Lumbar disc herniation occurs when the nucleus pulposus of an intervertebral disc protrudes through a tear in the surrounding annulus fibrosus. Symptoms include pain in the back, pain in the leg (sciatica), and numbness or weakness in the leg. Serious neurological sequelae may sometimes occur.
Conservative treatments include analgesics, non‑steroidal anti‑inflammatory medication, manual therapy and acupuncture. Epidural corticosteroid injections can also be used to reduce nerve pain in the short term. Lumbar discectomy is considered if there is evidence of severe nerve compression or persistent symptoms that are unresponsive to conservative treatment. Surgical techniques include open discectomy or less invasive alternatives using percutaneous approaches.
Percutaneous coblation of the intervertebral disc for low back pain may be used for patients with pain caused by contained herniated discs that have not responded to conservative treatment, when open surgery is not suitable.