NEUROSURGICAL INTERPRETATION OF DERMATOME HYPALGESIA WITH HERNIATION OF THE LUMBAR INTERVERTEBRAL DISC

摘要: 1. Herniated lumbar intervertebral discs commonly compress single nerve roots, and present associated dermatome hypalgesia in the lower extremity, which is accurately diagnostic of location lesion. 2. A new chart extremity presented, based upon from proved nerve-root loss. These findings are disagreement with common dictum that loss a root produces no sensation. 3. The most compressed by herniated disc first sacral root. Recognition syndrome lesions root, its characteristic ankle jerk, removes any extraspinal pathology as possible cause, this entirely intraspinal until exit through foramen. 4. Subjective objective numbness reflex organic neurological signs, not explainable reference obscure distant pathology. Numbness over distribution necessitates lesion directly discretely involving root. 5. occurrence fifth fourth discs, leading to later herniation, should be considered more often explanation early attacks low-back pain; manipulative treatment directed reduction beginning herniation. 6. Roentgenograms spine indicated finding unilateral hypalgesia. Other seen roentgenograms, related used explain finding. 7. conservative attitude maintained surgery disc, for many cases improvement occurs without surgical interference; however, or operation, these patients some permanent disability requires back protection. 8. Spine-fusion operation because both unreliability preoperative selection will require it, recognized imperfect results time-consuming procedure. 9. Deliberate section sometimes warranted effective relieve persisting pain after an disc. identified