Present as a clinical, low back pain (low-back pain, lumbago) is often associated with shock pain, tingling, loss of sensation or strength in one lower limb, rarely with involvement of the urinary and fecal control and sexual potency. Diagnosis is currently done by clinical neurological examination and confirmed by computed tomography (CT) exams and magnetic resonance imaging (MRI) of the lumbar column. The most commonly affected levels are L4/L5 and L5/S1. The treatment consists of analgesics, relative rest, rehabilitation with physical therapy and, in some cases, surgery. Among the types of surgery, we list a laminectomy with removal of herniated disc (discectomy) and the microdiscectomy (it is a less extensive laminectomy with a microscopic aid to the surgical discectomy). The more lateral herniations or the intervertebral foramen may need associated foraminotomy or more lateralized accesses with hemilaminectomy. Nowadays, there are techniques so-called minimally invasive to address this problem. In some situations it is possible to remove the hernia through surgery without cutting, such as nucleoplasty through radiofrequency and aspiration techniques (suction) of the herniated nucleus.

They are rare, most frequently associated with a history of trauma, and present with local pain, difficulty in walking, loss of sensation in the lower limbs and loss of sphincter control. Diagnosis is also made by neurological examination and confirmed by CT scans and MRI of the thoracic spine. Treatment is mainly surgical, and may consist of thoracotomy (access through the chest to the anterior portion of the vertebral column), thoracophrenic laparotomy (access through the chest and abdomen to the spine) and costotransversectomy (further access to the thoracic spine, with partial removal rib), depending on the position of the herniated disc. In some situations it is possible to withdraw from the herniated thoracic disc through minimally invasive techniques such as endoscopic surgery.

Its usually manifested with cervical pain radiated to the upper limbs (arm and forearm). It is common changing in sensitivity in the upper limbs with tingling and pain in shock. The diagnosis is confirmed by nuclear magnetic resonance of the cervical spine, and the treatment consists of rest, immobilization, analgesia, anti-inflammatory drugs and physiotherapy. The non-surgical treatment achieves success in approximately 90% of cases. After a period of 6 to 8 weeks of appropriated treatment to the measures described above, if the patient does not show significant improvement, he/she is indicated for surgical treatment (discectomy). The anterior cervical discectomy is the most common procedure, with access from the anterior region of the neck and removal of the herniated disc with the aid of a surgical microscope. You can do a merger with autologous material (patient's own bone) or substitute materials and prostheses (hydroxyapatite, screws, plates and "cages," artificial discs) depending on the existence of spinal instability and the presence of degenerative disease. The discectomy can also be made by posterior way, with the removal of a lamina and opening of the intervertebral foramen, indicated cases of lateralized disc herniation when combined with a significant narrowing of the spinal canal.

It manifests with difficulty in walking associated with low-back and inferior limbs pain (the patient reports pain when walking a certain distance and it improves when you stop walking). The sphincter disorders may be presented. The diagnosis is confirmed by x-ray, CT and MRI of the lumbar spine. Surgical treatment consists of removing the elements that lead to reduction of lumbar vertebral canal. The procedures performed are laminectomy (removal of the laminae), foraminotomy (opening of the foramen), flavectomy (removal of the yellow ligament/ ligamentum flavum) and osteotomies for removal of osteophytes ("bone spurs"). In circumstances where there is instability associated with it may be necessary procedure for spinal fusion with instrumentation (fixation with rods and screws).

It can be manifested in the same way that the cervical disc herniations, but with a slower route (gradual worsening) and greater prevalence of cervical pain on the movement. The diagnosis is made with the help of x-ray, CT and MRI of the cervical spine. The surgical treatment can range from a laminectomy on the extent of the narrowing, with flavectomy and foraminotomy, or removal of intervertebral discs and osteophytes ("bone spurs") by the anterior way, requiring or not the merger process if any signs of instability column appears.

The term spondylolisthesis means the slipping of one vertebra over another one closer. This predisposition to slip or the slipping itself can have several causes. The most common is congenital (related to birth defects of the spine) and degenerative (caused by damage of the joints and disorders of intervertebral discs). The congenital type is common and is a frequent cause of pain in childhood and adolescence. The degeneration occurs, in general, after 50 years of age and is more common in women. Treatment is not usually made by surgery but with exercises that strengthen the muscles of the spine and overall fitness. The temporary use of vest / orthesis eases the crisis of lumbar pain. Surgical treatment with arthrodesis (fusion) of the segments involved is indicated in children and adolescents with progressive and painful slip. In adults, the indication for surgery is reserved for situations where there is chronic low back pain or nerve root compression with severe sciatica pain. The fusion in children is followed by immobilization with plastic orthesis/ vest. In adults, the surgical procedure involves the fixation of screws to stabilization.