Herniated Nucleus Pulposus

• Herniated Nucleus Pulposus (HNP) it is rupture of intervertebral disk
• Herniated Nucleus Pulposus (HNP) it involves protrusion of nucleus pulposus (central part of intervertebral disc) into spine causing compression of spinal nerve roots
• Herniated Nucleus Pulposus (HNP)

  Most commonly affected disk: L4 & L5
• Lumbosacral Disk HNP Clinical Manifestations

  • Pain: Back
  • Radiating in: Buttocks down the leg - along sciatic nerve
  • Affected side foot, leg, toes: Weakness, Numbness
  • Lasegue's sign - Positive straight leg raise test; pain on leg below the knee when leg raised from a supine position
  • Depressed or absent: Achilles reflex
  • Lumbar region: Muscle spasm
• Cervical Disk HNP Clinical Manifestations

  • Pain: Shoulder
  • Radiating in: Arm to Hand
  • Weakness of affected upper extremity, paresthesia and sensory disturbances
• HNP Diagnostic Tests

  • Myelogram
  • CT Scan or MRI 
  • MRI - greater sensitivity
• HNP Conservative Management

  • BED REST on a firm mattress with bed board
  • Traction: Pelvic traction
  • DOC: Anti-inflammatory
  • Bend knees when lifting
  • REPORT signs of wound infection, sensory or motor deficits