Hoʻokumu ʻia ka tunnel i ka hui ʻana o ka ʻaoʻao ʻole o ka vertebrae, aia ka ʻāʻī o ke kuamoʻo i ke kuamoʻo a me nā aʻalolo. I kekahi manawa e emi iho, e hoʻopiʻi ana i nā hale neurological.

ʻO ka iwi kuamoʻo, a i ʻole ka iwi kuamoʻo, he pūʻulu o 33 vertebrae: 7 cervical vertebrae, 12 dorsal (or thoracic) vertebrae, 5 lumbar vertebrae, ka sacrum i hana ʻia me 5 fused vertebrae a ma hope o ka coccyx i hana ʻia me 4 vertebrae. Hoʻopili ʻia ka vertebrae e kahi disc vertebral.

Aia ma ka ʻaoʻao hope o kēlā me kēia vertebra he pio, a i ʻole puka. Hoʻohui ʻia ma luna o kekahi, ua hana kēia mau ʻāʻī vertebral i kahi tunnel: ʻo ia ka ʻāʻī kuamoʻo, i kapa ʻia hoʻi ʻo ka spinal canal, aia ka spinal cord a me nā aʻalolo ma kona kikowaena.

Hoʻomaka ka iwi kuamoʻo mai ka vertebra cervical mua a i ka vertebra lumbar lua. Hoʻopau ia ma ke kiʻekiʻe o ka lua o ka vertebra lumbar me ka dural sac i loaʻa i nā aʻa aʻalolo a me nā aʻa o nā wāwae a me ka ʻōpū a me nā sphincters rectal. Kapa ʻia kēia wahi ʻo ka huelo pony.

Kākoʻo a hoʻomalu ke kuamoʻo i ke kuamoʻo. I loko o kēia tunnel i hana ʻia e ke kuamoʻo kuamoʻo, pale ʻia ke kuamoʻo e nā meninges like ʻole: ka dura mater, ka arachnoid a me ka pia mater.

ʻO ka lāʻau liʻiliʻi liʻiliʻi a i ʻole ka stenosis lumbar canal

I kekahi poʻe, ma muli o ke kapa maoli a me ka waimaka (osteoarthritis), aia kahi haʻikiʻi o ke anawaena o ke kuamoʻo ma ke kiʻekiʻe o ka vertebrae lumbar, ʻo ia hoʻi, ma ke kua i lalo, ma luna o ka sacrum. E like me na ami a pau o ke kino o ke kanaka, ua pili maoli na ami o ka vertebrae i ka osteoarthritis i hiki ke alakai i ko lakou deformation me ka mānoanoa o ka hui capsule i ka poino o ke auwai. ʻO ka canal lumbar, he triangular maʻamau ke ʻano, a laila e lawe i kahi ʻano T-haiki, a i ʻole e lilo i ʻāpana maʻalahi. A laila e kamaʻilio mākou e pili ana i ke aʻa lumbar haiki, ʻokiʻoki ʻia ka canal lumbar i ka stenosis mau o ka canal lumbar degenerative. Hiki i ka stenosis ke hoʻopili wale i ka lumbar vertebrae L4 / L5, kahi i kū ai ke kahawai, ma ke kumu, ʻoi aku ka liʻiliʻi, a i ʻole ke ʻano o ka stenosis nui, nā papahele vertebral (L3 / L4, L2 / L3 a i ʻole L1 / L2).

ʻO kēia stenosis ke kumu o ka paʻi ʻana o nā aʻalolo i loko o ke kuamoʻo e hopena i ka ʻeha i wehewehe pinepine ʻia he "puhi" ma ke kua i lalo, me ka irradiation ma ka ʻāʻī a me nā wāwae (neurogenic claudication).

ʻO kēia mau ʻeha ke ʻano nui o ka hele ʻana a ma hope o ke kū lōʻihi ʻana. Hoʻomaha ia i ka wā e hoʻomaha ai, i kekahi manawa e hāʻawi i ke ala i ka numbness a i ʻole nāanu (paresthesia).

I kekahi manawa ua haiki kēia auwai lumbar mai ka hānau ʻana. Kapa ʻia kēia he kumukānāwai narrow lumbar canal.

ʻAulelo Cauda equina

ʻO ka maʻi cauda equina e pili ana i kahi pūʻulu o nā maʻi i hana ʻia i ka wā o ke kaomi ʻana o nā aʻa aʻalolo aia ma ke kua lalo, ma kēia wahi i kapa ʻia ʻo ka cauda equina. ʻO nā aʻa aʻa o nā wāwae a me ka ʻāʻī a me ka rectal sphincters e hoʻopili ʻia, ʻeha, sensory, motor a me nā maʻi genitosphincteric.

Stenosis canal lumbar

ʻO ka lāʻau lapaʻau mua ka lāʻau lapaʻau a me ka conservative: analgesics, anti-inflammatory drugs, rehabilitation, a hiki i ka corset a i ʻole infiltration.

I ka hopena o ka hoʻomaʻamaʻa ʻana i ka lāʻau lapaʻau, a i ka wā e lilo ai ka ʻeha i kēlā me kēia lā a i ʻole ka stenosis lumbar canal e alakaʻi i ka paralyzing sciatica, me ka maʻi maʻi wāwae a i ʻole nā ​​​​maʻi urinary, e hāʻawi ʻia ke ʻoki. A laila e hana ʻia kahi laminectomy a i ʻole spinal cord, kahi hana e wehe ai i kahi lamina vertebral (ʻaoʻao hope o ka vertebral) i mea e hoʻokuʻu ai i ke kuamoʻo i hoʻopili ʻia e ka stenosis. Hiki ke hoʻohana ʻia kekahi pae a ʻoi aku paha.

ʻAulelo Cauda equina

ʻO Cauda Equina Syndrome kahi maʻi ulia pōpilikia e koi ana i ka lāʻau lapaʻau e pale aku i nā hopena koʻikoʻi. Hiki ke hāʻawi ʻia ka lāʻau corticosteroid e hoʻomaha i ka ʻeha ma mua o ka neurosurgery. ʻO kēia ka manaʻo e hoʻohaʻahaʻa i ke aʻa aʻalolo, ma o ka wehe ʻana i ka nui nāna e hoʻopaʻa iā ia (he disc herniated i ka pinepine, ʻoi aku ka paʻakikī o ka ʻōpū), a i ʻole ma ka laminectomy.

No ka hoʻomaʻamaʻa ʻana i ka stenosis spinal, hana ʻia nā ʻāpana ʻāpana o ka spine me kahi CT scan a i ʻole MRI. E hōʻike ana nā kiʻi i ka iwi vertebral mānoanoa ma ka lilo o ke kuamoʻo.

ʻO kahi hoʻokolohua lapaʻau e hiki ai ke hana i kahi hōʻailona mua o ka cauda equina syndrome, i hōʻoia ʻia e kahi MRI i hana wikiwiki.