ʻO ke kuamoʻo lumbar, a i ʻole ke kuamoʻo lumbosacral, pili i ka ʻāpana o ke kuamoʻo aia ma ka ʻaoʻao i lalo, ma luna pono o ka sacrum. Kahi paʻa loa a kākoʻo i ke koena o ka iwi kuamoʻo, hoʻohana nui ʻia ia i kēlā me kēia lā a i kekahi manawa ka mea i hōʻeha ʻia i ka ʻelemakule ʻōpio. Eia kekahi, ʻo ka iwi kuamoo ka paena pinepine o ka ʻeha, nā kumu i hiki ke lehulehu.

ʻO ka huaʻōlelo kuamoʻo e pili ana i ka iwi kuamoʻo. Hana ʻia ia i kahi ʻōpala o nā vertebrae ʻokoʻa: 7 vertebrae cervical, 12 dorsal (a i ʻole thoracic) vertebrae, 5 lumbar vertebrae, ka sakuma i hana ʻia e 5 fused vertebrae a ʻo ka hope ka coccyx i hana ʻia e 4 vertebrae.

ʻO ka iwi lumbar e pili ana i ka ʻaoʻao haʻahaʻa o ke kuamoʻo, aia ma luna pono o ka sakum. Hana ʻia ia i ʻelima vertebrae lumbar: ʻo ka L1, L2, L3, L4 a me ka L5 vertebrae.

Pili kēia mau vertebrae ʻelima a haʻi ʻia ma ka hope e nā hono facet, a ma ka mua e nā iwi kuamoʻo. Ma waena o kēlā me kēia vertebra, puka ke aʻa aʻa ma nā puka i kapa ʻia ʻo foramina.

Hōʻike ka iwi lumbar i kahi pio kiki i ka hope, i kapa ʻia ʻo lumbar lordosis.

E like me ke koena o ka iwikuamoʻo, pale ka iwi lumbar i ka iwi kuamoo a i ka L1-L2 vertebrae, a laila nā iwi ʻalalā mai ka L1-L2.

ʻO Dynamically, ma muli o kona wahi, kākoʻo ka iwi lumbar i ke koena o ka iwikuamoʻo a hōʻoia i ka neʻe. Pāʻani pū kekahi i ke ʻano o ka mea hoʻopūʻiwa a me ka hoʻoili ukana ma waena o ka pelvis a me ka thorax. ʻO nā mākala kūkulu o ka iwi kuamoʻo, i kapa ʻia hoʻi nā mākala iwi kuamoʻo, kahi e hohola ma nā ʻaoʻao ʻelua o ke kuamoʻo e kōkua i ka hoʻopakele ʻana i kekahi o kēia kaomi i kau ʻia ma ka iwi kuamoo.

Ma muli o ka paʻakikī anatomical, nā kūkulu neurological i loaʻa iā ia, nā kaena mīkini o kēlā me kēia lā e kākoʻo ʻia akā ʻo ka ʻelemakule ʻōnaehana o kāna mau ʻano ʻano like ʻole, hiki i ka lumbar spine ke hoʻopili ʻia e nā pathology he nui. Eia nā mea nui.

ʻO kaʻeha hope loa

ʻO ke ʻeha o ke kua i lalo ka manawa umbrella no ka ʻeha o lalo. I kāna mau manaʻo hou loa e pili ana i ka mālama ʻana i ka ʻehaʻeha o ke kua, ua hoʻomanaʻo ka HAS (Haute Autorité de Santé) i kēia wehewehe ʻana: Hiki ke hoʻopili ʻia me radiculalgia e kūlike i ka ʻeha i hoʻokahi a i ʻole nā ​​lālā haʻahaʻa i hoʻokahi a ʻoi paha nā dermatome. “

Ma ka ʻepekema, hiki iā mākou ke hoʻokaʻawale:

