Menene Ciwon Faifan Degenerative (DDD)?: Bayani

by Dr Alex Jimenez | Back Pain, Chiropractic, Binciken Bikin baya na baya, kullum Pain, Health, Ƙwaƙwalwar Herniated, Raunin baya baya, Neck Pain, Sciatica, Sciatica Jijiya Pain, scoliosis, Lafiya ta asibiti, Spine Care, jiyya, Na zaman lafiya

Cutar cututtuka na Degenerative Disc cuta ce ta gaba ɗaya don yanayin da lalacewar intervertebral diski ke haifar da ciwo mai tsanani, wanda zai iya zama ko dai ƙananan ciwon baya a cikin kashin baya na lumbar ko wuyan wuyansa a cikin kashin mahaifa. Ba cuta ba ce, amma a zahiri rugujewar fayafai na kashin baya. Fayil na intervertebral wani tsari ne wanda ke da hankali sosai a kwanan nan, saboda abubuwan da ya shafi asibiti. Canje-canjen cututtukan da zasu iya faruwa a cikin lalata diski sun haɗa da fibrosis, kunkuntar, da lalata diski. Hakanan ana iya samun lahani iri-iri a cikin faifan intervertebral kamar sclerosis na endplates, fissuring da mucinous degeneration na annulus, da samuwar osteophytes.

Ƙananan ciwon baya da ciwon wuyansa sune manyan matsalolin cututtukan cututtuka, waɗanda ake tunanin suna da alaka da canje-canje na lalacewa a cikin faifai. Ciwon baya shine babban dalilin ziyarar likita a Amurka. An kiyasta cewa kusan kashi 80% na manya na Amurka suna fama da ƙananan ciwon baya aƙalla sau ɗaya yayin rayuwarsu. (Modic, Michael T., da kuma Jeffrey S. Ross) Saboda haka, ana buƙatar cikakken fahimtar cututtukan diski na degenerative don sarrafa wannan yanayin na kowa.

Tsarin Halittu na Abubuwan da suka danganci

Anatomy na Spine

Kashin baya shine babban tsari, wanda ke kula da matsayi kuma yana haifar da matsaloli daban-daban tare da hanyoyin cututtuka. Kashin baya yana kunshe da kashin mahaifa bakwai, vertebrae thoracic goma sha biyu, kashin lumbar biyar, da fused sacral da coccygeal vertebrae. Ana kiyaye kwanciyar hankali na kashin baya ta ginshiƙai uku.

An kafa ginshiƙi na gaba ta hanyar ligament na gaba da kuma ɓangaren gaba na jikin kashin baya. An kafa ginshiƙi na tsakiya ta hanyar ɓangaren baya na jikin kashin baya da kuma ligament na baya na tsaye. Shagon na baya ya ƙunshi baka na baya wanda ke da matakai masu jujjuyawa, laminae, fuskoki, da matakai masu juyayi. (

Anatomy na Intervertebral Disc

Fayilolin intervertebral yana ta'allaka ne tsakanin jikunan kashin baya guda biyu da ke kusa da su a cikin kashin kashin baya. Kimanin kashi ɗaya cikin huɗu na jimlar tsayin ginshiƙi na kashin baya an kafa su ta fayafai na intervertebral. Wannan diski yana haifar da haɗin gwiwa na fibrocartilaginous, wanda ake kira haɗin gwiwa na symphysis. Yana ba da izinin motsi kaɗan a cikin kashin baya kuma yana riƙe kashin baya tare. Fayilolin Intervertebral yana da alaƙa da juriya da ƙarfi da halayen juriya. Fayilolin intervertebral ya ƙunshi galibi sassa uku; na ciki gelatinous tsakiya pulposus, m annulus fibrosus, da guringuntsi endplates waɗanda suke mafi girma da kuma ƙasa a mahaɗin jikin kashin baya.

Nucleus pulposus shine sashi na ciki wanda shine gelatinous. Ya ƙunshi proteoglycan da gel na ruwa wanda aka haɗa tare da nau'in Collagen II da elastin fibers waɗanda aka shirya su ba tare da bin ka'ida ba. Aggrecan shine babban proteoglycan da ake samu a cikin tsakiya pulposus. Ya ƙunshi kusan 70% na tsakiya pulposus da kusan 25% na annulus fibrosus. Zai iya riƙe ruwa kuma yana samar da abubuwan osmotic, waɗanda ake buƙata don tsayayya da matsawa kuma suyi aiki azaman mai ɗaukar girgiza. Wannan babban adadin aggrecan a cikin diski na al'ada yana ba da damar nama don tallafawa matsawa ba tare da rushewa ba kuma ana rarraba kayan aiki daidai da annulus fibrosus da vertebral jiki a lokacin motsi na kashin baya. (Wheater, Paul R, et al.)

Ana kiran ɓangaren waje annulus fibrosus, wanda ke da nau'in nau'in nau'in collagen na nau'in nau'in nau'in nau'in nau'in nau'in nau'in nau'in nau'in nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i. Zaɓuɓɓukan collagen suna gudana cikin yanayin da ba a taɓa gani ba tsakanin lamellae na annulus a cikin madaidaitan kwatance suna ba shi ikon yin tsayayya da ƙarfi. Ƙwayoyin dawafi suna ƙarfafa annulus fibrosus na gefe. A gefe na gaba, ligament mai kauri yana ƙara ƙarfafa annulus fibrosus kuma ƙananan ligament yana ƙarfafa gefen baya. (Choi, Yong-Soo)

Yawancin lokaci, akwai fayafai guda ɗaya tsakanin kowane nau'i na kashin baya sai tsakanin atlas da axis, waɗanda suke na farko da na biyu na mahaifa a cikin jiki. Waɗannan fayafai na iya motsawa kusan 6? a cikin dukkan gatura na motsi da jujjuyawa a kusa da kowace axis. Amma wannan 'yancin motsi ya bambanta tsakanin sassa daban-daban na ginshiƙan kashin baya. Ƙwayoyin mahaifa suna da mafi girman kewayon motsi saboda fayafai na intervertebral sun fi girma kuma akwai faffadan daɗaɗɗen ƙasa da filaye na saman kashin baya. Hakanan suna da haɗin gwiwar facet masu daidaitawa. Ƙwayoyin ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun motsi a cikin jujjuyawa, tsawo, da juyawa, amma suna da sassaucin ra'ayi na kyauta yayin da aka haɗe su zuwa kejin hakarkarin. Lumbar Vertebrae suna da sassauƙa mai kyau da haɓaka, sake, saboda fayel nasu matakai masu laushi ne da kuma lokutan sa. Duk da haka, jujjuyawar lumbar na gefe yana iyakance saboda haɗin facet yana samuwa a sagitally. (

Samar da Jini

Fayilolin intervertebral shine ɗayan mafi girman tsarin jijiyoyin jini a cikin jiki tare da capillaries suna ƙarewa a ƙarshen faranti. Tsuntsun suna samun abubuwan gina jiki daga tasoshin da ke cikin ƙashin ƙashin ƙasa wanda ke kusa da guringuntsin hyaline a ƙarshen farantin. Wadannan sinadarai irin su oxygen da glucose ana ɗaukar su zuwa faifan intervertebral ta hanyar yaduwa mai sauƙi. (�Intervertebral Disc � Spine � Orthobullets.Com�)

Samar da Jijiya

Hannun hankali na fayafai na intervertebral yana da rikitarwa kuma ya bambanta gwargwadon wurin da ke cikin kashin baya. Ana tsammanin watsawar jijiya ana yin sulhu ta hanyar abubuwa P, calcitonin, VIP, da CPON. Sinu vertebral jijiya, wanda ya taso daga ganglion tushen dorsal, yana shigar da filayen filaye na annulus. Zaɓuɓɓukan jijiya ba su wuce abin da ke sama ba.

Hakanan ana ba da fayafai na lumbar intervertebral a gefen baya tare da rassa daga rami na farko na ventral da kuma daga rami mai launin toka kusa da mahaɗin su tare da rami na farko na ventral. Bangaren gefen fayafai ana ba da su ta rassan rassan masu sadarwa na rami. Wasu daga cikin masu sadarwa na rami na iya haye fayafai na intervertebral kuma su shiga cikin nama mai haɗi, wanda ke zurfi zuwa asalin psoas. (Palmgren, Tove, et al.)

Ana kuma ba da fayafai na intervertebral na mahaifa a gefen gefe ta rassan jijiyar kashin baya. An kuma gano jijiyoyi na sinus na mahaifa suna samun hanya zuwa sama a cikin canal na kashin baya suna ba da fayafai a wurin shigar su da kuma wanda ke sama. (BOGDUK, NIKOLAI, et al.)

Pathophysiology na Degenerative Disc cuta

Kimanin kashi 25% na mutane kafin shekaru 40 suna nuna canje-canje na lalata diski a wani matakin. Fiye da shekaru 40, shaidar MRI na nuna canje-canje a fiye da 60% na mutane. (Suthar, Pokhraj) Sabili da haka, yana da mahimmanci a yi nazarin tsarin lalacewa na diski na intervertebral kamar yadda aka gano ya ragu da sauri fiye da kowane nau'i na jiki a cikin jiki, yana haifar da ciwon baya da wuyansa. Canje-canje a cikin fayafai na intervertebral guda uku suna haɗuwa da canje-canje a cikin jikin kashin baya da haɗin gwiwa suna ba da shawarar ci gaba da aiki mai ƙarfi.

An raba tsarin lalacewa na fayafai na intervertebral zuwa matakai uku, a cewar Kirkaldy-Willis da Bernard, wanda ake kira �Degenerative cascade��. Waɗannan matakan na iya haɗuwa kuma suna iya faruwa a cikin shekaru da yawa. Duk da haka, gano waɗannan matakan a asibiti ba zai yiwu ba saboda haɗuwa da alamu da alamu.

