Izimpawu nokwelashwa kwediski ye-lumbar intervertebral disc

I-disc ye-Herniated ye-lumbar spine - ukuqhuma kwediski ye-intervertebral ngaphandle kwemizimba ye-vertebral esifundeni se-lumbar. Izindawo: L3-L4, kaningi i-L4-L5 ne-L5-S1 (phakathi kwe-lumbar yesihlanu ne-sacral vertebrae yokuqala). Kutholwe ngokususelwa kumlando wezokwelapha, izimpawu zomtholampilo, kanye nokutholwa kwe-CT noma kwe-MRI. Ekwenziweni komtholampilo, ukuze kube lula, ukuqhuma okungaphezulu kuka-5-6 mm ngaphesheya kwe-annulus fibrosus kuvame ukubizwa ngokuthi yi-hernia, ukuphuma okuncane.

Izigaba zeHernia

Ukuvela kwe-hernia kudlula ezigabeni eziningi:

1. I-Prolapse inguquko ngaphansi kwethonya lezinto zangaphandle endaweni yomzimba yediski, ngokuqedwa kwayo ebuyiselwe.
2. Protrusion - i-disc ayidluli imingcele enemibandela yemizimba ye-vertebral, kepha iguqula ngokuqinile isikhundla sayo.
3. Ukukhishwa - i-nucleus pulposus idlulela ngale kwemizimba ye-vertebral.
4. Ukulandelwa kwemingcele - ukuphuma koginindela ngaphandle.

Uma ukuphuma kwe-hernial kufudukele emzimbeni we-vertebra ephakeme noma ephansi, ushintsho lwe-pathological lubizwa ngokuthi yi-Schmorl's hernia.

Ukuvela kwe-hernia kumodeli yama-vertebrae. © rh2010 - stock.adobe.com

Izimbangela nezimpawu

Izimbangela ezivamile ze-hernia zifaka:

• Ukuwohloka kwe-trophism nokuthuthukiswa kwezinguquko ezonakalisayo endaweni yediski ye-intervertebral, ebangelwa:
  • umsebenzi ophansi womzimba;
  • ukukhuluphala ngokweqile ngenxa yokukhuluphala;
  • izinqubo ze-dysmetabolic (ankylosing spondylitis);
  • izifo ezithathelwanayo (isifo sofuba);
  • ukwabiwa okungalungile komthwalo emgogodleni ngenxa ye:
    • i-osteochondrosis;
    • izingozi zomsebenzi (ukushayela njalo);
    • ukuthuthuka kokuthuthuka komgogodla noma ukuhlangana kwe-hip;
    • ukuthambeka okutholakele (i-scoliosis);
• Ukucindezeleka ngokweqile emgogodleni:
  • ukuphakamisa izinsimbi endaweni engakhululekile;
  • ukuhlukumezeka.

Lesi sifo sibonakaliswa yi-lumbodynia, okuthi ekuqaleni kube semvelo okuguqukayo kanye ne-vertebral syndrome (izinguquko ezilinganayo zemisipha-tonic ezakha izimo ezikahle zokuthuthuka kwe-scoliosis).

Kungaba nzima:

• Isifo esibuhlungu, esilawulwa kabi ngamaphilisi ezinhlungu.
• I-Radiculopathy (i-radicular syndrome noma i-lumboischialgia), ihambisana nobunzima bezinguquko zemilenze emilenzeni:
  • ukunciphisa noma ukushintsha ekuzweleni kwesikhumba (paresthesias);
  • i-hypotrophy nobuthakathaka bemisipha.
• I-Myelopathy ebonakala ngo:
  • ukuqothulwa kwe-tendon reflexes nokuthuthukiswa kwe-flaccid paresis emilenzeni;
  • ukuphazamiseka emsebenzini wezitho ze-pelvic (ubunzima bokuchama kanye / noma ukuzikhandla, ukungasebenzi kahle kwe-erectile, ukuqothulwa kwe-libido, ukubukeka kwe-frigidity).

Izinkinga ezichazwe ngenhla ziyizinkomba zokwelashwa okuhlinzwa. Ukubonakala kwezimpawu ze-discogenic myelopathy kuyisisekelo sokuxazulula inkinga yokungenelela okuphuthumayo (inani liphezulu kakhulu futhi imiphumela ingaba yinhlekelele empilweni).

