Me ako tātou mō tō tuara o raro (Lumbar Spine). He aha rawa tēnei?

He mamae tō tuara o raro i ētahi wā? Ina noho roa koe i te wāhi kotahi, ina hiki rānei koe i tētahi kawenga taumaha, ko te tuara o raro te wāhanga tino taumaha. Nō reira, i tēnei rā ka kōrero tātou mō te tuara o raro, he wāhanga tino nui o tō tātou tinana, e kiia nei e ngā tākuta , ko te tuaiwi hope . Me mārama noa tātou he aha te mea nei, he aha ngā ratonga e whakaratohia ana e ia ki tō tātou tinana, he aha ngā raruraru ka pā mai, me ngā otinga mō ēnei.

He aha te tuaiwi lumbar?

Ki te whakarāpopototanga, e rima ngā wheua o te tuaiwi hope (e kiia ana ko ngā vertebrae) kei raro i tō tuara. Ka karangatia ēnei wheua e rima e ngā tākuta ko L1, L2, L3, L4, me te L5. (Ko te L te tikanga o te lumbar.) He nui ake, he matotoru ake hoki ēnei vertebrae hope i ngā vertebrae kē atu o tō tuaiwi katoa, he rite ki te kohatu tapawhā.

Whakaarohia, kei raro iho i ngā tuaiwi 12 o tō uma te tuaiwi hope (e kiia ana ēnei ko ngā tuaiwi thoracic) ā, kei runga ake i te wheua tapatoru e kiia nei ko te sacrum, he mea kei raro iho anō hoki.

Nā te nui o ēnei tuaiwi hope, ka pai te pumau o tō tātou tuaiwi. Waihoki, he maha ngā uaua me ngā hononga e hono atu ana ki tēnei wāhanga. Ko te mea nui, ko tēnei tuaiwi hope te mea e pikau ana i te taumaha nui rawa atu o tō tinana. Ehara i te mea koinā anake, engari ka āwhina anō hoki i a koe ki te pupuri i tō taurite. Mā ngā uaua me ngā hononga e piri ana ki tēnei tuaiwi hope ka āwhina i a koe ki te hikoi, ki te oma, ki te noho, ki te hiki i ngā mea, ki te piko me te takahuri i tō tinana ki ngā taha katoa.

He piko pakupaku kei roto i tō tuaiwi hope. Ka kiia he piko lordotic .

He aha te mea ka tupu ki te tuaiwi lumbar?

Kia tirohia ētahi o ngā mea e tupu ana i roto i tō tātou tuara o raro:

• Ka tautoko i tō tinana o runga, ka tohatoha hoki i tō taumaha: Ko te tuaiwi hope tēnei e tautoko ana i te taumaha o tō mahunga, me ngā tuaiwi e whitu o tō kaki (e kiia nei ko te tuaiwi kaki) me ngā tuaiwi tekau mā rua o tō uma (te tuaiwi uma). E hono ana hoki ki tō hope, koia te mea e pikau ana i te taumaha nui rawa atu o tō tinana, ā, e pikau ana i te pēhanga ina hiki, ina kawe rānei koe i tētahi mea. Koinei te wāhanga e whakawhiti ana i te taumaha o tō tinana o runga ki ō waewae.
• Āwhina i a koe ki te neke i tō tinana: Mā ngā uaua o tō tuara o raro me te ngāwari o tō tuaiwi hope ka taea e koe te piko i tō tinana ki ngā taha katoa (whakamua, whakamuri), te piko ki te taha, te hurihuri katoa, me te takahuri. Ko ngā tuaiwi hope e rua (L4, L5) te mea tino āwhina i ēnei nekehanga.
• Ka Tiaki i tō Taura Tuaiwi me te Cauda Equina: Ko te taura tuaiwi, e rere ana i roto i tō tuaiwi, he rite ki te taura io matua mai i tō roro. Ka tīmata i te pūtake o tō angaanga ka mutu i te tuara tuatahi o te hope (L1). Kātahi ka puta he paihere io e rere ana i te pito o te taura tuaiwi. He rite ki te hiku hōiho nā te meaKo tōna ingoa ko te cauda equina (ko te tikanga ko te hiku o te hōiho). Ko tēnei taurakira, ko te cauda equina, e tiakina ana e te hipoki i hangaia mai i ēnei tuaiwi.
• Whakahaere i ngā nekehanga o ngā waewae: Ko ngā io e puta mai ana i tō taurakira o raro me te cauda equina e whakahaere ana i ngā kare ā-roto me ngā nekehanga o ō waewae.