Mataki na 1 (Mataki na Farko)

Wannan mataki yana da alaƙa da lalacewa. Akwai sauye-sauye na tarihi, waɗanda ke nuna hawaye na kewaye da fissures a cikin annulus fibrosus. Wadannan hawaye na kewaye na iya juya zuwa hawaye na radial kuma saboda annulus pulposus yana da kyau a ciki, waɗannan hawaye na iya haifar da ciwon baya ko wuyan wuyansa, wanda aka gano kuma tare da motsi mai raɗaɗi. Saboda raunin raunin da ya faru a cikin fayafai, ƙananan faranti na iya rabuwa da ke haifar da rushewar samar da jini zuwa diski don haka, hana shi samar da kayan abinci da kuma kawar da sharar gida. Annulus na iya ƙunsar ƙananan ƙwayoyin cuta a cikin fibrils na collagen, wanda za'a iya gani akan microscopy na lantarki kuma MRI na iya nuna rashin jin dadi, ƙumburi na diski, da kuma yanki mai girma a cikin annulus. Fuskar fuska na iya nuna alamar synovial kuma yana iya haifar da ciwo mai tsanani tare da haɗin gwiwar synovitis da rashin iya motsa haɗin gwiwa a cikin haɗin gwiwar zygapophyseal. Waɗannan canje-canjen ba lallai ba ne su faru a cikin kowane mutum. (Gupta, Vijay Kumar, et al.)

Har ila yau, tsakiya pulposus yana da hannu a cikin wannan tsari yayin da ikonsa na ruwa ya ragu saboda tarin proteoglycans da aka canza. Wadannan canje-canjen ana kawo su ne ta hanyar enzymes guda biyu da ake kira matrix metalloproteinase-3 (MMP-3) da mai hana nama na metalloproteinase-1 (TIMP-1). (Bhatnagar, Sushma, da Maynak Gupta) Rashin daidaituwarsu yana haifar da lalata proteoglycans. Rage ƙarfin da za a iya sha ruwa yana haifar da raguwar matsa lamba na hydrostatic a cikin tsakiya pulposus kuma yana haifar da lamellae na annular zuwa dunƙule. Wannan na iya ƙara motsi na wannan ɓangaren yana haifar da damuwa mai ƙarfi zuwa bangon annular. Duk waɗannan canje-canje na iya haifar da wani tsari da ake kira annular delamination da fissuring a cikin annulus fibrosus. Waɗannan su ne matakai guda biyu daban-daban na pathological kuma duka biyu na iya haifar da ciwo, tausayi na gida, hypomobility, kwangilar tsokoki, ƙungiyoyi masu raɗaɗi. Duk da haka, gwajin jijiya a wannan matakin yawanci al'ada ne.

Mataki na 2 (Mataki na Rashin Zaman Lafiya)

Mataki na rashin aiki yana biye da wani mataki na rashin zaman lafiya, wanda zai iya haifar da ci gaba da ci gaba da ci gaban ingantacciyar ingantacciyar hanyar haɗin gwiwa. Ana iya samun sauye-sauye da yawa da aka ci karo da su a wannan matakin, gami da rushewar diski da resorption, wanda zai haifar da asarar tsayin sararin diski. Hawaye da yawa na annular kuma na iya faruwa a wannan matakin tare da canje-canje na lokaci guda a cikin mahaɗin zagopophyseal. Suna iya haɗawa da lalacewa na guringuntsi da facet capsular laxity wanda ke haifar da subluxation. Waɗannan sauye-sauye na biomechanical suna haifar da rashin kwanciyar hankali na ɓangaren da abin ya shafa.

Alamomin da ake gani a wannan lokaci suna kama da waɗanda ake gani a lokacin rashin aiki kamar ba da baya, jin zafi lokacin tsawan lokaci mai tsawo, da kamawa a baya tare da motsi. Suna tare da alamu kamar motsi mara kyau a cikin gidajen abinci yayin da ake taɗawa da kuma lura cewa kashin baya yana jujjuyawa ko kuma ya koma gefe bayan ya tsaya tsayin daka na wani lokaci bayan lanƙwasa. (Gupta, Vijay Kumar et al.)

Mataki na 3 (Mataki na Sake Tsayawa)

A cikin wannan mataki na uku da na ƙarshe, haɓakar ci gaba yana haifar da raguwar sararin diski tare da fibrosis da samuwar osteophyte da haɗin gwiwar transdiscal. Ciwon da ke tasowa daga waɗannan canje-canje yana da tsanani idan aka kwatanta da matakai biyu na baya, amma waɗannan zasu iya bambanta tsakanin mutane. Wannan kunkuntar sararin diski na iya samun tasiri da yawa akan kashin baya. Wannan na iya haifar da canal na intervertebral don kunkuntar a cikin mafi girma-ƙananan shugabanci tare da kusantar ƙafar ƙafar da ke kusa. Ganyayyaki masu tsayi, waɗanda ke goyan bayan ginshiƙin kashin baya, na iya zama rashi a wasu wuraren da ke haifar da laxity da rashin kwanciyar hankali na kashin baya. Motsi na kashin baya na iya haifar da flavum na ligamentum zuwa kumbura kuma zai iya haifar da ingantaccen tsarin subluxation na aricular. Wannan yana haifar da raguwar diamita a cikin hanyar anteroposterior na sararin intervertebral da stenosis na tushen jijiya na sama.

Samar da osteophytes da hypertrophy na facets na iya faruwa saboda canji a cikin nauyin axial a kan kashin baya da kuma jikin vertebral. Wadannan zasu iya samuwa a kan matakai masu girma da ƙananan ƙananan hanyoyi kuma osteophytes na iya fitowa zuwa canal intervertebral yayin da fuskokin hypertrophed zasu iya fitowa zuwa tsakiyar canal. Ana tsammanin za a yi osteophytes daga yaduwar guringuntsin guringuntsi a cikin periosteum bayan haka an sha maganin endochondral calcification da ossification. Hakanan an kafa osteophytes saboda canje-canje a cikin tashin hankali na iskar oxygen kuma saboda canje-canjen matsa lamba na ruwa baya ga lahani na rarraba kaya. Osteophytes da periarticular fibrosis na iya haifar da taurin haɗin gwiwa. Har ila yau, matakai na articular na iya kasancewa a cikin hanyar da ba ta dace ba wanda ke haifar da retrospondylolisthesis wanda ke haifar da raguwa na canal intervertebral, tushen jijiya, da kuma kashin baya. (KIRKALDY-WILLIS, WH et al.)

Duk waɗannan canje-canje suna haifar da ƙananan ciwon baya, wanda ya ragu da tsanani. Sauran alamun kamar raguwar motsi, taushin tsoka, taurin kai, da scoliosis na iya faruwa. Kwayoyin sel mai tushe na synovial da macrophages suna shiga cikin wannan tsari ta hanyar sakin abubuwan haɓaka da ƙwayoyin matrix na waje, waɗanda ke aiki azaman masu shiga tsakani. An gano sakin cytokines da ke hade da kowane mataki kuma yana iya samun tasirin warkewa a cikin ci gaban jiyya na gaba.

Ilimin Halittu na Abubuwan Haɗari na Cutar Cutar Cutar Cutar

Tsufa da Ragewa

Yana da wuya a bambanta tsufa daga canje-canje na lalacewa. Pearce et al sun ba da shawarar cewa tsufa da raguwa suna wakiltar matakai masu zuwa a cikin tsari guda ɗaya wanda ke faruwa a cikin dukan mutane amma a daban-daban. Ragewar diski, duk da haka, yana faruwa sau da yawa a cikin sauri fiye da tsufa. Saboda haka, ana ci karo da shi har ma a cikin marasa lafiya na shekarun aiki.

Da alama akwai alaƙa tsakanin tsufa da lalacewa, amma har yanzu ba a sami takamaiman dalili ba. An gudanar da bincike da yawa game da abinci mai gina jiki, mutuwar tantanin halitta, da tara abubuwan da aka lalatar da matrix da gazawar tsakiya. Abubuwan da ke cikin ruwa na diski na intervertebral yana raguwa tare da karuwar shekaru. Nucleus pulposus na iya samun fissures wanda zai iya shiga cikin fibrosus annulus. Farawa na wannan tsari ana kiransa chondrosis inter vertebralis, wanda zai iya nuna farkon lalacewa na lalacewa na diski na intervertebral, ginshiƙan ƙarewa, da jikin kashin baya. Wannan tsari yana haifar da hadaddun sauye-sauye a cikin tsarin kwayoyin halitta na diski kuma yana da biomechanical da na asibiti wanda sau da yawa zai iya haifar da nakasu mai mahimmanci a cikin mutumin da abin ya shafa.

Matsakaicin tantanin halitta a cikin annulus yana raguwa tare da haɓaka shekaru. Wannan ya faru ne saboda ƙwayoyin da ke cikin faifan suna fuskantar jin daɗi kuma suna rasa ikon haɓakawa. Sauran abubuwan da ke da alaƙa na ƙayyadaddun ƙayyadaddun ƙayyadaddun shekaru na fayafai na intervertebral sun haɗa da asarar tantanin halitta, rage cin abinci mai gina jiki, gyare-gyaren bayan fassarorin sunadaran matrix, tara samfuran ƙasƙanci na ƙwayoyin matrix, da gazawar gajiya na matrix. Rage yawan abinci mai gina jiki zuwa diski na tsakiya, wanda ke ba da damar tara kayan sharar sel da lalata ƙwayoyin matrix da alama shine mafi mahimmancin canji daga duk waɗannan canje-canje. Wannan yana ɓata abinci mai gina jiki kuma yana haifar da faɗuwar matakin pH, wanda zai iya ƙara lalata aikin tantanin halitta kuma yana iya haifar da mutuwar tantanin halitta. Ƙara yawan catabolism da rage anabolism na sel masu hankali na iya inganta lalacewa. (Buckwalter, Joseph A.) Bisa ga binciken daya, an sami ƙarin kwayoyin halitta a cikin tsakiya pulposus idan aka kwatanta da annulus fibrosus da herniated fayafai suna da damar mafi girma na kwayar halitta. � (Roberts, S. et al.)

Lokacin da tsarin tsufa ya ci gaba na ɗan lokaci, ƙididdigar chondroitin 4 sulfate da chondroitin 5 sulfate, wanda yake da ƙarfi hydrophilic, yana raguwa yayin da keratin sulfate zuwa chondroitin sulfate rabo ya karu. Keratan sulfate yana da sauƙi hydrophilic kuma yana da ɗan ƙaramin hali don samar da tsayayyen aggregates tare da hyaluronic acid. Kamar yadda aggrecan ya rabu, kuma nauyin kwayoyinsa da lambobi sun ragu, danko da hydrophilicity na tsakiya pulposus suna raguwa. Canje-canje na lalacewa zuwa fayafai na intervertebral suna haɓaka ta hanyar rage matsa lamba na hydrostatic na tsakiya pulposus da rage yawan wadatar abinci ta hanyar yaduwa. Lokacin da abun cikin ruwa na matrix extracellular ya ragu, tsayin diski na intervertebral shima zai ragu. Hakanan za'a rage juriyar diski zuwa nauyin axial. Saboda an canza nauyin axial kai tsaye zuwa annulus fibrosus, annulus clefts na iya tsage cikin sauƙi.