Yikuphi udokotela elapha

Udokotela wezinzwa (i-neuropathologist) welapha i-hernia. Noma yimuphi umtholampilo, osola lesi sifo, nakanjani uzodlulisela isiguli kudokotela wezinzwa ukuze aboniswane, okuthi, ngokususelwa esithombeni somtholampilo sesifo, imiphumela yokwelashwa kwezidakamizwa kanye nedatha ye-MRI, anganikeza ukubonisana kwe-neurosurgeon ukunquma ngokunenzuzo kokwelashwa okuhlinzekwayo.

I-MRI. © Olesia Bilkei - stock.adobe.com

Izindlela zokwelapha

Ukwelashwa kwe-Hernia kungaba ngolondolozayo nokusebenza. Ngokuya ngamasu akhethiwe, ukwelashwa okungahlinzeki kungaba yimithi, i-physiotherapy, ibhukwana noma ukuhlinza.

Ukwelashwa okwenziwa ngesandla

Amasu "ukunciphisa" okwenziwa ngesandla kwama-disc. Isikhathi esimaphakathi sesifundo siyizinqubo eziyi-10-15 njalo ezinsukwini ezi-2.

© glisic_albina - stock.adobe.com

Izidakamizwa

Ekwelashweni kwezidakamizwa, kusetshenziswa le mithi elandelayo:

• Ama-NSAID (izidakamizwa ezingezona ukuvuvukala ezingezona i-steroidal ngendlela yokugcoba noma amaphilisi - iDiclofenac, Movalis); ukusetshenziswa kwezimali kuhloswe ukukhulula izimpawu zobuhlungu.
• ukuphumula kwemisipha emaphakathi (Midocalm, Sirdalud); imishanguzo ikhuthaza ukuphumula okuthambile kwemisipha ebhekana nokucasuka okwenyuka kusuka kumaseli ezinzwa abandakanyeka enqubeni yokugula.
• i-glucocorticoids (iDiprospan, i-Dexamethasone); Izidakamizwa ziyekisa ukuvuvukala, zinikeze umphumela we-analgesic ongaqondile.
• i-paravertebral novocaine blockade, esetshenziselwa ukukhulula ngempumelelo i-syndrome ebuhlungu enzima ukuyelapha ngama-NSAID;
• ama-chondroprotectors namalungiselelo nge-hyaluronic acid (Alflutop, Teraflex, Karipain, Rumalon); kusho ukuthi kunomphumela we-trophic kwizicubu ze-cartilage, okuthuthukisa ukuvuselelwa kwayo.
• amavithamini weqembu B (abambe iqhaza ekubuyiselweni kwezicubu zemizwa kanye neziqu zemizwa).

I-Physiotherapy

Lokhu kwelashwa kufaka:

• traction (kunciphisa umthwalo kuma-disc intervertebral);
• i-acupuncture (iphuzu reflexology); inqubo isekelwe ekunciphiseni kwe-reflex ebukhali besifo se-muscle-tonic;
• i-phonophoresis ne-electrophoresis (izindlela zifaka isandla ekwandeni kwezidakamizwa endaweni ethintekile; ukukhetha imali kuhlala kudokotela oya khona);
• Ukuzivocavoca umzimba (okusetshenziselwa ukudala i-corset yemisipha kusuka emisipheni yomhlane engemuva, eyenzelwe ukuzinzisa umgogodla nokuwukhipha kancane);
• ukubhucungwa (ukujwayeza ithoni yemisipha).

© DedMityay - stock.adobe.com

Ukusebenza

Ezimweni lapho ukwelashwa okulondolozayo kunganikanga imiphumela elindelekile, noma i-disc ye-herniated iguqukile futhi yanikeza izinkinga eziyingozi, ukwelashwa okuhlinzekwayo kubonisiwe, kuhlukaniswe ngemibandela kwaba:

1. ukubhoboza i-laser valorization (ihlinzekela ukususwa komswakama kusuka kuginindela okhubazekile ukukhulisa amandla wediski ye-intervertebral futhi kuvimbele ukwanda okuqhubekayo kokuphrinta);
2. ukwelashwa kwe-electrothermal (imisebenzi efana ne-laser valorization);
3. i-microdiscectomy (eyenziwa lapho usayizi we-hernia ungaphansi kuka-6 mm);
4. i-discectomy (ukususwa okuphelele kwe-hernia);
5. i-laminectomy (ukunwetshwa kokuhlinzwa komsele womgogodla; ukuhlinzwa okuyinkimbinkimbi kwezobuchwepheshe, okunenkathi yokutakula isikhathi eside);
6. ukufakwa kwe-B-Twin-implants (ukusebenza kwenziwa ngemuva kwe-discectomy ukugcina ibanga elifanele le-intervertebral nokuqinisa umgogodla).

