Ọkpụkpụ lumbar, ma ọ bụ azụ azụ lumbosacral, na -ezo aka na akụkụ azụ nke dị na azụ ala, dị n'elu sacrum. Mpaghara na -agagharị agagharị nke ukwuu ma na -akwado ọkpụkpụ azụ niile, a na -eji ya kwa ụbọchị na mgbe ụfọdụ onye ịka nká. Ọzọkwa, mpaghara lumbar na -abụkarị ebe mgbu, ihe kpatara ya nwere ike ịdị ọtụtụ.

Okwu okwu spain na -ezo aka n'ọkpụkpụ azụ. Ọ mejupụtara nchịkọta nke vertebrae dị iche iche: 7 cervical vertebrae, 12 dorsal (ma ọ bụ thoracic) vertebrae, 5 lumbar vertebrae, sacrum mejupụtara 5 fused vertebrae na n'ikpeazụ coccyx mejupụtara 4 vertebrae.

Ọkpụkpụ lumbar na -ezo aka na akụkụ dị ala, mkpanaka nke spain, nke dị n'elu sacrum. Ọ mejupụtara vertebrae lumbar ise: L1, L2, L3, L4 na L5 vertebrae.

A na -ejikọta vertebrae ise a ma kọwaa ya n'azụ site na nkwonkwo ihu, yana n'ihu site na diski vertebral. N'etiti vertebra ọ bụla, mgbọrọgwụ akwara na -apụta site na oghere akpọrọ foramina.

Ọkpụkpụ lumbar na -egosi oghere concave n'azụ, nke a na -akpọ lumbar lordosis.

Dị ka akụkụ ndị ọzọ nke spain, mpaghara lumbar na-echebe eriri azụ ruo L1-L2 vertebrae, mgbe ahụ irighiri akwara sitere na L1-L2.

Dynamically, n'ihi ọnọdụ ya, oghere lumbar na -akwado ọkpụkpụ azụ nke ọzọ ma hụ na ọ na -agagharị agagharị. Ọ na -arụkwa ọrụ dị ka onye na -amata ujo na nkesa ibu n'etiti pelvis na thorax. Mgbochi akwara nke spain, nke a na -akpọkwa akwara akwara, nke na -agbatị n'akụkụ abụọ nke spain na -enyere aka belata ụfọdụ nrụgide a na -eme na spain.

N'ihi mgbagwoju anya anatomical ya, akụkụ akwara ozi nke ọ nwere, ihe mgbochi kwa ụbọchị nke ọ na -akwado kamakwa ịka nká nke akụkụ ya dị iche iche, ọtụtụ ọrịa nwere ike imetụta ọkpụkpụ azụ lumbar. Nke a bụ ndị isi.

Obere ihe mgbu

Obere ihe mgbu azụ bụ okwu nche anwụ maka mgbu azụ dị ala. N'ime ndụmọdụ ọhụrụ ya banyere njikwa mgbu azụ dị ala, HAS (Haute Autorité de Santé) na -echeta nkọwa a: “A na -akọwa mgbu azụ dị ala site na mgbu dị n'etiti eriri thoracolumbar na obere gluteal n'ogige. Enwere ike jikọta ya na radiculalgia kwekọrọ na mgbu na otu ma ọ bụ abụọ ụkwụ ala na otu ma ọ bụ karịa dermatomes. “

Schematically, anyị nwere ike ịmata:

• mgbu azụ dị ala, nke a na -eji mgbu azụ dị ala nke na -enweghị ihe ịdọ aka na ntị. Na 90% nke ikpe, mgbu azụ na -adịkarị nke ọma na -erughị izu 4 ruo 6, na -echeta HAS;
• mgbu azụ na -adịghị ala ala, ya bụ mgbu azụ dị ala karịa ọnwa 3;
• “oke mgbu nke mgbu azụ” ma ọ bụ nnukwu mgbu azụ, ma ọ bụ lumbago n'asụsụ kwa ụbọchị. Ọ bụ nnukwu ihe mgbu, nwa oge n'ihi na ọ na -abụkarị n'ihi mmegharị na -ezighi ezi, iburu ibu dị arọ, mgbalị mberede (ama ama "tụgharịrị akụrụ"). 

Lumbar kwupụta ya

A na -egosipụta diski herniated site na mgbatị nke akwara pulposus, akụkụ gelatinous nke diski intervertebral. Ahịhịa a ga -agbakọta otu mgbọrọgwụ akwara ma ọ bụ karịa, na -akpata mgbu azụ ma ọ bụ ihe mgbu n'apata ụkwụ dabere na ebe hernia nọ. Ọ bụrụ na emetụta L5 vertebra, hernia ga -ebute sciatica nke ihe mgbu na apata ụkwụ na -agbada, na -agbada n'ụkwụ gaa na mkpịsị ụkwụ ukwu.

