Herniation size and symptoms
How heavy is a spinal disc herniation?
A study of intervertebral disc bulges by Mariajoseph et al. in 122 middle-aged patients with sciatica took an unusual approach to measuring the bigness of the bulge: they weighed whatever they cut off! (The usual method is to use pictures taken with an MRI scan.)
Fun fact: the average fragment weight they removed from peoples’ spines was just half a gram. (Anatomy is tightly packed; most things are smaller than you think.) If it seems hard to believe that such a teensy amount of material could be the cause of so much discomfort, the results of this investigation will back you up on that: it didn’t really matter how big it was, because “disc fragment weight no effect on the severity of pain at presentation or after microdiscectomy.”
They looked at other factors as well — spinal canal compromise, herniation classification, and vertebral level — and none of those were clearly linked to symptom severity either.
Interesting. But, for perspective, the size of a splinter doesn't seem to have much to do with how much it hurts either. Just because it’s small doesn't mean it’s not a problem! But interesting.
| title | Relationship between herniated intervertebral disc fragment weight and pain in lumbar microdiscectomy patients |
|---|---|
| journal | J Clin Neurosci |
| Volume 102, Aug 2022, 75–79 | |
| authors | Frederick P Mariajoseph, Mendel Castle-Kirszbaum, Jeremy Kam, Myron Rogers, Reece Sher, Chris Daly, Jack Roadley, Phillipa Risbey, Kylie Fryer, and Tony Goldschlager |
| links | publisher • PubMed • PainSci bibliography |
(Un-fun fact: This is part of a project I started almost a year ago, upgrading all my content on intervertebral discs. This study was a year old when I started, and now it’s two years old, yikes! It’s not unusual for me to chip away at many big projects for a long time, but this is getting a bit ridiculous even by my standards.)