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• W2220103178 abstract "During the past six years, since Mixter and Barr (1) emphasized the importance of ruptured intervertebral disc as a clinical entity, there have been a great number of published articles by neurosurgeons, roentgenologists, neurologists, and orthopedic surgeons dealing with this interesting and important subject. These contributions have led to an increasingly accurate understanding of the problem and have aided in focusing the attention of the medical profession upon a not uncommon pathological condition, which often incapacitates the patient and may be definitely relieved by surgical measures. When confronted with a case of intractable “lumbago,” recurrent “sciatica,” “lumbo-sacral strain,” or “sacroiliac arthritis,” the physician must take into consideration the possibility of a ruptured intervertebral disc and make an effort to confirm or disprove such a diagnosis. It is important to bear in mind that a portion of the firm, elastic, fibrocartilaginous disc located between the bodies of any two vertebrae may herniate, protrude, or rupture posteriorly and encroach upon the neural contents of the spinal canal. Such herniations usually result from trauma, such as heavy lifting or sudden twisting movements of the body. If herniations occur above the level of the first lumbar vertebra, they give rise to symptoms and signs of spinal cord compression, simulating closely the clinical picture of tumors. When a lumbar intervertebral disc herniates posteriorly, the protrusion usually occurs at the site of least resistance, lateral to the mid-line, which is strongly reinforced by the tough posterior longitudinal ligament, with consequent impingement against the sheath of one of the nerves of the cauda equina near its exit from the main dural envelope. This condition gives rise to unilateral pain, which commonly radiates into one leg. Larger protrusions of a disc or free extrusions of fragments of the nucleus pulposus into the spinal canal may compress the main dural sac with its contained bundle of nerves, producing a clinical picture similar to that observed in tumors of the cauda equina. Inasmuch as the great majority of disc ruptures occur in the lumbar region, particularly between the fourth and fifth lumbar vertebrae and at the lumbosacral joint, a brief clinical description of a patient presenting such a lesion will suffice. The patient frequently is a healthy young adult who complains of pain which often is localized in the lumbosacral region with radiation into one buttock, down the back of a thigh, into the calf, or along the lateral aspect of the lower leg and foot on one side. Not uncommonly there is a history of antecedent trauma in the form of heavy lifting or sudden violent twisting of the body; such a history, however, may be entirely absent." @default.
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• W2220103178 date "1941-05-01" @default.
• W2220103178 modified "2023-09-25" @default.
• W2220103178 title "Surgical Aspects of Ruptured Intervertebral Disc" @default.
• W2220103178 doi "https://doi.org/10.1148/36.5.604" @default.
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