Osteopathic Diagnosis of the Lumbar Region

Spinal disk herniation (also known as herniated nucleus pulposus) describes the expulsion of the nucleus pulposus through a perforation in the annulus fibrosus of the intervertebral disk. Spinal disk herniation is an important pain syndrome with the potential for neurologic impairment and is most commonly caused by degenerative disk disease. Clinical presentation depends on the presence or absence of spinal cord or nerve root compression and the downstream neurologic sequelae (e.g., radicular pain, muscle weakness, sensory deficit, reflex deficit). Diagnosis is initially clinical and can be confirmed with diagnostic imaging (e.g., MRI). Management can range from conservative to surgical, depending on the situation.

The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum. The vertebral column is the foundation for the trunk, provides an attachment for muscles and ligaments, and protects the spinal cord and nerve roots.