of the most frequent neurosurgical pathologies, consisting of a posterior migration of the nucleus pulposus which protrudes through the surrounding protective connective tissue. The patient usually exhibits leg pain, paraesthesia or a variable degree of discomfort at the lower extremities, those clinical characteristics are correlated to the extent of nucleos pulposus protrusion. Regarding neuroimaging diagnosis, the gold standard of evaluation is Magnetic resonance imaging in different sequences which highlights a precise topography of the herniated disc. Currently, in a well-digitalized era, machine learning and deep learning algorithms are used to assess the sensibility of detecting a lumbar disc hernia, with promising results. In those cases requiring surgical intervention, besides the open lumbar microdiscectomy, a less invasive surgical approach regularly used in the medical practice is endoscopic lumbar discectomy, being limited to cases where a wide intraoperative perspective is not necessary. In the actual neurosurgical management, postoperative complications following lumbar disc hernia surgery are rare and accessible to manage.

Keywords

• LDH
• LBP
• neuroimaging
• microdiscectomy
• endoscopic techniques
• neuroplasty