Duk waɗannan hanyoyin suna haifar da canje-canjen tsarin da aka gani a cikin cututtukan diski na degenerative. Saboda raguwar abun ciki na ruwa a cikin annulus fibrosus da hasara mai alaƙa da bin doka, nauyin axial zai iya samun sake rarrabawa zuwa yanayin baya na facets maimakon na al'ada na gaba da tsakiyar sassan. Wannan na iya haifar da cututtukan fata na facet, hypertrophy na jikin vertebral da ke kusa, da ƙasusuwan kasusuwa ko haɓakar ƙashi, wanda aka sani da osteophytes, sakamakon sakamakon fayafai na lalacewa. (Choi, Yong-Soo)

Halittar Halittar Halittar Halittar Halittar Halitta (Genetics and Degeneration).

An gano sashin kwayoyin halitta a matsayin babban abu a cikin cututtukan diski na degenerative. Nazarin tagwaye, da nazarin da suka shafi beraye, sun nuna cewa kwayoyin halitta suna taka rawa wajen lalata diski. (Boyd, Lawrence M., et al.) Kwayoyin halittar da ke lamba don collagen I, IX, da XI, interleukin 1, aggrecan, mai karɓar bitamin D, matrix metalloproteinase 3 (MMP � 3), da sauran sunadaran suna daga cikin kwayoyin halittar da suke. ana ba da shawarar shiga cikin cututtukan diski na degenerative. Polymorphisms a cikin 5 A da 6 A alleles da ke faruwa a cikin yankin masu haɓakawa na kwayoyin halitta wanda ke tsara ayyukan MMP 3 an samo su zama babban mahimmanci don haɓakar ƙwayar ƙwayar cuta a cikin tsofaffi. Ma'amala tsakanin waɗannan nau'ikan kwayoyin halitta daban-daban suna ba da gudummawa sosai ga cututtukan cututtukan diski na intervertebral gabaɗaya.

Gina Jiki da Ragewa

Ana kuma yarda da lalata diski na faruwa saboda gazawar samar da abinci mai gina jiki ga ƙwayoyin diski na intervertebral. Baya ga tsarin tsufa na yau da kullun, ƙarancin abinci mai gina jiki na sel diski yana da mummunan tasiri ta hanyar ƙididdige platelet, shan taba, da yanayin abinci gabaɗaya. Rashin abinci mai gina jiki zai iya haifar da samuwar lactic acid tare da ƙarancin iskar oxygen mai alaƙa. Sakamakon ƙananan pH zai iya rinjayar ikon ƙwayoyin diski don ƙirƙirar da kuma kula da matrix extracellular na fayafai kuma yana haifar da lalatawar diski na intervertebral. Fayilolin da suka lalace ba su da ikon amsawa akai-akai ga ƙarfin waje kuma suna iya haifar da rushewa ko da daga ɗan ƙarancin baya. (Tahir, Fadi, et al.)

Abubuwan haɓaka suna ƙarfafa chondrocytes da fibroblasts don samar da ƙarin adadin matrix na waje. Hakanan yana hana haɗakar matrix metalloproteinases. Misalin waɗannan abubuwan haɓaka sun haɗa da abubuwan haɓaka haɓaka, abubuwan haɓaka mai kama da insulin, da mahimman abubuwan haɓakar fibroblast. An gyara matrix da aka lalata ta hanyar haɓakar matakan canza yanayin girma da mahimmancin ci gaban fibroblast.

Muhalli da lalacewa

Ko da yake duk fayafai suna da shekaru ɗaya, fayafai da aka samu a cikin ƙananan sassan lumbar sun fi sauƙi ga sauye-sauye na lalacewa fiye da fayafai da aka samo a cikin ɓangaren sama. Wannan yana nuna cewa ba kawai tsufa ba amma, har ma da lodin inji, shine dalilin da ya sa. Ƙungiyar da ke tsakanin cututtukan cututtuka na degenerative da abubuwan muhalli an bayyana su ta hanyar da ta dace ta hanyar Williams da Sambrook a cikin 2011. (Williams, FMK, da PN Sambrook) Ƙaƙƙarfan nauyin jiki mai nauyi da ke hade da aikin ku shine haɗarin haɗari wanda ke da wasu gudunmawa ga diski. cututtukan degenerative. Haka kuma akwai yuwuwar sinadarai na haifar da lalacewar diski, kamar shan taba, kamar yadda wasu bincike suka nuna. (Batti�, Michele C.) An saka nicotine a cikin binciken tagwaye don haifar da raunin jini zuwa fayafai na intervertebral, wanda ke haifar da lalata diski. (BATTI�, MICHELE C., et al.) Bugu da ƙari, an sami ƙungiya tsakanin cututtukan atherosclerotic a cikin aorta da ƙananan ciwon baya wanda ke nuna hanyar haɗi tsakanin atherosclerosis da cututtukan diski na degenerative. (Kauppila, LI) Rashin lalacewar diski yana da tasiri a cikin kiba, kiba, ciwo na rayuwa, da karuwar yawan adadin jiki a wasu nazarin. (�Nazari na tushen yawan jama'a na lalata faifan yara da ƙungiyarsa tare da kiba da kiba, ƙarancin ciwon baya, da raguwar Matsayin Aiki. Samartzis D, Karppinen J, Mok F, Fong DY, Luk KD, Cheung KM. J Bone Joint Surg Ina 2011; 93 (7): 662 ~ 70�

Jin zafi a cikin Ragewar Disc (Ciwoyi na Discogenic)

Rashin ciwo na Discogenic, wanda shine nau'in ciwon nociceptive, ya taso daga masu nociceptors a cikin annulus fibrosus lokacin da tsarin jin tsoro ya shafi cutar da cututtuka na degenerative. Annulus fibrosus yana ƙunshe da zaruruwan jijiyoyi masu amsawa na rigakafi a cikin Layer na waje na diski tare da wasu sinadarai irin su polypeptide na intestinal vasoactive, peptide mai alaƙa da ƙwayoyin halittar calcitonin, da abu P. (KONTTINEN, YRJ� T., et al.) Lokacin da canje-canje na degenerative a ciki. fayafai na intervertebral suna faruwa, tsarin al'ada da kayan aikin injiniya sun canza suna haifar da motsi mara kyau. Waɗannan nociceptors na diski na iya samun wayewar kai ga abubuwan motsa jiki. Hakanan za'a iya tsokanar ciwon ta hanyar ƙananan yanayin pH da ke haifar da kasancewar lactic acid, yana haifar da ƙara yawan samar da masu shiga tsakani.

Ciwo daga cututtukan diski na degenerative na iya tasowa daga asali da yawa. Yana iya faruwa saboda lalacewar tsari, matsa lamba, da haushi akan jijiyoyi a cikin kashin baya. Faifan da kansa ya ƙunshi ƴan zaruruwan jijiya kawai, amma duk wani rauni na iya wayar da kan waɗannan jijiyoyi, ko waɗanda ke cikin ligament na baya, don haifar da ciwo. Ƙananan motsi a cikin kashin baya na iya faruwa, wanda zai iya haifar da spasms tsoka mai raɗaɗi saboda diski ya lalace kuma ya lalace tare da asarar tashin hankali da tsayi. Motsi masu raɗaɗi suna tasowa saboda jijiyoyi da ke ba da wurin suna danne ko haushi ta hanyar haɗin gwiwa da haɗin gwiwa a cikin farar fata da ke haifar da ciwon ƙafa da baya. Wannan ciwo na iya ƙara tsanantawa ta hanyar sakin sunadaran masu kumburi da ke aiki a kan jijiyoyi a cikin jijiyoyi ko saukowa a cikin kashin baya.

Samfayyu samfuran discory na lalata, lokacin da aka lura a karkashin Muranci, ya nuna cewa akwai abubuwan da ke cikin rudani da faduwa ta hanyar Annulus fibrosus mirgiro zuwa full nucleus flibrosus. Yankin nama na granulation yana shiga cikin sel masu yawa na mast kuma koyaushe suna ba da gudummawa ga tsarin cututtukan cututtukan da ke haifar da ciwon discogenic. Wadannan sun hada da neovascularisation, intervertebral disc degeneration, diski nama kumburi, da samuwar fibrosis. Kwayoyin mast kuma suna sakin abubuwa, irin su ƙwayar necrosis factor da interleukins, waɗanda zasu iya yin alama don kunna wasu hanyoyin da ke taka rawa wajen haifar da ciwon baya. Sauran abubuwan da zasu iya haifar da waɗannan hanyoyi sun haɗa da phospholipase A2, wanda aka samar daga cascade na arachidonic acid. An samo shi a cikin ƙananan ƙididdiga a cikin uku na uku na annulus na diski na degenerative kuma ana tunanin ya motsa nociceptors da ke can don saki abubuwa masu kumburi don haifar da ciwo. Wadannan abubuwa suna haifar da raunin axonal, edema na ciki, da demyelination. (Brisby, Helena)

Ana tunanin ciwon baya yana tasowa daga diski na intervertebral kanta. Don haka me yasa ciwon zai ragu a hankali a kan lokaci lokacin da diski mai lalacewa ya daina haifar da ciwo. Duk da haka, zafi a zahiri yana fitowa daga diski kanta kawai a cikin 11% na marasa lafiya bisa ga binciken endoscopy. Ainihin dalilin ciwon baya yana da alama saboda ƙaddamar da iyakar tsakiya na jijiyoyi da kuma ciwo mai zafi tare da hannu ko ƙafa yana da alama ya tashi saboda ƙaddamar da ainihin jijiya. Maganin lalata diski ya kamata ya fi mayar da hankali kan rage radadi don rage radadin majiyyaci saboda ita ce mafi yawan alamun nakasa da ke dagula rayuwar majiyyaci. Sabili da haka, yana da mahimmanci a kafa tsarin jin zafi saboda yana faruwa ba kawai saboda sauye-sauyen tsarin a cikin kwakwalwa na intervertebral ba amma kuma saboda wasu dalilai kamar sakin sinadarai da fahimtar waɗannan hanyoyin zasu iya haifar da tasiri mai tasiri. (Choi, Yong-Soo)

Gabatarwar Clinical na Cutar Cutar Cutar Cutar

Marasa lafiya da ke fama da cutar faifai suna fuskantar ɗimbin alamun bayyanar cututtuka dangane da wurin cutar. Wadanda ke da raunin diski na lumbar suna samun ƙananan ciwon baya, alamun radicular, da rauni. Wadanda ke da raunin diski na mahaifa suna da wuyan wuyansa da ciwon kafada.

