Mgbaàmà na ọgwụgwọ nke diski herniated nke spine thoracic

Herniated disc nke thoracic spain - prolapse nke intervertebral diski nke thoracic vertebra (ICD-10 M51). Ejiri nhụjuanya mara, enweghị ncheta nke anụ ahụ na nsogbu somatic. A na-eme nchoputa ahụ na-adabere na usoro data: nsonaazụ nke nyocha nke akụkụ na sistemụ iji wepụ ọrịa na-akpata n'ihi ihe ndị ọzọ, na MRI. A na-emetụta disks nke obere thoracic vertebrae (Th8-Th12).

Ọgwụgwọ na-agbanwe agbanwe ma na-arụ ọrụ. Hernia nke shmorl nke thoracic spain bụ ihe a na-eme na hernia nke anụ ahụ dị elu ma ọ bụ nke dị ala n'ihi nkwụsị nke anụ ahụ cartilaginous nke diski intervertebral. Enweghị ọgwụgwọ ịwa ahụ achọrọ.

Ihe kpatara ya

Usoro etiology nke ọrịa a dabere na usoro ndị na-eduga n'ile anya mgbawa na mbelata nke ike nke annulus fibrosus:

• ibi ndụ otu ebe;
• ogologo oge static na static-ike ibu nke dị ịrịba ike;
• trauma;
• osteochondrosis nke eriri thoracic;
• nsogbu dysmetabolic;
• ọrịa autoimmune.

Mgbanwe nke nkwanye ugwu

Na mmepe ha, prolapses gafere ọtụtụ usoro:

1. Mgbapu nke obere diski ahụ ruo 1-5 mm site na ịchekwa akwa nke mpụga nke eriri fibrous. A na-akpọ ya protrusion.
2. Extrusion ma ọ bụ kpụrụ hainia site na imebi iguzosi ike n'ezi ihe nke mgbanaka na ngbanye nke 5-8 mm.
3. Ihe njiri mara ya bụ necrosis aseptic na nkwụsị nke anụ ahụ hernia (nke ya na-akarịkarị 8 mm), na-esote mbugharị ha na ọwa mmiri, bụ nke nwere nsogbu nsogbu.

Dika ogo nke uzo nke ogwu ogwu, a na-ekewa ihe ndi ozo na obere (0-10%), ọkara (10-20%) na nnukwu (> 20%).

Mgbaàmà na nchoputa dị iche iche

Ha kpebisiri ike site na omume nke hernia, mpaghara ya na ogo nke ịgba. Nke a nwere ike ịbụ mkpakọ nke mgbọrọgwụ akwara azụ ma ọ bụ ihe nke eriri afọ. Dabere na njirisi ọdịdị ala, njigide bụ:

• mpụta,
• ventral (na-anọchite obere ihe egwu);
• Central (etiti ma ọ bụ nke ikpeazụ), nke kachasị dị ize ndụ maka nsogbu ya;
• paramedian.

Fọdụ ndị na-agwọ ọrịa na-amata ọdịiche dị n'etiti, etiti (dị ka ọdịiche nke evolushọn azụ), okirikiri, ikuku, na mpaghara mmebi.

N'ihe gbasara akụkụ nke spain - elu, etiti na ala thoracic.

Ọzọkwa:

• N'ebe dị n'etiti, a na-ahụ mkpakọ nke eriri afọ, yana mmepe nke mkpakọ myelopathy na ọdịdị nke spastic mono- ma ọ bụ papararesis dị ala, yana nsogbu pelvic.
• Site na mpaghara mpaghara, mgbaàmà mgbagwoju anya nke mkpakọ nke mgbọrọgwụ azụ na ngosipụta nke nsogbu na-apụta n'elu:
  • nghọta sensory na igbe;
  • Mmetụta nke obi ụtọ mgbe hernia na-emetụta alaka visceral, nke na-akpata mgbanwe ọrụ na ọrụ nke akụkụ ahụ.

Ihe isi ike na nchoputa na-akpata site na nkọwa nke mgbaàmà nke ọrịa ahụ. Ntughari, dabere na ọnọdụ ahụ, nwere ike iicomi ihe ịrịba ama nke ọrịa thoracic na afọ. Ya mere, iji nyochaa nchoputa, onye na-agwọ ọrịa na-agwọ ọrịa nwere ike ịgụnye ndị ọkachamara pụrụ iche.

