- Annular Tears are the commonest cause of minor sciatica or brachialgia, and are usually the result of trauma to the spine. Tears can be either radial or circumferential, and their natural history is that they usually spontaneously heal after 6 months. In a small proportion of people, the tears do not heal, and go on to become chronic.
- They occur most commonly at C5/6 and C6/7 in the neck, and at L4/5 and L5/S1 in the low back.
- Treatment consists of a series of epidural steroid injections (caudal, lumbar or cervical), or a nerve root block. Topically applied depot steroids (triamcinolone) help to reduce nerve root inflammation, and produce pain relief usually lasting 6 - 8 weeks per injection. Epidurals can produce significant pain relief allowing earlier rehabilitation and recovery. Chronic annular tears may be helped by Intra-discal Electro Thermal Annuloplasty (IDET)
- Disc Prolapses are caused by disruption of the posterior annulus, allowing the central nuclear material to prolapse into the epidural space. Depending on the position and size of the prolapse, there may be single or multiple spinal nerve root compression.
- Some central prolapses can cause compression of the spinal cord producing a myelopathy, or compression of the sacral nerve roots producing bladder, bowel and sexual dysfunction. These, and therefore require urgent referral, investigation, and treatment to prevent permanent neurological damage (paralysis).
- Large disc prolapses which are causing severe leg weakness and / or bladder and bowel dysfunction require an urgent surgical referral for Spinal Decompression. Permanent leg weakness and incontinence can occur when treatment for this problem is delayed.
- Smaller disc prolapses which are not producing major leg weakness or bladder involvement can be managed conservatively with a series of Epidural Injections and active rehabilitation
- 2 minggu kene constipation !
- pegi GP, GP kate buah pinggang i bengkak sebab tak pegi toilet. Bagi ubat, telan sampai habis..tak jugak pegi toilet! suke ati je cakap something wrong with my buah pinggang- bengong betul !
- pegi ER, dah siap siap nak X-ray..tak jadi sbb Doc takut pregnant! balik rumah balik...malam merana tak boleh tido!
-next day dapat jumpa specialist terus buat test pregnancy. Confirmed takde pun! terus x-ray and MRI.
- haa...ambik tgk tgk dapat hadiah ni - L5-S1 prolapse disc with annular tear. Patut la sakit yang amat...especially malam. Harusla tak tido lena.
- masuk OT terus, cucuk dgn epidural steroid!
- first nite kat hospital, tak bole tido...berpeluh gile bagai. Hubby menggeletar kesejukan.
- nasib baik tak sambut new year kat hospital!
