Momwe Ducleus Disc imasinthira
Kulumikizana kwabwino pakati pa ma discs anu ndi mizu yapafupi ya msana ndizofunikira kuti musunge ululu wammbuyo. Koma pamene gawo (kapena mbali zina) zazitsulo zotayika, zingapangitse mitsempha. Zizindikiro za disk ya herniated, yomwe imatchedwa radiculopathy, imakhala yokhudzana ndi mitsempha , ndipo imaphatikizapo kupweteka, kupsinjika, kufooka, kufooka ndi / kapena kumverera kwa magetsi komwe kumatsika mwendo umodzi.
Tonse timadziwa kuti ululu ndi ululu. Mofananamo, mitundu 4 ya discyniation ilipo ndipo imayambitsa zizindikiro.
Mankhwala a disc aliwonse akuti mankhwala ofewa, odzola omwe ali pakati (omwe amatchedwa " core pulpus" ) ali ndi zida zolimba zomwe ziri kunja. Chovala chokunja ichi chimatchedwa annulus fibrosus . Pakapita nthawi, wodwalayo akhoza kugwa pansi ndi / kapena kugwedeza, kusiya mnofu ndi mitsempha ya msana kumatha kuvulaza. Izi zikachitika, kusagwirizana pakati pa mankhwala a herniated ndi mitsempha ya msana kumatha kuchitika, zomwe zingachititse ululu ndi / kapena zizindikiro za mitsempha.
Ndi mtundu uliwonse wa chisokonezo cha disk yomwe ili pansipa, mutu wa pakati uli pa siteji yosiyana ya kusamukira kunja kwa annulus, ndi herniation yomwe ikuyimira kwambiri kwambiri.
Disc Protrusion
Kuthira kwa diski kumachitika pamene makina a disk nucleus koma sagumuka. Mutuwu umakhalabe mkati mwa chisindikizo cha disk.
Kutuluka kwa Disc
Pamene kachilombo kamatuluka, phokosoli lidali mkati mwa chiwongolero koma chifukwa chakuti mawonekedwe akunja akugwiritsira ntchito. (The annulus ili ndi zigawo zingapo zamagetsi zomwe zimayikidwa pa diagonal. mpangidwe wosanjikizira pamwamba - kapena pansipa; izi zimapereka zowonongeka ndi zothandizira ku dongosolo lonse.)
Kuthamanga kwaulendo
Pokhala ndi extrusion, zipangizo zofewa zomwe zimakhala ndi phokoso zimachokera ku chipangizo cha disk kupita ku malo omwe ali pafupi koma zimagwirizanitsidwa ndi diski. Izi ndizotheka chifukwa cha misonzi m'magetsi omwe amatha kutseguka kumene zinthu zofewa zimatha kuyenda.
Dongosolo lokhazikitsidwa
Pankhani ya disk sequestered, zidutswa zochokera ku chipinda chimodzi ndi chigawo zimapanga kunja kwa disc. Vuto lalikulu lomwe limachokera ku disque sequestered ndizowopsya mitsempha ya msana, chifukwa chakuti zidutswazo zimalowa mu mitsempha yambiri yomwe imapanga mitsempha ya msana. Kawirikawiri, mawu akuti "herniated disc" amagwiritsidwa ntchito kutanthauzira ku disque sequestered.
Mavuto ena omwe amachokera ku disquestered discs amatengera myelopathy (kupanikizika kapena kupsa mtima kwa msana) ndi / kapena cauda syina (zomwe sizikuchitika nthawi yomwe mitsempha ya kumapeto kwa msana umasokonezedwa. kupweteka kapena kufooka kumene kumaipira pang'onopang'ono, "amnesia" kapena / kapena mavuto ndi matumbo kapena chikhodzodzo - kawirikawiri amawoneka kuti ndiwopweteka kuchipatala.)
Pankhani ya zizindikiro zomwe zimagwirizanitsidwa ndi ma disquestered discs, kawirikawiri zimakhala zovuta kuikidwa pamagulu a mitsempha ndi zidutswa zomasulidwa zomwe ndizozidziwitsa.
