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Perspectives on orthopaedics

Disc prolapse

Andrew W Leicester

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Abstract

Most patients with a disc prolapse will respond to a conservative approach, which includes rest, analgesics, anti-inflammatory agents, physiotherapy and pelvic traction.

Article Extract

Case presentation

A 41-year-old man presents with acute sciatica following a lifting injury. How is this best managed?

Discussion

About 90% of people will experience an acute episode of lower back pain, and many of these episodes are caused by a prolapsed disc. The intervertebral disc is comprised of a thick annulus fibrosis and the gelatinous nucleus pulposus.

With time, the disc degenerates and this can be associated with a prolapse of disc material, which results in the clinical picture of sciatica. Sciatica is caused by both the mechanical effect of the disc prolapse and an intense inflammatory response.

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