Intervertebral hernia nyob rau hauv lub lumbar qhia tias hnav los yog overload ntawm sab qis ntawm tus txha caj qaum. Qhov no pathology yog ib qho ntawm feem ntau thiab txaus ntshai. Nws yog tus yam ntxwv los ntawm ib qho kev tawm ntawm lub intervertebral disc, lub luag hauj lwm ntawm uas yog los faib lub siab ntawm lub vertebrae ntawm lub slightest load.
Tus yam ntxwv ntawm tus kab mob
Hernia nyob rau hauv qis rov qab feem ntau tshwm sim ntawm plaub thiab thib tsib vertebrae, los yog ntawm thawj sacral thiab huab lumbar. Mob nyob rau hauv lub intervertebral hernia ntawm lub lumbar, uas radiate mus rau ceg thiab tiv thaiv tag nrho-fledged lub cev muaj zog kev ua si, yog ib tug yam ntxwv feature ntawm tus kab mob. Tawm tsam keeb kwm yav dhau los ntawm lub lumbar hernia, protrusion ntawm intervertebral discs nyob rau hauv lwm qhov chaw ntawm tus txha nraub qaum feem ntau tshwm sim, uas ua rau qhov muag tsis pom ntawm daim duab kho mob thiab cov tsos mob ntawm atypical.
Dab tsi tuaj yeem ua rau hernia hauv qab
Hauv cheeb tsam sacral thiab lumbar, tus kab mob no ntau duatxhim kho raws li kev loj hlob ntawm osteochondrosis - ib tug complex dystrophic hloov nyob rau hauv articular pob txha mos. Cov pab pawg muaj kev pheej hmoo feem ntau yog cov neeg muaj hnub nyoog tshaj 60 xyoo, tab sis txawm tias qhov no, tus kab mob kuj tuaj yeem tshwm sim rau cov neeg thaum muaj hnub nyoog yau. Ntawm cov xwm txheej uas ua rau muaj kev loj hlob ntawm herniated lumbar disc, nws tsim nyog sau cia:
- tsheb raug mob, ntog ntawm qhov siab;
- kev tawm dag zog ntau dhau (ua haujlwm ntsig txog);
- nqa hnyav hnyav;
- teeb meem metabolic;
- haujlwm sedentary thiab kev ua neej nyob sedentary;
- deformation (curvature) ntawm tus txha caj qaum;
- overweight;
- congenital anomalies;
- mob qog nqaij hlav thiab mob malignant.
Cov kab mob sib kis tsis ntev los no, kev haus cawv, thiab haus luam yeeb tuaj yeem ua lub luag haujlwm tsis zoo hauv qhov tshwm sim ntawm hernia.
YYuav ua li cas pathology tshwm sim
Cov tsos mob ntawm lub lumbar disc herniation thaum ntxov tuaj yeem muab zais. Raws li kev tsim thiab lub sijhawm ntawm tus kab mob nce, qhov hnyav ntawm nws qhov tshwm sim nce. Hauv qhov no, cov tsos mob tseem ceeb ntawm hernia yog mob ntau yam. Cov tsos mob kuj muaj xws li tingling thiab hnyav ntawm cov ceg, loog ntawm cov ntiv taw tom qab zaum ntev.
Thaum xub thawj, cov tsos mob ntawm lub lumbar disc herniation tsis ua rau tus neeg mob tsis xis nyob. Tsis kaj siabKev hnov lus, nyob hauv thaj tsam lumbosacral, tsis ruaj khov, tshwm sim ib ntus. Feem ntau, qhov mob hnyav zuj zus thaum lub sijhawm txav mus los, nrog khoov dua, tig ntawm lub cev thiab nqa qhov hnyav. Nyob rau tib lub sijhawm, qhov mob tau pom meej meej nyob rau sab nraub qaum, uas yog, tshwj xeeb tshaj yog nyob rau hauv qhov cuam tshuam ntawm tus txha nraub qaum.
Thaum lub protrusion ntawm lub disc loj dua, qhov xwm ntawm qhov mob hloov pauv:
- dab ntxwg nyoog tua hauv qab sab;
- mob radiates rau lub plab mog, ncej puab, sab ceg thiab txawm ko taw, raws li qhov tshwm sim ntawm tus neeg mob pib qaug zog, thiab txhua qhov kev txav yog nyuaj;
- thaum hnoos lossis txham, sab nraub qaum pib mob ntau dua;
- tejzaum qhov pom kev pom qhov curvature ntawm tus txha nraub qaum;
- o hauv ntu sacro-lumbar;
- txhim kho hypertonicity ntawm cov leeg ntawm nraub qaum thiab plab;
- limited mobility.