Mwa njira, sikuti nthawi zonse kuvulaza kokha kumayambitsa mavuto a mitsempha; Kungakhale kuphatikizapo chovulaza ndi kutukumula komweko, komanso.
Kuyika Thupi ndi Dokotala Wanu Wachilombo
Thupi lanu likhoza kudziwa momwe kuchulukira kulikuyikira pa diski yanu. Izi zimatchedwa intradiscal. Kawirikawiri, L5-S1 (yotsiriza lumbar vertebra ndi pamwamba pa sacrum bone kugwirizana) imayamba kukakamizidwa kwambiri. Ichi ndi chifukwa chakuti kulemera kwa thupi lanu kumasunthidwira pamenepo, kuphatikizapo gawo la msana ndi malo osintha; mwa kuyankhula kwina, ndi kumene malo amtundu wamakono amalowerera mu sacral.
Kafukufuku wina wa ku Sweden omwe Nachemson ndi Elfstrom anapeza anayeza intradiscal kukakamiza m'munsi mwachindunji (malo otsika) kuchokera kumalo osiyanasiyana. Phunziroli linayamba ndi mfundo yakuti disk ili ndi thanzi labwino, kupanikizika kumaphatikiza kufalikira mofanana pamtunda wonse. Ochita kafukufukuwo anadziyesa kuyeza ndi kuyerekeza kusiyana kwa kusiyana pakati pa kuyimirira (komwe kunkagwiritsidwa ntchito ngati mtengo woyerekeza) ndi kayendedwe ka mitundu, kayendedwe, ndi malo osiyanasiyana.
Iwo adapeza kuti kuyenda kunabweretsa mavuto ochepa kusiyana ndi kupindika ndi / kapena kupotoza, ndi kupindika kumbali komanso kusokoneza kunabweretsa mavuto ochepa kusiyana ndi kudumpha, kukokera ndi kuseka.
Mutha kuganiza kuti kukhala ndi zovuta kwambiri mu phunziro lino, koma kwenikweni choipa chachikulu chinali kupitiliza, chomwe chinapangitsa kuti azikhala ndi madigiri akuluakulu a intradiscal. Ofufuzawa ananena kuti izi zikuthandizira zomwe iwo amatcha "ergonomic malangizo," mwachitsanzo, mobwereza mobwerezabwereza "kuguguda ndi mawondo anu osati ndi msana wanu mukakweza chinachake cholemera kapena chowopsa."
Phunziro la 2008 linatsimikizira ichi, pofufuza kuti ma diski a thanzi, kukhala pakhomo sikungapweteke kwambiri. Ndipotu, olemba a phunziroli amanena kuti kukhala ndi kuimirira kumafanana ndi momwe intradiscal imayendera.
Mtundu wokhawokha umene akatswiri ofufuza anapeza unapangitsa kuti pakhale mavuto ochepa kusiyana ndi kuyima. Mwachiwonekere, kuganiza kuti supine (yomwe ili kumbuyo kwanu) mwachiwonekere imapangitsa 50% zochepetsetsa intradiscal kuposa momwe wofufuza amawerengera kuimira.
> Zotsatira:
> Claus, A., ndi. al. Kukhazikika motsutsana ndi maimidwe: kodi intradiscal imayambitsa matenda osokoneza ubongo kapena zowawa zochepa? J Electromyogr Kinesiol. Aug. 2008. https://www.ncbi.nlm.nih.gov/pubmed/17346987
> Magee, David, J. Orthopedic Physical Assessment. 4th Edition. Saunders Elsevier. St. Louis, MO. 2006.
> Fishman, L. ndi Ardman, C., Kubwezera Kumbuyo: Mmene Mungathetsere Ululu Wammbuyo ndi Sciatica. WW Norton ndi Company, New York, London. 1997
> Nachemson, A. ndi Elfstrom, G. Kuchepetsa Kupsyinjika kwa Mphamvu mu Zovuta. Almqvist & Wiksell. 1970. Stockholm. http://www.energycenter.com/grav_f/studies_nachemson.pdf