Cov leeg txha caj qaum ntawm tus neeg laus yog kev txhawb nqa rau tag nrho lub cev thiab tuaj yeem tiv taus hnyav. Yog tias koj nqa qhov hnyav ntawm caj npab tawm, ces qhov hnyav nce mus rau 400 kilograms. Qhov loj tshaj plaws ntog nyob rau hauv lub lumbar cheeb tsam, vim hais tias qhov no yog ib tug ntawm cov feem ntau mobile qhov chaw ntawm lub cev, thiab qhov chaw ntawm kev tshuav nyiaj li cas yog nyob ntawm no. Hauv qhov no, txhua yam uas tau piav qhia saum toj no provoke kev loj hlob ntawm herniated lumbar disc, cov tsos mob uas yooj yim tsis tuaj yeem nco.
Thiab hernia tshwm sim vim tias, vim muaj kev ntxhov siab hnyav, cov discs ntawm lub vertebrae, uas ua rau poob siab absorber, hnav tawm ntxov dua li lwm lub tuam tsev.
Cov discs qis txawv ntawm lwm tus hauv lawv cov qauv tshwj xeeb. Hauv lawv qhov chaw muaj ib lub qe zoo li jelly tuav los ntawm annulus fibrosus. Tab sis hernias kuj pom nyob rau lwm qhov chaw ntawm tus txha nraub qaum, thiab muaj ntau yam laj thawj rau qhov no.
Caus of intervertebral hernias
Muaj ntau yam laj thawj rau herniated disc. kab mobFeem ntau muaj teeb meem tom qab pathologies xws li scoliosis, osteochondrosis, lordosis thiab ntau dhau kyphosis. Ib qho hernia tuaj yeem tshwm sim los ntawm kev raug mob ntawm tus txha caj qaum, poob rau sab nraub qaum lossis lub tshuab muaj zog.
Tus kab mob tuaj yeem tshwm sim nws tus kheej vim yog lub zog tsis ua haujlwm ntawm cov disks. Lawv tsis muaj ib leeg hlab ntsha, thiab lub xeev ntawm cov pob txha mos intervertebral discs yog nyob ntawm qhov sib sib zog nqus cov leeg ntawm lub nraub qaum. Yog tias lawv thauj khoom me me, ces lub zog ntawm cov disks txo qis, lawv poob lawv lub zog.
yam uas pheej hmoo rau herniated disc suav nrog:
- hnub nyoog tshaj 30 thiab siab;
- nrawm nrawm cuam tshuam rau tus txha nraub qaum: ntog, pob thiab tig;
- pojniam, vim nws yog nws tus uas feem ntau raug tus kab mob;
- kev ua neej nyob;
- qoj ib ce;
- zaum hauv ib txoj haujlwm ntev;
- tsav tsheb ntev;
- smoking;
- poor posture;
- lub cev hnyav;
- hypothermia.
Cov neeg mob uas muaj kev pheej hmoo yuav tsum tau hloov qhov chaw nyob ib ntus, piv txwv li, yog tias lawv zaum hauv computer ntev lossis tsav tsheb. Nco ntsoov mus kuaj lossis ua gymnastics los txhim kho cov khoom noj khoom haus ntawm cov leeg nraub qaum.
Type of spinal hernias
Herniated discs raug cais raws li lawv qhov chaw nyob. Yog li ntawd, hernias ntawm lub ncauj tsev menyuam, thoracic, lumbar thiab sacral cheeb tsam tuaj yeem tshwm sim. ua li casCov txheeb cais qhia tau hais tias, feem ntau cov kws kho mob tom qab kuaj pom cov hom hernias:
- Central, lossis Shmol's hernia. Hom no tsis tau txais, vim nws tsis tshwm sim los ntawm kev cuam tshuam ntawm lwm yam uas cuam tshuam rau tus txha nraub qaum, tab sis suav hais tias yog ib qho mob hauv lub cev. Nrog rau daim ntawv no, tsis muaj protrusion, tab sis muaj ib qho indentation ntawm qhov chaw ntawm qhov txhab.