Imvamisa, esigabeni esidla ngoludala, ongoti bazama ukuhlanganisa ukwelashwa kwezidakamizwa nezindlela zokwelapha zokuzivocavoca kanye ne-ERT. Ukwelashwa okuyinkimbinkimbi kuhlose ukwehlisa umgogodla ngokuqinisa i-corset yemisipha nemisipha ejulile yangemuva.

Ubunzima bungavela kwabesifazane ngesikhathi sokukhulelwa ngenxa yokuphikisana nokusetshenziswa kwemithi namasu amaningi.

Imithi yesintu

Zisuselwe kumphumela we-reflex ezindaweni ezithintekile ngesikhathi sokuxolelwa.

Zisetshenziswa ngendlela yezingcindezi ezilungiselelwe nge-96% yotshwala bezokwelapha:

Izindlela zokwelapha zokuzivocavoca

Isikhathi sokuzivocavoca sisuka emizuzwini eyi-10 kuye kwesigamu sehora. Yakhelwe ukusetshenziswa kwasekhaya. Indawo ejwayelekile ilele ngomhlane. I-roller kufanele ibekwe ngaphansi kwesifunda se-lumbar. Isimo esithandekayo noma esisemuva naso siyasetshenziswa.

Kumele kukhunjulwe ukuthi lapho kwenziwa izivivinyo, ukunyakaza kwenziwa kahle, futhi i-gymnastics kufanele ilethe umuzwa wenduduzo.

© UJacob Lund - stock.adobe.com. Ukuzivocavoca nge-roller ngaphansi komhlane wakho.

Isakhiwo seGymnastic endaweni yokulala:

• Izingalo zisondele emzimbeni. Ukuhogela nokukhipha umoya kuyenziwa. Lapho uhogela, izingalo nezinyawo ziyazelulela kubo, lapho ziphefumula, izingalo zibuyela endaweni yazo yasekuqaleni, imilenze iyakhululeka.

• Indawo efanayo yokuqala. Ikhanda liphenduka kwesobunxele nangakwesokudla, libambezele phakathi nendawo. Ngokubala izikhathi ikhanda liphendukela kwesobunxele, ekubaleni kwamabili maphakathi, ekubaleni kathathu kwesokudla, ekubaleni kwezine futhi enkabeni.

• Ikhanda ligobile libheke esifubeni, amasokisi abheke wena ngokwakho, ngokubala okubili, ikhanda lisemethini, imilenze iyakhululeka.

• Izandla zihlanganiswe izibhakela, imilenze iqhelelene kancane. Ukunyakaza okuyindilinga kwenziwa ngezandla nezinyawo amahlandla ama-4 ngaphandle nangaphakathi.

• Izandla emahlombe akho. Ukunyakaza okuyindilinga emajoyintini ehlombe, 4 phambili nangasemuva.

• Umlenze wesokudla ugobile emadolweni bese kubalwa u-2 ubekwe ohlangothini, ekubaleni kuka-3 ubuye wagoba emadolweni, ngokubala kwe-4 indawo yokuqala. Okufanayo kuyaphindwa ngomlenze wesobunxele.

• Ingalo yangakwesokudla nomlenze wesobunxele zihlehliswe ngasikhathi sinye ohlangothini. Okufanayo kuyaphindwa nangezinye izitho.

• Unyawo luziqonde lodwa, luzama ukwelula ngemuva komlenze.

• Izandla emzimbeni, imilenze igobile emajoyintini amadolo. Imisipha yesisu ishubile.

• Izandla ngemuva kwekhanda, imilenze iqonde. Isigaxa siyakhuphuka, imilenze ayiphumi phansi.

Ekwehlisweni kwezimo, izinhlelo zokwelashwa kodokotela sezisabalele: uSergei Bubnovsky noValentin Dikul.