Nws tsis yog qhov nyuaj rau kev paub txog herniated lumbar disc los ntawm kev kho mob tshwm sim. Txawm li cas los xij, txhawm rau kuaj mob, nrog rau kev txiav txim siab qhov chaw thiab qhov loj ntawm qhov protrusion, yuav tsum muaj kev kuaj mob dav dav (MRI, CT, radiography) yuav tsum tau ua.
Yuav ua li cas pathology tuaj yeem ua rau
Yog tias tsis muaj kev kho kom raug, tus hernia tuaj yeem ua rau muaj kev tsis taus. Qhov tseeb tias tus kab mob tab tom loj hlob tuaj yeem qhia tau los ntawm cov tsos mob ntawm sciatica. Nws yog tus cwj pwm los ntawm kev mob ntawm cov paj hlwb, uas ua rau mob hnyav heev.
Ib qho tseem ceeb tshaj qhov tshwm sim ntawm herniated disccheeb tsam lumbar yog suav tias yog tuag tes tuag taw ntawm ob txhais ceg. Immobility ntawm lub cev qis yog ua tau vim tsis saib xyuas ntawm cov pathology lossis nws qhov kev kuaj mob belated. Qhov tshwm sim ntawm tus kab mob loj hlob yog kev tsis taus thiab tsis muaj peev xwm ntawm tus neeg mob ua lub neej tag nrho. Ib qho bulging intervertebral disc tuaj yeem ua rau lub plab tsis ua haujlwm, tsis muaj peev xwm tswj kev tso zis thiab tso zis. Vim lub compression ntawm cov hlab ntsha, qhov rhiab heev ntawm qhov chaw mos plab hnyuv siab raum poob, uas ua rau ib tug xov tooj ntawm cov teeb meem nyob rau hauv lub cev xeeb tub.
kev kho mob yooj yim
Nrog intervertebral hernia ntawm lub lumbar qaum, tus neeg mob yuav pab tau conservatively los yog phais. Raws li txoj cai, kev kho mob pib nrog kev siv cov txheej txheem uas tsis yog-radical. Nws yog ib qho tseem ceeb kom nkag siab tias nws muaj peev xwm ua tiav kev kho mob kom tiav tsuas yog nrog kev pab cuam ntawm kev phais. Qee qhov xwm txheej, kev saib xyuas kev kho mob pab kom tsis txhob muaj tus kab mob thiab txhim kho lub neej zoo ntawm tus neeg mob. Qhov nruab nrab ntawm kev kho mob yog 3-4 lub hlis. Thaum lub sijhawm no, nws tuaj yeem nres qhov mob ntawm qhov mob tshwm sim ntawm hernia thiab tiv thaiv nws qhov loj me.
Ib qho kev pab cuam yog tsim rau txhua tus neeg mob, suav nrog cov hauv qab no:
- kho lub cev thiab zaws;
- tshuaj kho mob.
Yog tias kev saib xyuas kev kho mob tsis tso cai rau kev saib xyuas qhov zoo lossis tus neeg mob tus mob tau mob sai sai, qee zaumKev cuam tshuam ntawm cov kws phais yuav tsim nyog, txawm tias muaj kev pheej hmoo tshwm sim hauv kev kho radical ntawm intervertebral hernia ntawm lumbar qaum. Yog tsis muaj kev phais, nws yog tsis yooj yim sua kom tshem tau ntawm cauda equina syndrome, kho ib tug pinched paj hlwb thiab rov qab ib feem poob musculoskeletal zog. Ua tsaug rau kev phais, lub siab ntawm tus txha caj qaum thiab cov paj hlwb raug tshem tawm, uas tso cai rau tus neeg mob zoo dua.
kho mob gymnastics
Kev tawm dag zog rau kev sib cuam tshuam ntawm lub lumbar qaum yog ib feem tseem ceeb ntawm ob qho tib si kev kho mob thiab lub sijhawm rov ua haujlwm tom qab. Kev kawm lub cev qhia tau tias muaj kev kho mob siab tshaj plaws thaum ua ke nrog kev noj tshuaj. Txhua qhov kev tawm dag zog uas tau ua los kho tus mob hernia yog ua raws li lub hauv paus ntsiab lus ntawm kev ncab ntawm tus txha caj qaum, txuas ntxiv thiab flexion ntawm nraub qaum. Lub gymnastic complex yog xaiv ib tus zuj zus rau txhua tus neeg mob tom qab MRI kev kuaj mob.
Kev cob qhia pib nrog ntau qhov kev ua kom sov (piv, qaij lub taub hau, lub cev), tom qab ntawd lawv mus rau qhov tseem ceeb:
- Zaum saum pem teb, muab koj txhais taw rau hauv qab. Nias koj ob txhais tes mus rau hauv pem teb thiab sim ncav tes nrog koj txhais tes kom deb li deb tau yam tsis tau rub koj lub duav. Tus neeg mob yuav tsum hnov qhov ncab ntawm sab nraub qaum. Koj yuav tsum rov ua qhov kev tawm dag zog 10-12 zaug.
