# Herniated Disk --- A **herniated disk** (sometimes spelled "disc", both are accurate but with the 'c' is more British) (sometimes called called a **slipped** or **ruptured disk**) is a condition where there is damage to an [[vertebral column|intervertebral disc]] such that some of the inner tissue budges out and presses onto a [[spinal nerves|spinal nerve]]. This condition is quite painful, but treatable. The intervertebral disks are made up of [[cartilage]] and function as shock absorbers and sit between each individual [[vertebral column|vertebrae]]. They are made up of a softer tissue on the inside called the nucleus pulposus surrounded but a tougher tissue called the annulus fibrosus. A herniated disc is when the inner nucleus breaks through the surrounding annulus and this can squish a nerve. This is quite painful. A herniated disk is most often found in the lumbar region, and can occur from trauma or happen spontaneously. ![[herniated disk.png]] ## Risk Factors/Cause - AMAB people ## Signs & Symptoms The signs and symptoms of herniated disk include: - pain—may be sharp, shooting or burning - most often in the neck, back, arms or legs - numbness or tingling - weakness - loss of reflexes - a sign of nerve damage ## Complications A rare but concerning complication of a herniated disk, especially in the lower back, is bowel or bladder problems. ## Diagnostic Tests An MRI is the test of choice, but a myelogram may also be done ## Treatment Surgery may be done as a last effort, but many herniated disks can be successfully treated with rehab and other supportive care. - continue normal activities - take medications for pain - NSAIDS, muscle relaxants, tranquillizers, sedatives - massage - heat - traction, corsets, binders - exercises/PT Potential surgeries include: - A **discectomy** is a form of spinal decompression surgery to treat a herniated disc. In a discectomy, damaged parts of a herniated disc are removed to relieve pressure on spinal nerves and alleviate pain. - A **microdiscectomy** is smaller like a discectomy but smaller. - A **laminectomy** is a removal of the vertebral bone itself (the lamina portion) - A **nucleotomy** is the removal of the nucleus pulposus ## Nursing Considerations Postop these patients are often in a lot of pain, so avoid exacerbating that. - logroll - keep patient flat with pillow for head - frequent neuro assessment especially on legs - mobilize as orders - bowel meds - important - monitor for urinary retention - check site for CSF leakage ___