Iyo lumbar musana, kana lumbosacral musana, inoreva chikamu chemuzongoza chiri muzasi kumashure, pamusoro pe sacrum chete. Yakanyanya nharembozha uye inotsigira ese akasara musana, inoshandiswa zvakanyanya zuva nezuva uye dzimwe nguva inobatwa nekukwegura kusati kwasvika. Zvakare, iyo lumbar musana kazhinji inzvimbo yekutambudzika, izvo zvikonzero zvinogona kuve zvakawandisa.

Izwi rekuti musana rinoreva musana. Inoumbwa nesitakiti yemarudzi akasiyana-siyana: 7 cervical vertebrae, 12 dorsal (kana thoracic) vertebrae, 5 lumbar vertebrae, iyo sacrum inoumbwa ne5 yakasanganisa vertebrae uye pakupedzisira coccyx yakaumbwa ne4 vertebrae.

Iyo lumbar musana inoreva iyo yakaderera, inofamba chikamu chemuzongoza, iri pamusoro pechirum chete. Iyo inoumbwa nemashanu lumbar vertebrae: iyo L1, L2, L3, L4 uye L5 vertebrae.

Aya ma vertebrae mashanu akabatana uye akatsanangurwa kumashure neakabatana maficha, uye kumberi nema vertebral discs. Pakati peimwe vertebra, midzi yemitsipa inobuda kuburikidza nemakomba anonzi foramina.

Iyo lumbar musana inopa concave arch kune iyo yekumashure, inonzi lumbar lordosis.

Kufanana neyakazara musana, iyo lumbar musana inodzivirira musana wechipfuva kusvika kuL1-L2 vertebrae, kozoti tsinga dzemusana kubva kuL1-L2.

Simba, nekuda kwenzvimbo yaro, iyo lumbar musana inotsigira iyo yese yemuzongoza uye inosimbisa kufamba kwayo. Iyo zvakare inoita basa rekuvhunduka absorber uye mutoro kugoverwa pakati pechiuno uye thorax. Erector mhasuru yemusana, inonziwo mhasuru yemusana, iyo inowedzera pamativi ese emusana kunobatsira kubvisa kumwe kumanikidza kunoitwa kumusana.

Nekuda kwekuomarara kwayo kweatomical, zvimiro zvetsinga zvirimo, zvipingaidzo zvezuva nezuva zvemuchina zvainotsigira asi zvakare kukwegura kwemuviri kwemaumbirwo ayo akasiyana, iyo lumbar musana inogona kukanganiswa nezvakawanda pathologies. Heano makuru acho.

Kutambudzika kwakadzoka shure

Kutambudzika kwekudzokera shure ndiyo amburera izwi rekutambudzika kwepashure. Mukurudziro yazvino uno nezve manejimendi ekurwadziwa kwepashure, iyo HAS (Haute Autorité de Santé) inoyeuka iyi tsananguro: "kurwadziwa kwakadzika kumashure kunotsanangurwa nekurwadziwa kuri pakati pechigadziko che thoracolumbar neparutivi rwepazasi. Iyo inogona kusangana ne radiculalgia inoenderana nekurwadziwa mune rimwe kana maviri ezasi emakumbo kana imwe kana kupfuura dermatomes. "

Schematically, tinogona kusiyanisa:

• zvakajairika kurwadziwa kwepashure kumashure, kunozivikanwa nekurwadziwa kwakadzika musana kusina zviratidzo zvekunyevera. Mune makumi mapfumbamwe muzana ezviitiko, zvakajairika kurwadziwa kwepashure kunochinja zvakanaka musingasviki mavhiki mana kusvika matanhatu, anoyeuka iyo HAS;
• marwadzo ekurwadziwa kusingaperi, kureva kurwadziwa kwepashure kunogara kwemwedzi inopfuura mitatu;
• iyo "acute flare yemarwadzo kumashure" kana kurwadziwa kwakanyanya musana, kana lumbago mumutauro wezuva nezuva. Iwo kurwadziwa kwakanyanya, kwechinguva nekuti kazhinji kazhinji nekuda kwekufamba kusiri iko, kutakura mutoro unorema, kuedza nekukasira (inozivikanwa "kutendeuka kwetsvo"). 