- Tuag koj nraub qaum, khoov koj lub hauv caug. Nrog cov caj npab tawm, koj yuav tsum tau nce me ntsis thiab nyob hauv txoj haujlwm no li 5-7 vib nas this, tom qab ntawd rov qab mus rau qhov chaw pib thiab rov ua qhov kev tawm dag zog 10 zaug.
- Dov saum koj lub plab, so koj lub puab tsaig rau hauv pem teb, ncab koj txhais tes ntawm cov seams, xib teg. Lub luag haujlwm ntawm tus neeg mob hauv qhov kev tawm dag zog no nrog kev sib cuam tshuam ntawm lub lumbar yog txhawm rau ua kom lub cev thiab lub nraub qaum. Nws yog ib qho tseem ceeb uas yuav tsum tau tsa tes. Hauv txoj haujlwm no, koj yuav tsum khov rau ob peb feeb thiab rov qab mus rau qhov chaw pib.
- Siv lub hauv caug-lub luj tshib, hloov caj npab thiab txhais ceg rov qab rau pem hauv ntej, kho txoj haujlwm rau 10 vib nas this. Piv txwv li, txuas sab caj npab sab xis thiab sab laug, khov rau hauv txoj hauj lwm no ib pliag, rov qab mus rau qhov chaw pib thiab tso rau pem hauv ntej ntawm sab caj npab thiab sab xis.
Yog tias tus neeg mob txoj kev noj qab haus huv zoo dua, nws yuav raug tso cai suav nrog kev sib tw thiab khoov hauv qhov chaw kho mob-gymnastic complex. Koj tuaj yeem cob qhia hauv tsev, vim tias cov haujlwm zoo li no tsis tas yuav siv cov cuab yeej ua kis las, cov cuab yeej tshwj xeeb, khoom siv.
Ntxiv rau cov qauv kev kawm lub cev, yoga, ua luam dej, Pilates zoo heev rau lumbar hernia. Nyob rau tib lub sijhawm, koj yuav tsum nkag siab tias kev tawm dag zog tsis zoo tuaj yeem ua rau muaj kev phom sij es tsis txhob muaj kev txhim kho. Thaum pib ntawm kev kho mob ntawm intervertebral hernia ntawm lub lumbar yam tsis muaj kev phais, nws yog advisable mus tawm dag zog nyob rau hauv kev saib xyuas ntawm ib tug physiotherapist. Tom qab tus neeg mob tau ua tiav cov txheej txheem thiab cov txheej txheem ntawm kev ua haujlwm, koj tuaj yeem txav mus rau kev ua haujlwm hauv tsev.
Tshuaj rau lub lumbar hernia los txo qhov mob
tshuajtxhais tau hais tias yuav txo tau qhov kev siv ntawm manifestations, txo o thiab o. Nyob rau hauv kev kho mob ntawm bulging intervertebral disc, siv:
- Non-steroidal anti-inflammatory tshuaj uas pab nrog mob me mus rau nruab nrab. Hauv cov kab mob ntawm txoj hnyuv, cov tshuaj no tsis raug sau tseg. Cov no suav nrog Ibuprofen, Naproxen, Nimesil, Aspirin, Celebrex, Diclofenac. Nyob rau hauv kev sib raug zoo rau lub circulatory system, lawv xyaum tsis muaj kev phiv, yuav siv tau ua ntej los yog tom qab phais.
- tshuaj tiv thaiv hormonal. Tsis zoo li yav dhau los, lawv tau thov rau lub sijhawm txwv (5-7 hnub). Rau intervertebral hernia ntawm lub lumbar qaum, Methylprednisolone, Decadron yog siv, uas txo o thiab o.
- Cov leeg nqaij. Qhia rau cov neeg mob uas spasms ntawm paravertebral leeg (Valium, Mydocalm, Sirdalud).
Analgesic (systemic and local) tshuaj
txhawm rau thaiv qhov mob receptors, tsis yog tsuas yog siv tshuaj tua kab mob xws li Analgin, Paracetamol, Tylenol, tab sis kuj siv tshuaj tiv thaiv kev nyuaj siab. Qhov kawg txhawb kev tsim cov tshuaj tua kab mob hauv lub cev - endorphins. Nyob rau theem siab ntawm tus kab mob, thaum tus neeg mob raug mob los ntawm qhov mob hnyav, opiates tuaj yeem muab tshuaj - tshuaj kho mob raws li cov tshuaj narcotic (Morphine, Codeine, Tramadol), uas, yog tias siv uncontrollably, muaj yees thiab ua rau muaj kev phiv loj heev.
