Publications

Neurodeficit due to lumbar disc herniation (LDH) is a serious complication and can range from sensory hypoesthesia in a single
dermatome to a debilitating condition like cauda equina syndrome (CES). Many authors have described variable
clinical and radiological risk factors for neurodeficit in LDH. Similarly the prognostic factors influencing recovery
have been variable across the studies. This narrative review discusses the pathogenesis, most consistent factors
associated with the occurrence of neurodeficit in LDH patients and also the factors which have a prognostic role
in recovery. Pathological mechanisms like venous congestion, neuronal ischaemia and multiple root impairment act
either individually or in combination to result in neurodeficit in LDH patients. Among the clinical risk factors,
diabetes mellitus and acute onset of symptoms have been associated with neurodeficit while pre-existing spinal canal
stenosis, non-contained discs (sequestrated/migrated) are potential radiological risk factors for developing
neurodeficit. When considering prognostic factors for recovery, pre-operative muscle strength is the only significant
factor. Knowledge about the causative and prognostic factors in neurodeficit following LDH would help in the
successful management of this condition.
Keywords Lumbar disc . Motor deficit . Neurological deficit . Foot drop