- Medial yog qhov paub tsis meej rau cov kws kho mob, vim nws tshwm sim nws tus kheej tsis paub vim li cas thiab ploj mus yam tsis muaj kev kho mob. Nws nrog rau qhov mob hnyav uas dhau los ntawm qhov muaj zog mus rau qhov tsis muaj zog.
- Qhov kev pom dorsal cuam tshuam nrog lub protrusion ntawm ib tug hernia nyob rau hauv lub cheeb tsam ntawm tus txha caj qaum, uas ua rau infringement ntawm lub paj hlwb. Thaum pib, qhov mob nrog daim ntawv no yog nyob hauv thaj tsam lumbar, tab sis dhau sij hawm nws tuaj yeem tawg mus rau ceg.
- Sequestered disc herniation, kev kho mob uas yuav tsum tau muaj kev paub txog txoj hauv kev, tshwm sim nws tus kheej los ntawm kev ua txhaum ntawm kev ncaj ncees ntawm lub disc, uas ua rau kev tso tawm ntawm cov nucleus pulposus mus rau hauv lub lumen ntawm kwj dej. Nrog rau daim ntawv no, tus neeg mob lub neej zoo raug kev txom nyem loj heev. Hom no tshwm sim feem ntau hauv caj dab thiab sab nraub qaum.
Txhua yam yuav tsum tau ua haujlwm zoo, yog li thawj cov tsos mob nws yog qhov zoo dua mus ntsib tus kws kho mob tshwj xeeb.
Hernia ua li cas?
Thawj pib, muaj qhov hloov pauv me ntsis ntawm cov pob txha intervertebral los ntawm ob peb millimeters, uas yog hu ua prolapse. Qhov kev hloov ntawm 4 mm yog hu ua protrusion. Nyob rau tib lub sijhawm, kev hloov pauvtam sim no, tab sis lub nucleus pulposus tsis ntev tshaj li lub annulus fibrosus. Nyob rau theem no, cov tsos mob tseem ceeb yog khaus ntawm tus txha caj qaum nyob rau hauv qhov siab tshaj plaws.
Nrog rau kev nce qib ntxiv, lub hernia ua rau tawg hauv cov tshuaj ntsiav thiab prolapse ntawm lub nucleus pulposus. Cov mob no hauv cov tshuaj hu ua extrusion. Nyob rau theem no, ib qho herniated disc tuaj yeem ua rau cov leeg txha caj qaum thiab cov hlab ntsha, thaum kawg ua rau radiculopathy, radicular syndrome nrog cov tsos mob ntawm cov hlab ntsha.
Tom qab ntawd los txog theem thaum lub prolapsed nucleus pulposus nkag mus dhau qhov sib txawv ntawm lub vertebrae, hu ua sequestration. Nws yog qhov mob no uas xaus nrog kev tawg ntawm cov tshuaj ntsiav fibrous thiab ua tiav tag nrho ntawm cov nucleus. Thaum lub sij hawm extrusion thiab sequestration, lub hernia loj hlob mus rau qhov loj me me uas muaj qhov tshwm sim ntau ntawm kev nyem tus txha caj qaum nrog kev loj hlob ntawm compression myelopathy.
Cov tsos mob ntawm herniated disc
Thaum pib, nws tuaj yeem nyuaj rau kev txiav txim siab tus kab mob, vim tias nws tshwm sim hauv daim ntawv ntawm qhov mob. Thiab nws tuaj yeem yog lub cim qhia tias lub cev nkees thiab xav tau so. Tab sis yog tias tsis muaj kev ntsuas, tom qab ntawd cov tsos mob ntawm herniated disc yuav tsis ploj. Cov cim qhia hauv qab no tuaj yeem qhia txog tus kabmob:
- nqaij atrophy hauv thaj chaw cuam tshuam;
- mob nraub qaum;
- mob taub hau;
- migraines;
- teeb meem nrog plab hnyuv microflora, uas tuaj yeem ua rau chim siab lossis cem quav;
- tso zis tsis yooj yim;
- ntawm qhov chaw hauv cheeb tsamhernia manifests o;
- hypoxia tshwm nyob rau hauv qaum qaum;
- nyuaj taug kev, ceg tsis muaj zog;
- txhob mob rau qhov chaw uas hernia tau tsim;
- npaum ntiv tes, tingling sensation nyob rau hauv libs;
- mob thaum hnoos, tig lub cev thiab lub taub hau;
- mob hnyav thaum txav mus tsis tau.
