A combination of mechanical compression caused by a protruding disc and leakage of nucleus pulposus np from the disc core is presumed to contribute. It is under pressure and has a migratory character. The ivd is a cartilagelike tissue and consists of two. The nucleus pulposus is a mucoid protein that binds approximately three times its weight in water and allows for distribution of forces. Orthopaedic physical therapy secrets third edition, 2017. The natural history of herniated nucleus pulposus with. It functions to distribute hydraulic pressure in all directions within each disc under compressive loads. Differential ct diagnosis of extruded nucleus pulposus. The purpose of this study is to investigate the effect of ages in the degeneration process of diabetic nucleus pulposus np in rats and humans. I ntervertebral disc hernia was first described by mixter and barr, 1 and the ensuing pain has been suggested to arise as a result of the mechanical compression that a ruptured disc exerts on adjacent nerves.
Obesity increases the risk of recurrent herniated nucleus pulposus after lumbar microdiscec. Herniation of the calcified nucleus pulposus is a rare complication, possibly producing minor symptoms and alarming roentgenographic findings which suggest the need for neurosurgical intervention. Cramer, in clinical anatomy of the spine, spinal cord, and. In this study of 100 cases in which a herniated nucleus pulposus was removed, all patients had sciatic pain, and, with one exception, all had back pain. Herniation of nucleus pulposus definition of herniation. The radicular pain caused by disc herniation can be explained by two mechanisms. Structure and function of the lumbar intervertebral disk.
The tear causes pain because of the nerves in the disk, and when the disk impinges on an adjacent nerve root, a segmental radiculopathy with paresthesias and weakness in the distribution of the affected root results. In between them are soft disks filled with a jellylike substance. The author presents 4 cases in which spontaneous resorption of the herniated nuclear material and remission of symptoms occurred with conservative. Definisi hernia nucleus pulposus hnp adalah turunnya kandungan annulus fibrosus dari diskus intervertebralis lumbal pada spinal canal atau rupture annulus fibrosus dengan tekanan dari nucleus pulposus yang menyebabkan kompresi pada element saraf. The use of traction does not justify hospital admission. Technique of percutaneous transforaminal endoscopic.
Nucleus pulposus is the jellylike substance in the middle of the intervertebral disc. Radiologic findings included erosion andor fracture of the anterior aspect of the vertebra, usually with interspace narrowing. On examination of the literature dealing with the nucleus pulposus and the conditions of vertebral epiphysitis and osteo chondritis, it is evident that a proper appreciation of certain radiological appearances in the spine calls for familiarity with the anatomy, function and pathology of the nucleus pulposus. It is known that disc degeneration begins with changes in the biochemical content of the nucleus pulposus. Cell sources for nucleus pulposus regeneration, european. Mechanical compression and nucleus pulposus application on. Degeneration of the intervertebral disc ivd is a natural process occurring during ageing and is under continuous investigation. The stimulation of lymphocytes by nucleus pulposus in patients with degenerative disk disease of the lumbar spine. Hasan sadikin general hospital bandung indonesia article pdf available june 2015 with 2,123 reads how we measure reads. In this study of 100 cases in which a herniated nucleus pulposus was removed, all patients had sciatic pain, and, with one exception. The detection and differential diagnosis of extruded free disk fragments by ct has not been described in detail. Hydrated nucleus pulposus herniation in seven dogs. Berolahraga secara teratur, terutama jenis olahraga yang dapat menguatkan otot serta sendi di tungkai dan punggung, misalnya berenang. Treatment modalities for lumbar herniated discs that.
Next step after insertion of the needle at the proper site is to dye the nucleus pulposus and the herniated mass by using indigo carmine, after dyeing the nucleus pulposus changes to blue color but the annulus figure 4. It may result in back pain, pain or sensation in different parts of the body, and physical disability. Percutaneous lumbar discectomy, percutaneous microdiscectomy, percutaneous mechanical disc decompression, lumbar herniated nucleous pulposus, radiculopathy abstract introduction. Hernia nucleus pulposus hnp adalah suatu penyakit, dimana bantalan lunak diantara ruasruas tulang belakang soft gel disc atau nukleus pulposus mengalami tekanan dan pecah, sehingga terjadi penyempitan dan terjepitnya uraturat saraf yang melalui tulang belakang kita. The disk material may include elements of the nucleus pulposus, annulus fibrosus.
