Herniated Nucleus Pulposus (HNP)

Herniated Nucleus Pulposus (HNP). Everyone had spinal pain ( back pain) , both in the neck, back , and waist . In general (90%) spinal pain can go away with simple pain medication (drug store). Ten percent will recur . Although the percentage is a little , very severe consequences thereof , including permanent neurological disability . Nerve defects can be paralysis of the arm and leg either side, impotence, and loss of ability to control the desire to urinate and defecate.

Pain in the spine can be an early symptom of a pinched nerve caused by a narrowing of the space / cavity through which the nerve or group of nerves . This narrowing in medical language called stenosis. Cause pinching nerves in the spine (stenosis) may be a spinal cord tumor , the cancer spread to the spine, infection and spread of the infection to the spine, trauma or impact on the spine , and degenerative illnesses or premature aging network.

Premature aging of tissues in the spinal area can be premature aging pads between the vertebrae causing vertebral protrusion (herniation nucleus pulposus (HNP), HNP degeneration is a disease of the spine in the area that became the beginning of the spinal cord clamping can ie fatal paralysis.

Causes & Symptoms of Herniated Nucleus Pulposus

HNP common in the border area between the vertebrae to move more vertebrae can not move. This is an area that gets the most mechanical loads so rapidly aging and loss elastisitas.Akibatnya bearing protrusion can occur between vertebrae tapping / pinching the nerve . Factors that facilitate the process of aging include smoking , faktorketurunan / genetic , improper posture , and especially the repeated impact load . Vertebrae are most commonly affected are the lower neck vertebra and lumbar vertebra below .

HNP symptoms and sign depend on the vertebrae are affected and the severity of suppression / clasps that happen . HNP on neck vertebra will cause pain or pegel in the neck or shoulder that spreads to the arms . HNP pain may increase when coughing or straining . Another symptom include numbness or tingling/ numbness spreading to the arm. At the HNP will be characterized by severe limb paralysis . At the initial stage of weakness in grip , arms raised further difficulties such as hair combing motion or buttoning a shirt. In the more severe state of paralysis will follow the other arm and both legs. Other symptoms that may occur are impotence .

HNP at waist segment will cause pain in the low back that spreads to the limbs. Generally to the calf area . In layman’s language as nyetrum pain . As with HNP neck , pain in the waist HNP will also be felt when coughing or straining. Other symptoms are tingling , Baal / numb . In the more severe conditions will be increasingly felt pain when walking or sitting for long. HNP waist paralysis is the inability to walk with hopscotch / tiptoe or walk with heels .

How to diagnose Herniated Nucleus Pulposus

To ensure the diagnosis and severity of illness , required supplementary examination is the examination of nerve fibres with electrical conductivity EMG .

Examination of the structure of the vertebral column with neck or lumbar spine x-rays , and an MRI or CT Scan . MRI examination is more advantageous because it can see the soft tissue structures such as neural networks .

Treatment for Herniated Nucleus Pulposus

Treatment of a pinched nerve include oral medications treatment or administration of drugs , physiotherapy , and surgery . Most (70 % ) HNP for the first time and have not damaged the nerves do not require surgery . In this case given pain medication , healing ulcers , and physiotherapy for 3 months . If the symptoms persist, surgery for herniated nucleus pulposus will be recommended . Alternative treatment in this condition is a nerve block ( injection of anti- inflammatory drugs and / or anti- pain to a pinched nerve ) .

When surgery is needed for Herniated Nucleus Pulposus

Surgery for Herniated Nucleus Pulposus is needed when there is impingement to nerve. This procedure is expected to relieve pain , prevent nerve damage , and allow for recovery when nerve damage has not been severe . Neurosurgeons using specific markers to assess whether or not the results of operations and estimates that can be obtained by surgery . Markers were obtained from patient examination and assessment of compliance with the supplementary examination results . The more appropriate the better operating results . In the case of HNP examination , the doctor will perform a provocation test to ensure diagnosis and predict outcomes that can be achieved with surgery .

Nerve impingement surgery procedures can be conventional or Microsurgery . Microsurgery is done with the aid of a microscope or endoscope . Choice of surgical procedure depends on the availability of tools and findings from the examination of patients and the findings of the MRI images . Recurrence rate after surgery ranged from 7-14 % . This recurrence usually occurs in the same segment or at the link above or below .

Treatment includes surgery and non HNP operations . In the case of HNP neurological deficit that has not happened yet , the majority ( 70 % ) pain will diminish or disappear with medication . In the cases that have occurred deficit disorder neulogis a touch – sense and muscle strength , the treatment of choice is surgery . In addition to these two treatment modalities , nerve block is an alternative treatment in certain cases with adequate results .

Each operation always carries the risk of complications. Complications that can occur are bleeding surgery wound , infection, and paralysis. In the modern era the risk of complications is very low ( < 2 % ) . Operation done by trained surgery carried a paralysis risk of < 0.5 %.

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Herniated Nucleus Pulposus (HNP)