He aha ngā uaua me ētahi atu kiko ngohengohe kei roto i te tuaiwi hope?

Ngā uaua o te tuaiwi lumbar

Ko ō uaua o raro o te tuara, me ō uaua o raro o te puku, ka neke i tō tinana me tō tuara o raro. Mā ēnei uaua me ngā hononga e whakarato te kaha me te pumau ki tō tuara o raro, e āwhina ana i a koe ki te piko whakamua, ki muri, me te hurihuri. Anei ētahi o ngā uaua matua e hono ana ki te tuaiwi hope:

• Latissimus Dorsi: He uaua nui, papatahi, tapatoru tēnei. Ka rere i waenganui o tō tuara me raro. Ka āwhina i a koe ki te hiki i ngā taumaha ki ō ringaringa, te hiki i tō uma ina manawa koe, me te piko i tō tuara ki te taha.
• Iliopsoas: He rōpū uaua tēnei e toru. Ka nekehia tō hononga hope. Ka āwhina tēnei uaua ki te pupuri i tō hope me tō tuara o raro kia pumau ina hikoi, ina oma, ina ara ake koe i te tūru.
• Ngā uaua paraspinal: Kei te taha o tō tuaiwi ēnei rōpū uaua e toru. Ka āwhina i a koe ki te tū tika, ki te piko ki te taha, me te hurihuri. He mea nui hoki ēnei mō te pupuri i tō tū.

Ngā kōpae i roto i te tuaiwi lumbar

Ko ngā kōpae o waenga i ngā tuaiwi he wāhanga o te tuaiwi e mahi ana pērā i ngā "urunga ātete ru" i waenganui i ngā tuaiwi e rua. E rima o ēnei kōpae i waenganui i ō tuaiwi hope. Haunga te mimiti i te ru, ka āwhina hoki ēnei kōpae ki te tautoko i te taumaha e haere ana i raro i tō tuaiwi, ā, ka taea te neke i waenga i ngā tuaiwi.

He mea nui: Ko tēnei kōpae i tō tuara o raro te mea tino pea ka pirau, ka hernia rānei. Koinei te wā ka tīmata koe ki te rongo i te mamae i tō tuara o raro, i raro rānei i ō waewae, i ētahi wā ki ō waewae.

Ngā hononga o te tuaiwi lumbar

Ko ngā hononga ko ngā kiko e hono ana i tētahi wheua ki tētahi atu. Mā ngā hononga i roto i te tuaiwi hope ka āwhina i te pupuri i te tuaiwi kia pumau, kia maeneene te nekehanga, ā, ka āwhina hoki ki te mimiti i te pānga mēnā ka pā mai he aituā. Ko ētahi o ngā hononga matua ko:

• Hononga Roroa o Mua: Ka rere tēnei i te taha mua o ngā tuaiwi hope. Ka whakau i ngā hononga hope, ā, ka whakawhāiti i te piko whakamuri (toro).
• Te hononga roa o muri: Ka rere tēnei i te tuara o ngā tuaiwi hope. Ka whakawhāiti i te piko whakamua.
• Hononga o runga/hononga o roto o te pito:Ka āwhina hoki tēnei here ki te whakaiti i te piko whakamua.
• Ligamentum Flavum: Ka hipokina e ēnei te roto o te awa tuaiwi, ā, ka tiakina te taurakira mai i muri.
• Ngā hononga whakawhiti-whiti: Ka hono ēnei i ngā tukanga whakawhiti o ngā tuaiwi. Ka āwhina rātou ki te ātete i te piko taha o tō tinana.
• Te hononga Iliolumbar: Ka rere tēnei mai i te tuara L5 ki te wheua pelvis. Ka āwhina i te whakau i te tuaiwi lumbosacral.