Osteoarthritis nke lumbar

Osteoarthritis, nke dịka ihe ncheta bụ ọrịa na -emebi emebi nke cartilage, nwere ike imetụta nkwonkwo n'etiti vertebrae abụọ. Ọrịa ogbu na nkwonkwo nke lumbar a nwere ike ọ gaghị ebute mgbaàmà ọ bụla, ebe ọ nwere ike ibute uto ọkpụkpụ a na -akpọ osteophytes nke, site na mgbakasị akwara, ga -ebute mgbu azụ ala.

Ọkpụkpụ akwara lumbar ma ọ bụ ọwa mmiri lumbar dị warara

Lumbar stenosis bụ mbelata nke ọwa mmiri etiti nke spain, ma ọ bụ ọwa lumbar, nke nwere mgbọrọgwụ akwara. Ọ na -emetụtakarị afọ, ọ na -ebutekwa nhịahụ n'iji mmetụta adịghị ike na -aga ije, ịma jijiji, tingling na ụkwụ, sciatica na -eme na ezumike ma ọ bụ n'oge ike, na ọ dịkarịsịrị nta, ahụ mkpọnwụ. ọ dị mkpa ma ọ bụ dị mkpa na obere aka ma ọ bụ ọrụ sphincter.

Ọrịa ọrịa Lumbar

A na -ahụkarị ọrịa diski degenerative, ma ọ bụ mbibi diski, site na ịka nká nke diski intervertebral na nkụda mmụọ na -aga n'ihu nke etiti gelatinous ya. A na -atụkọta diski ahụ wee gbanye mgbọrọgwụ akwara, nke na -ebute mgbu na azụ ala. A na -elekwa ọrịa diski degenerative anya dị ka isi ihe na -akpata mgbu azụ dị ala.

Ọrịa scoliosis degenerative

Degenerative lumbar scoliosis na -egosipụta onwe ya dị ka nkwarụ nke spain. Ọ na -adịkarị n'ime ụmụ nwanyị, ọkachasị mgbe nsọ nsọ gasịrị. Ọ na -egosipụta onwe ya site na mgbu azụ na azụ, na -enwu n'ime apata ụkwụ, na -abawanye mgbe ọ na -eje ije. Degenerative lumbar scoliosis bụ nsonaazụ nke ọtụtụ ihe: diski ọdịda nke agbakwunyere enweghị ụda akwara, osteoporosis yana adịghị ike ligament spinal.

Ihe omimi nke ogwugwu

Ọrịa a jikọtara ya na ịka nká nke ọkpụkpụ azụ na-egosipụta onwe ya site na ịmịfe otu vertebra na nke ọzọ, n'ozuzu L4-L5. Ọkpụkpụ ọwa Lumbar na akara ya na -eso.

Ọkpụkpụ Lumbar

Mgbaji ọkpụkpụ azụ nwere ike ime n'oge mmetụta siri ike (ọkachasị ihe mberede okporo ụzọ). Enwere ike jikọta mgbaji ọkpụkpụ azụ a na mmerụ ahụ na akwara akwara na / ma ọ bụ mgbọrọgwụ akwara, ihe egwu nwere ike bụrụ mkpọnwụ. Ọkpụkpụ ahụ nwekwara ike bụrụ ihe na -akwụghị chịm, ma ọ bụrụ na mwepụ nke abụọ na -ebute ihe egwu akwara ozi.

Obere ihe mgbu

N'ime ndụmọdụ ọhụrụ ya na njikwa nke mgbu azụ dị ala, HAS na -echeta na mmega ahụ bụ isi ọgwụgwọ na -enye ohere mgbanwe dị mma nke ọrịa a. A na -egosikwa ọgwụgwọ anụ ahụ. Banyere ọgwụgwọ ọgwụ, a na -echeta "na ọ nweghị ọgwụ analgesic gosipụtara nke ọma na ọkara oge maka mmepe nke nnukwu mwakpo mgbu azụ dị ala, mana nchịkwa analgesic gụsịrị akwụkwọ, malite na ọkwa analgesics I (paracetamol, NSAIDs), nwere ike emebere iji belata mwakpo na -egbu mgbu ”. HAS na-egosikwa "mkpa nlekọta ahụike zuru ụwa ọnụ nke onye ọrịa a maara dị ka" bio-psycho-social ", na-eburu n'uche ahụmịhe onye ọrịa na nsonaazụ nke mgbu ya (akụkụ anụ ahụ, nke uche na nke mmekọrịta ọha na eze).