Yog tias tsawg kawg ib qho ntawm cov tsos mob ntawm herniated lumbar disc tau tshwm sim, kev kho mob yuav tsum tau pib sai sai txhawm rau tiv thaiv cov teeb meem uas tsuas yog tshem tawm los ntawm kev phais.
Kev mob ntawm herniated disc
Muaj ntau qhov teeb meem loj ntawm herniated discs. Lawv tshwm sim hauv cov neeg mob uas kho tus kheej thiab tsis xav nrhiav kev pab los ntawm kws kho mob.
Tus mob radicular tshwm sim nws tus kheej nyob rau lub sijhawm thaum tus hernia cuam tshuam rau tus txha caj qaum. Qhov teeb meem no tuaj yeem txhim kho nyob rau theem: thawj zaug, cov tsos mob ntawm cov hauv paus khaus tshwm sim, cov neeg mob hnov mob nraub qaum lossis xav zoo li lawv xav tsis thoob. Nyob rau hauv lub cheeb tsam ntawm innervation ntawm lub hauv paus, paresthesia yog pom. Kev poob ntawm cov hauv paus hniav ua rau kev txhim kho ntawm cov leeg tsis muaj zog, txo cov ntshav siab thiab rhiab heev rau thaj tsam cuam tshuam. Tom qab qee lub sijhawm, flaccid paresis txhim kho nrog cov leeg nqaij atrophy thiab mob trophic.
Discogenic myalopathy yog lwm qhov teeb meem uas tshwm sim thaum muaj kev tsim hernial ua rau nqaim ntawm tus txha caj qaum thiab compression tshwm sim.tus txha caj qaum. Thaum pib, lub cev muaj zog ua haujlwm raug kev txom nyem, peripheral paresis tsim nyob rau hauv qhov chaw cuam tshuam, tom qab ntawd muaj kev ua txhaum ntawm rhiab heev thiab rhiab ataxia ntxiv.
Lwm qhov teeb meem yog vertebral artery syndrome, uas tshwm sim thaum hernia nyob rau hauv lub caj dab compresses ib tug nyob ze vertebral artery. Lub syndrome manifests nws tus kheej nyob rau hauv daim ntawv ntawm kiv taub hau, vestibular ataxia, tinnitus, fainting. Nws kuj tseem tuaj yeem ua rau muaj kab mob hauv lub hlwb.
Txhawm rau tiv thaiv qhov teeb meem, nws yog qhov ceev kom nrhiav kev pab tsim nyog thiab tau txais kev kho mob rau herniated lumbar disc, cov tsos mob uas tsis tuaj yeem saib tsis tau.
Txoj kev kuaj mob
txhawm rau tsim kom muaj kev kuaj mob kom raug thiab txiav txim siab daim ntawv ntawm tus kab mob, tus kws kho mob pom zoo kom kuaj xyuas, vim tias hernia ntawm lub vertebrae tuaj yeem yooj yim tsis meej pem nrog Bechterew tus kab mob thiab lwm yam kab mob. Txhawm rau kuaj xyuas thiab txheeb xyuas qhov chaw tshwj xeeb uas muaj hernia tshwm sim, siv cov hauv qab no:
- MRI;
- CT;
- Spine ultrasound;
- X-ray ntawm qaum;
- lab research.
