Herniated disc

1. What is the most common age for a disc herniation?
2. What are the most common levels of herniation?
3. How does the location of the herniation affect the symptoms?
4. What are common causes of disc herniation?
5. What is the presentation of disc herniation?

Answers:
1. 30-40 years.
2. L5-S1, followed by L4-L5, followed by C5-C6.
3. A central protrusion may or may not have radicular symptoms. A posterolateral protrusion (most common in L-spine) injures the nerve of the lower disc. A far lateral/foraminal herniation affects the exiting nerve root (nerve of upper disc).
4. Spontaneous, lifting, coughing, sneezing, bending, twisting.
5. Acute radiating neck/back pain, weakness, numbness, paresthesias, pain, list or shift, exacerbated by increased intra-abdominal pressure. If central or posterolat herniation, will be worse with flexion. If lateral herniation, will be worse with extension.