Intervertebral Intervertebral Di skDiskHerniation Herniation - A diso rder involv ing im pingem ent of a A disorder involving impingement of a vertebral disk¶s nucleus vertebral disk¶s nucleus pulposus pul posus on spi nal on spinal nerve roots, causing pain and possible nerve roots, causing pain and possible neuromus cular deficit. neuromus cular deficit.
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IntervertebralIntervertebral Disk Disk HerniationHerniation
-- A disorder involving impingement of aA disorder involving impingement of avertebral disk¶s nucleusvertebral disk¶s nucleus pulposus pulposus on spinalon spinal
nerve roots, causing pain and possiblenerve roots, causing pain and possibleneuromuscular deficit.neuromuscular deficit.
P athophysiologyP athophysiology: :R upture of theR upture of the annulusannulus
pulposus pulposus allows part of theallows part of thenucleusnucleus pulposus pulposus to protrudeto protrude
and stress against spinal nerveand stress against spinal nerveroots, producing symptomsroots, producing symptoms
HerniationHerniation occur anywhereoccur anywherealong the vertebral column butalong the vertebral column butis most common in the lumbar is most common in the lumbar
a.a. Low back /neck pain can vary widelyLow back /neck pain can vary widely b. b. Mild tingling, dull ache / a burning pulsatingMild tingling, dull ache / a burning pulsating
sensationsensationc.c. Numbness Numbness
The pain most often occurs on one side of theThe pain most often occurs on one side of the body body
-- sharp pain in one part of the leg,sharp pain in one part of the leg,hip/buttocks, numbness in other parts.hip/buttocks, numbness in other parts.Sensations felt on the back of the calf/ sole of Sensations felt on the back of the calf/ sole of thethe footfoot..
C ervical disk C ervical disk h herniationerniation
-- pain when moving the neck pain when moving the neck, deep, deep pain painnear/over the shoulder bladenear/over the shoulder blade,/ ,/ pain that pain thatradiates to the upper arm,radiates to the upper arm, forearm,/ rarelyforearm,/ rarelyfingers.fingers.
M edical and S u rgical Interventions:M edical and S u rgical Interventions:
Medications:Medications:
NSA I DS NSA I DS ± ±aspirin,ibuprofenaspirin,ibuprofen((Advil,NuprinAdvil,Nuprin),),diclofenacdiclofenac ketoprufenketoprufen ((ActronActron))
TramadolTramadol ((ultramultram))
OpioidOpioid
Epidural steroid I njectionsEpidural steroid I njections ± ± used to treat low back used to treat low back pain caused by nerve impingement pain caused by nerve impingement
Spinal FusionSpinal Fusion-- is a surgery usedis a surgery used toto fusefuse spinebonesspinebones(vertebrae) that cause you to have back (vertebrae) that cause you to have back
problems. problems.
PercutaneousPercutaneous VertebroplastyVertebroplasty-- involves an injection of involves an injection of a cementa cement--likelike bone bone
substitute into vertebrae w/ compressionsubstitute into vertebrae w/ compressionfractures.fractures.
-- the health care provider injects bone cementthe health care provider injects bone cementinto the space surrounding a fractured vertebra.into the space surrounding a fractured vertebra.
a.a. Support affected body parts usingSupport affected body parts using pillows/rolls, air mattress pillows/rolls, air mattress, water , water bed bed ..
b. Provide conservative management b. Provide conservative management, if , if indicated, includingindicated, including: :