Ƙananan ciwon baya na iya kara tsanantawa ta hanyar motsi da matsayi. Yawancin lokaci, alamun bayyanar sun fi muni ta hanyar jujjuyawar, yayin da tsawo yakan sauƙaƙa su. Ƙananan raunin raunin da ya faru, ko da daga lilon wasan golf, na iya haifar da alamun. Yawancin lokaci ana lura da zafi ya zama ƙasa lokacin tafiya ko gudu, lokacin canza matsayi akai-akai da lokacin kwanciya. Duk da haka, ciwon yawanci yana da mahimmanci kuma a lokuta da yawa, ya bambanta da yawa daga mutum zuwa mutum kuma yawancin mutane za su sha wahala daga ƙananan ƙananan ciwo na ƙananan baya a ci gaba da ci gaba yayin da lokaci-lokaci suna fama da maƙarƙashiya, hip, da ciwon ƙafa. Ƙarfin ciwon zai ƙaru daga lokaci zuwa lokaci kuma zai kasance na 'yan kwanaki sannan kuma ya ragu a hankali. Wannan �flare up� wani lamari ne mai saurin gaske kuma yana buƙatar a yi masa magani da magunguna masu ƙarfi. An sami ciwo mai tsanani a cikin wurin zama kuma yana da tsanani yayin lankwasawa, ɗagawa, da karkatar da motsi akai-akai. Tsananin zafin zai iya bambanta da yawa tare da wasu suna jin zafi na lokaci-lokaci ga wasu suna da tsanani kuma suna kashe ciwo na lokaci-lokaci. (Jason M. Highsmith, MD)

Jin zafi da jin zafi a cikin gida yana fitowa ne daga nociceptors da aka samu a cikin fayafai na intervertebral, facet gidajen abinci, sacroiliac gidajen abinci, dura mater na jijiya tushen, da kuma myofascial Tsarin samu a cikin axial kashin baya. Kamar yadda aka ambata a cikin sassan da suka gabata, sauye-sauye na degenerative anatomical canje-canje na iya haifar da raguwa na canal na kashin baya da ake kira spinal stenosis, overgrowth of spinal systems da ake kira osteophytes, hypertrophy na ƙananan ƙwayoyin cuta da ƙananan ƙwayoyin cuta, spondylolisthesis, bulging na ligamentum flavum da disc herniation. . Wadannan canje-canje suna haifar da tarin alamun bayyanar da aka sani da claudication neurogenic. Ana iya samun alamun bayyanar cututtuka irin su ƙananan ciwon baya da ciwon ƙafa tare da ƙumburi ko tingling a kafafu, raunin tsoka, da sauke ƙafa. Rashin kula da hanji ko mafitsara na iya ba da shawarar toshewar kashin baya kuma ana buƙatar kulawa da gaggawa don hana nakasa ta dindindin. Waɗannan alamomin na iya bambanta da tsanani kuma suna iya nunawa zuwa mabanbantan yanayi a cikin mutane daban-daban.

Haka nan ciwon na iya yaduwa zuwa wasu sassan jiki saboda yadda kashin baya ya ba da rassa da dama zuwa wurare daban-daban guda biyu na jiki. Sabili da haka, lokacin da faifan da ya lalace ya danna tushen jijiya na kashin baya, kuma za a iya samun ciwon a cikin ƙafar da jijiyar ta shiga ciki. Wannan al'amari, wanda ake kira radiculopathy, zai iya faruwa daga wurare da yawa da ke tasowa, saboda tsarin lalacewa. Faifan bulging, idan ya fito a tsakiya, zai iya rinjayar tushen tushen cauda equina, idan ya yi girma a baya, zai iya rinjayar tushen jijiya da ke fitowa a cikin ƙananan ƙananan intervertebral na gaba da kuma jijiyar kashin baya a cikin ramus na ventral na iya samun tasiri lokacin da diski ya fito. a gefe. Hakazalika, osteophytes da ke fitowa tare da babba da ƙananan ɓangarorin na baya na jikin kashin baya na iya yin tasiri akan kyallen jikin jiki guda ɗaya wanda ke haifar da alamomi iri ɗaya. Babban aikin hawan jini kuma na iya yin tasiri akan tushen jijiya dangane da tsinkayarsu. Jijiyoyin na iya haɗawa da tushen jijiya kafin su fita daga canal na intervertebral na ƙasa na gaba da tushen jijiya a cikin tushen jijiya na sama da jakar dural. Wadannan alamun bayyanar cututtuka, saboda raunin jijiya, an tabbatar da su ta hanyar nazarin cadaver. Ana tunanin sasantawa na jijiyoyi yana faruwa lokacin da diamita na foraminal neuro ya cika da mahimmanci tare da raguwa 70%. Bugu da ƙari kuma, ana iya samar da daidaituwar jijiyoyi lokacin da diski na baya ya matsa ƙasa da milimita 4 a tsawo, ko kuma lokacin da aka rage tsayin daka zuwa ƙasa da 15 millimeters wanda ke haifar da stenosis foraminal da jijiyoyi. (Tahir, Fadi, et al.)

Hanyar Bincike

An fara ƙididdige marasa lafiya tare da ingantaccen tarihi da cikakken nazarin jiki da binciken da ya dace da gwaji mai tsokana. Duk da haka, tarihin sau da yawa yana da wuyar gaske saboda ciwo mai tsanani wanda ba za a iya gano shi da kyau ba da kuma wahalar tantance ainihin wurin da ake ciki a lokacin gwaji na tsokana saboda tasirin maƙwabta na maƙwabta.

Ta hanyar tarihin mai haƙuri, ana iya gano dalilin ƙananan ciwon baya kamar yadda ya taso daga nociceptors a cikin diski na intervertebral. Har ila yau, marasa lafiya na iya ba da tarihin yanayin yanayi na yau da kullum na alamun bayyanar cututtuka da kuma haɗin gwiwa na yanki na gluteal, tingling da kuma taurin kai a cikin kashin baya wanda yawanci yakan tsananta tare da aiki. Ana iya haifar da taushi ta hanyar lanƙwasa a kan kashin baya. Saboda yanayin cutar da ke zama na dindindin kuma mai raɗaɗi, yawancin marasa lafiya na iya fama da yanayin yanayi da damuwa. Ana tsammanin damuwa yana haifar da mummunan nauyin cutar. Koyaya, babu bayyananniyar alaƙa tsakanin tsananin cuta da yanayi ko rikicewar tashin hankali. Yana da kyau a yi taka tsantsan game da waɗannan yanayin lafiyar kwakwalwa kuma. Don ware wasu cututtuka masu tsanani, dole ne a yi tambayoyi game da gajiya, asarar nauyi, zazzabi, da sanyi, wanda zai iya nuna wasu cututtuka. (Jason M. Highsmith, MD)

Dole ne a cire wani ilimin ilimin ilimin cututtuka na ƙananan ciwon baya lokacin da ake nazarin majiyyaci don cututtukan cututtuka na degenerative. Ciwon ciki, wanda zai iya haifar da ciwon baya kamar aortic aneurysm, renal calculi, da ciwon pancreatic, dole ne a cire.

Cutar cututtuka na degenerative yana da nau'i-nau'i daban-daban da za a yi la'akari da shi lokacin da mai haƙuri ya gabatar da ciwon baya. Wadannan sun hada da; ƙananan ciwon baya na idiopathic, raunin haɗin gwiwa na zygapophyseal, myelopathy, lumbar stenosis, spondylosis, osteoarthritis, da lumbar radiculopathy. (

bincike

Ana amfani da bincike don tabbatar da ganewar asali na cututtukan cututtuka na degenerative. Ana iya raba waɗannan zuwa binciken dakin gwaje-gwaje, nazarin hoto, gwaje-gwajen tafiyar da jijiya, da hanyoyin bincike.

Nazarin Hoto

Hoton hoto a cikin cututtukan diski na degenerative ana amfani dashi galibi don bayyana alaƙar jikin mutum da sifofin sifofi na fayafai da abin ya shafa, wanda ke da babban darajar warkewa a yanke shawara na gaba don zaɓuɓɓukan magani. Duk wata hanyar yin hoto, kamar bayyananniyar rediyo, CT, ko MRI, na iya ba da bayanai masu amfani. Duk da haka, ana iya samun dalilin da ya sa kawai a cikin 15% na marasa lafiya kamar yadda babu wani canje-canje na radiyo da aka bayyana a cikin cututtukan cututtuka na degenerative a cikin rashin ƙwayar cuta da kuma rashin lafiyar jiki. Bugu da ƙari, babu wani dangantaka tsakanin sauye-sauye na jiki da aka gani akan hoto da kuma tsananin alamun bayyanar cututtuka, ko da yake akwai dangantaka tsakanin adadin osteophytes da tsananin ciwon baya. Hakanan ana iya ganin canje-canje masu lalacewa a cikin rediyo a cikin mutanen asymptomatic waɗanda ke haifar da wahala wajen daidaita ma'anar asibiti da lokacin fara jiyya. (

Filayen Radiyo

Wannan rahusa mai rahusa kuma akwai ko'ina a sarari na rediyo na mahaifa na iya ba da mahimman bayanai kan nakasu, daidaitawa, da sauye-sauyen ƙasusuwan ƙashi. Don ƙayyade kasancewar rashin daidaituwa na kashin baya da ma'auni na sagittal, gyare-gyare mai mahimmanci, ko nazarin tsawo dole ne a yi.