Alexandr Mitiuc - ngwaahịa.adobe.com. Ihe ngosi ichoro nke ebe hainia di na ogwu ogwu.

Ule nwere Nitroglycerin ma ọ bụ Corvalol nwere ike inye aka ịmata ọdịiche dị na mkpochapu diski na ngosipụta nke mgbagwoju anya nke angina pectoris, bụ nke a na-agaghị akwụsị ihe mgbu nke mkpakọ nke mgbọrọgwụ akwara.

Mgbe ị na-eme nchọpụta dị iche iche nke diski pathogenesis (nkwupụta diski) na ọrịa nke akụkụ eriri afọ, ekwesiri iburu n'uche na ihe mgbu dị n'ime afọ adịghị n'ụzọ metụtara nri oriri.

Mgbaàmà nwere ike ịdị iche na ụmụ nwanyị na ụmụ nwoke. Nke ikpeazụ nwere ike belata libido na nrụrụ erectile. Womenmụ nwanyị na-arịa ọrịa ọrịa ovarian, nsogbu oge, nke na-eduga nbelata ohere nke ịtụrụ ime, ihe mgbu na mpaghara mpaghara, nke na-enwekarị mgbagwoju anya na mmalite nke mastitis (ọrịa ara ara).

Ihe nyocha

Diagnosis dabeere:

1. ụdị mkpesa ndị ọrịa na-eme (mmekpa ahụ nke akụkụ dị nro na nke moto, mgbanwe ngbanwe na ọrụ nke akụkụ ahụ, nke akpakọba akwara abịakọrọ);
2. data nyocha nyocha na nyocha nke oria;
3. Ihe nchoputa nke MRI (ya na nghota ndi ozo, dika ima atu nke pacemaker artificial, enwere ike iji CT nke spain mee ihe, mana izizi nke ihe omumu a adighi ala karia MRI);
4. data sitere na nyocha ụlọ nyocha, nyocha nke ngwa na nyocha nke ndị ọkachamara metụtara ya, na-enye ohere maka nyocha dị iche iche (iji nyere aka chọpụta hernia ma wezuga angina pectoris, nchịkọta akụkọ ihe mere eme zuru ezu, data ECG na ule arụmọrụ na-egosi enweghị myocardial ischemia ga-enyere aka).

Ihe isi ike na ịme nchọpụta nwere ike ịbụ n'ihi ọrịa ndị na-agakọta ọnụ. Onye ọrịa ahụ nwere ike na-echegbu onwe ya site na thoracalgia yana onye na-achọpụta na ọ na-eme ihe na-eme ka ọkpụkpụ azụ na azụ azụ nke azụ azụ na azụ azụ azụ. Ọzọkwa, hainia nwere ike ịkpasu ọgụ nke angina pectoris.

Usoro nke ọgwụgwọ nwere ike kpebisie ike site na ndị ọkachamara abụọ - onye na-agwọ ọrịa na onye na-agwọ ọrịa (ma ọ bụ onye na-agwọ ọrịa obi).

Ọgwụgwọ

E kewara ya n'ime nchekwa na ịwa ahụ. A na-eme ọgwụgwọ ọgwụgwọ na-agwọ ọrịa na ọnọdụ ụlọ, na-enye ihe maka iji:

• mkpochapu ma ọ bụ mbelata nke thoracalgia;
• mgbochi nke uto protrusion.

Ọgwụ ọgwụ

Gụnyere oru:

• NSAIDs (Naproxen, Ibuprofen, Celecoxib, Ketoprofen, Carprofen, wdg);
• corticosteroids (metipred);
• mgbochi mpaghara (ọgwụ mgbochi + corticosteroids);
• ndị na-eme ka ahụ ike na-arịa ọrịa spastic siri ike (Tolperisone, Mydocalm, Sirdalud);
• a na-eji chondroprotectors (Glucosamine, Aorta - iji meziwanye trophism nke nucleus pulposus, ha na-egosipụta arụmọrụ kachasị na ọkwa nke ngagharị nke diski intervertebral);
• B vitamin (B1 na B6, na-akpali mweghachi nke eriri akwara).

Usoro ọgwụ na-enye gị ohere ịkwụsị ọrịa mgbu ma mepụta ndabere dị mma maka iji usoro ọgwụgwọ ndị ọzọ na-agbanwe agbanwe.