Ntau yam kev kho mob rau qhov mob thiab o nyob rau hauv cov ntaub ntawv ntawm intervertebral hernia ntawm thaj av lumbosacral yog tsim los ntawm muv los yog nab venom (Apizartron, Viprosal, Virapin). Raws li kev siv tshuaj loog sab nraud hauv zos rau tus kab mob no, koj tuaj yeem siv Diclofenac, Movalis, Ketoprofen, Phenylbutazone lossis cov tshuaj pleev ua ke thiab gel-chondroprotectors (Dolobene, Teraflex, Deep Relief).
Surgery
Radical kev kho mob ntawm intervertebral hernia ntawm lub lumbar qaum yog tsim nyog thiab tsim nyog tsuas yog nyob rau hauv loj heev mob. Txawm hais tias txoj kev nkag mus rau qhov cuam tshuam disc, qhov tseem ceeb ntawm kev cuam tshuam yog raws li hauv qab no: qhov kev phais yog ua los ntawm qhov uas tus kws phais tshem tawm cov annulus fibrosus thiab nucleus pulposus ib nrab lossis tag nrho (qhov no, kev teeb tsa tom qab ntawm ib qho intervertebral disc. kev cog lus yuav tsum).
YLaser tshem tawm
Txoj kev no ntawm lumbar disc herniation yog ib qho zoo tshaj plaws thiab kim. Thaum lub sijhawm ua haujlwm, tsis tas yuav tshuaj loog, vim tias tus kws kho mob tshwj xeeb tsis ua cov ntaub so ntswg incision. Cov txheej txheem minimally invasive tuaj yeem ua tau siv ib qho ntawm cov hauv qab no:
- Reconstruction - txhais tau tias tsis muaj zog hluav taws xob, ua rau cua sov ntawm cov pob txha mos intervertebral. Feem ntau yuav tsum tau kho ntau yam.
- Vaporization - evaporation ntawm ib feem ntawm lub intervertebral disc. Lub laser beam rhuav tshem lub protruding loj.
Hluav taws xob impulses
Ntxiv rau kev ua haujlwm kom tshem tawm cov kab mob intervertebral ntawm lub lumbar,Kev kho mob phais yog siv lwm yam, niaj hnub thiab cov tswv yim tshiab. Ib tug ntawm lawv, uas tau ua pov thawj nws tus kheej zoo, yog tus txha caj qaum stimulation. Lub hauv paus ntsiab lus ntawm kev cuam tshuam zoo li no yog raws li hauv qab no. Stimulating electrodes yog cog rau hauv thaj tsam sacro-lumbar ntawm tus neeg mob, thiab lub tshuab hluav taws xob mem tes tau muab tso rau hauv lub pob tw lossis lub plab.
Lub cuab yeej yog tswj hwm los ntawm cov khoom siv tshwj xeeb thiab txuas cov xov hlau. Cov khoom no txhawb kev ua haujlwm ntawm tus txha caj qaum, peripheral paj hlwb thiab cerebral hemispheres, yog li tshem tawm qhov mob. Yog li, mob tsis xis nyob, tus yam ntxwv ntawm intervertebral hernia ntawm cheeb tsam lumbar, yog relieved los ntawm pulsating kev txiav txim ntawm hluav taws xob signals.
Rehabilitation tom qab phais
Tom qab kev phais, txawm tias nws tshem tawm laser lossis tag nrho cov discectomy, nws yog ib qho tseem ceeb kom ua raws li tag nrho cov lus qhia ntawm tus kws kho mob uas tuaj koom, uas tau lees paub kom txo qis kev pheej hmoo ntawm cov teeb meem thiab rov tshwm sim ntawm tus kab mob.
Tom qab tshem tawm ntawm qhov intervertebral hernia ntawm lub lumbar qaum, cov neeg mob raug xaiv kom hnav corset tshwj xeeb. Tsis tas li ntawd, nws raug txwv nruj heev:
- hnyav nqa;
- kev ua lub cev;
- hypothermia thiab overheating.
Rau qhov kev rov zoo sai, nws yog ib qho tseem ceeb uas yuav tsum xaiv lub txaj orthopedic thiab pw hauv cov haujlwm no nkaus xwbuas tau pom zoo los ntawm kws kho mob. Piv txwv li, koj tsis tuaj yeem pw ib nrab zaum. Kev ceev faj yuav tsum tau ua thaum nce ntaiv - koj yuav tsum taug kev nrog lawv maj mam thiab tsis nrawm, tsis muaj kev txav tam sim ntawd. Tsis tas li, tsis muaj ib qho xwm txheej twg koj yuav tsum hnav khaub ncaws nruj thiab tshem tawm cov ntaub qhwv los yog kev txhawb nqa corset yam tsis tau kev tso cai los ntawm kws kho mob.
