lumbar region while twisting, stooping or coughing. He is unable to move. The acute
pain gradually lessens in severity, but after a few days a radiating pain is felt in one or
other buttock and down the back or side of the thigh to the calf and foot. Tingling or
numbness is felt in the calf or foot. The pain is aggravated by coughing or sneezing.
Investigations
The diagnosis is made chiefly on the symptoms and clinical examination. X-rays may
show narrowing of disc space while an MRI may confirm disc bulge or herniation.
However, invariably there is no correlation between the findings and the severity of
symptoms. Bulging or even herniated discs may be seen on MRI scans with the patient
having minimal or no symptoms whatsoever as discussed in Chapter 1. On the other
hand, the patient may be incapacitated due to pain with the scan showing minimal disc
degeneration.
Spondylolisthesis
Spondylolisthesis is the term applied to spontaneous displacement of a vertebral body
upon the segment next below it i.e. one vertebral body slides over the other.
Displacement is usually forwards, but it may be backwards. There is a racial predilection
as well. African-American women are two to three times more likely than white women