Mpempe akwụkwọ Herniated

Usoro ọgwụgwọ ahịrị nke mbụ bụ ihe mgbaàmà: analgesics, ọgwụ mgbochi mkpali, mbanye. Ọ bụrụ na ọgwụgwọ adaa, enwere ike ịwa gị ahụ. Usoro a, nke a na -akpọ discectomy, na -agụnye iwepu hernia iji gbarie mgbọrọgwụ akwara iwe.

Ọrịa Lumbar

Usoro ọgwụgwọ ahịrị nke mbụ bụ mgbanwe: analgesics, anti-inflammatories, rehab, ọbụna corset ma ọ bụ mbanye. Ọ bụrụ na ọgwụgwọ agaghị ada, enwere ike ịwa gị ahụ. Usoro a, nke a na -akpọ laminectomy ma ọ bụ mwepụ eriri akwara, gụnyere iwepụ vertebral lamina ka ọwepụta ọwa akwara.

Ọrịa disgenerative diski

Usoro ọgwụgwọ ahịrị nke mbụ bụ akara: analgesics, ọgwụ mgbochi mkpali, nbanye, nwughari ọrụ. A ga -atụle ịwa ahụ ma ọ bụrụ na ọdịda nke ọgwụgwọ ahụike na nkwarụ mgbu kwa ụbọchị. Lumbar arthrodesis, ma ọ bụ njikọta akwara, mejupụtara iwepu diski mebiri emebi wee tinye ngwaọrụ ahụike n'etiti vertebrae abụọ ahụ ka ọ nwee ịdị elu diski.

Ọrịa scoliosis degenerative

Analgesics, ọgwụ mgbochi mkpali na injections bụ ọgwụgwọ akara akara nke mbụ. N'ọnọdụ ọdịda na mgbu na -agwụ ike, enwere ike ịtụle ịwa ahụ. Arthrodesis ga -ezube ijikọ ala vertebral mkpanaka gabigara ókè wee mebie mgbọrọgwụ akwara.

Ọkpụkpụ Lumbar

Ọgwụgwọ dabere n'ụdị mgbaji ọkpụkpụ na mmebi akwara metụtara ma ọ bụ. Ịwa ahụ ga -achọ, dabere na ikpe ahụ, iji weghachite nkwụsi ike nke spain, iji weghachi mmewere nke vertebra gbajiri agbaji, iji mebie usoro akwara ozi. Maka nke a, a na -eji usoro dị iche iche eme ihe: arthrodesis, mgbatị akwara, wdg.

Ihe omimi nke ogwugwu

N'ọnọdụ ọdịda nke ọgwụgwọ ahụike (analgesics, ọgwụ mgbochi mkpali na ntinye), enwere ike ịtụle arthrodesis.

X-ray nke ọkpụkpụ azụ lumbar

Nnyocha ọkọlọtọ a na -enyocha mkpokọta akwara nke spain. A na-edekarị ya dị ka ọgwụgwọ ahịrị nke mbụ maka mgbu azụ dị ala. Ọ na -eme ka o kwe omume ịchọpụta ọnụnọ nke ọnya na -emebi emebi (lumbar osteoarthritis), mkpakọ vertebral ma ọ bụ nkwarụ morphological nke vertebrae, ihe na -adịghị mma nke statics (scoliosis) ma ọ bụ mịpụ nke vertebrae. N'aka nke ọzọ, ọ bụghị mgbe niile ka ọ ga -ekwe omume ịchọpụta mgbaji ọkpụkpụ azụ. Diski ahụ, eriri akwara, mgbọrọgwụ akwara bụ ihe owuwu redio (ha na-ekwe ka ụzarị X-ray gafere), x-ray nke spain lumbar anaghị egosi diski herniated ma ọ bụ pathologies nke eriri afọ.

MRI nke spine lumbar

MRI bụ nyocha ọkọlọtọ nke spain lumbar, ọkachasị ịchọpụta pathologies nke eriri azụ. Ọ na -enye ohere iji anya nke uche hụ akụkụ ahụ ọkpụkpụ na akụkụ dị nro na akụkụ 3: eriri afọ, ligament, diski, mgbọrọgwụ akwara. Ya mere, iji chọpụta ọrịa dị iche iche nke akwara lumbar: diski herniated, ọrịa diski degenerative, mgbapụta diski, stenosis lumbar, mbufụt nke efere vertebral, wdg.

Nyocha CT nke lumbar

Ihe nyocha CT lumbar ma ọ bụ tomography gbakọrọ bụ nyocha ọkọlọtọ ma ọ bụrụ na mgbaji ọkpụkpụ azụ. Ọ nwekwara ike ịchọpụta diski herniated, nyochaa ogo nke stenosis lumbar, chọpụta metastases ọkpụkpụ vertebral. A na -edekarịkwa ya dị ka akụkụ nke nyocha tupu arụ ọrụ ịwa ahụ spain, ọkachasị iji chọpụta ọnọdụ arịa ndị ahụ.