Disc herniation

Changed by Ayush Goel, 11 Nov 2014

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Disc herniation refers to displacement of intervertebral disc material beyond the normal confines of the disc, but involving less than ~~half~~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.

Herniations are further divided into:

protrusion
~~broad based~~/~~focal~~

~~contained/not contained~~

(base wider than herniation)
extrusion (base narrower than herniation)
- migration
- sequestration

Herniations can further be classified as:

contained
- with intact outer fibers of annulus fibrosus and posterior longitudinal ligament
- with intact posterior longitudinal ligament alone
not contained
- tear of outer fibers of annulus fibrosus and posterior longitudinal ligament

The distinction between a protrusion and an extrusion is made on the basis of the size of the neck versus the size of the 'dome' of the herniation as well as the relationship to the disc level.

A protrusion has a broader neck than 'dome' whereas an extrusion has a narrower neck than dome. Also, if a herniated disc extends above or beyond the vertebral endplates then it is par force an extrusion.

-Disc herniation refers to displacement of <a href="/articles/intervertebral-disc">intervertebral disc</a> material beyond the normal confines of the disc, but involving less than half the circumference (to distinguish it from a <a href="/articles/disc-bulge">disc bulge</a>. A herniation may contain <a href="/articles/nucleus-pulposus">nucleus pulposus</a>, <a href="/articles/vertebral-endplate">vertebral endplate</a> cartilage, apophyseal bone/osteophyte and <a href="/articles/annulus-fibrosus">annulus fibrosus</a>. Herniations are further divided into:<ul>
+Disc herniation refers to displacement of <a href="/articles/intervertebral-disc">intervertebral disc</a> material beyond the normal confines of the disc, but involving less than 25% of the circumference (to distinguish it from a <a href="/articles/disc-bulge">disc bulge</a>. A herniation may contain <a href="/articles/nucleus-pulposus">nucleus pulposus</a>, <a href="/articles/vertebral-endplate">vertebral endplate</a> cartilage, apophyseal bone/osteophyte and <a href="/articles/annulus-fibrosus">annulus fibrosus</a>. Herniations are further divided into:<ul>
~~-<a href="/articles/disc-protrusion">protrusion</a><ul>~~
+<a href="/articles/disc-protrusion">protrusion</a> (base wider than herniation)</li>
~~-<a href="/articles/broadbased-disc-protrusion">broad based</a>/<a href="/articles/focal-disc-protrusion">focal</a>~~
~~-</li>~~
~~-<li>contained/not contained</li>~~
~~-</ul>~~
~~-</li>~~
~~-<li>~~
~~-<a href="/articles/disc-extrusion">extrusion</a><ul>~~
+<a href="/articles/disc-extrusion">extrusion</a> (base narrower than herniation)<ul>
+</ul>Herniations can further be classified as:<ul>
+<li>contained<ul>
+<li>with intact outer fibers of annulus fibrosus and posterior longitudinal ligament</li>
+<li>with intact posterior longitudinal ligament alone </li>
+</ul>
+</li>
+<li>not contained<ul><li>tear of outer fibers of annulus fibrosus and posterior longitudinal ligament</li></ul>
+</li>

References changed:

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Spine

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Disc herniation

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