Hoto Resonance Magnetic (MRI)

MRI ita ce hanyar da aka fi amfani da ita don tantance sauye-sauye na lalacewa a cikin diski na intervertebral daidai, dogara, kuma mafi mahimmanci. Ana amfani da shi a farkon kimantawa na marasa lafiya da wuyan wuyansa bayan radiyo na fili. Yana iya samar da hotuna marasa cin zarafi a cikin filayen da yawa kuma yana ba da kyawawan hotuna masu inganci na diski. MRI na iya nuna hydration na diski da ilimin halittar jiki bisa tushen proton, yanayin sinadarai, da abun ciki na ruwa. Dole ne a yi la'akari da hoton asibiti da tarihin mai haƙuri lokacin da ake fassara rahotanni na MRI kamar yadda aka nuna cewa kusan 25% na masu aikin rediyo sun canza rahoton su lokacin da bayanan asibiti ke samuwa. Fonar ya samar da na'urar daukar hotan takardu ta MRI na farko tare da ikon majiyyaci don a duba shi a wurare daban-daban kamar tsaye, zaune, da lankwasawa. Saboda waɗannan fasalulluka na musamman, ana iya amfani da wannan na'urar na'urar MRI na buɗewa don duba marasa lafiya a cikin matsayi masu nauyi da kuma tsayawa tsayin daka don gano sauye-sauyen cututtuka na asali wanda yawanci ba a kula da su a cikin MRI na al'ada irin su cututtukan cututtuka na lumbar degenerative tare da herniation. Wannan na'ura kuma yana da kyau ga marasa lafiya na claustrophobic, yayin da suke kallon babban allon talabijin yayin aikin dubawa. (

Nucleus pulposus da annulus fibrosus na diski yawanci ana iya gano su akan MRI, wanda ke haifar da gano ɓarnawar diski kamar yadda aka ƙunsa kuma ba a ciki. Kamar yadda MRI kuma zai iya nuna hawaye na annular da ligament na baya na tsaye, ana iya amfani dashi don rarraba herniation. Wannan na iya zama mai sauƙi na shekara-shekara bulging zuwa guntuwar diski kyauta. Wannan bayanin zai iya kwatanta fayafai masu cutarwa kamar fayafai da aka fitar, fayafai masu fitowa, da fayafai masu ƙaura.

Akwai tsarin ƙididdiga da yawa dangane da ƙarfin siginar MRI, tsayin diski, bambanci tsakanin tsakiya da annulus, da tsarin diski. Hanyar, ta Pfirrmann et al, an yi amfani da ita sosai kuma an yarda da ita ta asibiti. Bisa ga tsarin da aka gyara, akwai maki 8 don cututtukan cututtuka na lumbar diski. Matsayi na 1 yana wakiltar diski na intervertebral na al'ada kuma 8 ya dace da matakin ƙarshen lalacewa, yana nuna ci gaban cutar diski. Akwai hotuna masu dacewa don taimakawa ganewar asali. Yayin da suke ba da bambance-bambancen nama mai kyau da cikakken bayanin tsarin diski, ana amfani da hotuna masu nauyi na sagittal T2 don manufar rarrabawa. (Pfirrmann, Christian WA, et al.)

Modic ya bayyana canje-canjen da ke faruwa a cikin jikin vertebral da ke kusa da fayafai masu lalacewa kamar yadda Nau'in 1 da Nau'in 2 suka canza. A cikin canje-canjen Modic 1, an sami raguwar ƙarfin hotuna masu nauyi na T1 da ƙara ƙarfin ma'auni na T2. Ana tunanin hakan zai faru ne saboda faranti na ƙarshe sun sami sclerosis kuma maƙarƙashiyar ƙasusuwan da ke kusa da ita yana nuna amsawar kumburi yayin da haɓakar haɓakar yaduwa. Wannan haɓakar haɓakar haɓakawa da juriya na ƙarshe na yaduwa ana haifar da su ta hanyar abubuwan sinadarai waɗanda aka fitar ta hanyar injin autoimmune. Canje-canje na nau'in 2 na Modic sun haɗa da lalata kasusuwan kasusuwa da ke kusa da ƙarshen kashin baya saboda amsa mai kumburi da shigar da mai a cikin bargo. Waɗannan canje-canje na iya haifar da ƙara yawan sigina akan hotuna masu nauyi na T1. (Modic, MT, et al.)

Kwamfuta Tomography (CT)

Lokacin da ba a samo MRI ba, ana ɗaukar hoto na ƙididdiga a matsayin gwajin gwaji wanda zai iya gano ɓangarorin diski saboda yana da mafi kyawun bambanci tsakanin ɓangarorin baya na kashin kashin baya, kitsen perineal, da kayan diski na herniated. Duk da haka, lokacin da ake bincikar cututtuka na gefe, MRI ya kasance yanayin hoto na zabi.

CT scan yana da fa'idodi da yawa akan MRI kamar yana da ƙarancin yanayin claustrophobic, ƙarancin farashi, da mafi kyawun gano sauye-sauye na bonny waɗanda ke da dabara kuma ana iya rasa su akan wasu hanyoyin. CT na iya gano farkon sauye-sauye na degenerative na sassan facet da spondylosis tare da ƙarin daidaito. Mutuncin kasusuwa bayan hadewa shima CT yafi tantancewa.

Za a iya gano ɓarnawar diski da haɗin gwiwar jijiyoyi ta hanyar amfani da ka'idodin da Gundry da Heithoff suka haɓaka. Yana da mahimmanci don fitowar diski ya kwanta kai tsaye a kan tushen jijiya da ke ratsa diski kuma ya zama mai da hankali da asymmetrical tare da matsayi na dorsolateral. Yakamata a sami matsewar tushen jijiya ko ƙaura. A }arshe, jijiyar jijiyar da ke damun jijiyar (wuri na herniation) sau da yawa yakan ƙara girma kuma yana tasowa tare da sakamakon edema, shaharar jijiyoyin epidural da ke kusa da su, da kumburin kumburi wanda ke haifar da blurring gefe.

Lumbar Discography

Wannan hanya tana da rikici kuma, ko sanin wurin da ke ciwo yana da wani darajar game da tiyata ko a'a, ba a tabbatar da shi ba. Ƙimar ƙarya na iya faruwa saboda tsakiyar hyperalgesia a cikin marasa lafiya da ciwo mai tsanani (neurophysiologic binciken) kuma saboda dalilai na psychosocial. Yana da shakka don kafa daidai lokacin da ciwon discogenic ya zama mahimmanci a asibiti. Wadanda ke goyan bayan wannan binciken suna ba da shawarar ƙayyadaddun ka'idoji don zaɓi na marasa lafiya da kuma lokacin fassarar sakamakon kuma sunyi imani wannan shine kawai gwajin da zai iya gano ciwon discogenic. Ana iya amfani da hoton lumbar a cikin yanayi da yawa, kodayake ba a kafa shi ta hanyar kimiyya ba. Wadannan sun hada da; ganewar asali na herniation na gefe, bincikar alamar bayyanar cututtuka a tsakanin rashin daidaituwa da yawa, yin la'akari da irin abubuwan da aka gani a kan CT ko MRI, kimantawa na kashin baya bayan tiyata, zaɓi na matakin haɗuwa, da kuma siffofi masu ban sha'awa na bayyanar cututtuka na discogenic.

Hoton hoto ya fi damuwa game da ƙaddamar da ilimin ilimin cututtuka maimakon ƙayyade tsarin jiki na diski. Sabili da haka, kimantawar jin zafi na discogenic shine manufar discography. MRI na iya bayyana diski mai kallon maras kyau ba tare da ciwo ba, yayin da za a iya ganin zafi mai tsanani akan zane-zane inda binciken MRI ya kasance kaɗan. A lokacin allurar saline na al'ada ko abubuwan da suka bambanta, madaidaicin spongy na iya faruwa tare da fayafai mara kyau suna karɓar ƙarin adadin bambanci. Abubuwan da aka kwatanta zasu iya shiga cikin tsakiya na pulposus ta hanyar hawaye da fissures a cikin annulus fibrosus a cikin ƙananan fayafai. Matsi na wannan nau'i na bambanci na iya haifar da zafi saboda abubuwan da ke ciki ta hanyar jijiyar meningeal mai maimaitawa, gaurayewar jijiyar kashin baya, rami na farko na baya, da ramin communicantes masu launin toka masu samar da annulus fibrosus na waje. Za a iya tsokanar ciwon radicular lokacin da bambancin abu ya isa wurin tushen tushen jijiya ta diski mara kyau. Duk da haka, wannan gwajin gwaji yana da rikitarwa da yawa kamar raunin tushen jijiya, sinadarai ko ƙwayar cuta ta kwayan cuta, rashin lafiyar bambanci, da kuma ƙarar ciwo. (Bartynski, Walter S., da A. Orlando Ortiz)

Haɗin Modality Hoto

Domin a kimanta tushen jijiyar jijiyoyi da jijiyar mahaifa daidai, ana iya buƙatar haɗin hanyoyin hoto.

CT Discography

Bayan yin zane-zane na farko, ana yin CT discography a cikin sa'o'i 4. Ana iya amfani da shi wajen ƙayyade matsayin diski kamar herniated, protruded, extruded, kunshe ko sequestered. Hakanan za'a iya amfani dashi a cikin kashin baya don bambanta yawan tasirin tabo ko kayan diski bayan tiyatar kashin baya.

CT Myelography

Ana ɗaukar wannan gwajin hanya mafi kyau don kimanta tushen tushen jijiya. Lokacin da CT aka yi a hade ko bayan myelography, cikakken bayani game da kashi kashi daban-daban jirage za a iya samu da dangi sauƙi.

Hanyoyin Bincike

Tushen Tushen Jijiya Mai Zaɓa (SNRBs)

Lokacin da ake zargi da cutar cututtukan cututtuka masu yawa a kan MRI scan, ana iya amfani da wannan gwajin don sanin takamaiman tushen jijiya wanda ya shafa. SNRB duka gwajin gwaji ne da gwajin warkewa wanda za'a iya amfani dashi don stenosis na lumbar. Gwajin yana haifar da yanki na matakin demotomal na hypoesthesia ta hanyar allurar maganin sa barci da wani abu mai banbanci a ƙarƙashin jagorancin fluoroscopic zuwa matakin tushen jijiya mai sha'awar. Akwai dangantaka tsakanin multilevel cervical degenerative disc cuta cututtuka na asibiti bayyanar cututtuka da kuma binciken akan MRI da binciken SNRB bisa ga Anderberg et al. Akwai daidaituwa na 28% tare da sakamakon SNRB kuma tare da raɗaɗin raɗaɗin dermatomal da wuraren raunin neurologic. Yawancin lokuta masu tsanani na degeneration akan MRI ana samun su tare da 60%. Ko da yake ba a yi amfani da shi akai-akai ba, SNRB gwaji ne mai amfani a kimanta marasa lafiya kafin a yi aiki a cikin ƙwayar cuta na degenerative multilevel musamman a kan kashin baya tare da siffofi na asibiti da kuma binciken akan MRI. (Narouze, Samer, and Amaresh Vydyanathan)

Electro Myographic Studies

Gwaje-gwajen sarrafa jijiya mai nisa da na jijiya, wanda ake kira nazarin electromyographic, waɗanda ke da al'ada tare da gwajin allura na al'ada na iya bayyana alamun matsi na jijiyoyi waɗanda aka haifar a cikin tarihin asibiti. Tushen jijiya mai haushi za a iya zama a cikin gida ta hanyar amfani da allurai don kwantar da jijiyoyin da suka shafa ko masu karɓar raɗaɗi a cikin sararin diski, haɗin gwiwa na sacroiliac, ko sassan facet ta hanyar discography. (�Journal Of Electromyography & Kinesiology Calendar�)

Nazarin Laboratory

Yawancin gwaje-gwajen dakin gwaje-gwaje ana yin su don keɓance wasu cututtukan cututtuka daban-daban.

