Ilyov Ilko, Vasvi Edvin, Petrov Petar-Preslav, Velchev Vladislav, Penchev Plamen
Department of Medicine, Medical University of Plovdiv, Plovdiv, BGR.
Department of Neurosurgery, St. Anna Hospital, Varna, BGR.
Cureus. 2024 Jan 3;16(1):e51568. doi: 10.7759/cureus.51568. eCollection 2024 Jan.
A herniated disc is a condition in which the nucleus pulposus is displaced from the intervertebral space. It usually leads to back pain, thus being the most common reason for it. Patients often describe the first symptoms of a herniated disc as extreme and decisive pain. Unlike the usual mechanical back pain, a herniated disc is often related to a stinging or burning sensation that often spreads to the lower extremities and proves to be continuous at lower temperatures. We present a case of a 58-year-old male patient who visited the Acibadem City Clinic with complaints of pain initially starting from his hip, which in time extended to his left leg (L5 radiculopathy) and a few days later to his right leg (L5 radiculopathy). Before visiting the clinic, he had been treated in Germany with physiotherapy and supplements, which had proved ineffective. After an MRI, which revealed an L4-L5 herniated disc, he underwent conservative treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) for 14 days in addition to Medrol 4mg tablets (3x1 per day for 10 days). On the third day of the treatment, 60% of the symptoms had subsided. Seven months later, he came in for a scheduled checkup, and 95% of the symptoms were gone. A controlled MRI was done, and the herniated disc had completely vanished. We hope that this type of research will benefit medical professionals, patients, researchers, doctors, and students, among others. Such cases also contribute to the quality of care for such patients and help set regulated factual guidelines regarding their treatment as a whole.
椎间盘突出是一种髓核从椎间隙移位的病症。它通常会导致背痛，是背痛最常见的原因。患者常将椎间盘突出的首发症状描述为剧烈且明确的疼痛。与常见的机械性背痛不同，椎间盘突出常伴有刺痛或灼痛，这种疼痛常蔓延至下肢，在温度较低时会持续存在。我们报告一例58岁男性患者，他因最初始于臀部的疼痛就诊于阿西巴德姆市诊所，疼痛后来扩展至左腿（L5神经根病），几天后又扩展至右腿（L5神经根病）。在就诊前，他在德国接受过物理治疗和补充剂治疗，但均无效。经MRI检查发现L4 - L5椎间盘突出后，除了服用美卓乐4毫克片剂（每天3次，每次1片，共10天）外，他还接受了14天的非甾体抗炎药（NSAIDs）和质子泵抑制剂（PPIs）保守治疗。治疗第三天，60%的症状已消退。七个月后，他前来进行定期检查，95%的症状已消失。再次进行的MRI检查显示，突出的椎间盘已完全消失。我们希望这类研究能使医学专业人员、患者、研究人员、医生和学生等受益。此类病例也有助于提高对此类患者的护理质量，并有助于制定关于其整体治疗的规范事实指南。
