Intravertebral Disc Prolapse

This occurs due to age-related degeneration of the Annulus Fibrosus (outer disc), therefore making it more likely to tear and lead to herniation of the softer, central portion of the disc. It typically occurs after spinal trauma or excessive strain e.g. lifting/twisting.

Presentation - Unilateral symptoms of:

• Pain that radiates in a dermatomal pattern

• Motor - Muscle weakness, Paralysis, Disrupted reflexes

• Sensory - Paraesthesia, Numbness, Tingling

• Sciatica if in lumbar region

Investigation - MRI

Management - Conservatively with analgesia, and the patient staying active

Complications

• Nerve root compression

• Cauda equine syndrome (L4-S1) - bilateral sciatica, saddle anaesthesia (inability to feel toilet paper when wiping), urinary and bowel disturbance (constipation/retention or incontinence)