Herniated disk
Alerts and Notices
Synopsis
Herniated disk (herniated disc) is a protrusion of the soft center nucleus pulposus of an invertebral disk through the outer fibrocartilage ligamentous annulus ring in the spinal vertebrae, which causes nerve irritation, nerve root compression, and pain. Causes include trauma and disk degeneration due to aging.Common symptoms include neck or back pain with or without tingling or numbness in the limbs. In more severe cases, weakness can be present as well. Disk herniation most commonly occurs in the lumbar spine, particularly at the L4-L5 and L5-S1 levels, as most movement of the spine occurs in this region. It is also common in the lower cervical spine C6-C7 but is rare in the thoracic spine.
Other common terms used to describe this include slipped disk and bulging disk. Technically, a bulging disk is a disk that protrudes out from the vertebral column, but without a ruptured annulus fibrosis.
Men are more commonly affected by herniated disks than women.
Codes
ICD10CM:M51.9 – Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder
SNOMEDCT:
73589001 – Intervertebral disc prolapse
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Diabetic lumbosacral plexopathy
- Epidural abscess
- Acute inflammatory demyelinating polyradiculoneuropathy
- Neoplasm (ependymoma, lymphomatous meningitis, astrocytoma, bony metastases to the spine)
- Vertebral fracture (see, eg, osteoporotic compression fracture)
- Musculoskeletal back pain
- Ankylosing spondylitis
- Spinal cord infarct
- Inflammatory or ischemic myelopathy
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Management Pearls
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Therapy
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References
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Last Reviewed:09/27/2018
Last Updated:06/11/2019
Last Updated:06/11/2019
Herniated disk