Lumbar disc herniation

Dhizaini yeherniated inoratidzirwa nekupararira kweiyo nucleus pulposus, iyo gelatinous chikamu cheiyo intervertebral disc. Iyi hernia inomanikidza imwe kana yakawanda midzi yemitsipa, ichikonzera kurwadziwa musana kana kurwadziwa muhudyu zvichienderana nenzvimbo yehernia. Kana iyo L5 vertebra ikabatwa, hernia inonyatso kukonzera sciatica inoratidzirwa nekurwadziwa muhudyu, ichidzika negumbo yakananga kugunwe guru.

Lumbar osteoarthritis

Osteoarthritis, iyo sechiyeuchidzo chirwere chinoparara chekatekete, inogona kukanganisa majoini pakati pemaviri vertebrae. Iyi lumbar osteoarthritis inogona kusakonzera chero zviratidzo, sezvo inogona kutungamira kukura kwemapfupa anonzi maosteophytes ayo, nekutsamwiswa kwerutsinga, kunokonzeresa kurwadziwa kwepashure.

Lumbar spinal stenosis kana yakatetepa lumbar canal

Lumbar stenosis ndiko kuderera kwepakati penzvimbo yemuzongoza, kana lumbar canal, ine mitsipa midzi. Inowanzoenderana nezera, uye inokonzeresa kufamba nekunzwa kushaya simba, chiveve, kurira mumakumbo, sciatica inoitika pazororo kana panguva yekushanda, uye kazhinji kacho, kuoma mitezo. zvakanyanyisa kana zvishoma kukosha kwemitezo yezasi kana sphincter mashandiro.

Lumbar disc chirwere

Degenerative disc chirwere, kana disc degeneration, inoratidzirwa nekukwegura kusati kwasvika kweiyo intervertebral disc uye kufambira mberi kupera simba kwepakati payo gelatinous nucleus. Dhisiki racho rinobva radonhedzwa uye midzi yemitsipa ikatsamwiswa, izvo zvinokonzeresa marwadzo muzasi kwezasi. Degenerative disc chirwere inoonekwawo seyakanyanya kukonzera marwadzo ekudzokera kumashure.

Degenerative lumbar scoliosis

Degenerative lumbar scoliosis inozviratidza seyakaremara musana. Inowanzoitika kune vakadzi, kunyanya mushure mekuguma kuenda kumwedzi. Inozviratidza nemarwadzo ekumusana uye muchiuno, ichipenya muhudyu, kazhinji ichiwedzera nekufamba. Degenerative lumbar scoliosis ndiyo mhedzisiro yezvinhu zvakasarudzika: disc kutadza kune iyo kunowedzerwa kushomeka kwemhasuru toni, osteoporosis pamwe neiyo spinal ligament fragility.

Degenerative spondylolisthesis

Ichi chirwere chakabatanidzwa nekukwegura kwepanyama kwepamusana kunozviratidza nekutsvedza kweimwe vertebra pane imwe, kazhinji iyo L4-L5. Lumbar canal stenosis uye zviratidzo zvayo zvinotevera.

Lumbar kuputsika

Kutsemuka kwemuzongoza kunogona kuitika panguva yakasimba kwazvo (tsaona yemumugwagwa kunyanya). Uku kutyoka kwepamuviri kunogona kusangana nekukuvara kumuzongoza uye / kana tsinga midzi, njodzi iriko iko kuve mitezo. Kutsemuka kwacho kunogona zvakare kusadzikama, uye kana zvikaitika zvechipiri kutama zvinotungamira kune njodzi yetsinga.

Kutambudzika kwakadzoka shure

Mukurudziro yazvino uno nezve manejimendi eakajairika marwadzo ekumusana, iyo HAS inoyeuka kuti kurovedza muviri ndiyo yekurapa kukuru inobvumidza shanduko yakanaka yeichi chirwere. Physiotherapy inoratidzwawo. Nezvekurapwa kwezvinodhaka, zvinorangarirwa "kuti hapana chinodhaka chakaratidza kushanda munguva yepakati pakuvandudzika kwekurwisa kwakanyanya kwemarwadzo ekudzokera shure, asi iyo yakapedza analgesic manejimendi, kutanga nezinga reanalgesics I (paracetamol, NSAIDs), inogona yakaitwa kudzikamisa kurwadza kunorwadza ”. Iyo inoratidzira zvakare "kukosha kwechengetedzo yepasi rose yemurwere inozivikanwa se" bio-psycho-social ", uchifunga nezve chiitiko chemurwere uye mhedzisiro yemarwadzo ake (epanyama, epfungwa uye ezvehukama nehunyanzvi)".

