Lumbar Disc Prolapse

Epidemiology & Risk Factors

Incidence

  • 56% of adults have disc bulging
  • MRI scans show that between 20% & 35% of working age adults have asymptomatic disc herniation
  • There is lifetime incidence of 2% for symptomatic disc herniation
  • 80% of general population will experience back pain but only 2-3% will have sciatica
  • mean onset = 35 years
  • unusual < 20 years & > 60 years
  • males = females (females present decade later than males)

Age

  • Most lumbar disc herniations occur between 30 & 50
  • Far lateral disc herniations occur in older age group (average age 65)
  • Lumbar disc herniations before 30 tend to have hereditary aetiology

Site

  • commonest site for prolapse is L4/L5 disc, then L5/S1 disc

Risk factors for back pain

  • obesity
  • smoking
  • M:F
  • Job: Lifting, vibration, sitting
  • Job satisfaction ++
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