Disc herniation
Last revised by Craig Hacking on 27 Mar 2024
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Hacking C, Worsley C, et al. Disc herniation. Reference article, Radiopaedia.org (Accessed on 08 Oct 2024) https://doi.org/10.53347/rID-6191
rID:
6191
Article created:
Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
27 Mar 2024,
Craig Hacking ◉
Disclosures:
At the time the article was last revised Craig Hacking had the following disclosures:
- Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)
These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Craig Hacking's current disclosures
Revisions:
27 times, by
11 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Herniated disc
- Disc herniations
- Disk herniation
- Disk herniations
- Herniation of the disc
- Herniation of the disk
- Herniated disk
Disc herniation refers to the displacement of intervertebral disc material beyond the normal confines of the disc but involving less than 25% of the circumference (to distinguish it from a disc bulge). A herniation may contain nucleus pulposus, vertebral endplate cartilage, apophyseal bone/osteophyte and annulus fibrosus.
Disc herniations can be divided into groups in a variety of ways. Commonly they are divided into protrusion vs extrusion:
-
protrusion
- base wider than herniation
- confined to disc level
- outer annular fibers intact
-
extrusion
- base (a.k.a. neck) narrower than herniation 'dome'
- may extend above or below endplates or adjacent vertebrae
- complete annular tear with passage of nuclear material beyond disc annulus
- disc material can then migrate away from annulus or become sequestered
Herniations can further be classified as:
- contained
- with intact outer fibers of annulus fibrosus and posterior longitudinal ligament, or
- with intact posterior longitudinal ligament alone
- not contained
- tear of outer fibers of annulus fibrosus and posterior longitudinal ligament
See also
Quiz questions
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References
- 1. Dora C, Schmid MR, Elfering A et-al. Lumbar disk herniation: do MR imaging findings predict recurrence after surgical diskectomy?. Radiology. 2005;235 (2): 562-7. doi:10.1148/radiol.2352040624 - Pubmed citation
- 2. Buy X, Gangi A. Percutaneous treatment of intervertebral disc herniation. Semin Intervent Radiol. 2010;27 (02): 148-59. doi:10.1055/s-0030-1253513 - Free text at pubmed - Pubmed citation
- 3. Pouriesa M, Fouladi RF, Mesbahi S. Disproportion of end plates and the lumbar intervertebral disc herniation. Spine J. 2013;13 (4): 402-7. doi:10.1016/j.spinee.2012.11.047 - Pubmed citation
- 4. Diehn FE, Maus TP, Morris JM et-al. Uncommon Manifestations of Intervertebral Disk Pathologic Conditions. Radiographics. 2016;36 (3): 801-23. doi:10.1148/rg.2016150223 - Pubmed citation
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Cases:
- Cervical disc extrusion
- Disc herniation nomenclature - axial
- Herniated disc - location
- L4-L5 right sub-articular disc protrusion
- Lumbar disc herniation with caudal migration
- Disc nomenclature - annular fissures
- Disc extrusion
- Calcified disc herniation
- Six lumbar type vertebrae
- Extramedullary haematopoiesis - presacral soft tissue mass
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- Disc extrusion
- Extraforaminal disc protrusion
- Incidental colonic carcinoma
- Lumbar disc protrusion
- Extradural spinal CSF leak
- Lumbar disc sequestration
- Ventrolateral lumbar disc herniation with psoas oedema
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