Umgogodla we-lumbar, noma umgogodla we-lumbosacral, ubhekisa engxenyeni yomgogodla osemhlane ongezansi, ngenhla nje kwe-sacrum. Indawo ephathekayo kakhulu futhi isekela wonke omunye umgogodla, isetshenziswa kakhulu nsuku zonke futhi kwesinye isikhathi isisulu sokuguga ngaphambi kwesikhathi. Futhi, umgogodla we-lumbar uvame ukuba yindawo yobuhlungu, izimbangela zazo zingaba ziningi.

Igama elithi umgogodla lisho umgogodla. Yenziwe isitaki sama-vertebrae ahlukene: ama-vertebrae womlomo wesibeletho ayi-7, ama-vertebrae ayi-12 e-dorsal (noma we-thoracic), ama-vertebrae ama-lumbar ama-5, i-sacrum enama-vertebrae ahlanganisiwe ama-5 futhi ekugcineni i-coccyx yakhiwa ama-vertebrae ama-4.

Umgogodla we-lumbar ubhekisa engxenyeni ephansi, ehambayo yomgogodla, etholakala ngenhla nje kwe-sacrum. Yenziwe ngama-vertebrae ayisihlanu we-lumbar: i-L1, L2, L3, L4 ne-L5 vertebrae.

Lawa ma-vertebrae ayisihlanu axhumekile futhi achazwe ngemuva ngamajoyinti wezinhlangothi, futhi ngaphambili ngama-disc vertebral. Phakathi kwe-vertebra ngayinye, izimpande zezinzwa ziphuma ngezimbobo ezibizwa nge-foramina.

Umgogodla we-lumbar wethula i-concave arch ngemuva, ebizwa nge-lumbar lordosis.

Njengawo wonke umgogodla, umgogodla we-lumbar uvikela umgogodla kuze kufike kumgogodla we-L1-L2, bese kuba yimizwa yomgogodla evela ku-L1-L2.

Ngokunamandla, ngenxa yendawo akuyo, umgogodla we-lumbar usekela wonke umgogodla futhi uqinisekisa ukuhamba kwawo. Iphinde idlale indima yokusatshalaliswa kokushaqeka nokusatshalaliswa komthwalo phakathi kwesikhumba nesifuba. Imisipha yomqolo yomgogodla, ebizwa nangokuthi imisipha yomgogodla, enweba ezinhlangothini zombili zomgogodla isiza ukuqeda le ngcindezi etholakala emgogodleni.

Ngenxa yokuxakaniseka kwayo kwe-anatomical, ukwakheka kwemizwa okuqukethe, izingqinamba zemishini zansuku zonke ezisekelayo kepha nokuguga komzimba kwezinhlaka zayo ezahlukahlukene, umgogodla we-lumbar ungathinteka yizifo eziningi. Nazi ezinkulu.

Ubuhlungu obuphansi emuva

Ubuhlungu obuphansi emuva yisikhathi sesambulela sezinhlungu eziphansi emuva. Ezincomweni zayo zakamuva zokuphathwa kobuhlungu obuphansi emuva, i-HAS (Haute Autorité de Santé) ikhumbula le ncazelo: “Ubuhlungu beqolo obuphansi buchazwa ubuhlungu obutholakala phakathi komnyango we-thoracolumbar kanye nomgogodla ophansi we-gluteal. Ingahlotshaniswa ne-radiculalgia ehambelana nobuhlungu kwesinye noma zombili izitho ezingezansi endaweni eyodwa noma ngaphezulu. "

Ngokwesikimu, singahlukanisa:

• Ubuhlungu obujwayelekile obuphansi emuva, obubonakala ngezinhlungu ezisezingeni eliphansi ezingenazo izimpawu zokuxwayisa. Ezimweni ezingama-90%, izinhlungu ezivamile ezibuhlungu emuva emuva ziguquka kahle ngaphansi kwamasonto amane kuya kwayisithupha, kukhumbula i-HAS;
• Ubuhlungu obungapheli obubuhlungu beqolo, okungukuthi ubuhlungu obuphansi emuva obuhlala ngaphezu kwezinyanga ezintathu;
• i- "flare acute of back pain" noma i-acute back pain, noma i-lumbago ngolimi lwansuku zonke. Kubuhlungu obukhulu, besikhashana ngoba imvamisa kungenxa yokunyakaza okungalungile, ukuthwala umthwalo osindayo, umzamo ongazelelwe (“ukujika kwezinso” okudumile). 

