Intervertebral Disc

Question 1

What are the 3 classes of migration of the nucleus? Explain

Answer 1

Protrusion: the nucleus shifts causing annular rings to bulge outward
Herniation: the nucleus has broken through the annular ring
Prolapse: the nucleus has broken through the fibrous annular ring material, part of the nucleus may break free into the spinal canal

Question 2

What is protrusion made of?

Answer 2

Edema resulting from displaced nucleus

Question 3

What is the main function of the nucleus?

Answer 3

• Holds the vertebrae apart by resisting compressive loads

- Allows normal ROM when situated properly acting as a pivotal ball bearing joint

Question 4

WHy is the IVF more apt to experience effects of disc bulging?

Answer 4

Because the ALL/PLL somewhat restrain anterior and posterior protrusion along with poor blood supply to the area

Question 5

What part of the disc is the fulcrum?

Answer 5

Nucleus pulposus

Question 6

What is the most hydrophilic tissue in the human body?

Answer 6

Nucleus pulposus

Question 7

How much water does the nucleus pulposus hold at birth?

Answer 7

88%

Question 8

What is the most important function of the disc?

Answer 8

Provide flexibility while limiting amount of displacement

Question 9

What kind of joint does the nucleus act as, with a vertebra on top of it?

Answer 9

a pivot ball-bearing joint

Question 10

What is the weight bearing part of the disc?

Answer 10

Nucleus pulposus

Question 11

What is the most important ligament of the spine?

Answer 11

IVD

Question 12

What are the 6 Stages of disc degeneration?

Answer 12

-D1–swollen disc: entire disc is thickened from acute injury obviously thicker than other discs in the area
-D2–Disc thin at poterior: space at posterior aspect of disc is diminished beyond acute stage, cutaneous is oily
-D3–Disc very thin and extremely wedged at posterior : at chronic state
-D4–Total disc is thin: About 2/3 of original height, minimal damage to body above
D5–Total disc is very thin: about 1/3 of origianl height, severe damage to vertebral body above, very chronic, hard to correct
-D6–Total disc extremely thin, entire disc space has greatly diminished, from 2/3 to totally reduced, most chronic, very hard to correct

Question 13

Can the disc be injured?

Answer 13

• Yes
• Resulting in bone spurring & osteophytes
• Eventually degeneration

Question 14

What 2 structures make up the IVD

Answer 14

• Nucleus pulposus

- Annulus fibrosis

Question 15

What does the disc look like on a base posterior sacrum?

Answer 15

the disc is wider/open at the posterior

Question 16

When does vascular supply to the disc diminish?

Answer 16

2nd decade of life

Question 17

About what time is the vascular supply to the disc completely gone?

Answer 17

3rd decade of life

Question 18

Where does the nucleus tend to protrude and why?

Answer 18

• Posterolateral

- Due to poor blood supply in the area & location of surrounding ligaments

Question 19

What type of nucleus migration will we see most often?

Answer 19

Protrusion

Question 20

Is the annulus still intact in protrusion of the nucleus?

Answer 20

YES

Question 21

What is the nucleus pulposus made up of?

Answer 21

semi-fluid gel consistency

Question 22

What is the main function of the annulus

Answer 22

• Keep the vertebrae together
• limiting extreme ROM
• keeping the nucleus intact

Question 23

Is the annulus still intact in protrusion of the nucleus?

Answer 23

YES