Herniated disc

Mutsara wekutanga kurapwa chiratidzo: analgesics, anti-anogumbura zvinodhaka, infiltrations. Kana kurapwa kukakundikana, kuvhiya kunogona kupihwa. Iyo nzira, inonzi discectomy, inosanganisira kubvisa hernia kuitira kuti idzore iyo yakashatirwa tsinga midzi.

Lumbar stenosis

Musana wekutanga kurapwa unochengetedza: analgesics, anti-inflammatories, kugadzirisa, kunyangwe corset kana kupinda mukati. Kana kurapwa kukakundikana, kuvhiya kunogona kupihwa. Maitiro acho, anonzi laminectomy kana musana wesipineti kuburitswa, anosanganisira kubvisa vertebral lamina kuti isunungure musana wesipinha canal.

Degenerative disc disc

Musana wekutanga kurapwa chiratidzo. Kuvhiya kunozotarisirwa mune chiitiko chekutadza kwekurapwa uye kuremadza kurwadziwa zuva nezuva. Lumbar arthrodesis, kana musana fusion, inosanganisira kubvisa dhisiki rakakanganisika uye nekuisa chigadzirwa chekurapa pakati pemaviri ma vertebrae kuchengetedza disc kukwirira.

Degenerative lumbar scoliosis

Analgesics, anti-anogumbura zvinodhaka uye majekiseni zvinoumba yekutanga-chiratidzo chiratidzo kurapwa. Mukana wekutadza uye kunetesa marwadzo, kuvhiyiwa kunogona kutariswa. Iyo arthrodesis inozovavarira kubatanidza yakanyanyisa mobile vertebral pasi uye decompress iyo nerve midzi.

Lumbar kuputsika

Kurapa kunoenderana nerudzi rwekutsemuka uye iyo inosanganisirwa neurological kukuvara kana kwete. Kuvhiya kunozovavarira, zvinoenderana nenyaya yacho, kudzoreredza kugadzikana kwemuzongoza, kudzoreredza chimiro cheiyo vertebra yakatsemuka, kudzikisira zvimiro zvetsinga. Kune izvi, matekinoroji akasiyana anoshandiswa: arthrodesis, kuwedzera kwemuzongoza, nezvimwe.

Degenerative spondylolisthesis

Kana zvikaitika kutadza kurapwa (analgesics, anti-anogumbura zvinodhaka uye infiltrations), arthrodesis inogona kutariswa.

Lumbar musana x-ray

Iyi bvunzo yekuongorora inoongorora iyo yakazara morphology yemuzongoza. Iyo inowanzo gadzirirwa seyekutanga-mutsara kurapwa kwekutambudzika kwepashure. Inoita kuti zvikwanise kuona kuvapo kwezvironda zvinodzikira (lumbar osteoarthritis), vertebral compression kana morphological kusagadzikana kweiyo vertebrae, kujairika kwema statics (scoliosis) kana kutsvedza kweiyo vertebrae. Kune rimwe divi, hazviite nguva dzose kuti zvikwanisike kuongorora kutsemuka kwemutsipa. Iwo ma discs, rwonzi rwepelinha, iyo midzi yemitsipa iri maratidziro emagetsi (anotendera X-rays kuti ipfuure), iyo x-ray yeiyo lumbar musana hairatidze herniated discs kana pathologies emuzongoza.

MRI yeiyo lumbar musana

MRI ndiyo yakajairwa kuongororwa kweiyo lumbar musana, kunyanya kuona pathologies yemuzongoza. Iyo inobvumidza kuona mumatanho matatu zvikamu zvemabhonzo uye zvidimbu zvakapfava: musana wesipinha, ligament, disc, nerve midzi. Uye nekudaro kuongorora kwakasiyana siyana maronda eiyo lumbar musana: herniated disc, degenerative disc chirwere, disc protusion, lumbar stenosis, kuzvimba kwema vertebral mahwendefa, nezvimwe.

Iyo lumbar musana CT scan

Iyo lumbar CT scan kana computed tomography ndiyo yakajairwa kuongororwa mune chiitiko chekutyorwa kwemuzongoza. Iyo inogona zvakare kuongorora iyo herniated disc, kuongorora iyo degree ye lumbar stenosis, kuona vertebral bone metastases. Izvo zvinowanzo ganhurirwa sechikamu cheiyo preoperative kuongororwa kwekuvhiya kwepasuru, kunyanya kuongorora nzvimbo yemidziyo.