Inqubo kaV. Dikul

Inqubo kaValentin Dikul isuselwe ekululekeni okunamandla komgogodla nasekuqiniseni okulinganayo kwemisipha yangemuva ngokuya ngohlelo ngalunye kumishini ekhethekile yokuvuselela eyenzelwe ukwakha i-corset yakho yemisipha ngokugcizelela ezindaweni ezinenkinga. Umphumela wecebo ukulungiswa kwe-scoliosis, kyphosis, kyphoscoliosis yobukhulu obuhlukahlukene.

Ukuzivocavoca nge-bandage enwebekayo ngokusho kohlelo olwenziwe lula kungenziwa ekhaya, lapha sizocubungula okunye okungenzeka. Ukuma kwesikhundla kuqala.

• Yenza ukugoba ngomhlane oqondile. Imilenze ivuleke kancane kunamahlombe, ibhandeshi lingaphansi kwezinyawo, futhi imikhawulo yalo isezandleni ngemuva kwekhanda, izingalo zigobile, izindololwane zisemaceleni. Kuhle ukutshekisa umzimba, ngenkathi ushiya imilenze iqonde, ibhandishi liyadonswa. Buyela endaweni yokuqala.

• Ukuzivocavoca okulandelayo: Phakamisa izingalo zakho ezinhlangothini. Izinyawo ngalesi sikhathi zihlukaniswe ububanzi behlombe, ibhandeshi ngaphansi kwezinyawo, nemikhawulo yayo ezandleni. Ngasikhathi sinye phakamisa izingalo eziqonde phezulu ezinhlangothini ziye ezingeni lehlombe.

• Futhi umsebenzi wokugcina: ukuxuba izandla. Imilenze iphinde ihlukaniswe ububanzi behlombe, izingalo zigobeke kancane ezindololwaneni, ibhandishi lidlula ezingalweni ezingenhla bese lilele emahlombe. Letha izandla zakho phambi kwesifuba sakho bese ubuyela endaweni yokuqala.

Konke ukuzivocavoca kwenziwa izikhathi eziyishumi kuya kwezingama-20, kuya ngesimo, kubalulekile ukubonana nodokotela.

Ukuvivinya umzimba okuyinkimbinkimbi ngu S. Bubnovsky

Ukuzivocavoca nge-birch

Indlela Yokuguqula Umlenze

Amasu wokuzivocavoca "Ixoxo"

Ezemidlalo nge-hernia yomgogodla we-lumbar

Ngokutholakala kwe-intervertebral hernia, okulandelayo kufanele kugwenywe:

• imithwalo ye-axial emgogodleni;
• ukushaqeka imithwalo (isinyathelo aerobics, ukweqa);
• ukwenza ukuphakamisa izinsimbi.

Ukuzivocavoca kwe-disc ye-herniated yomgogodla we-lumbar kuyasiza:

• ukubhukuda (ekuxolelweni, okungcono - ukukhasa);
• Uhlelo lokuzivocavoca umzimba (cishe ama-500);
• ukuqeqeshwa kokuqeqeshwa komzimba;
• amakilasi e-fitball;
• ukudonsa kubha evundlile (yamadoda).

Ukuvimbela

Ngokusekelwe ku:

1. Lawula isisindo somzimba ukuze wehlise umthwalo kuma-disc intervertebral, ikakhulukazi ezindaweni ze-lumbosacral ne-lumbar.
2. Ukukhishwa kwe-hypodynamia, i-hypothermia yomgogodla ongezansi nemithwalo ye-static eyinde (sebenza endaweni ehleliwe - lapha ngokuningiliziwe ngengozi yokuphila ngokweqile).
3. Ukusetshenziswa komatilasi abakhethekile bamathambo.
4. Ukugqoka ama-brace brace kanye nama-corsets akhulula isifunda se-lumbar.
5. Ukuzivocavoca umzimba. Isethi yokuzivocavoca ihlose ukuqinisa imisipha yangemuva futhi ikhethwe yodwa ngumfundisi.
6. Ukuphulukisa ukuhamba. Kufanele uhambe kahle ngokusukela esithendeni kuye ozwaneni.
7. Ukugwema ukucindezeleka okungazelelwe emgogodleni; ukunyakaza kufanele kube bushelelezi ngangokunokwenzeka.
8. Ukudla ukudla okunothe ngamavithamini B kanye ne-cartilage derivatives.

Bukela ividiyo: Lumbar Herniated Disc Overview (Novemba 2024).