Herniated Nucleus Pulposus

 Prolapse of an intervertebral disk through a tear in the surrounding annulus fibrosus.

 Basically, another term for the condition known as a herniated disc
 can occur in any disc in the spine, but the two most common forms are lumbar disc herniation
and cervical disc herniation.

Signs and Symptoms

 Arm or leg pain

 Numbness or tingling
 Muscle Weakness
 Muscle spasm
 Severe lower back pain

Diagnostic Procedure

 Computerized tomography (CT scan).

 Magnetic resonance imaging (MRI). This test can be used to confirm the location of the
herniated disk and to see which nerves are affected.
 Myelogram. A dye is injected into the spinal fluid, and then X-rays are taken. This test can show
pressure on your spinal cord or nerves due to multiple herniated disks or other conditions.
 Nerve tests

Electromyograms and nerve conduction studies measure how well electrical impulses are
moving along nerve tissue. This can help pinpoint the location of the nerve damage.

Medical Management

Medications

 Non-steroidal anti-inflammatory medications (NSAIDs) - used for long term pain

 Narcotic - pain killers
 Steroid injections - in the area of the herniated disk can help control pain for several months

Conservative Treatment

 Pelvic Girdle Traction - for lumbar spine affection

Surgical Intervention

 Diskectomy - removes a protruding disk

  Micro-diskectomy - a procedure removing fragments of nucleated disk through a very small
opening

Nursing Diagnosis

 Acute Pain
 Impaired physical mobility
 Anxiety
 Knowledge deficit

Nursing Responsibilities

 Acute Pain
a. Assess complaints of pain, location, duration of attacks, precipitating factors / which
aggravate. Pain scale of 0-10
b. Maintain bed rest, semi-Fowler position to the spinal bones, hips and knees in a state of
flexion, supine position
c. Teach relaxation techniques (Deep breathing exercise)
d. Collaboration: analgesics
 Impaired physical mobility
a. Give / aids patients to perform passive range of motion exercises and active
b. Assist patients in ambulation activity progressively
 Knowledge deficit
a. Explain the process of disease and prognosis, and restrictions on activities
b. Give information about your own body mechanics to stand and lif
c. Give information about the signs that need attention such as puncture pain, loss of
sensation / ability to walk.