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Intervertebral disc is a structure between the vertebral bodies in spine. Herniated intervertebral disc occurs when the outer fibrous ring ruptures due to degeneration or trauma, causing the nucleus pulpous of intervertebral disc to protrude to spinal cord cavity and compress the nerves, which leads to lower limb pain and sciatica.

Nerve compression usually triggers numbing pain and lack of strength. The locations of numbing pain are different based on the nerves that are compressed. Sciatica is not a name of a disease, but a symptom. This is a symptom of a pain spread to the lower calves from lower back or hips.

Herniated intervertebral disc is the most common cause for sciatica in adults with 1% of incident rate between the ages 20 to 50. 95% of herniated intervertebral disc occur between the fourth and fifth lumbar vertebra and between the fifth vertebra and the first sacral vertebra.

The typical symptoms of herniated intervertebral disc are back pain with sharp lower limb stinging pain and numbness. These symptoms get worse when sitting, coughing, and sneezing. Difficulties urinating and bowel movement may occur when nerve compression is severe.

When a doctor is concerned about herniated intervertebral disc, lumbar vertebra CT or MRI is required for accurate diagnosis. Treatments may start once the diagnosis is confirmed.

• Non-surgical treatments include taking pain medicine, rehabilitation, using lumbar brace, spinal epidural injection, and nerve root injection. These treatments may relieve most patients’ pain. Surgery is recommended if the pain is not improved after 6 months of non-surgical treatments. However, immediate surgical treatment is recommended when abnormal urination and bowel movement occur or nerve symptoms deteriorate and cause lack of strength in lower limbs.
• Many breakthroughs on surgical treatment have been made due to the progress of machines and technology. But the most traditional and classic surgery is still laminectomy and discectomy. Most surgeries are completed with endoscope because of its progress in recent years. The advantages of using endoscope include small wound, less muscle damage, and quicker recovery. However, not every physician is qualified for endoscope surgery due to its higher technical requirements. Moreover, endoscope surgery does not treat all herniated intervertebral disc. Therefore, doctors will choose the best surgical method based on detailed evaluations.