Prolapses intervertebral disc

1. SLIDE SHARE OF PROLAPSED INTERVERTEBRAL DISC_
BY Dr. RAJ BHARDWAJ (PT)
UTTAR PRADESH UNIVERSITY OF MEDICAL SCIENCES SAIFAI
ETAWAH .
SUBJECT _ ORTHOPEDIC.
TOPIC _
PIVD

2. INTERVERTEBRAL DISC COMPONENTS.
It is the consists of three components.
a. Cartilage end plates.
b. Nucleus pulposus.
c. Annulus fibrosis.
The cartilage plates is thin layers of hyaline cartilage. That's adjacent vertibral
bodies.
The annulus palposus is a gelatinous material
That's help in maintenance of pressure.

4. PATHOLOGY_
1. Nucleus degeneration _
The nucleus degeneration are occurs due to .
1. Softening of the nucleus material and it's fragmentation.
2. Weakening of nuclear material.
3. Disintegration of the annulus in posterior side
4. Infection of the nuclear material.
5. Decrease of fluidity etc.
It is a occurs before the nucleus displacement.
2. Nucleus displacement _
That's occurs due to

6. The nucleus displacement has four type .
1. Stage of degeneration.
(Due to the accumulation of the nuclear material and the stiffness)
1. Stage of protrusion
.( Due to the entire thickness has disintegration and fragment the nuclear material)
● It is also called the disc bulge.
1. Stage of extrusion
. (Due to the nuclear material out of the annulus and lies posterior longitudinal ligament.
1. Stage of sequestration
( it is a when the disc loose and nuclear material out of contact with the parent disc
3 STAGE OF FIBROSIS _
It is the residual nucleus pulposus becomes fibrosis.
The commonests level of disc prolapses between( L4_L5), L4_L3 ,. ( C5_ C6 )

10. DIAGNOSIS.
● CT, MRI etc.
CLINICAL FEATURES _
● Age 20 to 40 years person.
● Low back pain.
● Sciatica pain.
● Cauda equina syndrome.
EXAMINATION _
● Posture.
● Movements.
● Tenderness.
● Straight leg line test ( SLRT) .
● Lasegue test.
● Neuro examination.

11. TREATMENT _
● aim 3 to 6 weaks.
● Rest.
● Drugs.
● PHYSIOTHERAPY _
● The Physiotherapy is very usefull and effective in these candition .
● The best treatment of the Physiotherapy in low back pain’
● During the Physiotherapy are not any side effects.
● In these candition many types of exercise do it by the help of therapist.
● And the therapist use electric currents by the help of therapeutic machine.
● Like TENS , MS SURGE FARADID CURRENTS..
● And the use of lumbar traction., Back exercise like cats exercise .
● And use the theurapuitic ultrasound..
PRICORTION.
● Haevy weight bearing.
● More lumbar flexion .
● turn haevy weight lifeted
● Over streaching etc

12. OPERATIVE MATHODE _
1. FENESTRATION _
ligamentum flavum excised .
1. LAMINOTOMY _
a. Border of lamina excised.
3 HEMI__ LAMINECTOMY _.
half of lamina excised.
4. LAMINECTOMY _
Both lamina with spinous process excised

14. THANKYOU