Lumbar msana, kapena lumbosacral msana, amatanthauza gawo la msana womwe uli kumbuyo kwenikweni, pamwambapa pa sacrum. Malo oyenda kwambiri ndikuthandizira msana wonse, amagwiritsidwa ntchito kwambiri tsiku ndi tsiku ndipo nthawi zina amakhala okalamba msanga. Komanso, msana wa lumbar nthawi zambiri umakhala malo opweteka, zomwe zimayambitsa zochuluka.

Mawu akuti msana amatanthauza msana. Zimapangidwa ndi mitundu ingapo yama vertebrae: 7 khomo lachiberekero, 12 dorsal (kapena thoracic) vertebrae, 5 lumbar vertebrae, sacrum yopangidwa ndi 5 yosakaniza ma vertebrae ndipo pamapeto pake coccyx yopangidwa ndi 4 ma vertebrae.

Lumbar spine imatanthawuza gawo lotsika, loyenda msana, lomwe lili pamwambapa pa sacrum. Amapangidwa ndi ma lumbar vertebrae asanu: L1, L2, L3, L4 ndi L5 vertebrae.

Ma vertebrae asanuwa amalumikizidwa ndikufotokozedwa kumbuyo ndi mbali zazing'ono, komanso kutsogolo ndi ma disc a vertebral. Pakati pa vertebra iliyonse, mizu yamitsempha imatuluka kudzera m'mabowo otchedwa foramina.

Msana wa lumbar umapereka chingwe cha concave chakumbuyo, kotchedwa lumbar lordosis.

Monga msana wonsewo, lumbar spine imateteza msana mpaka L1-L2 vertebrae, kenako misana yam'mimba kuchokera ku L1-L2.

Mphamvu, chifukwa chakomweko, msana wa lumbar umathandizira msana wonsewo ndikuwonetsetsa kuti ukuyenda bwino. Imaseweranso ngati gawo lazowonjezera komanso kugawa katundu pakati pa mafupa ndi chiuno. Minofu yoyeserera ya msana, yomwe imadziwikanso kuti minofu ya msana, yomwe imafalikira mbali zonse ziwiri za msana imathandizira kuthana ndi mavuto ena omwe amapezeka pamsana.

Chifukwa cha kupangika kwake kwa maatomiki, minyewa yomwe imakhalapo, zopinga za tsiku ndi tsiku zomwe zimathandizira komanso kukalamba kwakapangidwe kazinthu zosiyanasiyana, msana wa lumbar umatha kukhudzidwa ndimatenda ambiri. Nazi izi zazikulu.

Kupweteka kwakumbuyo kwenikweni

Kupweteka kwakumbuyo kwenikweni ndi ambulera yotanthauza kupweteka kwakumbuyo. Malangizo ake aposachedwa pankhani yothana ndi kupweteka kwa msana, HAS (Haute Autorité de Santé) akukumbukira tanthauzo ili: "Kupweteka kwakumbuyo kumafotokozedwa ndi ululu womwe umakhala pakati pa chingwe cha thoracolumbar ndi khola lakumapeto. Ikhoza kugwirizanitsidwa ndi radiculalgia yofanana ndi kupweteka mu gawo limodzi kapena lonse m'munsi mwa dermatomes imodzi kapena zingapo. "

Mwachidziwitso, tikhoza kusiyanitsa:

• kupweteka kwapafupipafupi, komwe kumadziwika ndi kupweteka kwakumbuyo komwe kulibe zidziwitso. Mu 90% ya milandu, kupweteka kwakumbuyo kofala kumasintha bwino m'masabata ochepera 4 mpaka 6, akukumbukira HAS;
• kupweteka kwakumbuyo kwakanthawi, mwachitsanzo, kupweteka kwakumbuyo kwakanthawi kosatha miyezi yopitilira 3;
• "kupsyinjika kwakukulu kwa ululu wammbuyo" kapena kupweteka kwakumbuyo, kapena lumbago mchilankhulo chatsiku ndi tsiku. Ndikumva kuwawa kwakanthawi, kwakanthawi chifukwa nthawi zambiri kumachitika chifukwa cholakwika, kunyamula katundu wolemera, kuyesayesa kwadzidzidzi ("kutembenukira kwa impso" kotchuka). 

