Contents
Canal medullary
ʻO ke kuamoʻo ka lua e hoʻopili ana i ke kuamoʻo ma ka puʻuwai o ka iwi kuamoʻo. Hiki iā ia ke kahua o nā ʻano ʻano like ʻole, e hoʻopiʻi ai i ke kuamoʻo e hōʻeha ai i ka ʻeha, ka motika a me nā maʻi ʻike.
Anatomy
ʻO ka canal medullary, i kapa ʻia hoʻi ʻo ka medullary cavity, ʻo ia ka lua o ka iwi kuamoʻo i loko o ke kuamoʻo.
Ma ke ʻano he hoʻomanaʻo, ʻo ka spinal cord, a i ʻole spinal cord, he ʻāpana ia o ka ʻōnaehana nerve waena. ʻO ka hoʻolōʻihi ʻia o ka lolo, ʻo kēia kaula o kahi kanahā kenimika e hiki ai ke hoʻouna i ka ʻike ma waena o ka lolo a me ke kino, ma o nā aʻalolo kuamoʻo e puka mai ana mai loko mai o nā lua hui.
maʻi physio
Hoʻopili a hoʻopaʻa ʻia ke kahawai medullary i ke kuamoʻo.
Nā Anomalies / Pathologies
Pāʻina kaula iwi kuamoʻo
Ke kamaʻilio nei mākou e pili ana i ka hoʻopiʻi ʻana i ke kuamoʻo i ka wā e hoʻopili ʻia ai ke kuamoʻo a me nā aʻalolo e hoʻokaʻawale mai ia mea e kahi ʻeha. ʻO kēia kaomi ʻana a laila e hoʻoulu ai i ka ʻeha ma ke kua, irradiation a i nā hihia koʻikoʻi loa o nā maʻi kaʻa, sensory a me ka sphincter.
Hiki ke loa'a ka ma'i i ho'opi'i 'ia ma waho o ke kuamo'o (extramedullary lesion) a i loko paha (intramedullary lesion) a ma muli o kona 'ano, he acute a ma'i paha. Hiki ke:
- he disc herniated
- he hematoma subdural a epidural paha ma hope o ka ʻeha i alakaʻi ʻia i kahi ligament a i ʻole ʻeha iwi, kahi ʻeha lumbar, ka lawe ʻana i ka anticoagulant.
- he haʻihaʻi, ka hoʻoemi ʻana i ka iwi hope me nā ʻāpana iwi, kahi dislocation vertebral a i ʻole subluxation.
- he maʻi koko (ʻoi aku ka metastatic extramedullary tumor)
- he maningioma, he neuroma
- he abscess
- hoʻoemi iwi ma muli o ka osteoarthritis
- he hōʻino ʻana i ka arteriovenous
- cervicarthrosis myelopathy
ʻO Cauda Equina Syndrome
ʻO ka ʻāpana o ka spinal cord aia ma ka pae o ka vertebrae lumbar hope loa a me ka sacrum, a mai laila e puka mai ai nā aʻa aʻalolo he nui i pili i nā lālā haʻahaʻa a me nā sphincters, ua kapa ʻia he ponytail.
I ka wā e noho ai ke koʻikoʻi o ke kuamoʻo ma ke kiʻekiʻe o kēia huelo, ʻo ka pinepine ma muli o kahi disc herniated, hiki iā ia ke alakaʻi i ka maʻi cauda equina. Hōʻike ʻia kēia e ka ʻeha haʻahaʻa hope, ka ʻeha ma ka ʻāpana perineum a me nā lālā haʻahaʻa, ka nalowale o ka manaʻo, ka maʻi maʻi hapa a me nā maʻi sphincter. He ulia pōpilikia kēia.
ʻO ka medullary infarction
ʻAʻole kakaikahi, ʻo ka lesion ma ke kumu o ka hoʻoemi ʻana i ke kuamoʻo e hoʻolohi i ka vascularization arterial, a laila alakaʻi i kahi infarction medullary.
Nā hōʻailona
Ho'āla
ʻO ka ʻokiʻoki ka lāʻau maʻamau no ka hoʻopaʻa ʻana i ke kuamoʻo. ʻO ka hana, i kapa ʻia ʻo laminectomy, ʻo ia ka wehe ʻana i ka ʻaoʻao hope o ka vertebra (a i ʻole ka lau) e pili ana i ka ʻeha, a laila wehe ʻia i mea e hoʻohaʻahaʻa ai i ka momona a me kona mau aʻa. Hiki i kēia hana ke kālailai i ka lesion.
I ka hihia o ka cauda equina syndrome, pono e hana koke ʻia kēia hōʻoki decompression i mea e pale aku ai i nā kaʻa koʻikoʻi, sensory, sphincter a me nā sequelae moe kolohe.
Inā he hematoma a i ʻole he abscess ka ʻeha e hoʻopiʻi ai i ke kuamoʻo, e hoʻokahe ʻia kēia mau mea.
ʻO ke kelepona
I ka hihia o ka ma'i ma'i 'a'ai, ua hui 'ia ka radiotherapy i kekahi manawa me ke oki.
PalekanaEND_LINK
Ka hoʻokolokolo hoʻokolohua
Ke alo nei me ka ʻeha kaʻa, sensory, sphincter a i ʻole ka hoʻomaka koke ʻana o ka ʻeha hope, pono ke kūkākūkā me ka ʻole o ka kali. E hana mua ke kauka i kahi hoʻokolohua lapaʻau e alakaʻi i ka hōʻailona ma muli o nā hōʻailona a me ka palpation o ka spine.
MRI
ʻO MRI ke kūlana gula no ke kuamoʻo. Hiki iā ia ke ʻimi i ke kahua o ka hoʻopaʻa ʻana i ke kuamoʻo a kuhikuhi i kahi ʻike mua e pili ana i ke ʻano o ka lesion. Ma muli o ka hōʻailona no ka hoʻokolokolo, hiki ke hana ʻia kahi injection o Gadolinium.
CT myelography
Ke hiki ʻole ke MRI, hiki ke hana ʻia ʻo CT a i ʻole CT myelography. ʻO kēia hoʻokolohua ʻo ia ka hoʻokomo ʻana i kahi huahana opacifying i loko o ke kaila spinal i mea e ʻike ai i nā kihi o ka spinal cord ma nā x-ray.
X-ray iwi kuamoʻo
Inā manaʻo ʻia kahi ʻeha iwi, hiki ke lawe ʻia nā kukui X o ka spine me ka MRI.
Medullary arteriography
I kekahi mau hihia, hiki ke hana ʻia kahi arteriography e ʻimi ai i kahi ʻeha vascular. Loaʻa ia i ka injecting, ma lalo o ka anesthesia kūloko, kahi huahana ʻokoʻa a laila lawe i nā ʻano kiʻi i ka wā o ka arterial a me venous circulation phase o kēia huahana.