Te Taura Tuaiwi me ngā Io

E ai ki tā tātou i kōrero ai, he paihere io te taurakira e toro atu ana i te roro ki te tuarā L1. Koinei te mea e kawe ana i ngā karere mai i te roro ki ngā uaua. Ko ngā pakiaka io e heke iho ana i muri i te L1 e kiia ana ko te cauda equina .

E rima ngā takirua io e puta ana i tō tuaiwi hope (L1 ki L5, kotahi i ia taha). Ka haere ēnei io i tō tuaiwi ka hono atu ki ētahi atu io hei hanga i tētahi whatunga io e whakahaere ana i te mamae, te kare ā-roto, me te nekehanga o ō waewae o raro.

• Io L1: Ka whakarato i te kare ā-roto ki tō rohe hope me ngā ira tangata, ā, ka āwhina i te neke i ngā uaua o tō hope.
• Ngā io L2, L3, L4: Ka hoatu he rongo ki te taha mua o tō huha me te taha roto o tō waewae o raro. Ka whakahaere hoki i te nekehanga o ngā uaua o te hope me te turi.
• Io L5: Ka rongo i te tuara o tō waewae o raro, te tihi o tō waewae, me te rohe i waenganui i tō māhunga nui me tō māhunga tuarua. Ka whakahaere hoki i te nekehanga o ō hope, turi, waewae, me ō māhunga.
• Io Sciatic: Ka hangaia tēnei e ngā io L4, L5, me ētahi atu io sacral. Ka tīmata i roto i tō papa, ka rere ki raro i tō waewae, ā, ka mutu ki tō waewae. Ka puta te mamae sciatica ina pakaru, ina pēhia rānei tēnei io.

Ngā oko toto

Ka whiwhi toto me ngā matūkai i ngā tuaiwi, ngā uaua, me ngā hononga i te rohe hope mai i ngā manga e ahu mai ana i te aorta puku, te uaua matua i roto i tō puku.

He aha ngā mate me ngā āhuatanga e pāngia ai te tuaiwi lumbar?

Engari, he maha ngā raruraru ka pāngia e tēnei wāhanga o raro o tō tātou tuaiwi. Ka taea e ēnei raruraru te whakawhāiti i te whānuitanga o te nekehanga o tō tuara, o tō hope rānei, ā, ka mamae, ka ngoikore, ka ngoikore hoki tō tuara, ō hope, ō huha, ō waewae rānei.

Ko ētahi o ngā mate me ngā āhuatanga e pā ana ki te tuaiwi lumbar ko:

