Lumbar Degenerative Disease With Intervertebral Disk Herniation

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Degenerative disease of the lumbar spine results from normal age-related changes to intervertebral disks as they lose hydration and elasticity (Genevay & Atlas, 2010; Hsu, Armon, & Levin, 2017; PubMed Health, 2017; Schoenfeld & Weiner, 2010; U.S. Department of Health and Human Services [USDHHS], 2014a). As this process progresses, the intervertebral disks become compromised and disk material can be pushed beyond the boundaries of the vertebral bodies (Genevay & Atlas, 2010; Hsu et al., 2017; PubMed Health, 2017; Schoenfeld & Weiner, 2010; USDHHS, 2014a). Depending upon the anatomy involved, this may result in back pain or radicular symptoms of the lower extremities. The latter, which involves compression and irritation of the spinal cord or nerve roots as they exit the canal, is the more treatable condition (Genevay & Atlas, 2010; Hsu et al., 2017; PubMed Health, 2017; Schoenfeld & Weiner, 2010; USDHHS, 2014a). Herniation of and in itself is estimated to affect more than 50% of the population, but many of these individuals will remain asymptomatic (Genevay & Atlas, 2010; Hsu et al., 2017; PubMed Health, 2017; Schoenfeld & Weiner, 2010; USDHHS, 2014a). Of those with chronic back pain, about a quarter will experience radicular symptoms in their lifetime (Genevay & Atlas, 2010; Hsu et al., 2017; Schoenfeld & Weiner, 2010; USDHHS, 2014a). The estimated financial burden of treatments of low back pain, with or without radicular symptoms, in the United States is estimated at more than a billion dollars, with nearly $300 million dedicated to surgical procedures (Genevay & Atlas, 2010; USDHHS, 2014b).
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