• ʻeha haʻahaʻa haʻahaʻa maʻamau, ʻike ʻia e ka ʻehaʻeha o ka hoʻi i ʻole nā ​​hōʻailona hōʻailona. Ma 90% o nā hihia, hoʻololi maikaʻi ʻia ka ʻehaʻeha haʻahaʻa ma lalo o 4 a 6 mau pule, hoʻomanaʻo ʻo ka HAS;
• ʻehaʻeha hope loa, ʻo ia hoʻi ka ʻeha o ke kua haʻahaʻa i ʻoi aku ma mua o 3 mau mahina;
• ka "huʻi nui o ka ʻeha hope" a i ʻole ʻehaʻeha hope, a i ʻole lumbago i ka ʻōlelo o kēlā me kēia lā. He ʻehaʻeha nui ia, kūlohelohe no ka mea pinepine ma muli o kahi neʻe hewa, ka hāpai ʻana i kahi ukana kaumaha, kahi hana hoʻoweliweli (ka "turn of the kidney" kaulana). 

ʻO Lumbar e wehewehe i kānaʻike

Hōʻike ʻia kahi diski herniated e kahi protrusion o ka nucleus pulposus, ka ʻāpana gelatinous o ka disk intervertebral. E kaomi kēia hernia i hoʻokahi a i ʻole nā ​​aʻa aʻa, e hōʻeha ana i ka ʻeha a i ʻole ka ʻeha o ka ʻūhā ma muli o kahi o ka hernia. Inā pili ka L5 vertebra, ʻo ka hernia ke kumu o sciatica i hōʻike ʻia e ka ʻeha i ka ʻūhā, e iho ana i ka wāwae i ka manamana nui.

ʻO ka osteoarthritis lumbar

ʻO Osteoarthritis, kahi mea hoʻomanaʻo he maʻi hōʻino o ka cartilage, hiki ke hoʻopili i nā hono ma waena o nā vertebrae ʻelua. ʻAʻole hiki i kēia lumbar osteoarthritis kumu i kekahi mau ʻōuli, no ka mea, hiki ke alakaʻi i nā iwi ulu i kapa ʻia he osteophytes, ka mea e hoʻonāukiuki ai ke aʻalolo, e ʻeha ai ke kua i lalo.

Lumbar spinal stenosis a i ʻole lumbar canal canal

ʻO ka lumbar stenosis kahi mea liʻiliʻi o ka auwai waena o ka iwi kuamoʻo, a i ʻole ke aʻa lumbar, kahi i loaʻa nā aʻa aʻa. Pili pinepine ia i ka makahiki, a hoʻolilo i ka paʻakikī i ka hele wāwae ʻana me ka naʻau o ka nāwaliwali, numbness, ʻūlū ʻana i nā wāwae, sciatica e hana ana i ka hoʻomaha a i ka wā o ka hoʻoikaika ʻana, a kākaʻikahi loa ka maʻi lōlō. ʻoi aku a i ʻole mea nui o nā lālā o lalo a i ʻole nā ​​hana sphincter.

ʻO ka maʻi maʻi Lumbar

ʻO ka maʻi dis Degenerative disc, a i ʻole ka hoʻohaʻahaʻa disk, ʻike ʻia e ka wā ʻōpio o ka intervertebral disk a me ka holomua holomua o kāna kikowaena gelatinous. Hoʻopili ʻia ka pāpaʻi a hoʻonāukiuki ʻia nā aʻa aʻa, kahi e ʻeha ai ka ʻaoʻao haʻahaʻa. Ua manaʻo ʻia ka maʻi ʻo Degenerative disc ke kumu nui o ka ʻehaʻeha o ke kua.

Scoliosis lumbar degenerative

Hōʻike ʻo Degenerative lumbar scoliosis iā ia iho me he deformity o ka iwikuamoʻo. ʻOi aku ka maʻamau i nā wahine, keu hoʻi ma hope o ka menopause. Hōʻike ia iā ia iho e ka ʻeha o ke kua a ma ka puʻupuʻu, e hoʻomālamalama ana i ka ʻūhā, hoʻonui pinepine ʻia me ka hele wāwae. ʻO ka degenerative lumbar scoliosis ka hopena o ke ʻano o nā kumu: ka ʻole o ka diski kahi i hoʻohui ʻia ka nele o ke kani o nā mākala, ka osteoporosis a me ka palupalu ligament spinal.

