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Muskular
Intervertebral Disk Trauma
| Question | Answer |
|---|---|
| what causes of low back pain | acute lumboscral straininstability of the lumbosacral bony mechanismosteoarthritis of the lumbosacral vertebraedegenerative disk diseaseherniation of an intervertebrate disk |
| acute low back pain | lasts 4 weeks or less |
| straight leg raise | + for disk herniation when redicules pain occurs |
| how do you treate acute low back pain | treated with analgesics, muscle relaxants, massage and back manipulation, and alternating use of hot and coldavoid acitivities that aggravate pain |
| Chronic low back pain | lasts more thatn 3 months or is a repeated incapacitating epidosed |
| spinal stenosis | narrowing of the vertebral canal or nerve root canals caused by encroachment of bone on the space |
| compression of nerve roots with possible subsequent disk herniation | chrnoic low back pain |
| intervertebral lumbar disk damage | degenerative disk disease-product of agineherniated intervertebral disk |
| Cuada equina | dyndrome of bowel &bladder incontinence or impotence |
| what are the diagnostic studies | H & PX-rayCT scanMRIMyelogramDiskogramEMG |
| myelogram | when they put a dye in and you look at all of it |
| diskogram | you put a dye in the disk |
| EMG | determines the severity of the nerve damage. put a needle in the muscle. |
| what pt do which back pain. | restricted activity for several days, limit total bed restlocal ice or heatphysical therapyepidural corticoteroid injections. |
| what medications do they give for nerve pain | analgesics, NSAIDs, muscle relaxants |
| Physical therapy of back pain | local heat or iceultasound and massagetractiontranscutaneous electircal nerve stimulatinback exercises |
| Intradiscal electrothermoplasty (IDET) | minimally invasive outpatient procedureinsertion of a needle into the affected disk under xraywire threaded into diskwire heated which denervates the small nerve fibers that have invaded the degenerating disk |
| Radiofrequency discal nucleoplasty | put the needle into the disk radiofrequency probe generates energy that breaks up the molecular bonds of the gel in the nucles. 20% of the nucleus removed, which decompresses the disk and reduces the pressure on the disk and nerve roots. |
| interspinous Process Decompression System X-stop | made of titanium and fits onto a mount that is placed on vertebrae in the lower backpushes open the spinal cord by pressing against parts of either side of the vertebraeused for spinal stenosis |
| Laminectomy | surgical excision of part of the posterior arch of the vertebra (lamina) to gain access to part of or the entire prtruding disk to remove itminimal hospital stay |
| diskectomy/microdiskectomy | performed to decompress the nerve roothelps maintain bony stability of spine |
| microsurgical sikectomy | surgeon uses a microscope to allow better visulaiztion to aid the the rmoval of the damaged portion. |
| percutaneous laser Diskectomy | outpatient proceduretube is passed through the retroperitoneal soft tissues to the lateral border of the disk with local anesthesia and the aid of fluoroscopylaser is then used on the damaged portion of the disk |
| charite disk | usedin DDDI degenerative disk disease)artificial disk made of high density core sandwiched between 2 cobalt-chromium endplatesrusgically placed in the spine through a small incision below the umbilicus after the damaged disk is removed. |
| spinal fusion | performed if an unstable bony mechanism is presentstabilized by creating a fusion of contiguous vertebrae with a bone graft from the fibula or iliac crestmetal fixation with rods, plates, or screws may be implanted for more stability |
| what are the nursing care after procedures | maintain proper alignmanet of spinemay be albe to dangel, stand, or ambulate first postop dayPCA for 24-48 hrs. |
| nursing care | check for CSF leakageperipheral neurologic signs |
| assess extremity circulation by | temp, capillary refill and pulses |
| what to avoid | standing and sitting for long period of time |
| stiffness and neck pain | possible radiating in to the arm and the handmay also radiate into head, anteriod chest, throcacic spine region and shoulders |
| post op watch for sympotms of | spinal cord edema such as respiratory distress and a worsening neurologic status of the upper extremities. |
| the primary nursing responsibility in caring for a pt with a suspected disk herniation who presents with severe pain and muscle spasm is | assisting the pt to maintain activity restricions with a gradual increase in activity. |
| In caring for the pt after a spinal fusion, the nurse recognizes that interventions for this surgery differ from a simple laminectomy in that | the donor site for the bone graft may be more painful thatn the spinal incision. |
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