Kamar yadda seronegative spondyloarthropathies, irin su ankylosing spondylitis, sune abubuwan da ke haifar da ciwon baya, HLA B27 immuno-histocompatibility dole ne a gwada. Kimanin mutane 350,000 a cikin Amurka da 600,000 a Turai sun kamu da wannan cutar kumburin da ba a san komi ba. Amma HLA B27 ba a cika samunsa a cikin Baƙin Amurkawa. Sauran seronegative spondyloarthropathies da za a iya gwada ta yin amfani da wannan kwayar halitta sun hada da psoriatic amosanin gabbai, kumburi hanji cuta, da reactive arthritis ko Reiter ciwo. Maganin immunoglobulin A (IgA) na iya ƙarawa a wasu marasa lafiya.

Gwaje-gwaje kamar erythrocyte sedimentation rate (ESR) da C-reactive protein (CRP) matakin gwajin ga m lokaci reactants gani a kumburi haddasawa na ƙananan baya zafi kamar osteoarthritis da malignancy. Ana kuma buƙatar cikakken adadin jini, gami da ƙididdiga daban-daban don tabbatar da yanayin cutar. Ana zargin cututtuka na autoimmune lokacin da Rheumatoid factor (RF) da anti-nuclear antibody (ANA) gwaje-gwaje suka zama tabbatacce. Maganin uric acid da bincike na ruwa na synovial don lu'ulu'u na iya buƙatar a lokuta masu wuya don ware gout da pyrophosphate dihydrate.

Jiyya

Babu wata takamaiman hanyar magani da likitoci suka yarda da ita game da maganin cututtukan cututtuka na degenerative saboda dalilin ciwon zai iya bambanta a cikin mutane daban-daban kuma haka ne tsananin zafi da kuma bambance-bambance a cikin gabatarwar asibiti. Za a iya tattauna zaɓukan jiyya sosai a ƙarƙashin; magani mai ra'ayin mazan jiya, jinya, da maganin fiɗa.

Maganin Conservative

Wannan hanyar magani ta haɗa da aikin motsa jiki tare da halayen halayen, yanayin jiki, allura, ilimin baya, da kuma hanyoyin makaranta.

Maganin-Tsarin Motsa jiki tare da Sassan Hali

Dangane da ganewar asali na mai haƙuri, ana iya tsara nau'ikan motsa jiki daban-daban. Ana la'akari da daya daga cikin manyan hanyoyin kulawa na ra'ayin mazan jiya don magance ciwon baya na kullum. Za a iya gyaggyarawa darussan don haɗawa da motsa jiki, motsa jiki na motsa jiki, da motsa jiki na ƙarfafa tsoka. Ɗaya daga cikin manyan ƙalubalen wannan farfadowa ya haɗa da rashin iyawa don tantance tasiri a tsakanin marasa lafiya saboda bambance-bambance masu yawa a cikin tsarin motsa jiki, mita, da tsanani. Bisa ga binciken, mafi yawan tasiri ga ƙananan ƙananan ƙananan ciwon baya tare da bambancin tsawon lokaci na bayyanar cututtuka an samu ta hanyar yin shirye-shiryen motsa jiki masu daraja a cikin tsarin sana'a na mai haƙuri. An sami ci gaba mai mahimmanci a tsakanin marasa lafiya da ke fama da cututtuka na yau da kullum tare da wannan farfadowa game da inganta aikin aiki da rage ciwo. Hanyoyin hanyoyin kwantar da hankali da aka tsara don kowane majiyyaci a ƙarƙashin kulawa ta kusa da bin bin majiyyaci kuma suna da alama sun fi tasiri a cikin masu fama da ciwon baya. Za a iya amfani da wasu hanyoyin masu ra'ayin mazan jiya a hade don inganta wannan tsarin. (Hayden, Jill A., et al.)

Ayyukan motsa jiki, idan ana yin su akai-akai, na iya inganta jimiri. Don kawar da tashin hankali na tsoka, ana iya amfani da hanyoyin shakatawa. Ana kuma ɗaukar yin iyo a matsayin motsa jiki don ciwon baya. Ayyukan motsa jiki na bene na iya haɗawa da motsa jiki na tsawo, shimfiɗar hamstring, ƙananan baya baya, gwiwa biyu zuwa gaɗa, ɗaga wurin zama, gyare-gyaren zama, gyaran kafa na ciki, da motsa jiki da tsaunuka.

Hanyoyin Jiki

Wannan hanyar ta haɗa da amfani da motsa jiki na jijiyoyi na lantarki, shakatawa, fakitin kankara, biofeedback, pads na dumama, phonophoresis, da iontophoresis.

Ƙarfafa Jijiya Mai Wuta Mai Wuta (TENS)

A cikin wannan hanyar da ba ta da ƙarfi, ana isar da kuzarin lantarki zuwa fata don tada jijiyoyin da ke gefen yankin don rage zafi zuwa wani ɗan lokaci. Wannan hanyar tana kawar da zafi nan da nan bayan aikace-aikacen amma tasirinsa na dogon lokaci yana da shakka. Tare da wasu nazarin, an gano cewa babu wani ci gaba mai mahimmanci a cikin ciwo da matsayi na aiki idan aka kwatanta da placebo. Na'urorin da ke yin waɗannan TENS za su iya samun sauƙin shiga daga sashen marasa lafiya. Alamar illa ɗaya ɗaya ce mai laushin fata da aka samu a cikin kashi uku na marasa lafiya. (Johnson, Mark I)

Baya Makaranta

An gabatar da wannan hanyar tare da manufar rage alamun zafi da sake dawowa. An fara gabatar da shi a Sweden kuma yana la'akari da matsayi, ergonomics, motsa jiki na baya da ya dace, da kuma tsarin jiki na yankin lumbar. Ana koya wa marasa lafiya daidai yanayin zama, tsayawa, ɗaga nauyi, barci, wanke fuska, da goge haƙora don guje wa ciwo. Lokacin da aka kwatanta da sauran hanyoyin magani, an tabbatar da farfadowa na baya na baya yana da tasiri a cikin gaggawa da kuma tsaka-tsakin lokaci don inganta ciwon baya da matsayi na aiki.

Ilimi na haƙuri

A cikin wannan hanyar, mai badawa yana ba da umarni ga majiyyaci akan yadda za a sarrafa alamun ciwon baya. Ana koyar da ilimin jikin kashin baya na al'ada da biomechanics da suka haɗa da hanyoyin rauni da farko. Na gaba, ta yin amfani da samfurori na kashin baya, an bayyana ma'anar cututtukan cututtuka na degenerative ga mai haƙuri. Ga mai haƙuri ɗaya, an ƙayyade madaidaicin matsayi sannan kuma an nemi ya kula da wannan matsayi don kauce wa samun alamun bayyanar.

Hanyar Halitta-Psychosocial zuwa Magungunan Bayarwa Multidisciplinary

Ciwon baya na yau da kullun na iya haifar da damuwa mai yawa ga majiyyaci, haifar da rikicewar tunani da ƙarancin yanayi. Wannan na iya yin illa ga sakamakon warkewa wanda ke sa yawancin dabarun jiyya ba su da amfani. Don haka, dole ne a ilmantar da majiyyata kan koyan dabarun fahimi da ake kira �behavioral� da �bio-psychosocial� dabarun don samun sauƙi daga ciwo. Baya ga magance abubuwan da ke haifar da raɗaɗi, abubuwan tunani, da zamantakewa ya kamata a magance su ta wannan hanyar. Don rage fahimtar majiyyaci game da ciwo da nakasa, ana amfani da hanyoyi kamar gyare-gyaren tsammanin, dabarun shakatawa, kula da martani na ilimin lissafi ta hanyar ilmantarwa, da ƙarfafawa.

Massage Far

Don ƙananan ciwon baya na yau da kullum, wannan magani yana da alama yana da amfani. A cikin tsawon shekaru 1, an gano maganin tausa yana da tasiri mai mahimmanci ga wasu marasa lafiya idan aka kwatanta da acupuncture da sauran hanyoyin shakatawa. Koyaya, yana da ƙarancin inganci fiye da TENS da aikin motsa jiki kodayake marasa lafiya ɗaya na iya fifita ɗaya akan ɗayan. (Furlan, Andrea D., et al.)

Gyaran kashin baya

Wannan maganin ya ƙunshi yin amfani da haɗin gwiwa fiye da yanayin motsi na yau da kullum, amma bai wuce na al'ada ba. Wannan magani ne na hannu wanda ya haɗa da yin amfani da dogon lefa tare da ƙananan gudu. Ana tunanin inganta ƙananan ciwon baya ta hanyoyi da yawa kamar sakin jijiyoyi masu kama da juna, lalata articular da peri-articular adhesions, da kuma ta hanyar sarrafa sassan kashin baya da aka yi hijira. Hakanan zai iya rage ƙumburi na diski, shakatawa da tsokoki na hypertonic, tada filayen nociceptive ta hanyar canza aikin neurophysiological da sake mayar da menisci a kan farfajiyar articular.

Ana tunanin magudin kashin baya ya fi inganci idan aka kwatanta da mafi yawan hanyoyin kamar TENS, aikin motsa jiki, magungunan NSAID, da kuma maganin makaranta na baya. Binciken da ake samu a halin yanzu yana da inganci game da tasirin sa a cikin dogon lokaci da gajere. Hakanan yana da aminci sosai don gudanar da masu aikin kwantar da hankali waɗanda ba a horar da su tare da maganganun diski da cauda equina da aka ruwaito kawai a ƙasa da 1 cikin mutane miliyan 3.7. (Bronfort, Gert, et al.)

