Spinal disc herniation



Spinal disc herniation



Spinal disc herniation


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Spinal disc herniation

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A 42-year-old man presents to the emergency department as a level 1 trauma following a fall from scaffolding. The patient worked as a painter and slipped and fell approximately 20 ft, landing on his back. Upon arrival, the patient has a GCS of 15 and endorses pain in his lower back. Temperature is 37.0 °C (98.6 °F), pulse is 105/min, respirations are 18/min, blood pressure is 176/65 mmHg, and O2 saturation is 97% on room air. The patient's primary survey is intact, and his secondary survey is notable for a step-off and pain at the T12-L1 spinal level. An emergent MRI of the spine is demonstrated below. Which of the following additional clinical features is most specific to this patient's clinical condition?

Reproduced from: Radiopaedia

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Disc herniation p. 463

Vertebral disc herniation p. 524


Spinal disc herniation is a medical condition in which there is a tear in the outer fibrous ring of an intervertebral disc, allowing the central portion called the nucleus pulposus to bulge out beyond the damaged outer ring. This puts pressure on the spinal nerves and causes pain, numbness, tingling, or muscle weakness in the affected area. Disc herniation is usually due to age-related degeneration of the annulus fibrosus, although trauma, lifting injuries, and straining have been implicated. The severity of the symptoms can vary depending on the size and location of the herniation. Treatment options can range from conservative measures like pain management and physical therapy to surgical interventions in more severe cases.


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