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Samenvatting Hernia

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Informatie over een hernia

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  • October 31, 2021
  • 3
  • 2020/2021
  • Summary
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Anatomie/pathologie
Hernia

Hernia: Hernia Nuclei Pulposi (HNP)
 Uitpuilende tussenwervelschijf
 Een plaatselijke verzwakking in de ring kan leiden tot uitstulping van de zachte
kern

Tussenwervelschijf: discus intervertebralis
 Bestaat uit vezelige stevige ring: anulus fibrosus met daarin een geleiachtige
kern: nucleus pulposis



HNP:
- Theoretisch mogelijk bij elke
tussenwervelschijf
- In de praktijk:
 Meestal lumbaal: L4-L5 en L5-S1 (90%)
 Cervicaal: vooral tussen C5-C6 en C6-C7


Symptomen:
- Uitstralende pijn in been of arm (door druk
hernia op zenuwwortels)
- Pijn neemt toe bij hoesten, niezen en persen (door verhoging liquordruk)
- Bij lumbale hernia uitstralende pijn bil en achterzijde been (nervus ischiadicus=
Ischias)
- Soms uitvalsverschijnselen: krachtverlies, verlamming, gevoelsstoornissen,
incontinentie

Diagnose:
 Anamnese
- Zorgvrager klaagt over toenemende pijn laag in de rug met uitstraling naar bil/been,
soms tot in de voet
- Prikkelingen in been en voet. In ernstige gevallen zelfs tot gevoelsstoornissen van
billen en benen (rijbroekgebied)
- Verlammingsverschijnselen van de voeten en incontinentie (spoed OK)

Vervolg:
- Proef van Lasègue
- Proef van kemp
- Caudografie (röntgenonderzoek wervelkanaal)
- CT
- MRI

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