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Posterior inter vertibral disc herniation ko kya bolte hai

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posterior intervertebral disc herniation medical terminology Hindi explanation

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Ab main aapko ek detailed, clear explanation deta hoon:

Posterior Intervertebral Disc Herniation - Poori Jaankari

Naam / Terminology

Posterior Intervertebral Disc Herniation ko in naamon se jaana jaata hai:
TermMatlab
Prolapsed Intervertebral Disc (PIVD)Sabse common clinical naam
Herniated Nucleus Pulposus (HNP)Official medical naam
Slipped DiscCommon layman term
Ruptured DiscJab annulus phat jaaye
Disc ProlapseBailey & Love mein istemal hone wala term

Disc ki Anatomy (Samajhne ke liye)

Intervertebral disc do parts se bani hoti hai:
  • Nucleus Pulposus - Andar ka soft, jelly-jaisa part
  • Annulus Fibrosus - Bahar ka tough, fibrous ring

Kya hota hai Posterior Herniation mein?

Jab disc ki Annulus Fibrosus (bahari ring) weak ho jaati hai ya tear ho jaati hai, tab andar ka Nucleus Pulposus peeche ki taraf (posterior direction) bahar nikal aata hai. Yeh peeche ki taraf spinal canal mein ghus jaata hai aur spinal cord ya nerve roots par dabav (compression) dalta hai.
Grainger & Allison's Diagnostic Radiology ke anusar: "Herniation is defined as a displacement of disc material beyond the limits of the intervertebral disc space" - jisme annulus fibrosus ka toot-phoot hona zaroori hai.

Prakar (Types) - Direction ke Hisaab se

Disc herniation ki jagah ke anusaar:
  1. Central / Posterior Midline - Seedha peeche - Spinal cord/cauda equina compress hoti hai
  2. Posterolateral - Peeche aur ek taraf (sabse common) - Nerve root compress hoti hai
  3. Far Lateral / Extraforaminal - Neural foramen ke bahar - Exiting nerve root compress hoti hai

Shape ke Hisaab se Types

  • Disc Protrusion - Base broad, apex narrow (disc abhi bhi connected hai)
  • Disc Extrusion - Base narrow, apex broad ("toothpaste sign") - zyada bahar nikla hua
  • Sequestrated Fragment / Free Fragment - Disc ka tukda bilkul alag ho gaya
  • Disc Bulge - >50% circumference involved - yeh herniation NAHI maani jaati

Sabse Common Level

Bailey & Love's Surgery ke anusar:
90% se zyaada lumbar disc herniations L4/5 ya L5/S1 level par hoti hain.

Symptoms

  • Kamar mein dard (low back pain)
  • Sciatica - Pair mein bijli jaisi takleef (sciatic nerve dabne par)
  • Sunnpan / Jhanjhanahat (paraesthesia)
  • Muscular weakness
  • Reflex ka kam hona (e.g., knee jerk, ankle jerk)
  • Straight Leg Raise (SLR) test - positive hota hai
Yeh MRI image lumbar disc herniation ko dikhata hai:
Lumbar disc herniation - Sagittal MRI scan

Ilaj (Treatment)

Conservative (non-surgical) - 6-12 weeks pehle try karein:
  • Rest + pain killers (NSAIDs)
  • Pregabalin (GABA analogue)
  • Transforaminal Epidural Steroid Injection
  • ~70% patients theek ho jaate hain
Surgical - agar conservative fail ho:
  • Microdiscectomy - Standard surgery, offending disc fragment nikala jaata hai, patient agle din hi discharge ho jaata hai
Sources: Bailey and Love's Short Practice of Surgery 28th Ed.; Grainger & Allison's Diagnostic Radiology
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