Spondylolisthesis degenerative

Pili kēia pathology i ka ʻelemakule kūlohelohe o ka iwi kuamoʻo e hōʻike iā ia iho ma ka heʻe ʻana o kekahi vertebra ma kekahi, ʻo ka L4-L5 maʻamau. ʻO ka stenosis canal lumbar a me kāna mau ʻōuli e ukali.

Uha lumbar

Hiki ke haki o ka iwi kuamoʻo i ka manawa o kahi hopena ikaika loa (kahi ulia alanui). Pili paha kēia haʻi ʻōiwi me ka ʻeha i ka iwi kuamoʻo a me / a i ʻole nā ​​aʻa aʻa, ʻo ka makaʻu ka palalysis. Hiki i ka haki ke paʻa ʻole, a i ka hanana o ka neʻe ʻana i ke kula kiʻekiʻe e alakaʻi i kahi hopena neurological.

ʻO kaʻeha hope loa

I loko o kāna mau manaʻo hou loa e pili ana i ka mālama ʻana i ka ʻehaʻeha haʻahaʻa haʻahaʻa maʻamau, hoʻomanaʻo ʻo HAS ʻo ka hoʻoikaika kino ka hana nui e ʻae ai i ka ulu maikaʻi o kēia pathology. Hōʻike ʻia hoʻi ʻo Physiotherapy. E pili ana i ka lāʻau lapaʻau, hoʻomanaʻo ʻia "ʻaʻole i hōʻoia ʻia kahi lāʻau analgesic i loko o ka manawa waena i ka hoʻomohala ʻia ʻana o kahi ʻeha nui o ka ʻehaʻeha o ke kua, akā ua puka ka analgesic management, e hoʻomaka ana me ka analgesics level I (paracetamol, NSAIDs), hiki ke hoʻokō ʻia e hōʻoluʻolu i nā hōʻeha hōʻeha ". Kākoʻo hoʻi ka HAS i "ke koʻikoʻi o ka mālama honua ʻana o ka mea maʻi i ʻike ʻia ʻo" bio-psycho-social ", me ka noʻonoʻo ʻana i ka ʻike o ka mea hoʻomanawanui a me nā hopena o kona ʻeha (nā nui o ke kino, ka noʻonoʻo a me ka ʻoihana ʻoihana).

ʻO ka disc

ʻO ka lāʻau lapaʻau mua he hōʻailona: analgesics, anti-inflammatory drug, infiltrations. Inā holo pono ʻole ka lawelawe ʻana, hāʻawi ʻia paha ke ʻoki. ʻO ke kaʻina hana, i kapa ʻia he discectomy, pili i ka hemo ʻana i ka hernia i mea e decompress ai i ke aʻa aʻa i hoʻonāukiuki ʻia.

Lumbar stenosis

ʻO ka mālama ʻana i ka laina mua he conservative: analgesics, anti-inflammatories, rehabilitation, even corset or infiltration. Inā holo pono ʻole ka lāʻau lapaʻau, hāʻawi ʻia paha ke ʻoki. ʻO ke kaʻina hana, i kapa ʻia ʻo laminectomy a i ʻole hoʻokuʻu hoʻokuʻu iwi kuamoo, pili i ka lawe ʻana i kahi lamina vertebral e hoʻokuʻu ai i ke aʻa o ka iwi kuamoʻo.

