Herniated Nucleus Pulposus

DEFINITION:
 Herniated nucleus pulposus is prolapse of an intervertebral disk through a tear in the
surrounding annulus fibrosus.

 Spinal vertebrae are separated by cartilaginous disks consisting of an outer annulus

fibrosus and an inner nucleus pulposus.

 Radiculopathy occurs when the herniated nucleus compresses or irritates the nerve root.

Causes
 A single excessive strain or injury may cause a herniated disc.

 A relatively minor strain or twisting movement can cause a disc to rupture.

Symptoms and Signs

 Herniated disks often cause no symptoms

 Pain usually develops suddenly

 back pain is typically relieved by bed rest

 In contrast, nerve root pain caused by an epidural tumor or abscess begins more
insidiously, and back pain is worsened by bed rest.

Diagnosis
 X-ray

 Computed tomography scan (CT or CAT scan)

  Magnetic resonance imaging (MRI)

 Myleogram

 Electromyogram and Nerve Conduction Studies (EMG/NCS)

Treatment
 Conservative Treatment- Such as bed rest, physical therapy and NSAID.

 Surgery - A doctor may recommend surgery if conservative treatment options, such as

physical therapy and medications, do not reduce or end the pain altogether.

Surgical Terms
 Artificial disc surgery — Surgical replacement of a diseased or herniated lumbar disc
with a manufactured disc.

 Discectomy — Surgical removal or partial removal of an intervertebral disc.

 Laminectomy — Surgical removal of most of the bony arch, or lamina, of a vertebra.

 Laminotomy — An opening made in a lamina to relieve pressure on the nerve roots.

 Spinal Fusion — A procedure in which bone is grafted onto the spine, creating a solid
union between two or more vertebrae; instrumentation such as screws and rods may be
used to provide additional spinal support.