• Mamae o te tuara o raro: He raruraru noa tēnei mō te tini o te tangata. Ka taea te puta mai i ngā momo whara me ngā āhuatanga. Ngā mate whakaheke (hei tauira, te Osteoarthritis , te Ankylosing Spondylitis ), te Spinal Stenosis , te Herniated DiscKa pā mai pea te mamae o te tuara i ngā āhuatanga pēnei i te kopikopiko o ngā io, te whāwhā, te whati o te tuaiwi, te pukupuku, te kiore, te whēkau wheua, me te spondylolisthesis (te paheke o te tuaiwi).
• Te Mate Pūngāwerewere o te Tutukitanga o te Tua: He whakawhāiti tēnei o te wāhi huri noa i tō taurakira. Ka whakaitihia te wāhi mō ngā io e puta ana i te taurakira. Ka pā mai pea te pēhanga o ngā io, te mamae, te ngoikore o ngā waewae, te hope, te papa, me te tuara o raro. Ka kino ake pea ēnei tohu ina hikoi, ina tū rānei, ā, ka taea te whakamamae mā te takoto, te noho, te piko rānei ki mua.
• Spondylolisthesis: Koinei te wā e paheke whakamua ai te tuaiwi o te hope i te tuaiwi i raro iho. Ka taea e tēnei te pēhi i te io, ā, ka mamae te tuara, te waewae rānei.
• Te Whati Pehi o te Tuarā: Ka taea e te tangata whai mate pēnei i te osteoporosis te pāngia e te whati pehi o te tuarā ahakoa he aituā iti noa iho. Ka taea hoki e ngā whati kino te puta mai i ngā mea pēnei i ngā aituā motuka me te hinganga mai i ngā teitei.
• Sciatica: E mōhiotia ana ko te lumbar radiculopathy , he mamae io tēnei i puta mai i te kino, i te mumura rānei o te io sciatic. Ka puta pea i ngā mea pēnei i te herniated disc, te spondylolisthesis, te osteoarthritis rānei.
• Kōpae Herniated: Ka puta tēnei ina pupuhi, ka haehae, ka turuturu rānei te kōpae i waenganui i ngā tuaiwi. Ka mamae pea te tuara, ka ngoikore ngā waewae, ka ngoikore hoki ngā uaua.
• Lumbar Lordosis (e mōhiotia ana ko "Swayback"): He piko rawa tēnei o te tuara o raro. Ka pēhia ngā tuaiwi o te hope e te mate, te tū kino, me te piko rawa o te tuaiwi.
• Te Āwhiowhio o te Uaua: He uaua nui kei reira hei tautoko i te rohe hope. Ka taea e ēnei uaua te pēhi, te piko rānei. He take noa anō hoki tēnei o te mamae o te tuara.
• Mate Kōpae Whakaheke: Ka puta tēnei āhuatanga ina memeha haere ngā kōpae i roto i te tuaiwi hope. Ka heke te āputa i waenganui i ngā tuaiwi, ka pā te pēhanga io me te mamae o te tuara.
• Te Scoliosis Pakeke: Ko te Scoliosis he piko taha o te tuaiwi. Ka puta pea tēnei āhuatanga i te tuaiwi hope i a tātou e pakeke haere ana, i te ngoikore haere rānei o te tuaiwi.
• Te Mate Cauda Equina: Ka puta tēnei āhuatanga i te pēhanga o te paihere io e kiia nei ko te cauda equina. He āhuatanga ohorere hauora tēnei. Ko ngā tohu ko te mamae, te ngoikore, me te kore e taea te whakahaere i te puku me te pūkahukahu.

Me pēhea te tautuhi i ngā mate me ngā āhuatanga o te tuaiwi lumbar?

Tuatahi, ka pātai atu tō tākuta ki a koe mō tō hītori hauora, ngā rongoā e tangohia ana e koe, me ngā tohumate. Kātahi ka whakahaerehia he whakamātautau tinana, ā, ka whakaritea he whakamātautau me te matawai mēnā e tika ana.

Ka taea e koe te whakahaere i ngā whakamātautau penei:

• Matawai CT (Tomography Rorohiko - Matawai CT): Ka whakamahia ngā hihi-X me te rorohiko hei tango pikitia "porowhita" angiangi o te wāhi e tirohia ana. Ka taea te tirotiro i ngā mea pēnei i te āhua me te rahi o te awa tuaiwi, me te āhua o ngā wheua (ngā wheua e piri ana, te hanumitanga o te wheua, te whakangaromanga o te wheua nā te mate, nā te pukupuku rānei).
• Whakaahua Āhua Aukume (MRI): Ka whakamahia he aukume nui, he ngaru reo irirangi, me te rorohiko hei tango pikitia taipitopito. Ka taea e ia te āwhina ki te tautuhi i ngā raruraru o te taurakira me ngā io e puta mai ana i te tuaiwi, pērā i ngā kōpae herniated, ngā mate, me ngā pukupuku. Ka homai e te MRI he pikitia mārama ake o ngā io i te matawai CT.
• Ngā hihi-X: Ka whakamahia he iti noa te hihi hei tango pikitia o ngā wheua me ngā kiko ngohengohe. Ka taea e rātou te rapu i ngā mea pēnei i te whati, ngā raruraru kōpae, te uaua o te tuaiwi, me te rumatiki.
• Te Electromyogram (EMG) me ngā Rangahau Arataki Io: Ka tirohia e te EMG te hauora me te mahi a ngā io me ngā uaua. Ka ine te rangahau arataki io ​​i te tere o te haere o te ihu hiko i roto i te io. Ka taea e ēnei whakamātautau te āwhina ki te tautuhi i te kino o te io me te wāhi e pēhia ana te io.
• Myelogram: Ka tirohia e tēnei whakamātautau ngā hononga i waenga i ngā tuaiwi me ngā kōpae, te taurakira, me ngā pakiaka io. Ka taea e ia te tirotiro mēnā he pukupuku, he wheua koiwi, he kōpae hernia rānei e pēhi ana i te taurakira, i ngā io rānei, ka mamae, ka ngoikore rānei.

