Lumbar spondylosis - Lumbar intervertebral disc prolapse Factor
A lumbar intervertebral disc prolapse is a protrusion, herniation or rupture of an intervertebral disc of the lumbar spine, causing local pain and stiffness, and may include pain and paraesthesia radiating into the lower limbs.
The lumbar spine is the back extending from vertebra L1 to vertebra L5. The intervertebral discs lie between the adjacent surfaces of the bodies of the vertebrae in the spine, each disc being a highly elastic tissue mass which is compressed between the vertebral surfaces. Degenerative changes gradually cause fragmentation of the nucleus pulposus (soft gelatinous material under tension) and softening of the annulus fibrosus (the periphery of the disc). A portion of the nucleus may protrude through a rent or tear in the softened annulus and may impinge on the adjacent nerve roots or the spinal cord itself. The protrusion may be episodic and may continue intermittently over a period of months or years. In the final stage of the pathological changes commonly described as prolapsed intervertebral disc, the defective disc is replaced by fibrous tissue.
Disc protrusion may occur at any time in adult life. Classically the onset is sudden following a history of spinal strain, and is clearly defined. The pain may be aggravated by coughing or sneezing. Characteristically the symptoms may fluctuate in intensity, or appear intermittently. Paraesthesia, often described as a sensation of "pins and needles", often occurs at some time in the affected limb, and a degree of muscle wasting is often noted.
In some cases there is no prior history of strain or trauma, and the back pain may begin gradually and not radiate to a limb. The acute symptoms usually subside in a few weeks and recovery from symptoms may occur though the disc protrusion remains. Recurrence of symptoms is common and may occur at frequent intervals.
Intervertebral disc prolapse may be demonstrated by plain X-rays, myelography (X-ray of the spinal cord after injection of a contrast medium), CT (computerised tomography) scan or MRI (magnetic resonance imaging).
Last reviewed for CCPS 16 September 2011.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Medical Report | Lumbar Intervertebral Disc Prolapse - Lumbar Spondylosis |
Preliminary questions [26792]
22444 the condition under consideration has been accepted on the basis of an intervertebral disc prolapse.
22445 the veteran has had an intervertebral disc prolapse of side and site of the body at some time.
26444 intervertebral disc prolapse means protrusion, herniation or rupture of an intervertebral disc of the cervical, thoracic or lumbar spine, causing local pain and stiffness.
22447 the condition under consideration is at the level of the identified illness or injury
26445 the veteran has established the causal connection between the intervertebral disc prolapse and VEA service for the condition under consideration.
22446 the veteran had the identified illness or injury before the clinical onset of the condition under consideration at the level of the intervertebral disc prolapse.
22448 the veteran has established the causal connection between the intervertebral disc prolapse and VEA service for the clinical onset of the condition under consideration.
22449 the veteran has established the causal connection between the intervertebral disc prolapse and operational service for the clinical onset of the condition under consideration.
or
22450 the veteran has established the causal connection between the intervertebral disc prolapse and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
26446 the veteran had the identified illness or injury before the clinical worsening of the condition under consideration at the level of the intervertebral disc prolapse.
26447 the veteran has established the causal connection between the intervertebral disc prolapse and VEA service for the clinical worsening of the condition under consideration.
26448 the veteran has established the causal connection between the intervertebral disc prolapse and operational service for the clinical worsening of the condition under consideration.
or
26449 the veteran has established the causal connection between the intervertebral disc prolapse and eligible service for the clinical worsening of the condition under consideration.
Clinical onset and operational service [22449]
22451 the identified illness or injury is causally related to operational service.
Clinical onset and eligible service [22450]
22452 the identified illness or injury is causally related to eligible service.
Clinical worsening and operational service [26448]
22451 the identified illness or injury is causally related to operational service.
26450 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury is causally related.
Clinical worsening and eligible service [26449]
22452 the identified illness or injury is causally related to eligible service.
26451 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury is causally related.