Decision making in lumbar disc disease.

摘要: When a patient presents with an acute pain syndrome suggestive of herniated lumbar disc, nonoperative treatment is almost always the rule. Urgent surgery undertaken for intractable pain, significant or progressive neurological deficit, and abnormalities bowel, bladder, sexual function. Evaluation not needed in typical cases until care has failed. The decision to evaluate treat by intervention made after reasonable time, usually minimum 1 month maximum 3 who making progress. Slow recoveries can be monitored even longer if agreeable patient. never warranted face normal imaging studies. Several interventions are possible. Traditional surgery, without magnification, followed excellent outcome. Chymopapain injection alternative those expert its use. Percutaneous discectomy possibility but remains proved acceptable clinical Lumbar disc highly successful complications extremely unusual. They do occur however, serious. Unexpected postoperative should investigated immediately. Recovery from uneventful, no rehabilitation required. Some patients, particularly heavy work, helped program that stresses return Rarely will develop serious deficit following surgery. deficits require urgent reevaluation. Most patients work promptly assistance. For cannot, referral multidisciplinary assist function through general management comorbidities useful. It rare disabled back disorder, only thorough evaluation adequate rehabilitative therapy.