In the absence of motor deficits, a nonoperative course of analgesia, activity modification, and injections should be tried for several months. If the disc injury progresses to the point of neurologic compromise or limitations with activities of daily living, then surgical intervention may be required to decompress and stabilize the affected segments. This compression produces radiculopathy into the posterior leg and dorsal foot. Slightly more than 90% of herniated discs occur at the L4-L5 or the L5-S1 disc space, which will impinge on the L4, L5, or S1 nerve root. A disruption of the normal architecture of these round discs can lead to a disc herniation or a protrusion of the inner nucleus pulposus, possibly applying pressure to the spinal cord or nerve root and resulting in radiating pain and specific locations of weakness. These are primarily composed of two layers: (1) a soft, pulpy nucleus pulposus on the inside of the disc and (2) a surrounding firm structure known as the annulus fibrosus. This activity describes the pathophysiology, evaluation, and management of lumbar degenerative disc disease and highlights the role of the interprofessional team in improving care for affected patients.Ä«etween each vertebral body of the spine are pads of fibrocartilage-based structures that provide support, flexibility, and minor load-sharing, known as the intervertebral discs. A disruption of the normal architecture of these round discs can lead to a disc herniation or a protrusion of the inner nucleus pulposus, possibly applying pressure to the spinal cord, nerve root, or adjacent vertebral body, which may further result in radiating pain and possible weakness. These are primarily composed of two layers: (1) a soft, pulpy nucleus pulposus on the inside of the disc and (2) a surrounding firm structure known as the annulus fibrosus. Between each vertebral body of the spine are pads of fibrocartilage-based structures that provide support, flexibility, and minor load-sharing, known as the intervertebral discs.
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