Disc Bulge/Herniations

• Disc-related pain - Disc Bulge/Herniations:

  • disc bulges refer to the circumferential diffuse symmetric extension of the annulus beyond the end plates of the adjacent vertebral bodies
  • may be associated with mild loss of disc height
  • typically not clinically significant unless it occurs with the presence of other signs and symptoms which can cause pain or other disabling features
  • associated with local pain from the disc and its surrounding tissue
  • leading cause for referred pain
• Disc-related pain - Types of Disc Bulge:

  • Bulge / Degeneration - Annular fibres are intact
  • Protrusion - Localised bulging with some damage of annular fibres
  • Extrusion - Extended bulge with loss of annular fibres but disc remains intact
  • Sequestration - Fragment of disc broken off from nucleus pulposus
  • for pts 30 - 55 yrs, we expect them to present with acute disc symptoms when they come in with such signs and symptoms
  • for pts 55 + yrs we assume the reason for a disc bulge is due to degeneration
  • Studies show up to 60% of people without back symptoms have disc bulges and protrusions on MRI