Mmetụta nke mgbatị ahụ (mmega ahụ)

Gymnastics na-enye aka ịbawanye ọbara, belata spa ma mepụta corset muscular, nke na-enyere aka belata usoro musculoskeletal. A na-etinye mmega ahụ maka hernia nke azụ azụ thoracic na-agbasosi ike na ndabere nke mmadụ n'otu n'otu n'oge oge mgbaghara, oge ụfọdụ na mbido ọrịa ahụ, ma ọ bụ n'oge oge mgbake. Emere mmega ahụ na nke izizi n'okpuru nlekọta nke onye nkuzi mgbatị ahụ. A na-eme usoro ihe omume ndị a tụrụ aro n'ụlọ.

Acupuncture, reflexology

A na-eji ha eme ihe iji belata ihe mgbu na ahụ ike.

Usoro ọgwụgwọ na ịkpụkpụ azụ

A na-eji ha iji mee ka ebe dị anya n'etiti akụkụ vertebral.

Uld Mulderphoto - stock.adobe.com. Na-agbatị ọkpụkpụ azụ.

Mmetụta nke ịhịa aka n'ahụ

Edere aka ịhịa aka iji belata ụda olu nke akwara paravertebral. A na-eji ya izu ike ma melite ọkọnọ na mmalite nke ọrịa na oge mgbaghara.

Ahụ ike

A na-eji ya iji mee ka ahụ nwee ahụ ike na mgbochi mkpali na ọkwa niile nke mgbanwe hernia n'oge mgbagha. Ejiri: ultraphonophoresis nke Hydrocortisone, electrophoresis, magnetotherapy na UHF.

Na enweghị mmetụta nke ọgwụgwọ mgbanwe na / ma ọ bụ ọdịdị nke ihe ịrịba ama nke myelopathy, ha na-amalite ọgwụgwọ ịwa ahụ.

Mmetụta dị mma nke ERT mgbe arụ ọrụ gasịrị na mmalite mgbake (usoro nke EHF, laser na ọgwụgwọ magnetik, electromyostimulation) abụrụla nke ọma n'ụlọ ọgwụ.

Usoro Prọfesọ Bubnovsky

Dr. Bubnovsky na-atụ aro usoro omume ndị gbadoro anya na ịgbatị ahụ azụ:

• Iguzo ọtọ ma debe ụkwụ gị n'akụkụ obosara, ịkwesịrị iji nwayọ na-aga n'ihu, na-agbatị isi na aka gị n'etiti ikpere gị.

• Tọ ụkwụ gị kwụ ọtọ na azụ oche ahụ, ị ​​kwesịrị ịnwa idobe ahụ gị na apata ụkwụ mgbe ị na-eku ume, na-anwa ijide sock n'aka gị.

• Gha ụgha n'afọ gị, gbatịa aka gị n'ihu, na-eweli ahụ ma jiri aka gị na-agbada n'ala mgbe ị na-ekupụ ume.

• N'ọnọdụ guzo, gbatịa elu, na-anwa ịrị elu na mkpịsị ụkwụ gị dị ka o kwere mee.

Wa ahụ

Egosiri na adighi ike nke usoro nchedo nke onwa isii. Approachzọ ahụ gụnyere:

• laminotomy ma ọ bụ laminectomy - mmezigharị nke zuru oke ma ọ bụ nke akụkụ nke eriri afọ vertebral maka decompression nke canal vertebral; mgbe a na - ejikọta ya na njikọta - ndozi nke vertebrae dị n'akụkụ maka njikọta;
• laminoplasty - a tomia nke eriri ogwu iji mee ka oghere dị gburugburu mgbọrọgwụ ma mepụta mgbatị;
• ikpochapu diski (microdiscectomy (dika nhọrọ - endoscopic), discectomy).

Mgbe ịwa ahụ ọgwụgwọ, nsogbu ga-ekwe omume:

• na-efe efe - myelitis, spinal arachnoiditis;
• anaghị efe efe:
  • mmalite - ọbara ọgbụgba, ngbanwe nke irighiri akwara ma ọ bụ dura mater;
  • mbubreyo - e guzobere ankylosis (fusion) nke ozu nke dị n'akụkụ vertebrae.

