Adult Medical-Surgical Nursing Neurology Module: Spinal Disc Lesion

Disc Lesion: Description A protrusion or herniation of the cartilaginous intervertebral disc putting pressure on nerve roots of the spinal cord Most common sites are the cervical or lumbar spine

Disc Lesion: Aetiology “Wear and tear” Injury: major or minor Lifting, coughing, sneezing increasing localised pressure causing herniation

Disc Lesion: Clinical Manifestations A shooting pain down the nerve. Most commonly: From the back down the leg (Sciatica) From the neck down one or both arms Numbness and tingling of the extremities Limping, difficulty and pain on stretching and straightening limb

Disc Lesion: Diagnosis Patient history and clinical picture MRI (main diagnostic tool) CT scan Myelogram (invasive and less used now)

Disc Lesion: Management Surgery (micro-surgery): Discectomy: removal of the herniating disc Laminectomy: removal of the lamina of the vertebra to remove pressure on the nerve root

Disc Lesion: Nursing Considerations (Demonstrate pre-op): Breathing exercises Post-op alignment of the patient: “log- rolling” technique for position change How to get in and out of bed once mobile Collar or corset to immobilise the area Anti-embolism stockings Usually up to toilet 1 st day post-op but no sitting in a chair (raised toilet seat)