Tag nrho cov ntaub ntawv no yuav muaj peev xwm qhia tau tseeb seb qhov no yog herniated disc l5 s1 los yog lwm yam department. Hernia L5 S1 yog hu ua tsim nyob rau hauv lub lumbosacral cheeb tsam. Tsab ntawv L stands rau lumbar, los yog "lumbar" cheeb tsam, thiab S rau sacrum, los yog "sacral". Yog li ntawd, nws hloov tawm hais tias ib tug hernia tsim ntawm lub 5th vertebranyob rau hauv qab thiab thawj nyob rau hauv lub sacrum.
kev kho mob
Nws yooj yim heev los kho tus mob uas kuaj pom thaum ntxov. Tus neeg mob pib noj cov tshuaj sai dua, qhov kev pheej hmoo ntawm kev kho kom tiav thiab rov qab mus rau lub neej zoo. Conservative txoj kev muaj xws li phau ntawv massage, ce therapy, spinal kem traction, thiab acupuncture. Tsis tas li ntawd, tus kws kho mob tau sau ntau yam tshuaj los txo qhov mob thiab mob:
- yog cov tshuaj tua kab mob, koj tuaj yeem nres ntawm "Ketonov", "Baralgin", "Nise";
- NSAIDs raug xaiv los txo cov txheej txheem inflammatory - Diclofenac, Ibuprofen, Nimesulide lossis Ketoprofen;
- muscle relaxants - "Mydocalm";
- tshuaj tsis haum thiab tsis yog tshuaj yeeb tshuaj;
- sedatives;
- tshuaj hormone "Dexamethasone";
- novocaine blockades.
Thaum nyuaj tshaj plaws, tus kws kho mob yuav pom zoo rau kev phais. Nyob rau hauv cov ntaub ntawv no, lub herniated disc raug tshem tawm thiab rhiab heev nyob rau hauv cov nqaij ntshiv yog rov qab.
Surgery
Thaum kev kho mob ntawm herniated lumbar disc thiab lwm yam tsis muab cov txiaj ntsig xav tau, thiab tus neeg mob tsis tuaj yeem zam cov tsos mob, tus kws kho mob tuaj yeem ntsuas qhov hnyav - phais. Feem ntau siv rauendoscopic discectomy ua. Lub hernia raug tshem tawm nrog ib lub cuab yeej tshwj xeeb. Lub ntsiab kom zoo dua ntawm cov txheej txheem no yog tias tsis muaj incisions loj, tus neeg mob rov zoo dua. Yuav kom tshem tawm cov protrusion, nws yog txaus los ua ib tug me me puncture. Cov txheej txheem no muaj ib tug xov tooj ntawm undeniable zoo:
- tsis muaj tshuaj loog, tsuas yog tshuaj loog hauv zos;
- tsis ua txhaum ntawm kev ncaj ncees ntawm cov pob txha thiab cov leeg ntawm tus txha nraub qaum;
- tus neeg mob tuaj yeem rov qab los ua lub neej tag nrho tsis yog hnub tom ntej.
Lwm txoj hauv kev suav nrog nucleoplasty, radiofrequency denervation thiab percutaneous vertebroplasty.
kev tawm dag zog zoo
Thaum lub sijhawm kho tus mob herniated lumbar disc, thaum qhov mob thiab mob tau zoo lawm, nws yog qhov zoo rau tus neeg mob ua haujlwm txhua hnub. Kev tawm dag zog tshwj xeeb yuav pab ua kom qhov kev ncua deb ntawm cov vertebrae thiab txo qhov loj ntawm hernia. Koj tuaj yeem ua qhov nyuaj li no:
- Puag koj nraub qaum, txo koj ob txhais caj npab raws lub cev, nqa lub cev thiab tuav ob peb feeb, rov qab los. Ua 10-15 sets.
- Ntxiv dag zog rau koj nraub qaum, txhais caj npab kuj txuas nrog lub cev, rub lub puab tsaig mus rau hauv siab, thiab rub lub thom khwm. Thaum ua tiav, qhov nro ntawm tus txha nraub qaum yog hnov. Rov ua qhov kev tawm dag zog ntau zaus.
