Spinal disc herniation: from diagnosis to therapy

Disc herniation is a painful condition caused by the protrusion of the intervertebral disc which compresses the surrounding nerve roots causing "radiculopathy". Anatomically, the intervertebral disc is composed of a pulpy nucleus of gelatinous consistency and of an anulus fibrosus which has the structural function of containing the nucleus. When the anulus is damaged, the nucleus emerges from its seat, protruding towards the vertebral canal.

Causes

Traumatic events or, in most cases, the degeneration of the anatomical structure of the disc linked to ageing phenomena are the main causes of disc herniation.

Symptoms

The main symptom is the pain which can be perceived at the level of the area actually affected by the hernia, but which can also radiate to the entire nervous path of the nerves involved. Disc herniation is more frequent at the lumbar and cervical level - lumbar hernias are 15 times more frequent than cervical ones - these two types of hernias differ also in the location of the pain: affecting the neck and arms for cervical hernias, while lumbar disc protrusions cause irritation of the sciatic nerve and therefore sciatica. The level of suffering is generally progressive and can determine important limitations such as the inability to perform physical activity, which in turn causes a possible acceleration of further degenerative events which lead, for example, to an increase in pain and body weight.

Diagnosis

The diagnosis involves the physical examination of the patient, evaluating the site of the pain, the state of the reflexes, the sensitivity, strength and muscle trophism. X-ray examinations such as magnetic resonance imaging, which also allows the assessment of the involvement of the surrounding nerve structures and the degree of inflammation of the segment, are functional for confirming the disease.