Disc slip

WikiDoc Resources for Disc slip
Articles
Most recent articles on Disc slip Most cited articles on Disc slip Review articles on Disc slip Articles on Disc slip in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Disc slip Images of Disc slip Photos of Disc slip Podcasts & MP3s on Disc slip Videos on Disc slip
Evidence Based Medicine
Cochrane Collaboration on Disc slip Bandolier on Disc slip TRIP on Disc slip
Clinical Trials
Ongoing Trials on Disc slip at Clinical Trials.gov Trial results on Disc slip Clinical Trials on Disc slip at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Disc slip NICE Guidance on Disc slip NHS PRODIGY Guidance FDA on Disc slip CDC on Disc slip
Books
Books on Disc slip
News
Disc slip in the news Be alerted to news on Disc slip News trends on Disc slip
Commentary
Blogs on Disc slip
Definitions
Definitions of Disc slip
Patient Resources / Community
Patient resources on Disc slip Discussion groups on Disc slip Patient Handouts on Disc slip Directions to Hospitals Treating Disc slip Risk calculators and risk factors for Disc slip
Healthcare Provider Resources
Symptoms of Disc slip Causes & Risk Factors for Disc slip Diagnostic studies for Disc slip Treatment of Disc slip
Continuing Medical Education (CME)
CME Programs on Disc slip
International
Disc slip en Espanol Disc slip en Francais
Business
Disc slip in the Marketplace Patents on Disc slip
Experimental / Informatics
List of terms related to Disc slip

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Muneeb, MBBS[2] Synonyms and keywords: Intervertebral Disc Displacements; Disc Displacements, Intervertebral; Disc Displacement, Intervertebral; Intervertebral Disk Displacements; Disk Displacements, Intervertebral; Disk Displacement, Intervertebral; Intervertebral Disk Displacement; Disks, Prolapsed; Slipped Disk; Disk Prolapse; Discs, Slipped; Herniated Disks; Slipped Discs; Herniated Disc; Disks, Slipped; Disk, Prolapsed; Prolapsed Disk; Disc, Slipped; Prolapses, Disk; Slipped Disc; Discs, Prolapsed; Discs, Herniated; Prolapsed Discs; Disks, Herniated; Disk, Herniated; Herniated Disk; Prolapse, Disk; Disk Prolapses; Prolapsed Disc; Disc, Herniated; Disc, Prolapsed; Slipped Disks; Disk, Slipped; Herniated Discs; Prolapsed Disks

Historical Perspective

• [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
• In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
• In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].

Classification

• [Disease name] may be classified according to [classification method] into [number] subtypes/groups:

• [group1]
• [group2]
• [group3]

• Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

• The pathogenesis of disc slip is characterized by bulging of nucleus pulposus of the disk through the annulus pulposus. Nucleus pulposus is the central part of the intervertebral disc that contains proteoglycans. Proteoglycans cause water retention, thus nucleus pulposus is responsible for providing cushioning effect to vertebrae. Annulus fibrosis is the peripheral ring surrounding nucleus pulposus that is responsible for keeping nucleus pulposus in the center of the disk. Displaced fragments of nucleus pulposus can then compress the nerve roots passing behind the intervertebral disk space. Several underlying changes have been implicated in the development of slipped discs including decreased water content in nucleus pulposus, increased activity of degradative processes including inflammatory mediators, apoptosis, and matrix metalloproteinase enzyme leading to degeneration of intervertebral discs. Multiple genes have been considered responsible for intervertebral disc slip. It is also documented that axial overburdening of vertebral column may cause disc slip.
• Genes responsible for disc slip include genes coding for matrix metalloproteinases, structural proteins, Vitamin D receptor, apoptosis factors, growth factors.

Causes

Disc slip may be caused by age-related degenerative changes, systemic inflammatory processes, vertebral trauma, sudden vertebral strain, twisted movement of the spine.

Differentiating intervertebral disc slip from other Diseases

• Disc slip must be differentiated from other diseases that cause radicular pain, sensory deficits, and motor weakness, such as:

• Spinal tumors
• Spinal abscess
• Spinal fractures
• Spinal stenosis
• Arthritis

Epidemiology and Demographics

• The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
• In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

• Patients of all age groups may develop [disease name].

• [Disease name] is more commonly observed among patients aged [age range] years old.
• [Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

• Males are more commonly affected with intervertebral disc slip than females.

Race

• There is no racial predilection for [disease name].

• [Disease name] usually affects individuals of the [race 1] race.
• [Race 2] individuals are less likely to develop [disease name].

Risk Factors

• Common risk factors in the development of intervertebral disc slip are increasing age, male gender, excessive body weight, smoking, sedentary life style, abrupt increase in physical activity, heavy weight lifting, poor posture, poor nutrition.

Natural History, Complications and Prognosis

• The majority of patients with [disease name] remain asymptomatic for [duration/years].
• Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
• If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
• Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
• Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

• The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:

• [criterion 1]
• [criterion 2]
• [criterion 3]
• [criterion 4]

History and Symptoms

• Symptoms of Intervertebral disc slip depend upon the site and extent of the slipped disc and are present in the are supplied by the compressed nerve. They may include the following:

Lumbar disc slip

• Lower back pain
• electric shock like or sharp pain radiating from buttock to leg(sciatica)
• numbness or tingling in one leg
• lower extremity weakness
• loss of bowel or bladder control
• pain aggravation with walking, standing or sitting

Cervical disc slip

• Neck pain
• pain between shoulder girdles
• pain radiating down the arm to the hand or fingers
• numbness/tingling in the arm or shoulder
• increase in pain with neck movements.

Physical Examination

• Physical examination findings depend upon the nerve root compressed and maybe remarkable for:

• motor weakness of the muscles supplied by that nerve root
• loss of sensation in the dermatome innervated by that nerve
• Absent deep tendon reflexes
• positivestraight leg raise test in lumbar radiculopathy
• [finding 5]
• [finding 6]

Laboratory Findings

• There are no specific laboratory findings associated with [disease name].

• A [positive/negative] [test name] is diagnostic of [disease name].
• An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
• Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

There are no other diagnostic studies associated with [disease name].

OR

[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

• There is no treatment for [disease name]; the mainstay of therapy is supportive care.

• The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
• [Medical therapy 1] acts by [mechanism of action 1].
• Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

• Surgery is the mainstay of therapy for [disease name].
• [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
• [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

• There are no primary preventive measures available for [disease name].

• Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].

• Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].