Lumbar disc herniation

Dothi la herniated limawonetsedwa ndikutuluka kwa ma pulusosus, gawo la gelatinous la intervertebral disc. Nthendayi imachepetsa mizu imodzi kapena zingapo zam'mitsempha, zomwe zimayambitsa kupweteka kwakumbuyo kapena kupweteka ntchafu kutengera komwe kuli chophukacho. Ngati L5 vertebra imakhudzidwa, chophukacho chimachititsadi sciatica yodziwika ndi ululu wa ntchafu, kutsikira mwendo kulowera chala chachikulu chakuphazi.

Lumbar osteoarthritis

Osteoarthritis, yomwe monga chikumbutso ndimatenda osachiritsika a cartilage, imatha kukhudza mafupa a pakati pama vertebrae awiri. Lumbar osteoarthritis mwina siyingayambitse zizindikiro zilizonse, chifukwa zimatha kubweretsa mafupa otchedwa osteophytes omwe, chifukwa cha kukwiya kwa mitsempha, amayambitsa kupweteka kwakumbuyo.

Lumbar spinal stenosis kapena ngalande yopapatiza ya lumbar

Lumbar stenosis ndikuchepetsa kwa ngalande yapakati ya msana, kapena ngalande ya lumbar, yomwe imakhala ndi mizu ya mitsempha. Nthawi zambiri zimakhudzana ndi ukalamba, ndipo zimayambitsa kuyenda poyenda ndikumva kufooka, dzanzi, kumva kulira m'miyendo, sciatica yomwe imachitika popuma kapena nthawi yolimbikira, ndipo nthawi zambiri, kufooka. osafunikira kwenikweni pamiyendo yakumunsi kapena ntchito za sphincter.

Matenda a Lumbar

Matenda opatsirana pogonana, kapena kuchepa kwa disc, amadziwika ndi kukalamba msanga kwa disvertebral disc komanso kuchepa kwa madzi mkatikati mwa gelatinous. Diskiyo imatsinidwa ndipo mizu ya mitsempha imakwiya, zomwe zimapweteka kumunsi kwakumbuyo. Matenda opatsirana pogonana amadziwikanso kuti ndi omwe amachititsa kupweteka kwakumbuyo kochepa.

Chotsitsa lumbar scoliosis

Matenda opatsirana a lumbar scoliosis amadziwonetsera ngati kuwonongeka kwa msana. Amakonda kwambiri amayi, makamaka atatha kusamba. Amadziwonetsera ndi kupweteka kwa msana komanso kutako, kutulutsa ntchafu, nthawi zambiri kumawonjezeka poyenda. Matenda opatsirana opatsirana lumbar scoliosis ndi chifukwa cha zinthu zingapo: kulephera kwa disc komwe kumawonjezera kusowa kwa minofu, kufooka kwa mafupa komanso kufooka kwa msana.

Kusintha kwapondylolisthesis

Matendawa olumikizidwa ndi ukalamba wachilengedwe wa msana amadziwikiratu poterera kwa vertebra imodzi mbali inayo, makamaka L4-L5. Lumbar canal stenosis ndipo zizindikiro zake zimatsatira.

Kuphulika kwa lumbar

Kuphulika kwa msana kumatha kuchitika panthawi yamphamvu kwambiri (ngozi zapamsewu makamaka). Kuphulika kwa msana kumeneku kumatha kuphatikizidwa ndi kuvulala kwa msana ndi / kapena mizu ya mitsempha, chiopsezo ndiye kukhala wolumala. Kuphulika kungakhalenso kosakhazikika, ndipo ngati kusamukira kwina kungayambitse matenda a ubongo.

Kupweteka kwakumbuyo kwenikweni

M'malingaliro ake aposachedwa pothana ndi zowawa zapweteka zapafupifupi, a HAS amakumbukira kuti kulimbitsa thupi ndiye chithandizo chofunikira kwambiri chololeza kusintha kwa matendawa. Physiotherapy imasonyezedwanso. Ponena za chithandizo chamankhwala, zimakumbukiridwa "kuti palibe mankhwala opha ululu omwe akhala akugwira ntchito pakatikati pakukula kwa kupweteka kwakumbuyo kwa msana, koma omwe adamaliza maphunziro a analgesic, kuyambira ndi analgesics level I (paracetamol, NSAIDs), atha kukhala kukhazikitsidwa kuti muchepetse ziwopsezo ". HAS imatsindikanso "kufunikira kwa chisamaliro chapadziko lonse lapansi cha wodwala yemwe amadziwika kuti" bio-psycho-social ", poganizira zomwe zimamuchitikira wodwalayo komanso zomwe zimamupweteketsa (matupi am'mutu, amisala komanso magwiridwe antchito)".

