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Lumbar prolapsed intervertebral disc treatment (PIVD)

Lumbar (intervertebral) disk disease is a frequent source of low back pain. Bulging, protruding, extruding, or sequestered disks can result in lumbar disk disease.


Signs and symptoms

Signs and symptoms of lumbar disk disease include the following:

  • Sharp (rather than dull) pain
  • Typically, bilateral pain located at the posterior belt line
  • Referred pain rather than radicular
  • Usually preceded by multiple episodes of less severe low back pain
  • Localized to the lower back and gluteal area
  • Pain with flexion, rotation, or prolonged sitting or standing
  • Pain relieved in a recumbent position
  • Pain of sudden onset or gradual onset after injury
  • See Clinical Presentation for more detail.

  • Diagnosis

    Examination in a patient with suspected lumbar (intervertebral) disk disease may feature the following:

  • Abnormal gait
  • Abnormal postures
  • Decreased lumbar range of motion
  • Positive straight leg raising test: Indicative of nerve root involvement
  • Usually negative nerve root stretch test results
  • Perform the usual motor, sensory, and reflex examinations (including perianal sensation and anal sphincter tone when appropriate). It is also mandatory to perform a careful abdominal and vascular examination.