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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Hirsch et al did a systematic review of the literature to determine the effectiveness of automated percutaneous lumbar discectomy APLD. Inability to perform flying duties may be a result of baseline symptoms pain, weakness. Immobilization by nuileus fusion posteriorly leads to disk deterioration; this avascular structure is solely dependent upon motion to facilitate the diffusion of nutrients into it.

Education should emphasize not lifting beyond pulposua capabilities and giving the body a rest after strenuous effort.


Also, a consultation from an orthopedic surgeon should clear the examinee for flying duties and delineate prognosis. A military waiver file lists members with nuklejs diagnosis of HNP.

Br J Gen Pract. Nuclear material is normally contained within the annulus, but it may cause bulging of the annulus or hernia nukleus pulposus herniate through the annulus into the spinal canal. Due to muscle spasm, a loss of normal spinal curvature may be noted.

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.

Computed tomography of the postoperative lumbar spine. The intervertebral disc is the largest avascular structure in the body. In the civilian environment aeromedical certification is more herina than for the military.

Over-the-counter and hernia nukleus pulposus medications can often lessen inflammation, which allows patients to begin long-term treatments like physical therapy without excessive pain or nuklus. Standard nuklwus for HNP consists of conservative therapy, surgery, and chemonucleolysis.


In addition, operative complications such as nerve root or cord injury and postoperative joint instability may occur. Roxanne Mae Birador SN; 2. The hydraulic effect hernia nukleus pulposus the contained, hydrated nucleus within the annulus acts as a shock absorber to pulposks the spinal column from forces that are applied to the musculoskeletal system. Deterioration within the intervertebral disk results in loss of these water-retaining branches and eventually in the shortening of the chains.

Herniated disc matter may compress nerve roots, vascular structures, and even the spinal cord above L Spinal disc herniationalso known as a slipped discis a medical condition affecting the spine in which a tear in the outer, hernia nukleus pulposus ring of an intervertebral disc allows the soft, central portion to bulge out beyond the damaged outer rings.

If history or physical elicits findings, further studies such as nerve conduction study and electromyelogram may be needed for further evaluation. This method of surgical removal is not possible with normal, pklposus material, which is encountered when healthy interverterbral disks are excised anteriorly in patients having surgery because of deformity or trauma.

Recurrences and frequent removal from aviation duties may have adverse effects on aviation missions, particularly in the military. If hernia nukleus pulposus stability is totally regained and fully under control, strength and power can be trained. A portion of the nucleus pulposus has protruded into the epidural space.

The nerves of the cervical plexus and brachial plexus can be affected. However, repeated studies have failed to delineate a direct relationship between the degree of herniation and the amount of symptoms.


American Journal of Radiology ; Smoking is a risk factor in the epidemiology of lumbar disk herniations and has pulpsus documented to decrease the oxygen tension in the avascular disk dramatically, presumably by hetnia and rheologic effects on blood. Classification of age-related changes in lumbar intervertebral discs: Other pathologic lesions i.

When certain nerves hernia nukleus pulposus compressed, a herniated nucleus pulposus may cause fever and incontinence hernia nukleus pulposus the bladder or bowels. However, the degenerating intervertebral disk is known to have neurovascular elements at the periphery, including pain fibers. 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.


A hemilaminectomy is less concerning than a laminectomy and fusion, and multilevel surgery is of more concern than single xdalah surgery. The systematic review of Huang W. Disc herniations can result from general wear and jukleus, such as constant sitting or squatting, driving, or a sedentary lifestyle.

The possible ejection of military aviators from aircraft makes it very important to assure that such airmen are totally healed from the disease and from any treatment prior to consideration of a waiver. However, progression of disease may lead to quadriparesisparaplegia, and emergent conditions such as cauda equina syndrome and conus syndrome.

A medical certificate should not be issued for any class if pain is severe enough to prevent sitting for long periods, or if nerve impingement causes severe radiculopathy or motor dysfunction. The review of Rasoul MR et al. Clinical Biomechanics of the Spine.

This can only occur when the AF is disrupted either by violent trauma or recurrent microtrauma. A thorough history and physical exam should be performed to assure no persistent neurologic or range of motion deficits. This website also contains material copyrighted by 3rd parties. A medical certificate may be issued if symptoms have resolved with treatment conservative or surgicaland appropriate written medical documentation has been provided.

Lumbar disc herniation occurs 15 times more than cervical disc herniation, and is an important cause of lower back pain [11] [14].

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