Me pēhea te rongoā i ngā mate hauora o te tuaiwi lumbar?

He maha ngā maimoatanga kore-pokanga, me ngā maimoatanga pokanga hoki mō ngā āhuatanga maha e pā ana ki te tuaiwi hope. Ko te tikanga maimoatanga e whiriwhiria e koe ka whakawhirinaki ki te pūtake o te raruraru me tōna kaha.

He aha ngā maimoatanga kore-pokanga?

Mena kāore tō mamae o raro i puta mai i tētahi aituā, i tētahi pukupuku rānei, ka tūtohu pea tō tākuta i ngā maimoatanga iti ake te whakaekenga i te tuatahi. Ko ētahi o ngā maimoatanga kore-pokanga noa ko:

• Okioki.
• He kōpeke hukapapa, he kōpeke wera rānei.
• Te karo i ngā mahi hoha, e whakanui ana rānei i te mamae.
• Te Whakaora Tinana.
• Ngā rongoā: ngā rongoā whakangāwari uaua, ngā rongoā whakamamae mamae (hei tauira, te paracetamol), me ngā rongoā ārai-mumura (hei tauira, te ibuprofen, te naproxen).
• Werohanga Steroid: E toru ngā momo werohanga steroid ka taea te whakaaro mō te mamae o te hope. Ko te Lumbar Epidural Block he werohanga steroid ki roto i te wāhi epidural, arā, te wāhi i waho o te taurakira.Ko te aukati hononga taha hope he werohanga steroid ki roto i te hononga taha i waenganui i ngā tuaiwi. Ko te werohanga interlaminar , te werohanga transforaminal rānei, he werohanga steroid ki roto i te āputa i waenganui i te taurakira me te pou tuaiwi.
• Te Poraka Manga Hauora me te Whakakorenga Auautanga Reo Irirangi: E whakaarohia ana tēnei maimoatanga mō ētahi mamae hope roa. Tuatahi, ka werohia he rongoā whakamoe ā-rohe ki roto i te io e hono ana ki te hononga taha o te tuaiwi. Mena ka heke te mamae, ko te mahi e whai ake nei ko te ngana ki te whakakore i te mamae tuturu. Ka mahia tēnei mā te whara i te io mā te whakamahi i tētahi tikanga e kiia nei ko te whakakorenga auautanga reo irirangi . Kua whakaitihia te mamae mō ngā marama. Heoi, ki te tipu anō te io, ka taea e te mamae te hoki mai anō.

Me pēhea taku mōhio mēnā me pokanga te tuaiwi hope?

Tērā pea ka hiahiatia he pokanga mō te tuaiwi lumbar mēnā:

• Mena kāore ētahi atu maimoatanga e āwhina.
• Ki te kino haere ngā tohu o tō tuara o raro, hope me/ranei tō waewae (ko te tikanga ka mahia te pokanga mō te mamae o te waewae kaua mō te mamae o te tuara).
• Mena kei te hauora koe kia taea ai te pokanga.

Mena kua whara tō hope i tētahi aituā (pērā i te aituā motuka), te mate pukupuku, te whēwhe epidural (he mate i waenganui i te taurakira me te uhi o te taurakira), te osteomyelitis (he mate o te wheua), te mate cauda equina, te mate conus medullaris rānei (he momo mate taurakira), ko te pokanga te huarahi tuatahi ki te rongoā.

He aha ngā pokanga e wātea ana mō ngā mate o te tuaiwi lumbar?

