© 2002 Journal of Neurology Neurosurgery and Psychiatry
Article
SURGICAL DISORDERS OF THE THORACIC AND LUMBAR SPINE: A GUIDE FOR NEUROLOGISTS
Correspondence to:
Correspondence to:
Mr Nitin Patel, Department of Neurosurgery, Frenchay Hospital, Frenchay Park Road, Bristol BS16 1LE, UK;
nitinp@lineone.net
Keywords: thoracic spine disorders; lumbar spine disorders; intervertebral disc prolapse; lumbar stenosis; vertebral osteomyelitis; spinal tumours
| The first 150 words of the full text of this article appear below. |
Degenerative and pathological disorders of the thoracolumbar spine may present with symptoms which warrant further evaluation by a neurologist. This article aims to provide an overview of the typical presentation and standard management of various thoracolumbar spinal disorders and includes information that is intended to facilitate the investigative and diagnostic process.
LUMBAR INTERVERTEBRAL DISC PROLAPSEMixter and Barr in 1934 first described the herniated disc to be a cause of segmental leg pain (sciatica or femoralgia). Acute low back pain is a relatively common condition and is accompanied by sciatica in only 1–2% of cases. Patients presenting with acute low back pain alone are therefore unlikely to have a disc prolapse. Lumbar intervertebral disc prolapse is most prevalent between the ages of 30–50 years, and the L5/S1 and L4/5 intervertebral discs account for 95% of all lumbar prolapses.
A lumbar disc prolapse typically presents with gradual or sudden onset localised back pain radiating through
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