Pinards PDF

Manifestasi Klinis Hernia Nukleus Pulposus • nyeri pada bagian spinal • Kelemahan otot • Parasthesia atau baal – servical – torakal – Lumbal Servical • C4 – C5. Symptoms from HNP vary from asymptomatic to paraplegia. Herniated disc matter may compress nerve roots, vascular structures, and even the spinal cord. In the radiological examination of the spine one frequently sees in association with kyphoses very varied contours of the upper and lower vertebral margins.

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However, progression of disease may lead to quadriparesisparaplegia, and hernla conditions such as cauda equina syndrome and conus syndrome. As of January there were 3, First-class, 2, Second-class, and 5, Third-class airmen with issued medical certificates in the FAA for all variety of HNP, laminectomyand cervical disk surgery. Initial evaluation should include history and physical examination to ensure that the examinee is asymptomatic and able to perform duties without limitations.

For consideration, an individual must provide a complete orthopedic or neurosurgical evaluation.

If core stability is totally regained and fully under control, strength and power can be trained. Efforts to seal the annulus are under investigation. The intervertebral disc is the largest avascular structure in the body. Although this procedure has been in use for twenty years, long-term effects from chemonucleolysis are unknown; this treatment modality has fallen into disfavor in the past few years. Surgery may be useful in aadlah with a herniated disc that is causing significant pain radiating into the leg, significant leg weakness, bladder problems, or loss hernia nukleus pulposus bowel control.


An intervertebral disk acts as shock absorber 24 disk protect.

The age-incidence curve for lumbar HNP peaks in the second through fourth decades of life and the incidence is higher in males than females.

A pulposuz disc in the lumbar spine can cause radiating nerve pain.

The systematic review of Huang W. Nucleus pulposus is the inner core of the vertebral disc.


Herniation of the nucleus pulposus HNP occurs when the nucleus pulposus gel-like substance breaks through. September 19, Education. After pulposs operation they might follow physiotherapy to support their rehabilitation.

Standard treatment for HNP consists of conservative therapy, surgery, and chemonucleolysis. The following pulposud can be used as a protocol for rehabilitation following a lumbar microdiscectomy [72]: Clinical Biomechanics of the Spine.


After a patient underwent an operation, the first thing to do is offer information about the rehabilitation program they will follow the next few weeks. Arch Phys Med Rehabil ; Mild HNP will most likely not create aviation problems after conservative therapy has concluded. Am J Phys Med Rehabil. Disc herniation is usually due to age-related degeneration of the outer ring, known as the anulus fibrosus, although traumalifting injuriesor straining have been implicated as well.

They hukleus hernia nukleus pulposus from little or no pain if the disc is the only tissue injured, to severe uplposus unrelenting neck pain or low back pain that will radiate into the regions served by affected nerve roots that are irritated or impinged by the herniated material.

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And finally, the forces applied to the intervertebral disc under high-G stress may lead to accelerated progression of disease. Diagnosis of HNP is based on characteristic symptomatologyconfirmed by radiologic studies. Due to muscle spasm, a loss of normal spinal curvature may be noted.


HNP – Wikipedia

This causes an oscillatory pressure to decrease pain. A thorough history and physical exam should be performed to assure no persistent neurologic or range of motion deficits. Surgery should be limited to: In addition, operative complications such as nerve root or puplosus injury and postoperative joint instability may occur.

The aealah ejection of military aviators from aircraft makes it very important to yernia that such airmen are totally healed from the disease and from any treatment prior to consideration of a waiver. This can only occur when the AF is disrupted either by violent trauma or recurrent microtrauma. An annular tear or weak spot has not been demonstrated to result from repetitive normal stress from customary activities or from physically stressful activities.

However, repeated studies have failed to delineate a direct relationship between the degree of herniation and the amount of symptoms.

Other pathologic lesions i. In the patients that have non-MRI comparable implanted devices, CT myelography can be performed to visualize herniated disc. Herniated disc matter may compress nerve roots, vascular structures, and even the spinal cord above L In the meta-analysis of Yan Hu et al.

In the hernnia environment aeromedical certification is more likely than for the military. Deterioration within the intervertebral disk results in loss of these water-retaining branches and eventually in the shortening of the chains.