Anei ētahi tikanga pokanga e whakamahia whānuitia ana:

Pokanga Whakaiti i te Korepa o te Tuaiwi Lumbar

He kupu whānui tēnei. E pā ana ki ngā momo tikanga pokanga e mahia ana hei whakamamae i ngā tohu mā te whakaiti i te pēhanga, te kōpeketanga rānei ki te taurakira, ki ngā pakiaka io rānei. Ko ngā tikanga pokanga noa ko:

• Lumbar Diskectomy: I roto i tēnei mahi, ka tangohia e te taote pokanga tetahi wāhanga o te kōpae hei whakamama i te pēhanga ki ngā pakiaka io tata.
• Laminotomy Lumbar, Laminectomy rānei: I tēnei tikanga, ka tangohia e te taote pokanga tētahi wāhanga iti o te āwhata wheua (lamina) o te awa tuaiwi. I roto i te laminotomy, he wāhanga iti noa iho o te lamina ka tangohia. I roto i te laminectomy, ka tangohia te lamina katoa, me ngā whēkau wheua, ngā kongakonga kōpae, me ngā hononga matotoru, mēnā e tika ana. Ina tangohia te lamina, ka whānui te awa tuaiwi, ā, ka whakamama te pēhanga.
• Te tango i te foraminotomy o te lumbar, te foraminectomy rānei:Ka mahia ēnei pokanga e rua hei whakanui i te pūaha (foramen) e puta atu ai ngā pakiaka io i te taurakira, mā te tango i ētahi o ngā wheua i taua wāhi. I roto i te foraminectomy, ka tangohia he nui o te wheua.
• Te tango i te tinana o te tuaiwi: I tēnei pokanga, ka tangohia e te taote pokanga te wāhanga matua o te tuaiwi (te tinana tuaiwi) me te kōpae hei whakamama i te pēhanga ki te taurakira. I ētahi wā, ka honoa ngā tuaiwi ( te whakakotahitanga tuaiwi ) hei whakau i te tuaiwi hope.

Pokanga Whakakapinga Kōpae Lumbar

I roto i tēnei, ka tangohia he kōpae hope mate, ā, ka whakauruhia he kōpae horihori. He maha ngā wā ka mahia tēnei hei whakakapi i te kōpae hope. Heoi, i ngā tau tata nei, kua iti haere te mahi pokanga nā te mea he maha ngā raruraru ka puta i muri i te pokanga.

Te Hononga Tuaiwi Lumbar

He pokanga tēnei e hono pūmau ana i tētahi, i ētahi rānei o ngā tuaiwi lumbar kia kotahi, kia kore ai e nekenekehia i waenga i ngā tuaiwi.

Te Whakaoho Hiko Mahi mō te Whara o te Taura Tuaiwi

I tēnei tikanga, ka whakamahia ngā hiko iti hei whakahohe i ngā uaua me ngā io o te tinana o raro e whakahaerehia ana e ngā io hope, e ngana ana ki te whakaora i tā rātou mahi.

Ka taea e au te mahi pokanga iti rawa te whakaekenga o te tuaiwi hope?

Kōrero ki tō taote pokanga mō tēnei. I roto i te nuinga o ngā wā, kua whakakapia te pokanga tuwhera tuku iho e te pokanga tuaiwi iti-whakaeke . Engari i te hanga i tētahi tapahi nui ki te kiri, ka mahia te pokanga iti-whakaeke mā te kotahi, neke atu rānei ngā tapahi iti. Nā te mea he iti ngā tapahi, he iti ake te kino ki ngā uaua me ngā kiko ngohengohe i te tapahi nui.

Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)

Ko tō tuaiwi hope te wāhanga o raro o tō tuara. E rima ōna tuaiwi (L1-L5). Kei roto hoki ko ngā kōpae intervertebral, te taurakira, me ngā io, ngā uaua, ngā uaua, me ngā hononga. Ko te tuaiwi hope te mea e tautoko ana i te taumaha o tō tinana, ā, e āhei ai te nuinga o ngā nekehanga o tō tinana.

Ko te mea nui, ki te mamae tonu tō tuara o raro, te ngoikore rānei o ō waewae, te ngoikore rānei, kaua e warewaretia. Me toro atu ki te tākuta, me te rapu tohutohu.

He maha ngā maimoatanga kore-pokanga, me ngā maimoatanga pokanga hoki mō ngā mate maha. Nō reira, kāore he mea hei manukanuka. Ka taea hoki e koe te āwhina ki te pupuri i te hauora o tō tuaiwi hope mā te pupuri i te tū tika, te hiki tika i ngā taumaha, me te whakakori tinana.

Mamae tuara, tuaiwi hope, tuaiwi, raruraru kōpae, sciatica, taurakira, mamae io