Talk:Spinal disc herniation

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Contents

[edit] Launch of new article

This article is a product of the cooperative efforts of Dematt, a chiropractor, and Fyslee, a physiotherapist.

We felt the need for this article, so we have combined two articles and then developed the article even further. The existing articles that were used were:

  • Slipped disc, and
  • Lumbar disc herniation

The "slipped disc" article is an article that should have never been more than a redirect, since the very expression is quite misleading. Its very existence as an article served to bolster the impression that the term represented an anatomical reality, rather than a common and misleading layman's term, based on a gross misunderstanding. Consequently this misleading article ended up being the article many proper terms were redirected to, since there was no better article! The need for a replacement was obvious.

For quite some time the "slipped disc" article has been enlarged with much good content, and the "lumbar disc herniation" article also has some good content. By combining them we hope to provide a good article that can replace them and become the proper object of Wikilinks and redirects.

We hope our efforts will be appreciated, and that the article will be positively received and further developed with time. -- Dematt and Fyslee 23:15, 28 August 2006

[edit] Merge

I think both source articles could be merged into this article.--Steven Fruitsmaak (Reply) 23:00, 28 August 2006 (UTC)

It shouldn't be any problem, since Dematt and myself, Fyslee, used all of their content to make this article, and then we developed it even further to make it more complete. If any small changes have been made since then, anyone is welcome to add them to this article. -- Fyslee 19:58, 29 August 2006 (UTC)
If you're sure your article completely supersedes the other two, then you could install a redirect from both pages to yours, and check for any double redirects.--Steven Fruitsmaak (Reply) 22:47, 29 August 2006 (UTC)
A check should be made of both articles for any changes in the last week or so. If they are good, they should be incorporated here before deleting those articles.
Would it be a good idea to place archived copies of the discussion pages from both articles here? -- Fyslee 04:50, 30 August 2006 (UTC)
Yes that would be a good idea.--Steven Fruitsmaak (Reply) 06:25, 31 August 2006 (UTC)
I have checked both articles, and there is nothing more to move, so they can both be blanked and replaced by redirects.
Before blanking the talk pages, what about archiving them here, as suggested above? -- Fyslee 05:20, 30 August 2006 (UTC)
I think it would be a good idea to archive the articles just in case. --Dematt 11:53, 30 August 2006 (UTC)
Archives are now made, and all contents are copied to them. Now the old contents and the articles themselves can be blanked, and substituted with redirects. -- Fyslee 14:22, 30 August 2006 (UTC)

Redirects are now in place, and all content is blanked. Now the edit histories need to be blanked as well, but I don't know how that's done. -- Fyslee 16:38, 30 August 2006 (UTC)

No, they don't need to be blanked. Also, archives weren't necessary. The page histories already contain that.
What you should do is check for double redirect like Lumbar disc prolapse, by going to the redirect page and clicking: what links here. Look for redirect pages there and replace those.--Steven Fruitsmaak (Reply) 06:25, 31 August 2006 (UTC)
I think I've succeeded in tracking down and changing all instances of "slipped disc," except of course on talk pages. -- Fyslee 18:16, 30 August 2006 (UTC)

[edit] Lumbar Radiculopathy

Is the term "Spinal disc herniation" the same as or sysnonymous with Lumbar Radiculopathy? If so, it would be nice to have a redirct for searches for Lumbar Radiculopathy to this wiki topic. YORD-the-unknown 15:44, 27 September 2006 (UTC)

The radicular portion of the nerve is that part of the nerve that is within the spinal canal before it leaves the spinal column. When that part of the nerve is diseased it will cause pain into the leg along with some other symptoms. This is called Lumbar radiculopathy. By far the most common reason for Lumbar Radiculopathy is disc herniation, but there may be other reasons as well, especially space occupying lesions (called SOLs) like tumors, vascular anomalies and some types of cysts as well as primary conditions such as diabetes that may affect blood supply to the nerve itself as well as cause nerve damage. IOW, spinal disc herniations can cause lumbar radiculopathy, but not all lumbar radiculopathies are the result of spinal disc herniations. It should have an article of its own. It should also be linked here. I'll take a better look at it. Thanks for the heads up! --Dematt 04:06, 28 September 2006 (UTC)
Lumbar Radiculopathy is more synonymous with sciatica. If we're going to redirect, that is the one to redirect to. Any input?--Dematt 04:11, 28 September 2006 (UTC)
Dematt is correct. "Lumbar radiculopathy" and "sciatica" say something about symptoms arising from certain structures, which often give rise to the same symptoms. Lumbar radiculopathy involves the spinal nerve roots and can cause sciatica, while sciatica doesn't necessarily involve the spine at all, often being caused by piriformis syndrome. -- Fyslee 04:28, 28 September 2006 (UTC)
Maybe what we need to do is redirect all of the nerve diagnoses to sciatica where we can differentiate and explain each of them. Then we can link them to potential causes such as spinal disc herniation, piriformis syndrome, etc.. --Dematt 11:47, 28 September 2006 (UTC)
Okay, I redirected Lumbar Radiculopathy and Radiculitis to Sciatica. If any problems with this, let me know. --Dematt 23:27, 1 October 2006 (UTC)

[edit] Request that more information be added.

