Herniated nucleus pulposus, or HNP, is a prolapse of an intervertebral disk through a tear in the surrounding annulus fibrosus. It occurs most often in people in their 30s-40s and is caused by a combination of genetic predisposition, age, occupation, weight, and sudden injury like heavy lifting. Symptoms include low back pain radiating into the leg, tingling, numbness, and weakness. Diagnosis involves physical exam, imaging like x-rays, CT scans, MRI, and EMGs. Treatment options are nonsurgical like medication, physical therapy, or weight loss, or surgical like discectomy to remove the protruding disk material.
Herniated nucleus pulposus, or HNP, is a prolapse of an intervertebral disk through a tear in the surrounding annulus fibrosus. It occurs most often in people in their 30s-40s and is caused by a combination of genetic predisposition, age, occupation, weight, and sudden injury like heavy lifting. Symptoms include low back pain radiating into the leg, tingling, numbness, and weakness. Diagnosis involves physical exam, imaging like x-rays, CT scans, MRI, and EMGs. Treatment options are nonsurgical like medication, physical therapy, or weight loss, or surgical like discectomy to remove the protruding disk material.
Herniated nucleus pulposus, or HNP, is a prolapse of an intervertebral disk through a tear in the surrounding annulus fibrosus. It occurs most often in people in their 30s-40s and is caused by a combination of genetic predisposition, age, occupation, weight, and sudden injury like heavy lifting. Symptoms include low back pain radiating into the leg, tingling, numbness, and weakness. Diagnosis involves physical exam, imaging like x-rays, CT scans, MRI, and EMGs. Treatment options are nonsurgical like medication, physical therapy, or weight loss, or surgical like discectomy to remove the protruding disk material.
Herniated nucleus pulposus, or HNP, is a prolapse of an intervertebral disk through a tear in the surrounding annulus fibrosus. It occurs most often in people in their 30s-40s and is caused by a combination of genetic predisposition, age, occupation, weight, and sudden injury like heavy lifting. Symptoms include low back pain radiating into the leg, tingling, numbness, and weakness. Diagnosis involves physical exam, imaging like x-rays, CT scans, MRI, and EMGs. Treatment options are nonsurgical like medication, physical therapy, or weight loss, or surgical like discectomy to remove the protruding disk material.
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Herniated Nucleus
Pulposus By Limytch Diaz Before we start
• An intervertebral disk acts as shock absorber
(24 disk) • protect the nerves that run down the middle of the spine and intervertebral disks What is HNP? • Herniated nucleus pulposus or HNP is prolapse of an intervertebral disk through a tear in the surrounding annulus fibrosus. Pathophysiolog y Predisposing Precipitating factors factors • Genetics • Weigh • Age t • Occupation • Smoking
lifting heavy objects
aging-related can lead to a herniated wear and disk, as can twisting tear and turning while lifting
Annulus fissures predispose to a weakness, which allows disc material to bulge or migrate outside the which allows disc annulus margins material to bulge or migrate outside the annulus margins ETIOLOGY • Most disc herniations occur when a person is in their 30’s or 40’ • sAfter age 50 or 60, osteoarthritic degeneration (spondylosis) or spinal stenosis are more likely causes of low back pain or leg pain. Stages of Disc Herniation Signs and Symptoms • Pain- if disc does press on a nerve, symptoms may include: Pain that travels through the buttock and down a leg to the ankle or foot because of pressure on the sciatic nerve. Low back pain (LUMBAGO) may accompany the leg pain. Signs and Symptoms • Tingling ("pins-and-needles“ sensation) or numbness in one leg that can begin in the buttock or behind the knee and extend to the thigh, ankle, or foot. • Weakness in certain muscles in one or both legs. • Pain in the front of the thigh. • Severe deep muscle pain and muscle spasms. Signs and Symptoms • Long term nerve compression can cause • Cauda equina syndrome • Bladder/bowel dysfunction • Low back pain (Sharp) • Sciatica / Motor weakness Diagnostic Test • Physical Exam- Straight Leg Raise • The straight leg raise, also called Lasègue's sign, Lasègue test or Lazarević's sign, is a test done during the physical examination to determine whether a patient with low back pain has an underlying herniated disk, often located at L5 (fifth lumbar spinal nerve) Diagnostic Test • The test is positive if significant back pain, or radicular pain in the lower extremity is present.
• A positive test may indicate sciatic or lumbosacral
nerve root irritation, for example due to a prolapsed lumbar disc Diagnostic Test • Imaging • X- • RAY COMPUTED • TOMOGRAPHY MAGNETIC RESONANCE IMAGING • MYELOGRAM Xra y COMPUTED TOMOGRAPHY MRI Myelogra m Diagnostic Test • Electromyogram and Nerve conduction studies (EMG/ NCS) These tests measure the electrical impulse along nerve roots, peripheral nerves, and muscle tissue. • This will indicate whether there is ongoing nerve damage, if the nerves are in a state of healing from a past injury, or whether there is another site of nerve compression. Treatment s • MEDICATIO •NAcetaminophen (paracetamol) • NSAIDs • Muscle relaxants • Antidepressants • Antiseizure drugs Treatment s • NON SURGICAL • Education on proper body mechanics • Physical therapy, to address mechanical factors, and may include modalities to temporarily relieve pain (i.e. traction, electrical stimulation, massage) • Weight • control Traction • Belt Pelvic Girdle traction Treatment s • SURGICAL • Discectomy • Lumbar Discectomy • Neck Discectomy Nursing Management
Effectiveness of Progressive Inhibition of Neuromuscular Structures (PINS) and Spinal Mobilization with Leg Movement (SMWLM) in Lumbar Disk Herniation with Radiculopathy: A Case Report with Two Year Follow-up
Effectiveness of Progressive Inhibition of Neuromuscular Structures (PINS) and Spinal Mobilization with Leg Movement (SMWLM) in Lumbar Disk Herniation with Radiculopathy: A Case Report with Two Year Follow-up