Lumbar Taimakawa

Marasa lafiya da ke fama da ciwon baya na yau da kullum saboda matakai na lalacewa a matakan da yawa tare da dalilai da yawa na iya amfana daga tallafin lumbar. Akwai hujjoji masu karo da juna game da tasirin sa tare da wasu nazarin da ke da'awar haɓaka matsakaici a cikin taimako na gaggawa da na dogon lokaci yayin da wasu ke ba da shawarar babu irin wannan ci gaba idan aka kwatanta da sauran hanyoyin jiyya. Tallace-tallacen Lumbar na iya daidaitawa, gyara nakasu, rage ƙarfin injin, da iyakance motsi na kashin baya. Hakanan yana iya yin aiki azaman placebo kuma yana rage zafi ta hanyar yin tausa a wuraren da abin ya shafa da kuma amfani da zafi.

Ƙunƙarar Lumbar

Wannan hanyar tana amfani da kayan doki da aka haɗe zuwa gaɓoɓin iliac da ƙananan haƙarƙarin kuma yana amfani da ƙarfi mai tsayi tare da axial kashin baya don sauƙaƙa ƙananan ciwon baya na yau da kullun. An daidaita matakin da tsawon lokacin ƙarfin bisa ga mai haƙuri kuma ana iya auna shi ta amfani da na'urori duka yayin tafiya da kwance. Ƙunƙarar ƙwayar ƙwayar cuta tana aiki ta hanyar buɗe wuraren diski na intervertebral da kuma ta rage ƙwayar lordosis. Alamun cututtukan cututtukan diski na degenerative sun ragu ta hanyar wannan hanya saboda gyare-gyaren kashin baya na wucin gadi da abubuwan da ke tattare da shi. Yana kawar da jijiyar jijiyoyi da damuwa na inji, ya rushe adhesions a cikin facet da annulus, da kuma alamun zafi na nociceptive. Duk da haka, babu wata shaida da yawa game da tasirinsa wajen rage ciwon baya ko inganta aikin yau da kullum. Bugu da ƙari kuma, haɗarin da ke tattare da haɗin gwiwa na lumbar yana ci gaba da bincike kuma ana samun wasu rahotanni inda ya haifar da jijiyar jijiyoyi, matsalolin numfashi, da hawan jini da canje-canjen jini saboda karfi mai nauyi da kuskuren sanya kayan aiki. (Harte, A et al.)

Kiwon Lafiya

Magungunan likita sun haɗa da maganin miyagun ƙwayoyi tare da masu shakatawa na tsoka, injections na steroid, NSAIDs, opioids, da sauran analgesics. Ana buƙatar wannan, ban da magani mai ra'ayin mazan jiya, a yawancin marasa lafiya da cututtukan diski na degenerative. Pharmacotherapy yana nufin sarrafa nakasa, rage zafi da kumburi yayin inganta yanayin rayuwa. Ana ba da shi bisa ga kowane majiyyaci saboda babu yarjejeniya game da magani.

Natsuwa da tsoka

Cutar cututtuka na degenerative na iya amfana daga masu shayarwa na tsoka ta hanyar rage spasm na tsokoki kuma don haka rage zafi. An kafa tasirin masu kwantar da hankali na tsoka don inganta ciwo da matsayi na aiki ta hanyar bincike da yawa. Benzodiazepine shine mafi yawan shakatawa na tsoka da ake amfani dashi a halin yanzu.

Magungunan Anti-inflammatory marasa steroidal (NSAIDs)

Ana amfani da waɗannan magungunan a matsayin mataki na farko a cikin cututtuka na degenerative na diski wanda ke ba da analgesia, da kuma maganin kumburi. Akwai shaida mai ƙarfi cewa yana rage ƙananan ciwon baya na kullum. Duk da haka, amfani da shi yana iyakance ta hanyar rikice-rikice na gastrointestinal, kamar m gastritis. Zaɓaɓɓen masu hana COX2, kamar celecoxib, na iya shawo kan wannan matsalar ta hanyar niyya kawai masu karɓar COX2. Ba a yarda da amfani da su ba saboda yuwuwar illolinsa wajen haɓaka cututtukan zuciya da jijiyoyin jini tare da amfani mai tsawo.

Magungunan Opioid

Wannan mataki ne mafi girma a matakin ciwon WHO. An tanada shi ga marasa lafiya da ke fama da ciwo mai tsanani ba tare da amsawa ga NSAIDs da waɗanda ke da damuwa na GI ba tare da maganin NSAID ba. Duk da haka, takardun magani na narcotics don magance ciwon baya ya bambanta sosai tsakanin likitoci. Dangane da wallafe-wallafen, 3 zuwa 66% na marasa lafiya na iya ɗaukar wani nau'i na opioid don taimakawa ciwon baya. Ko da yake an nuna alamar raguwar ɗan gajeren lokaci a cikin bayyanar cututtuka, akwai haɗarin cin zarafi na dogon lokaci, yawan juriya, da damuwa na numfashi a cikin tsofaffi. Tashin zuciya da amai wasu daga cikin illolin da ake fuskanta na ɗan gajeren lokaci. (

Anti-Depressants

Anti-depressants, a cikin ƙananan allurai, suna da ƙimar analgesic kuma yana iya zama da amfani a cikin marasa lafiya marasa ciwo na baya wanda zai iya gabatar da alamun rashin tausayi. Zafin da wahala na iya rushe barcin majiyyaci kuma yana rage bakin kofa. Ana iya magance waɗannan ta hanyar yin amfani da magungunan rigakafi a cikin ƙananan allurai ko da yake babu wata shaida da ta inganta aikin.

Maganin Injection

Epidural Steroid Injections

Epidural steroid injections sune nau'in allurar da aka fi amfani da su don maganin cututtukan diski na yau da kullum da radiculopathy. Akwai bambanci tsakanin nau'in steroid da aka yi amfani da shi da adadinsa. 8- 10 ml na cakuda methylprednisolone da saline na al'ada ana la'akari da kashi mai tasiri da lafiya. Ana iya yin allurar ta hanyar interlaminar, caudal, ko hanyoyin trans foramina. Ana iya shigar da allura a ƙarƙashin jagorancin fluoroscopy. Sabanin farko, sannan maganin sa barci na gida kuma a ƙarshe, ana allurar steroid a cikin sararin epidural a matakin da abin ya shafa ta wannan hanya. Ana samun sauƙin jin zafi saboda haɗuwa da sakamako daga duka maganin sa barci da kuma steroid. Za'a iya samun sauƙin jin zafi na gaggawa ta hanyar maganin sa barci ta hanyar toshe siginar siginar zafi da kuma tabbatar da ganewar asali. Har ila yau, an rage kumburi saboda aikin steroids don toshe cascade pro-inflammatory.

A cikin shekaru goma da suka gabata, yin amfani da allurar steroid na epidural ya karu da 121%. Duk da haka, akwai gardama game da amfani da shi saboda bambancin matakan amsawa da kuma yiwuwar illa mai tsanani. Yawancin lokaci, waɗannan alluran an yi imanin suna haifar da sauƙi na ɗan gajeren lokaci na bayyanar cututtuka. Wasu likitocin na iya yin allura 2 zuwa 3 a cikin tsawon mako guda, kodayake sakamakon dogon lokaci iri ɗaya ne ga majiyyaci da aka yi musu allura ɗaya kawai. Har tsawon shekara guda, bai kamata a yi fiye da allurai 4 ba. Don ƙarin taimako na gaggawa nan da nan kuma mai inganci, ana iya ƙara morphine wanda ba shi da kariya ga allurar. Hatta magungunan kashe-kashe na gida, kamar lidocaine da bupivacaine, ana kara su don wannan dalili. Shaida don rage jin zafi na dogon lokaci yana iyakance. (�Gwaji-Tsarin Gudanar da Placebo Don Ƙimar Tasirin Taimakon Rage Ciwo Ta Amfani da Ketamine Tare da Epidural Steroids Don Ciwon Ƙarƙashin Ƙarƙashin Ƙarshen Baya)

Akwai yuwuwar illar illa saboda wannan maganin, baya ga tsadar sa da damuwar ingancin sa. Ana iya yin kuskuren allura idan ba a yi amfani da fluoroscopy a cikin kusan kashi 25% na lokuta ba, har ma da kasancewar gogaggun ma'aikata. Za a iya gano wuri na epidural ta hanyar pruritus dogara. Bacin rai na numfashi ko riƙewar fitsari na iya faruwa bayan allura tare da morphine don haka ana buƙatar kulawa da majiyyaci na tsawon awanni 24 bayan allurar.

Allurar fuska

Ana ba da waɗannan alluran ga haɗin gwiwa na facet, wanda kuma ake kira haɗin gwiwa na zygapophysial, waɗanda ke tsakanin kashin baya biyu maƙwabta. Ana iya allurar maganin sa barci kai tsaye zuwa sararin haɗin gwiwa ko zuwa ga reshe na tsakiya na dorsal rami, wanda ke sa shi shiga ciki. Akwai shaida cewa wannan hanya tana inganta ikon aiki, ingancin rayuwa, da kuma rage zafi. Ana tsammanin su samar da fa'idodi na gajere da na dogon lokaci, kodayake binciken ya nuna duka allurar facet da allurar steroid na epidural suna kama da inganci. (Wynne, Kelly A)

SI Injections na haɗin gwiwa

Wannan haɗin gwiwa ne na diarthrodial synovial tare da samar da jijiya daga duka axon jijiya na myelinated da wadanda ba na myelin ba. Allurar za ta iya magance cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukanትም da cututtukan cututtukan da ke haifar da kumburi da kumburi. Ana iya maimaita allurar kowane watanni 2 zuwa 3 amma yakamata a yi kawai idan ya zama dole a asibiti. (MAUGARS, Y. et al.)�

Magungunan Intradiscal marasa Aiki don Ciwo na Discogenic

Kamar yadda aka bayyana a ƙarƙashin binciken, za'a iya amfani da zane-zane duka a matsayin hanyar bincike da magani. Bayan an gano diski mara lafiya, ana iya gwada hanyoyin da ba za a iya cutar da su ba kafin a fara aikin tiyata. Za a iya amfani da wutar lantarki da zafinsa don daidaita annulus na baya ta yadda za a ƙarfafa zaruruwan collagen, da lalata da lalata masu shiga tsakani da nociceptors, da ƙididdige adadi. Hanyoyin da ake amfani da su a cikin wannan ana kiran su intradiscal electrothermal therapy (IDET) ko radiofrequency posterior annuloplasty (RPA), wanda ake amfani da na'urar lantarki zuwa diski. IDET yana da matsakaicin shaida a cikin sauƙi na alamun bayyanar cututtuka ga marasa lafiya na cututtuka na diski, yayin da RPA ke da iyakacin tallafi game da ɗan gajeren lokaci da ingantaccen lokaci. Duk waɗannan hanyoyin zasu iya haifar da rikitarwa irin su raunin tushen jijiya, rashin aikin catheter, kamuwa da cuta, da kuma ɓarna diski bayan tsari.

