Introduction

Pathogenesis

Etiology

• Compression of vertebral disks most commonly T14L1 but also found in other locations particularly lumbar intervertebral spaces.
• Intervertebral disks are the shock absorbers between the vertebral bodies; they can partially or completely herniate compressing the spinal cord. This compression alters the function of the spinal cord and the symptoms that result are the consequence of the site along the spinal cord and the degree of compression. Pain, weakness or paralysis may occur from the mechanical compression or from secondary vascular or other changes of the tissue around the site.
• Disks may become compressed as a function of trauma or age.
• The exact cause of herniation of the intervertebral disk is unknown.
• The condition may be caused from trauma or other causes, including genetic, neoplasia and infection.

Pathophysiology

• The intervertebral disks consist of the nucleus pulposus that offers flexibility to the vertebral column and it is surrounded by the annulus fibrosus, a tough fibrous structure.
• Degeneration of the disk leads to calcification of the nucleus with weakening of the annulus leading to rupture.
• Trauma can also result in rupture of the disk.
• Compression or alteration of the structure by tumor cells or infectious agents can weaken and cause rupture of the disk.
• Spondylosis may be noted which may contribute to nerve pinching.

Diagnosis

Treatment

Outcomes