I am requesting that information be added about herniated discs which have fragmented and the fragments have become trapped in the sacrum (or wherever they may migrate). This is a condition which definitely requires surgery. The fragments can do additional damage to the spine by compressing the spinal cord, nerves which exit from the spinal cord, and other areas. The injury can damage areas by physical pressure or an inflammatory response. This is a serious medical/surgical emergency and can cause permanent damage and/or chronic pain. It can be disabling because of lack of muscle control and/or intractable pain. There is also a danger that the surgery to remove these fragments can do further damage.

It seems to be difficult to find information on this injury and the consequences of the injury. I do not know if this is because it is not as common as a simple herniated disc, or because there may not be much known about the condition, or some other reason. I do know from personal experience that this can be a permanently disabling sequence of events. In some places doctors may not consider this possibility when the patient presents with extreme leg and foot pain (but no back pain).--Antigone2 05:06, 21 January 2007 (UTC)

Please feel free to add information from verifiable and reliable sources. Your concern is shared by others, but we have the same limitations as yourself, we have to use verifiable and reliable information. You may also have another concern with minority POV, but I personally don't have a probelm with your adding whatever information you have, just make sure it is presented NPOV and does not advocate any particular POV. --Dematt 16:04, 21 January 2007 (UTC)
Can you provide us with some form of documentation for your condition? Do you have any references from the medical literature we could read? -- Fyslee 10:14, 22 January 2007 (UTC)
Sounds like a sequestrated (prolapsed intervertebral) disc. That would do for the 4th picture in the main illustration. I'd not expect it to migrate to the sacrum if it is above L5/S1 Midgley 21:39, 28 January 2007 (UTC)

[edit] Opening sentence

The opening sentence as is, "A spinal disc herniation is a pathological condition in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to be extruded (herniated) to the outside of the disc.", I would suggest is entirely not understandable to the average non medically qualified person and needs a re-write so that it can be explained in layman's terms. --Rebroad 11:06, 28 January 2007 (UTC)

[edit] Herniation v. protrusion

We need to distinguish between a true herniation and the condition that precedes it -- a disc protrusion. Now terminology can differ from country to country. I'm an American PT in Denmark, and Midgley is an MD in the UK. What's the proper English terminology. Right now (in the lead) "bulging" is not the same as the former "allows the soft, central portion (nucleus pulposus) to be extruded (herniated) to the outside of the disc." Can we find acceptable language to make sure we describe the subject of the article, and not the subject of some (potential) other article (Spinal disc protrusion). -- Fyslee 21:49, 28 January 2007 (UTC)

Extrusion suggests to me detachment - as in plastic components and models made by extrusion of plastic into or though a mould or template. We tend to call the discs between the spinal vertebrae "intervertebral discs" as well. Midgley 13:56, 29 January 2007 (UTC)
Agree, for us, protrusion can be any stage that "bulges" until that actual "prolapse" when the pulposus "extrudes" through the outer fibers of the annulus. The prolapsed material could still be directly behind the disc and basically behave in the same manner as just a bulge. When they acturally seperate and "float" to other areas, they are then "sequestered". --Dematt 14:06, 29 January 2007 (UTC)
That's also my understanding of the three stages that can occur: protrusion, prolapse, sequestration (bulge, herniation, separation). -- Fyslee 18:49, 29 January 2007 (UTC)

[edit] Slipped disc and references

I have added a refs section with code, and turned all internal links into embedded references. I also found a few references that debunk the "slipped disc" terminology. For plenty more, try this search: "slipped disc" not slip

The references need better descriptions and uniform formatting. More references and more content would also be welcomed.

The three stages described above could be developed into a paragraph. -- Fyslee 18:59, 2 February 2007 (UTC)

[edit] Back pain and low back pain and lumbago and lumbar disc herniation

I just moved lumbar disc herniation content from the surgery sections of back pain and low back pain. See rationale.Badgettrg 15:55, 31 May 2007 (UTC)

[edit] Treatment

The article says "The majority of herniated discs will heal themselves in about six weeks and do not require surgery." To me, that seems to say that the herniation goes away without treatment. I don't think that's true. Would it be more accurate to say, "In the majority of cases in which a herniated disc causes pain, the pain goes away within six weeks without treament."? Dwasserm 02:01, 26 July 2007 (UTC)

The entire treatment section is poorly referenced. I think your question is a good one, and a good start to set the example by including whatever a reliable source says about the issue. Sancho 05:04, 24 September 2007 (UTC)

Number 1 on the list is "bed rest" and I don't think that really is the best treatment. Many patients complain saying the most severe pain they experience is after having slept for 3-4 hours. As such, treatment should emphasize mobility of the affected areas, to the extent possible and comfortable. —Preceding unsigned comment added by 69.113.126.46 (talk) 03:00, 1 May 2008 (UTC)

[edit] Commercial link ?

I'm very skeptical about this link, given at the bottom of the page :

http://www.herniateddischell.com/herniated-disc-order-faq.html (herniated disk order FAQ)

It's for a specific product and doesn't seem to have any medical references whatsoever... It's just a webpage to buy a videotape (?)

I'm not to familiar with Wiki editing but I thought I'd just let people know... 74.122.211.152 05:57, 26 September 2007 (UTC) Anya 74.122.211.152 05:57, 26 September 2007 (UTC)

Good catch. I removed that link along with most of the others. Sancho 22:47, 26 September 2007 (UTC)
You can read Wikipedia:External links to see what links should be avoided, and feel free to improve the encyclopedia by making these types of edits yourself :-) Sancho 22:48, 26 September 2007 (UTC)