Because the lower neck or cervical region and the lower back or lumbar region are most subject to stress and strain these are the common sites for herniated discs following a motorcycle or auto accident. I have represented many people over the years who have unfortunately suffered from these injuries.
So long as the displaced disc is confined to the space surrounded by the annulus fibrosus there is no discomfort or disability. Once the nucleus begins to ooze through a defect in the annulus fibrosus trouble is apt to begin. The initial defect is usually small and may occur at any point.
Anterior protrusions are rare because the anterior longitudinal ligament is much denser and stronger than the posterior ligament. Even if anterior protrusion would occur, symptoms requiring treatment would not be produced. Abnormal bulging occurs more readily posteriorly or postero-laterally through the weaker posterior longitudinal ligament. Further weakening or tearing of the ligament and further protrusion leads to pressure on the sensitive nerve root and the syndrome known as “protruded intervertebral disc.”The bony spinal canal holds the spinal cord and the nerve roots, leaving little room for any other substance.
When the outer layers of the annulus fibrous are badly fragmented, this may also go into the herniated material. Sometimes these herniated fragments break off to form ‘loose cartilage.” The fragments of annulus fibrous must be removed along with the nuclear part of the protrusion by surgery.
Pain in Back and Extremities
Lumbar disc herniation and nerve root pressure can cause severe low back pain, extremity pain, numbness, tingling, and weakness. To differentiate the herniated disc from other causes of back pain calls for a detailed history, a complete examination, and adequate laboratory studies. Confirmation can be found in electromyograms (EMG), MRIs, and X rays of the spine (especially oblique views).
Most patients with disc herniation are benefited by bed rest ( with a board under the mattress), with heat, traction, and relaxants . Surgery should be reserved for those patients whose pain and disability persist after an adequate trial of conservative therapy.
As should be apparent, the cardinal symptom of patients with back injuries is pain, either in the cervical region or the lumbar region. The sciatic nerve seems to be involved in the lower back injury, and often, where there is nerve root impingement in that area, there will be a tingling or loss of sensation in one or both of the lower extremities. Where the disc involvement is in the cervical area, there may be pain in that section of the spine, plus a tingling or loss of sensation in one or both of the upper extremities. There may be atrophy of muscles and loss of sensation in addition to the foregoing symptoms.
If you or someone you love has been injured in an automobile accident due to the negligence of another, please call me at 916-694-0002 for free, friendly advice. If you are outside the Elk Grove/Sacramento area, you can call us at (800) 404-5400.
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