ʻO ka maʻi Disiki Degenerative

ʻO ka lāʻau lapaʻau mua he hōʻailona: analgesics, lāʻau anti-inflammatory, infiltrations, rehabilitation function. E noʻonoʻo ʻia ke kaha ʻana inā loaʻa ʻole ka lāʻau lapaʻau a me ka hōʻeha ʻana i ka ʻeha i kēlā me kēia lā. ʻO ka Lumbar arthrodesis, a i ʻole ke kuʻi ʻana o ka iwi maha, komo i ka wehe ʻana i ka disikia poino a laila kau i kahi lāʻau lapaʻau ma waena o nā vertebrae ʻelua e mālama i ka kiʻekiʻe o ka disk.

Scoliosis lumbar degenerative

ʻO nā analgesics, nā lāʻau anti-inflammatory a me nā injection i hoʻokumu ʻia i ka lāʻau lapaʻau hōʻailona mua. Inā loaʻa ʻole ka ʻeha a hōʻeha hoʻi i ka ʻeha, hiki ke noʻonoʻo ʻia ke ʻoki. A laila e hoʻoholo ka arthrodesis e hoʻohui i ka papa vertebral mobile loa a decompress i nā aʻa nerve.

Uha lumbar

Pili ka mālama ʻana i ke ʻano o ka haki a me nā neurological pili a i ʻole ʻaʻole. E ʻoki ana ke ʻoki kino, kaukaʻi ʻia i ka hihia, e hoʻihoʻi i ke kūpaʻa o ka iwi kuamoʻo, e hoʻihoʻi i ka anatomy o ka vertebra i haki, e hoʻohaʻahaʻa i nā hanana neurological. No kēia, hoʻohana ʻia nā ʻenehana ʻokoʻa: arthrodesis, hoʻonui ʻōiwi, etc.

Spondylolisthesis degenerative

I ke kūleʻa ʻole o ka lāʻau lapaʻau (analgesics, anti-inflammatory drug and infiltrations), hiki ke noʻonoʻo ʻia ka arthrodesis.

X-ray iwi kuamoʻo lumbar

Loiloi kēia loiloi maʻamau i ka morphology āpau o ka iwi kuamoʻo. Hoʻonohonoho pinepine ʻia ia ma ke ʻano he lālani mua no ka ʻehaʻeha o ke kua. Hiki iā ia ke ʻike i ke alo o nā lepa degenerative (lumbar osteoarthritis), vertebral compression a i ʻole morphological abnormalities o ka vertebrae, kahi mea maʻamau o nā statics (scoliosis) a i ʻole kahi slippage o ka vertebrae. Ma ka ʻaoʻao ʻē aʻe, ʻaʻole hiki ke hana i ke kuhi hewa i ka haki o ka vertebral. ʻO nā diski, ka iwi kuamoo, nā aʻa aʻa nā radiolucent kūkulu (ʻae lākou e hala nā X-ray), ʻaʻole hōʻike ka x-ray o ka iwi lumbar i nā diski herniated a i ʻole nā ​​pathologies o ka iwi kuamoʻo.

MRI o ka iwi kuamoo

ʻO MRI ka hoʻokolokolo maʻamau o ka iwi kuamoo, i mea e ʻike ai i nā pathologies o ka iwi kuamoʻo. ʻAe ia e nānā i nā ana 3 i nā ʻāpana iwi a me nā ʻāpana palupalu: kaulaʻi iwi, ligament, disc, nā aʻa nerve. A pēlā e kuhikuhi ai i nā ʻano pathologies like ʻole o ka iwi lumbar: herniated disc, degenerative disc disease, disc protusion, lumbar stenosis, inflammation of the vertebral plate, etc.

ʻO ka lumbar spine CT scan

ʻO ka lumbar CT scan a i ʻole ka tomography i helu ʻia ʻo ia ka hoʻokolokolo maʻamau i ka hanana o ka haʻi o ka iwi kuamoʻo. Hiki iā ia ke kuhi i kahi diski herniated, loiloi i ke kēkelē o ka lumbar stenosis, ʻike i nā metastases iwi iwi. Hoʻonohonoho ʻia ia hoʻi ma ke ʻano he ʻāpana o ka loiloi mua o nā ʻōpala, ʻoiai e nānā i ke kūlana o nā moku.