Disc slip

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Muneeb, MBBS[2] Synonyms and keywords: Intervertebral Disc Displacements; Disc Displacements, Intervertebral; Disc Displacement, Intervertebral; Intervertebral Disk Displacements; Disk Displacements, Intervertebral; Disk Displacement, Intervertebral; Intervertebral Disk Displacement; Disks, Prolapsed; Slipped Disk; Disk Prolapse; Discs, Slipped; Herniated Disks; Slipped Discs; Herniated Disc; Disks, Slipped; Disk, Prolapsed; Prolapsed Disk; Disc, Slipped; Prolapses, Disk; Slipped Disc; Discs, Prolapsed; Discs, Herniated; Prolapsed Discs; Disks, Herniated; Disk, Herniated; Herniated Disk; Prolapse, Disk; Disk Prolapses; Prolapsed Disc; Disc, Herniated; Disc, Prolapsed; Slipped Disks; Disk, Slipped; Herniated Discs; Prolapsed Disks

Overview

Historical Perspective

  • [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
  • In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
  • In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].

Classification

  • [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
  • [group1]
  • [group2]
  • [group3]
  • Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

Causes

Disc slip may be caused by age-related degenerative changes, systemic inflammatory processes, vertebral trauma, sudden vertebral strain, twisted movement of the spine, connective tissue disorders.

Differentiating intervertebral disc slip from other Diseases

Epidemiology and Demographics

Age

Gender

Race

Risk Factors

Natural History, Complications and Prognosis

  • Two-third of patients with lumbar disc herniation improve within 6 months as herniated disk tends to regress over time. After 6 weeks, only around 10% of the patients have persistent pain to consider surgery.
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

Diagnosis

Diagnostic Criteria

There are no specific diagnostic criteria for intervertebral disc slip.

History and Symptoms

  • Symptoms of Intervertebral disc slip depend upon the site and extent of the slipped disc and are present in the are supplied by the compressed nerve. They may include the following:

Lumbar disc slip

Cervical or thoracic disc slip

Physical Examination

  • Physical examination findings depend upon the nerve root compressed and maybe remarkable for:

Laboratory Findings

Electrocardiogram

There are no ECG findings associated with intervertebral disc slip.

X-ray

There are no x-ray findings associated with intervertebral disc slip. However, an x-ray may be helpful in detecting other etiologies causing similar symptoms like fractures, abscesses, tumors, bony spurs etc.

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with intervertebral disc slip.

CT scan

CT scan may be helpful in the diagnosis of intervertebral disc slip. Like MRI, CT scan also provides a detailed view of the spinal canal and its contents, thus it can detect disc slip along with its extent and location.Findings on CT scan suggestive of intervertebral disc slip include bulging of intervertebral disc, nerve root compression, and spinal cord compression.

MRI

MRI may be helpful in the diagnosis of intervertebral disc slip, as it is considered the gold standard for the diagnosis of this disorder. MRI has an excellent capacity to visualize all the soft tissues including the spinal cord, and nerve roots thus it can easily detect bulging intervertebral disc and also if there is any compression of nerve root or spinal cord. MRI is also very helpful in ruling out other differentials.

Other Imaging Findings

Myelogram may be helpful in the diagnosis of intervertebral disc slip. It is a modified x-ray technique in which the spinal canal is visualized after injection of a contrast material. It can show if a slipped disk is compressing a nerve root or spinal cord

Other Diagnostic Studies

Electromyogram and nerve conduction studies may be helpful in the diagnosis of intervertebral disc slip. These tests assess the response of nerve or muscle to electric stimulation. They can reveal if there is any nerve damage or compression as a consequence of slipped disk.

Treatment

Certain non-pharmacologic treatments and lifestyle modifications can be used before any pharmacologic treatment is done. They include maintenance of activity level that is painless, physiotherapy, avoidance of any activity that incites pain, avoidance from lifting heavy weights, weight control, use of spinal support, spinal massage, spinal manipulation, spinal traction, heat or ice application.

Medical Therapy

Surgery

Prevention

References

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