Clinical outcomes of patients treated with percutaneous. A disc with a herniated nucleus pulposus can almost always be managed or fully repaired through proper treatment. Hernia nucleus pulposus hnp hernia nucelus pulposus hnp adalah suatu nyeri yang disebabkan oleh proses patologik dikolumna vertebralis pada diskus intervertebralis diskogenik harsono, 1996. Presumptive acute noncompressive nucleus pulposus extrusion in 11 cats. Low back pain is the second leading cause of doctor visits each year, afflicting over 65 million americans. The results in seventy cases with complete records one year or more after operation were twentyfour excellent, thirtythree good, thirteen poor. Hydrated nucleus pulposus herniation in seven dogs, the. The most conclusive diagnostic tool for disc herniation is mri, and treatment may range from painkillers to surgery. A prospective study disclosed eight patients three children and five adults with anterior herniation of the nucleus pulposus ahnp. The journal of bone and joint surgery british volume. Pubmed journal articles for nucleus pulposus herniated were found in prime pubmed. Herniasi diskus intervertebralis ke segala arah dapat terjadi akibat trauma atau stress fisik. Standardisation of basal medium for reproducible culture.
The lumbar spine is made up of 5 load transferring bones called vertebrae. Herniated lumbar disc north american spine society. Autoimmune response to nucleus pulposus in the rabbit. Pdf nucleus pulposus herniation is the most common cause of sciatic pain and one of the most common indications for spine surgery.
We would like to show you a description here but the site wont allow us. Hernia nukleus pulposus gejala, penyebab dan mengobati. It is composed of a thin lattice of collagen fibers. Pdf nucleus pulposus herniation statpearls ncbi bookshelf. The lumbar spine comprises the 5 vertebrae that are below the thoracic vertebrae and. Traction in the acute setting may help muscle spasms, but it does not reduce the herniated nucleus pulposus hnp and has no good evidence of efficacy. The intervertebral disc consists of an inner nucleus pulposus np and an outer annulus fibrosus af. The precise cause of back pain is largely unknown, but degeneration of the intervertebral disc has been implicated as a possible source. The most frequent cause of a herniated nucleus pulposus is agerelated degeneration that develops over time as the spine bears the strain and stress of everyday life. Hnp causes hernia nucleus pulposus darling nuban the hydraulic effect hernia nukleus pulposus the contained, hydrated nucleus within the annulus acts as a shock absorber to cushion the spinal column from forces that are applied to. The diagnosis has been largely presumptive, although supported in some cases by findings at surgery.
Saraf terjepit lainnya di sebabkan oleh keluarnya nukleus pulposus. Bulging disk, compressed disk, herniated intervertebral disk, herniated nucleus pulposus, prolapsed disk, ruptured disk, slipped disk. These disks cushion the vertebrae and keep them in place. They are stacked in a column with an intervertebral disc sandwiched between each set of vertebrae.
Diabetes mellitus dm has been clinically proved as a risk factor of disc degeneration, and the accumulation of advanced glycation end products ages is known to be potentially involved in diabetes. Herniated nucleus pulposus hnp is one of the most common diseases of the spine. Hydrated nucleus pulposus extrusion hnpe is a cause of cervical myelopathy in nonchondrodystrophic and chondrodystrophic dogs beltran et al. Pencegahan hernia nukleus pulposus hnp meski hnp tidak selalu dapat dicegah, anda bisa mengurangi risiko saraf kejepit dengan melakukan langkahlangkah berikut. Current strategies for management of intervertebral disc. The clinical outcome is generally favourable with either medical or surgical management, but followup. Herniated nucleus pulposus is a condition in which part or all of the soft, gelatinous central portion of an intervertebral disk is forced through a weakened part of the disk, resulting in back pain and nerve root irritation. Percutaneous laser disc decompression pldd was introduced for the treatment of lumbar disc hernias in the 1980s. Benjamin ma, md, professor, chief, sports medicine and shoulder service, ucsf. Advanced glycation end products in degenerative nucleus. The lifetime prevalence of degenerative disc disease ddd is very high. A spine fusion was done at the time of removal of the herniated nucleus in eightythree cases.
Cell sources for nucleus pulposus regeneration cell sources for nucleus pulposus regeneration kregar velikonja, nevenka. Your backbone, or spine, is made up of 26 bones called vertebrae. While mechanical compression is still presumed to be of major importance, 24 leakage of nucleus pulposus np from the disc core onto nervous tissue may. The effect of laser irradiation for nucleus pulposus. Hernia nukleus pulposus hnp atau potrusi diskus intervertebralis pdi adalah suatu keadaan dimana terjadi penonjolan pada diskus intervertebralis ke dalam kanalis vertebralis protrusi diskus atau ruptur pada di s kus vebrata yang diakibatakan oleh menonjolnya nukleus pulposus yang menekan anulus fibrosus yang menyebabkan kompresi pada syaraf, terutama. Gross anatomy it is located within the annulus fibrosus and between the vertebral body endplates. Free publisher full textpmc free full textpmc free pdf. Over 90% of over age 50 show radiographic signs of ddd in magnetic resonance imaging studies. In brief, the nucleus pulposus, a remnant of the notochord, is a soft gelatinous oval or beanshaped mass found in the centre of each intervertebral disc.
1141 1170 1012 876 207 148 250 900 210 915 376 818 1487 1232 168 63 1513 126 1532 1394 198 325 351 1256 482 47 504 136 1280 1165 486 316