b'\n_START_ARTICLE_\nPengherniaan cakera spina\n_START_PARAGRAPH_\nPengherniaan cakera spina ialah satu keadaan patologi yang disebabkan oleh koyak pada gegelang berserat luar (anulus fibrosus) untuk cakera intervertebra. Koyak ini membenarkan bahagian tengah cakera yang lembut (nukleus pulposus) untuk mengalir ke luar._NEWLINE_Keadaan ini biasanya merupakan perkembangan lanjut untuk protusi cakera yang telah wujud. Walaupun lapisan-lapisan annulus fibrosus yang paling luar masih belum koyak dalam peringkat permulaan ini, cakera yang terlibat akan bonjol apabila mengalami tekanan.\n_START_SECTION_\nKekerapan\n_START_PARAGRAPH_\nDisc herniation can occur in any disc in the spine, but the two most common forms are the cervical disc herniation and the lumbar disc herniation. The latter is the most common, causing lower back pain (lumbago) and often leg pain as well, in which case it is commonly referred to as sciatica._NEWLINE_Lumbar disc herniation occurs 15 times more often than cervical (neck) disc herniation, and it is one of the most common causes of lower back pain. The cervical discs are affected 8% of the time and the upper-to-mid-back (thoracic) discs only 1 - 2% of the time. _NEWLINE_The following locations have no discs and are therefore exempt from the risk of disc herniation: the upper two cervical intervertebral spaces, the sacrum, and the coccyx._NEWLINE_Most disc herniations occur when a person is in their thirties or forties when the nucleus pulposus is still a gelatin-like substance. With age the nucleus pulposus changes ("dries out") and the risk of herniation is greatly reduced. At the same time osteoarthritic degeneration makes its inroads.\n_START_SECTION_\nPengherniaan cakera servikal\n_START_PARAGRAPH_\nCervical disc herniations occur in the neck, most often between the sixth and seventh cervical vertebral bodies. Symptoms can affect the back of the skull, the neck, shoulder girdle, scapula, shoulder, arm, and hand. The nerves of the cervical plexus and brachial plexus can be affected.\n_START_SECTION_\nPengherniaan cakera toraks\n_START_PARAGRAPH_\nThoracic discs are very stable and herniations in this region are quite rare. Herniation of the uppermost thoracic discs can mimic cervical disc herniations, while herniation of the other discs can mimic lumbar herniations.\n_START_SECTION_\nPengherniaan cakera lumbar\n_START_PARAGRAPH_\nLumbar disc herniations occur in the lower back, most often between the fourth and fifth lumbar vertebral bodies or between the fifth and the sacrum. Symptoms can affect the lower back, buttocks, thigh, and may radiate into the foot and/or toe. The sciatic nerve is the most commonly affected nerve, causing symptoms of sciatica. The femoral nerve can also be affected.\n_START_SECTION_\nPunca\n_START_PARAGRAPH_\nCauses of a disc herniation can include general wear and tear on the disc over time, repetitive movements, stress on the disc that occurs while twisting and lifting, or other injuries.\n_START_SECTION_\nGejala\n_START_PARAGRAPH_\nSymptoms of a herniated disc can vary depending on the location of the herniation and the types of soft tissue that become involved. They can range from little or no pain if the disc is the only tissue injured to severe and unrelenting neck or back pain that will radiate into the regions served by an affected nerve root when it is irritated or impinged by the herniated material. Other symptoms may include sensory changes such as numbness, tingling, muscular weakness or paralysis, and affection of reflexes. Unlike a pulsating pain or pain that comes and goes, which can be caused by muscle spasm, pain from a herniated disc is usually continuous._NEWLINE_It is possible to have a herniated disc without any pain or noticeable symptoms, depending on its location. If the extruded nucleus pulposus material doesn\'t press on soft tissues or nerves, it may not cause any symptoms. It has been estimated that as many as 50% of the population have focal herniated discs in their cervical region that do not cause noticeable symptoms. _NEWLINE_Typically, symptoms are experienced only on one side of the body. If the prolapse is very large and presses on the spinal cord or the cauda equina in the lumbar region, affection of both sides of the body may occur, often with serious consequences.'