Herniated disc

Chithandizo cha mzere woyamba ndichizindikiro: analgesics, anti-inflammatory drugs, infiltrations. Ngati mankhwala alephera, opaleshoni ingaperekedwe. Njirayi, yotchedwa discectomy, imakhudza kuchotsa chophukacho kuti ichepetse mitsempha yotupa.

Lumbar stenosis

Chithandizo cha mzere woyamba ndiwofatsa: analgesics, anti-inflammatories, konzanso, ngakhale corset kapena kulowa mkati. Ngati mankhwala akulephera, opaleshoni ingaperekedwe. Njirayi, yotchedwa laminectomy kapena kumasulidwa kwa msana, imaphatikizapo kuchotsa lamina wam'mimba kuti amasule chingwe cha msana.

Matenda osokoneza bongo

Chithandizo cha mzere woyamba ndichizindikiro: analgesics, mankhwala odana ndi zotupa, kulowerera, kukonzanso magwiridwe antchito. Kuchita opaleshoni kumaganiziridwa pakalephera kulandira chithandizo chamankhwala ndikulepheretsa kupweteka tsiku ndi tsiku. Lumbar arthrodesis, kapena kusakanikirana kwa msana, kumakhala ndikuchotsa chimbale chowonongeka ndikuyikapo chida chamankhwala pakati pama vertebrae awiriwa kuti akhalebe kutalika kwama disc.

Chotsitsa lumbar scoliosis

Ma analgesics, mankhwala oletsa kutupa ndi jakisoni amapanga mankhwala oyamba azizindikiro. Pakulephera ndikumva kuwawa, opareshoni angaganiziridwe. Arthrodesis idzayesetsa kuphatikizira malo oyenda kwambiri osunthika ndikuwononga mizu ya mitsempha.

Kuphulika kwa lumbar

Chithandizo chimadalira mtundu wa kusweka ndi kuwonongeka kwa mitsempha kapena ayi. Kuchita opaleshoniyi kudzatengera, kutengera momwe zimakhalira, kubwezeretsa kukhazikika kwa msana, kubwezeretsa mawonekedwe amtundu wa vertebra wosweka, kusokoneza mawonekedwe amitsempha. Pachifukwa ichi, njira zosiyanasiyana zimagwiritsidwa ntchito: arthrodesis, kufalikira kwa msana, ndi zina zambiri.

Kusintha kwapondylolisthesis

Pakachitika kulephera kwa mankhwala (analgesics, anti-inflammatory drug and infiltrations), arthrodesis imatha kuganiziridwa.

Lumbar msana x-ray

Kuyesa koyesaku kumayang'ana momwe morphology imagwirira ntchito msana. Nthawi zambiri amalembedwa ngati chithandizo choyamba chothandizira kupweteka kwakumbuyo. Zimapangitsa kuti azindikire kupezeka kwa zotupa zosafunikira (lumbar osteoarthritis), kuponderezana kwamtundu wam'mimba kapena zovuta zam'mimbamo zam'mimba, zovuta za statics (scoliosis) kapena kutsika kwa vertebrae. Kumbali inayi, sikuti nthawi zonse zimathandiza kuti munthu adziwe kuti pali vuto linalake lomwe lachita kuwonongeka. Ma disc, msana wam'mimba, mizu ya mitsempha imakhala yowala kwambiri (amalola ma X-ray kudutsa), x-ray ya msana wa lumbar sisonyeza ma disc a herniated kapena pathologies a msana.

MRI ya msana wa lumbar

MRI ndiyomwe imayesa msana wa lumbar, makamaka kuti izindikire zovuta za msana. Amalola kuti muwoneke pamiyeso itatu mbali zamathambo ndi zofewa: msana, ligament, disc, mizu ya mitsempha. Ndipo potero mutha kudziwa mitundu ingapo yamatenda am'mimba: herniated disc, matenda opatsirana ndi disc, kutulutsa kwa disc, lumbar stenosis, kutupa kwa ma vertebral mbale, ndi zina zambiri.

Lumbar spine CT scan

Lumbar CT scan kapena computed tomography ndiyowunika koyesedwa pakadaphulika msana. Ikhozanso kuzindikira matenda a herniated disc, kuwunika kuchuluka kwa lumbar stenosis, kuzindikira mafupa am'mitsempha am'mitsempha. Amatchulidwanso kuti ndi gawo la kuyezetsa koyambirira kwa maopaleshoni a msana, makamaka kuwunika momwe zombozo zilili.