M Jiyya

An keɓe maganin fiɗa don marasa lafiya waɗanda ke da raunin ra'ayin mazan jiya la'akari da tsananin cutar, shekaru, sauran cututtuka, yanayin zamantakewa da tattalin arziki, da matakin sakamakon da ake tsammanin. An kiyasta cewa a kusa da 5% na marasa lafiya da cututtukan diski na degenerative suna yin tiyata, ko dai don cutar lumbar ko cutar mahaifa. (Rydevik, Bj�rn L.)

Hanyoyin Lumbar Spine

An nuna aikin tiyata na Lumbar a cikin marasa lafiya tare da ciwo mai tsanani, tare da tsawon lokaci na 6 zuwa 12 watanni na maganin miyagun ƙwayoyi marasa amfani, waɗanda ke da mahimmanci na kashin baya. Tiyata yawanci hanya ce ta zaɓe sai dai a yanayin ciwon cauda equina. Akwai nau'ikan tsari guda biyu waɗanda ke nufin haɗawa da haɗin kashin baya ko ragewa ko duka biyun. (

Fusion fuska ya haɗa da dakatar da motsi a wani yanki na kashin baya mai raɗaɗi don rage zafi ta hanyar haɗa kashin baya da yawa tare ta amfani da dashen kashi. An yi la'akari da tasiri a cikin dogon lokaci ga marasa lafiya tare da cututtukan diski na degenerative da ciwon ƙwayar cuta na kashin baya ko motsi mai yawa. Akwai hanyoyi da yawa don tiyatar fusion. (Gupta, Vijay Kumar, et al)

• Lumbar kashin baya na guttur fusion

Wannan hanya ta haɗa da sanya ƙashi a cikin ɓangaren baya na kashin baya. Za a iya girbe dashen kashi daga ƙwanƙolin ƙwanƙwasa na baya. Ana cire ƙasusuwan daga periosteum don nasarar dasawa. Ana buƙatar takalmin gyare-gyaren baya a bayan tiyata kuma marasa lafiya na iya buƙatar zama a asibiti na kimanin kwanaki 5 zuwa 10. Ana buƙatar ƙayyadaddun motsi da daina shan taba don samun nasarar haɗuwa. Koyaya, haɗari da yawa kamar rashin haɗin gwiwa, kamuwa da cuta, zubar jini, da ƙaƙƙarfan ƙungiyar tare da ciwon baya na iya faruwa.

• Na baya lumbar interbody fusion

A wannan hanyar, ana iya yin ɓarna ko hanyoyin diskictomy ta hanya ɗaya. Ana amfani da sassan kasusuwa kai tsaye zuwa sararin diski kuma an cire flavum na ligamentum gaba daya. Don cutar diski mai lalacewa, sararin interlaminar yana haɓaka bugu da ƙari ta hanyar yin wani ɓangaren tsakiyar facetectomy. Abubuwan gyaran kafa na baya na zaɓi ne tare da wannan hanyar. Yana da rashin amfani da yawa idan aka kwatanta da tsarin gaba kamar ƙananan ƙananan gyare-gyare kawai za a iya shigar da shi, da raguwar filin da ake samuwa don haɗuwa, da wahala lokacin yin tiyata a kan marasa lafiya na kashin baya. Babban haɗarin da ke tattare da shi shine rashin haɗin gwiwa.

• Fusion na gaba na lumbar interbody

Wannan tsari yana kama da na baya sai dai an tunkare shi ta cikin ciki maimakon baya. Yana da amfani na rashin rushe tsokoki na baya da kuma samar da jijiya. An hana shi a cikin marasa lafiya tare da osteoporosis kuma yana da hadarin zubar jini, retrograde maniyyi a cikin maza, rashin haɗin gwiwa, da kamuwa da cuta.

• Transforaminal lumbar inter fus fusion

Wannan sigar tsarin baya ne wanda aka gyara wanda ke zama sananne. Yana ba da ƙananan haɗari tare da kyawawa mai kyau kuma an nuna shi yana da kyakkyawan sakamako tare da ƴan rikitarwa irin su CSF leak, rashin jin daɗi na wucin gadi, da ciwon rauni.

Jimlar Disc Artroplasty

Wannan madadin faifan diski ne kuma an yi amfani da shi don magance cututtukan diski na lumbar ta hanyar amfani da diski na wucin gadi don maye gurbin diski da ya shafa. Ana iya amfani da jimillar prosthesis ko makaman nukiliya dangane da yanayin asibiti.

Decompression ya haɗa da cire wani ɓangare na diski na jikin kashin baya, wanda ke damun jijiyar don saki wannan kuma ya ba da dakin farfadowa ta hanyar hanyoyin da ake kira diskectomy da laminectomy. Ana iya tambayar ingancin aikin duk da cewa tiyata ce da aka saba yi. Matsaloli kaɗan ne tare da ƙananan damar sake dawowa da alamun bayyanar cututtuka tare da mafi girman gamsuwar haƙuri. (Gupta, Vijay Kumar, et al)

• Lumbar discectomy

Ana yin aikin tiyata ta hanyar tsakiyar layi ta baya ta hanyar rarraba flavum na ligamentum. An gano tushen jijiya wanda ya shafa kuma an yanke annulus mai kumburi don sake shi. Ya kamata a yi cikakken gwajin jijiya daga baya kuma marasa lafiya yawanci sun dace su koma gida bayan kwanaki 1 zuwa 5. Ya kamata a fara motsa jiki na baya nan da nan tare da aikin haske sannan aiki mai nauyi a makonni 2 da 12 bi da bi.

• Lumbar laminectomy

Ana iya aiwatar da wannan hanya daidai matakin ɗaya, da kuma ta matakan da yawa. Laminectomy ya kamata ya zama gajere kamar yadda zai yiwu don kauce wa rashin kwanciyar hankali na kashin baya. Marasa lafiya sun sami alamar taimako na bayyanar cututtuka da raguwa a cikin radiculopathy bin hanya. Haɗarin na iya haɗawa da rashin daidaituwar hanji da mafitsara, zubar CSF, lalacewar tushen jijiya, da kamuwa da cuta.

Hanyoyin Kashin mahaifa

Ana nuna cutar cututtukan ƙwayar cuta ta mahaifa don tiyata lokacin da akwai ciwon da ba za a iya jurewa ba tare da ci gaba da motsin motsi da raunin hankali. Tiyata tana da sakamako mai kyau fiye da 90% idan akwai shaidar rediyo na matse tushen jijiya. Akwai zaɓuɓɓuka da yawa da suka haɗa da discectomy na gaban mahaifa (ACD), ACD, da fusion (ACDF), ACDF tare da gyare-gyaren ciki, da foraminotomy na baya. (

Maganin Tantanin halitta

Ciwon ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta yana da sakamako mai ban sha'awa. An samo gabatarwar chondrocytes na autologous don rage ciwon discogenic a cikin shekaru 2. Wadannan hanyoyin kwantar da hankali suna fuskantar gwaji a halin yanzu. (Jeong, Je Hoon, et al.)

Gene Far

Fassarar kwayoyin halitta don dakatar da tsarin lalata diski har ma da haifar da farfadowa na diski a halin yanzu yana kan bincike. Don haka, dole ne a gano kwayoyin halitta masu fa'ida yayin rage ayyukan haɓakar ƙwayoyin cuta. Waɗannan zaɓuɓɓukan jiyya na sabon labari suna ba da bege ga jiyya na gaba don a jagorance su a sake haɓaka fayafai na intervertebral. (Nishida, Kotaro, et al.)

Cutar cututtuka na rashin lafiya shine batun kiwon lafiya wanda ke fama da ciwon baya na yau da kullum saboda lalacewar intervertebral diski, irin su ƙananan ciwon baya a cikin kashin baya na lumbar ko wuyan wuyansa a cikin kashin mahaifa. Rushewar diski ce ta kashin baya. Yawancin canje-canje na ilimin cututtuka na iya faruwa a cikin lalata diski. Hakanan ana iya samun lahani iri-iri a cikin faifan intervertebral. Ƙananan ciwon baya da ciwon wuyansa sune manyan matsalolin cututtukan cututtuka, waɗanda ake tunanin suna da alaka da cututtukan cututtuka na degenerative. Ciwon baya shine abu na biyu da ke jagorantar ziyarar ofisoshin likitoci a Amurka. An kiyasta cewa kusan kashi 80% na manya na Amurka suna fama da ƙananan ciwon baya aƙalla sau ɗaya yayin rayuwarsu. Don haka, ana buƙatar cikakken fahimtar cututtukan diski na degenerative don sarrafa wannan yanayin gama gari. - Dr. Alex Jimenez DC, CCST Insight

Iyalin bayananmu yana iyakance ga chiropractic, tsoka, magungunan jiki, lafiya, da batutuwan kiwon lafiya masu mahimmanci da / ko labaran aikin likitanci, batutuwa, da tattaunawa. Muna amfani da ka'idojin lafiya na aiki & lafiya don jiyya da tallafawa kulawa ga raunin da ya faru ko cuta na tsarin musculoskeletal. Rubutunmu, batutuwa, batutuwa, da kuma bayananmu sun haɗa da batutuwa na asibiti, batutuwa, da batutuwan da suka shafi da kuma tallafawa kai tsaye ko a kaikaice aikin aikin mu na asibiti. karatu masu goyan bayan rubutun mu. Har ila yau, muna ba da kwafi na tallafin bincike ga hukumar da ko jama'a bisa buƙata. Mun fahimci cewa mun rufe batutuwan da ke buƙatar ƙarin bayani game da yadda zai iya taimakawa a cikin wani tsarin kulawa ko ƙa'idar kulawa; don haka, don ƙarin tattauna batun da ke sama, don Allah jin daɗin tambayar Dr. Alex Jimenez ko tuntuɓe mu a 915-850-0900. Ana ba da (s) lasisi a Texas*& New Mexico*�

Dr. Alex Jimenez DC, CCST ne ya shirya shi

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