SPINAL CORD HERNIATION---- INTRODUCTION, DEFINITION, TYPES, SIGNS AND SYMPTOMS, DIAGNOSTIC EVALUATION, MANAGEMENT

1. SPINAL CORD HERNIATION &
POTT’S DISEASE
PRESENTED BY:
RITIKA RANA
MSC NSG
NEUROSCIENCES

3. DEFINITION
 Spinal cord herniation or herniated intervertebral disc (slipped
disc) can be result of natural degeneration with age or repeated stress
and trauma to spine.
 Common site of rupture is lumbosacral disc specially L4, L5.
 Disc herniation also occur at C5-C6-C7.

4. CAUSES
 Idiopathic.
 Age.
 Sex.
 Trauma.

5. CLINICAL FEATURES
 Low back pain.
 Altered range of motion.
 L3-L4—pain from back to buttocks to posterior thigh to inner calf.
 L4-L5--- pain from back to buttocks to dorsum of foot & big toe.

6. DIAGNOSTIC EVALUATION
 History .
 Physical examination .
 X-ray & CT-Scan.
 Myelogram.
 Discogram.

7. MANAGEMENT
1.Medical management: Rest for 4 weeks with conservative therapy.
 After subsiding back pain strengthening exercises are began twice a
day.
 Baclofen given to reduce chronic spasticity.
 Chlorzoxazone (muscle relaxant) to reduce pain or discomfort.
 NSAIDS such as ibuprofen & paracetamol to reduce back pain.

8. CONT…….
2. Surgical management:
 Intradiscal electrothermoplasty is a minimally invasive outpatient
procedure.
 Radiofrequency discal nucleoplasty (coblation nucleoplasty).
 Laminectomy.
 Discectomy.
 Charite artificial disc.

10. INTRODUCTION
 It’s also called as angular kyphosis, kyphosis secondary to T.B., T.B
of spine, David disease, Pott’s curvature, Pott’s caries.
 It’s named after “perival pott” (1714-1785) who was surgeon in
London.
 Usually, site to be involved are lumbar-thoracic area, upper lumbar
vertebra.

11. DEFINITION
Pott’s Disease, also known as tuberculosis spondylitis, is a rare
infectious disease of the spine which is typically caused by an
extraspinal infection.
Pott’s Disease is a combination of osteomyelitis and arthritis which
involves multiple vertebrae.

12. RISK FACTORS
Tuberculosis.
Poor socio-economic condition.
HIV infection.

13. CLINICAL FEATURES
Back pain.
Fever.
Paresthesia.
Muscle weakness.
Psoas abscess may be present in groin area and resemble hernia.

14. CONT…..
Anorexia.
Night sweating.
Spinal cord deformities such as scoliosis and kyphosis.
Spinal mass.

15. DIAGNOSTIC EVALUATION
History.
Physical examination.
Blood test show increase ESR.
X-ray.
CT-scan & MRI.
Needle biopsy of bone or synovial tissue
shows tubercle bacilli.
TB skin test.

16. MANAGEMENT
Immobilization of spine for 2-3 months.
Anti-tuberculin drugs such as isoniazid & rifampicin are mostly given
to patient having Pott’s disease.
Analgesics such as ibuprofen & aspirin given.
Surgery may done to drain spinal abscess and to spine stabilisation.
Richard intramedullary hip screw to facilitate bone healing.
Austin Moore (intramedullary rod).

18. PREVENTIVE MEASURES
BCG vaccination.
Improvement of socio-economic status.
Prevention of HIV infection.