Ngalande inapanga kuphatikizika kwa gawo lopanda kanthu la vertebrae, ngalande ya msana imakhala ndi msana ndi mitsempha. Nthawi zina imachepa, kuchititsa psinjika ya minyewa nyumba.

Msana, kapena msana, umapangidwa ndi ma vertebrae a 33: 7 vertebrae, 12 dorsal (kapena thoracic) vertebrae, 5 lumbar vertebrae, sacrum yopangidwa ndi 5 vertebrae yosakanikirana ndipo pamapeto pake coccyx yopangidwa ndi 4 vertebrae. Mitsemphayi imagwirizanitsidwa ndi vertebral disc.

Msana uliwonse umakhala ndi fupa lakumbuyo kwake. Kuphatikizana pamwamba pa mzake, ma vertebral arches awa amapanga ngalande: ndi ngalande ya msana, yomwe imatchedwanso ngalande ya msana, yomwe ili ndi msana ndi mitsempha pakati pake.

Mtsempha wa msana umachokera ku vertebra yoyamba ya chiberekero kupita ku lumbar vertebra yachiwiri. Imathera pa mlingo wa yachiwiri lumbar vertebra ndi wapawiri thumba lomwe lili galimoto ndi zomverera mitsempha mizu ya miyendo ndi chikhodzodzo ndi rectal sphincters. Dera limeneli limatchedwa ponytail.

Msana wa msana umathandizira ndikuteteza msana. Mkati mwa ngalandeyi yopangidwa ndi ngalande ya msana, chingwe cha msana chimatetezedwa ndi ma meninges osiyanasiyana: dura mater, arachnoid ndi piamater.

Njira yopapatiza ya lumbar kapena lumbar canal stenosis

Mwa anthu ena, chifukwa cha kuvala kwachilengedwe ndi kung'ambika (osteoarthritis), pali kuchepa kwa m'mimba mwake mwa ngalande ya msana pamtunda wa lumbar vertebrae, ndiko kuti, m'munsi kumbuyo, pamwamba pa sacrum. Mofanana ndi ziwalo zonse za thupi la munthu, ziwalo za vertebrae zimakhala ndi nyamakazi ya osteoarthritis yomwe ingayambitse kusinthika kwawo ndi kukhuthala kwa capsule yolumikizana kuti iwononge ngalande. Mphuno ya m'chiuno, yomwe nthawi zambiri imakhala ya katatu, imatenga mawonekedwe a T, kapena kukhala ophweka. Ife ndiye kulankhula yopapatiza lumbar ngalande, lumbar ngalande yopapatiza akadali stenosis wa osachiritsika lumbar ngalande. The stenosis zingakhudze lumbar vertebrae L4 / L5, kumene ngalande kale, m'munsi, yopapatiza, kapena pakakhala aakulu stenosis, ena vertebral pansi (L3 / L4, L2 / L3 kapena L1 / L2) .

Stenosis iyi imayambitsa kupanikizika kwa mitsempha mumsana wa msana kumayambitsa kupweteka komwe nthawi zambiri kumatchedwa "kuwotcha" kumunsi kwa msana, ndi kuwala kwa matako ndi miyendo (neurogenic claudication).

Zowawa izi zimakhala ndi kukulirakulira poyenda kapena mutayima nthawi yayitali. Zimakhala pansi zikamapuma, nthawi zina zimachititsa dzanzi kapena nyerere (paresthesia).

Nthawi zina ngalande iyi ya lumbar imakhala yopapatiza kuyambira pakubadwa. Izi zimatchedwa kuti Constitutional yopapatiza lumbar ngalande.

Cauda equina syndrome

Cauda equina syndrome imatanthawuza za zovuta zomwe zimachitika panthawi ya kukanikizana kwa minyewa yomwe ili kumunsi kwa msana, kudera lino lotchedwa cauda equina. Mitsempha yamagalimoto ndi minyewa yam'miyendo ndi chikhodzodzo ndi rectal sphincters zikumizidwa, zowawa, zomverera, zamagalimoto ndi genitosphincteric zimawonekera.

Lumbar canal stenosis

Chithandizo cha mzere woyamba ndi mankhwala ndi osungira: analgesics, anti-inflammatory drugs, kukonzanso, ngakhale corset kapena kulowa mkati.

Pakachitika vuto la mankhwala osokoneza bongo, ndipo pamene ululu umakhala wolemetsa kwambiri tsiku ndi tsiku kapena lumbar canal stenosis imayambitsa sciatica yakufa ziwalo, ndi kufooka kwa phazi kapena matenda a mkodzo, opaleshoni idzaperekedwa. Laminectomy kapena kutulutsidwa kwa msana kudzachitidwa, opaleshoni yomwe imaphatikizapo kuchotsa vertebral lamina (gawo lakumbuyo la vertebral) kuti amasule msana wopanikizika ndi stenosis. Mulingo umodzi kapena zingapo zitha kuyendetsedwa.

Cauda equina syndrome

Cauda Equina Syndrome ndi vuto lachipatala lomwe limafunikira chithandizo chamsanga kuti mupewe zotsatira zoyipa. Mankhwala a Corticosteroid angaperekedwe kuti athetse ululu musanayambe opaleshoni ya mitsempha. Izi cholinga chake ndikuchepetsa muzu wa minyewa, mwina pochotsa misa yomwe imakakamira (dimba la herniated nthawi zambiri, osati chotupa), kapena ndi laminectomy.

Kuti muzindikire stenosis ya msana, magawo a msana amapangidwa pogwiritsa ntchito CT scan kapena MRI. Zithunzizo zikuwonetsa fupa la vertebral lokhuthala pamtengo wa ngalande ya msana.

Kufufuza kwachipatala kumapangitsa kuti adziwe kuti ali ndi matenda a cauda equina, omwe amatsimikiziridwa ndi MRI yochitidwa mwamsanga.