Disc herniations usually occurs posterolaterally, but it may
also be central. The cauda equina is composed of several nerves within the
lower end of the spinal canal. The top of the spinal cord is a tubular bundle
of nervous tissue extending from the brain.
The following section of the spinal
cord is called the Conus Medullaris and is the lower end of the spinal cord.
The Cauda Equina is made up of multiple nerve roots beginning at the level of
L1.
The most common disc herniation is the Posterolateral Disc
Herniation. This type of herniation is a nerve root injury, which will cause
changes to both the sensory and motor skills as well as the reflexes. A
posterolateral disc herniation usually affects the foot and ankle, and may
cause unilateral leg pain and weakness. Observe for a positive straight leg
raising test. These herniations are usually initially treated with conservative
methods.
A central disc herniation will cause cauda equina syndrome,
which is a compression over the lumbosacral nerve roots. This compression will
cause more back pain than leg pain, and bladder and bowel symptoms will be
evident. This herniation is considered a surgical emergency.