Egwuregwu maka ịlaghachi azụ nke azụ azụ (egwuregwu a machibidoro iwu na nke amachibidoro)

Egwuregwu na-ejedebe. Mitteddị ndị a kwadoro gụnyere:

• aqua aerobics na igwu mmiri (dika ọgwụgwọ na mgbochi):
  • uru ahụ zuru ike, ibu dị na spain na-ebelata, akwara na nkwonkwo na-ewusi ike;
  • na-ewusi usoro iku ume, imeziwanye ọbara.
• ọzụzụ na mgbatị ahụ n'okpuru nlekọta nke onye nkụzi ọgwụgwọ mgbatị ahụ;
• Paịlet;
• ibili elu;
• ahụike na klaasị yoga;
• na-emega ahụ na simulators;
• ịnọdụ ala na bọọlụ;
• nghọta n’elu osisi kwụ ọtọ;
• Gba ịnyịnya ígwè na a ji nwayọọ nwayọọ na-agba ọsọ;
• squats (n'oge mgbaghara).

Omume ọ bụla dị n'elu ga-eme naanị n'okpuru nlekọta nke ọkachamara. Nlere chọrọ oche ma ọ bụ iguzo kwesịrị ịhapụ:

1. ibuli elu;
2. elu na ogologo jumps;
3. football, basketball, ịgba ọsọ, ịgba ọsọ;
4. ije ije;
5. egwuregwu ike.

Nsogbu na nsonaazụ nke prolapse

Ọganihu nke nosology nwere ike iduga:

• akpọ intercostal neuralgia;
• mgbanwe ngbanwe mkpịsị akwara (otu n'ime nsogbu kachasị njọ):
  • paresis nke aka na aka;
  • zuru ezu nke ọrụ nke akụkụ pelvic.
• ọgba aghara na-arụ ọrụ nke obi na akụkụ iku ume (a na-eche ihe mgbu n'obi na nkwụsịtụ na-arụ ọrụ nke obi; mkpụmkpụ ume na-eme, ọ na-esiri ike iku ume);
• ọganihu nke ọrịa orthopedic (scoliosis, kyphosis);
• e guzobere hernias intervertebral n'akụkụ ndị ọzọ nke spain - n'ihi nkesa na-enweghị nchịkwa nke ibu na nhụsianya nke ọrịa ahụ.

N'ihi imebi nke Invation, nzaghachi na otu ma ọ bụ ọzọ visceral ngwa na-ata ahụhụ. E bibiri usoro nke usoro iwu kwadoro. Colon dyskinesia nwere ike itolite na colitis, na nsogbu ndozi nke pancreas nwere ike gbanwee na pancreatitis. Ọzọkwa, prolapse nwere ike ibute ọgba aghara na-eyi ndụ egwu nke usoro obi (nnukwu myocardial infarction; exertional angina na angina na-ejighị n'aka; mberede obi obi).

Mgbochi

Tù ahụ nwere ihe egwu gụnyere ndị nnọchi anya nke ọpụrụiche na ọrụ ndị ahụ gụnyere ogologo oge na-adịghị agbanwe agbanwe ibu na spain: ndị dọkịta na-awa, ndị egwuregwu, ndị ahịa, ndị ọrụ ụlọ ọrụ.

Ọ dị nnọọ mfe igbochi nhazi nke hernia karịa ịgwọ ya. Imega ahụ kwa ụbọchị ga-enyere gị aka izere ya. Omume dịgasị iche iche na-enye aka ọ bụghị naanị na ịmepụta mmiri synovial na hydration nke diski ahụ, kamakwa iji wusi akwara miri emi nke azụ, nke na-ebelata ibu na spine.

Mgbe ị na-emega ahụ mgbochi, ọ dị mkpa icheta na:

1. The discs ka mma ruru eru ka vetikal ibu karịa ka kwụ ma ọ bụ oblique ibu. Nke a pụtara na mgbe ị na-ebuli ihe dị arọ, ị kwesịrị ịpịa, mana agbada.
2. Rụ ọrụ ịnọ otu ebe, ọ dị mkpa ịgbanwe ọnọdụ ahụ ọtụtụ ugboro n'ụbọchị, na-eme mmemme mgbochi, gbalịa ịnọdụ ala dị ka o kwere mee.
3. Igwu mmiri na mmiri aerobics bara ezigbo uru na usoro mgbochi, ebe ọ bụ na ha na-enye gị ohere iwusi akwara akwara ike, ma na-ebelata ọkpụkpụ azụ n'otu oge.

Lelee vidiyo ahụ: Spine Surgery: Surgical removal of a herniated disk resulting in leg weakness (November 2024).