- Cia li txhos caug, muab koj txhais tes rau hauv pem teb. Hloov pauv, koj yuav tsum ncab koj txhais caj npab mus rau pem hauv ntej thiab sab nraub qaum mus rau sab.
- Tseem tshuav ntawm plaub plaub, arch koj nraub qaum nce thiab nqis.
kev tawm dag zog tsis tu ncua yuav ntxiv dag zog rau koj cov leeg nraub qaum thiab txo qhov nro.
txoj kev tiv thaiv
Yog tus neeg mob paub tias nws nyob hauv thaj chaw muaj kev pheej hmoo, ces nws yuav tsum ua txhua yam ua tau los tiv thaiv kev tsim ntawm herniated disc l5 s1. Txhawm rau txiav tawm hernia, cov kws kho mob pom zoo:
- Mus da dej tsis tu ncua.
- Khawb kev noj qab nyob zoo.
- Ua kis las, txawm taug kev tuaj yeem daws qhov teeb meem.
- Thaum taug kev, ib txwm ua kom koj nraub qaum ncaj, tsis txhob slouch.
- Puag saum lub txaj tshwj xeeb orthopedic.
- Saib koj qhov hnyav, vim phaus ntxiv yog lub nra hnyav ntawm tus txha nraub qaum.
- Txhob tus cwj pwm phem.
- Ib txwm ntsuas qhov hnyav ntawm ob txhais tes.
- Thaum ua haujlwm hauv computer, tig rov qab ntawm lub rooj zaum, kom koj tuaj yeem txo qhov nro ntawm qaum.
- Yog tias txoj haujlwm cuam tshuam tas li zaum ntawm lub rooj, ces txhua ob teev nws yog qhov zoo dua los ncab koj nraub qaum, tig rov qab txawm tias zaum.
Txhais tau
Yog tias koj tsis tau txais kev kho mob raws sij hawm, ces ib qho herniated disc ntawm lub lumbar thiab lwm lub tuam tsev tuaj yeem ua rau muaj qhov tshwm sim loj thiab rov qab tsis tau:
- Kev qaug zog ntawm cov leeg nraub qaum hauv thaj chaw uas muaj qhov protrusion. Tus neeg mob yuav tsis muaj peev xwm nthuav tawm nws tus kheej mus rau kev tawm dag zog lub cev, txawm tias nce tojntaiv thiab sawv ntev yuav ua rau nws mob hnyav.
- Lub zos tsis zoo ntawm cov leeg nqaij. Tus neeg mob tsis tuaj yeem tiv taus txawm tias kev tawm dag zog me me, vim tias cov leeg tsis muaj zog.
- Cov leeg nqaij atrophy tshwm sim, thaum lub sij hawm daim duab ntawm cov teeb meem kev txom nyem. Muaj qhov smoothing ntawm gluteal quav, ntim ntawm ob txhais ceg raug txo.
- Kev nkag siab tsis zoo ntawm qhov chaw ntawm qhov protrusion thiab raws txoj hauv kev ntawm cov hlab ntsha.
- Ua tsis tiav hauv cov txheej txheem thermoregulation, qhov chaw uas cov hernia nyob hauv zos, qhuav lossis muaj hws ntau ntxiv.
- Paralysis yog qhov tshwm sim loj tshaj plaws uas tshwm sim yog tus neeg mob tsis nrhiav kev pab raws sijhawm lossis tsis ua raws li tus kws kho mob cov lus pom zoo. Raws li qhov tshwm sim, tuag tes tuag taw ua rau muaj kev tsis taus, nws nyuaj, thiab qee qhov ua tsis tau, rov qab mus rau lub neej li qub.
Cov tsos mob ntawm herniated disc ntawm lub lumbar los yog lwm yam yuav tsum ua kom tus neeg mob saib xyuas nws kev noj qab haus huv thiab mus ntsib kws kho mob. Kev kho mob thaum ntxov tau lees paub qhov kev pom zoo.
