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lumbar_disc_prolapse [2026/09/15 04:16] – [introduction] gary1lumbar_disc_prolapse [2026/09/15 04:20] (current) gary1
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   *[[cervical_disc_prolapse]]   *[[cervical_disc_prolapse]]
  
-=====introduction=====+=====Introduction=====
   *the intervertebral disc / disk comprises the annulus fibrosus and the nucleus pulposus.   *the intervertebral disc / disk comprises the annulus fibrosus and the nucleus pulposus.
   *degenerative disc disease (DDD) results from proteoglycans within the nucleus pulposus breaking down and losing their ability to retain water, thereby reducing the volume of intervertebral discs and decreasing their weight-bearing capacity, subsequent mechanical loading then shifts to the annulus fibrosus, creating fissures and tears that leak crucial factors in the pain to cascade into the intradiscal space and trigger inflammation   *degenerative disc disease (DDD) results from proteoglycans within the nucleus pulposus breaking down and losing their ability to retain water, thereby reducing the volume of intervertebral discs and decreasing their weight-bearing capacity, subsequent mechanical loading then shifts to the annulus fibrosus, creating fissures and tears that leak crucial factors in the pain to cascade into the intradiscal space and trigger inflammation
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-=====radiculopathies=====+=====Radiculopathies=====
 <note> <note>
   *unlike lower disc herniations, the less common upper lumbar disc herniations, perhaps due to narrower canal anatomy and potential for multiple nerve roots to be involved, result in ill-defined polyradiculopathies that cannot be clearly categorized into typical muscle group weakness, dermatomal sensory deficits, or reflex deficits   *unlike lower disc herniations, the less common upper lumbar disc herniations, perhaps due to narrower canal anatomy and potential for multiple nerve roots to be involved, result in ill-defined polyradiculopathies that cannot be clearly categorized into typical muscle group weakness, dermatomal sensory deficits, or reflex deficits
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   *sexual dysfunction   *sexual dysfunction
   *see also [[CES]]   *see also [[CES]]
-=====genetic aetiologies=====+=====Genetic aetiologies=====
   *it is likely that [[genetics]] plays a large role (perhaps > 60%) in the degenerative and herniation processes(([[http://www.biolsci.org/v04p0283.htm]]))   *it is likely that [[genetics]] plays a large role (perhaps > 60%) in the degenerative and herniation processes(([[http://www.biolsci.org/v04p0283.htm]]))
   *lumbar disc degeneration is determined by:   *lumbar disc degeneration is determined by:
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     *it appears this gene may be switched off in people with LDD     *it appears this gene may be switched off in people with LDD
   *a zebra fish study suggests intervertebral disc disease may be due to disruptions to how the body handles fat and to a growth-control pathway called mTOR, alongside changes in phosphate handling and vitamin A signalling – all processes linked to mineral buildup in the ligaments which is a precursor to the disease, and bisphosphonates appear to reduce this as well as restricting food intake, or using drugs that dampen fat metabolism (([[https://www.nature.com/articles/s42003-026-10702-1|2026: Targeted modulation of phosphate and lipid metabolism reduces ligament mineralization in col9a1b deficient zebrafish]]))   *a zebra fish study suggests intervertebral disc disease may be due to disruptions to how the body handles fat and to a growth-control pathway called mTOR, alongside changes in phosphate handling and vitamin A signalling – all processes linked to mineral buildup in the ligaments which is a precursor to the disease, and bisphosphonates appear to reduce this as well as restricting food intake, or using drugs that dampen fat metabolism (([[https://www.nature.com/articles/s42003-026-10702-1|2026: Targeted modulation of phosphate and lipid metabolism reduces ligament mineralization in col9a1b deficient zebrafish]]))
 +
 +=====Mx in the ED=====
 +  ***see [[sciatica]]**
 +
 +=====Potential invasive treatments=====
 +  *local steroid injections 
 +  *laminectomy
 +  *percutaneous injection of polymer-based hydrogel into the disc
 +    * currently in trials - early study appears to show most have significant improvement although ~9% had to have endoscopic intervention to remedy increased pain due to hydrogel migration (([[https://pubmed.ncbi.nlm.nih.gov/41481877/|2025: Feasibility and Safety of Treatment of Painful Lumbar Degenerative Disc Disease with an Injectable Hydrogel Implant at One-year Follow-up]]))
lumbar_disc_prolapse.txt · Last modified: 2026/09/15 04:20 by gary1

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