I-Lumbar disc herniation

I-disc ye-herniated iboniswa ukuphuma kwe-nucleus pulposus, ingxenye ye-gelatinous yediski ye-intervertebral. Le hernia izocindezela impande eyodwa noma ngaphezulu yezinzwa, ibangele izinhlungu emuva noma ubuhlungu ethangeni kuye ngendawo ye-hernia. Uma i-vertebra ye-L5 ithintekile, i-hernia izobangela i-sciatica ebonakala ngobuhlungu ethangeni, yehle emlenzeni ibheke kuzwane olukhulu.

I-Lumbar osteoarthritis

I-osteoarthritis, okuyisikhumbuzo esiyisifo esiwohloza uqwanga, ingathinta amalunga phakathi kwama-vertebrae amabili. Le lumbar osteoarthritis kungenzeka ingabangeli zimpawu, ngoba ingaholela ekukhuleni kwethambo okubizwa nge-osteophytes okuthi, ngokucasulwa inzwa, kubangele izinhlungu ezisezingeni eliphansi.

I-Lumbar stenosis yomgogodla noma umsele omncane we-lumbar

I-Lumbar stenosis ukuncipha komsele omaphakathi womgogodla, noma i-lumbar canal, equkethe izimpande zezinzwa. Kuvame kakhulu ukuhlobana nobudala, futhi kubangele ubunzima ekuhambeni nomuzwa wobuthakathaka, ukuba ndikindiki, ukuncinza emilenzeni, i-sciatica eyenzeka lapho uphumule noma ngesikhathi sokuzikhandla, futhi kuyaqabukela, ukukhubazeka. okubaluleke kakhulu noma okungaphansi kwezitho ezingezansi noma imisebenzi ye-sphincter.

Isifo se-Lumbar disc

Isifo se-degenerative disc, noma ukwehla kwe-disc, kubonakala ngokuguga ngaphambi kwesikhathi kwe-disc ye-intervertebral kanye nokoma okuqhubekayo kwe-nucleus yayo ephakathi ye-gelatinous. I-disc ibese icindezelwa futhi izimpande zemizwa ziyacasuka, okudala ubuhlungu emhlane ongezansi. Isifo se-degenerative disc naso sithathwa njengembangela enkulu yezinhlungu ezisezingeni eliphansi.

I-degenerative lumbar scoliosis

I-degenerative lumbar scoliosis izibonakalisa njengokukhubazeka komgogodla. Kuvame kakhulu kwabesifazane, ikakhulukazi ngemuva kokunqamuka kokuya esikhathini. Sizibonakalisa ngezinhlungu zasemhlane nasethangeni, elikhanyisa ethangeni, livame ukwanda ngokuhamba. I-degenerative lumbar scoliosis ingumphumela wesethi yezinto: ukwehluleka kwe-disc okunezelwa ukungabi bikho kwethoni yemisipha, i-osteoporosis kanye ne-spinal ligament fragility.

I-spondylolisthesis ehlukumezayo

Le pathology exhumene nokuguga okungokwemvelo komgogodla kubonakala ngokuslayida kwe-vertebra eyodwa kolunye, imvamisa i-L4-L5. I-Lumbar canal stenosis nezimpawu zayo ziyalandela.

Ukuqhekeka kweLumbar

Ukuphuka komgogodla kungenzeka ngesikhathi somthelela onamandla kakhulu (ikakhulukazi ingozi yomgwaqo). Lokhu kuphuka komgogodla kungahle kuhlotshaniswe nokulimala kwentambo yomgogodla kanye / noma izimpande zemizwa, ingozi bese kuba ukukhubazeka. Ukwephuka nakho kungazinzi, futhi uma kwenzeka ukufuduka kwesibili kuholela engozini yezinzwa.

Ubuhlungu obuphansi emuva

Ezincomweni zayo zakamuva zokuphathwa kobuhlungu obujwayelekile obujwayelekile emuva, i-HAS ikhumbula ukuthi ukuzivocavoca umzimba kuyindlela yokwelashwa eyinhloko evumela ukuvela okuhle kwalesi sifo. I-Physiotherapy nayo ikhonjisiwe. Ngokuphathelene nokwelashwa kwezidakamizwa, kuyakhunjulwa "ukuthi akukho muthi we-analgesic obonakalise ukusebenza esikhathini esiphakathi ekuthuthukiseni ukuhlaselwa okunamandla kobuhlungu beqolo elincane, kepha lokho kuphathwa kwe-analgesic, okuqala ngezinga le-analgesics I (paracetamol, NSAIDs), kungaba kwenziwe ukuqeda ukuhlaselwa okubuhlungu ”. I-HAS iphinde igcizelele "ukubaluleka kokunakekelwa komhlaba wonke kwesiguli esaziwa ngokuthi" bio-psycho-social ", kucatshangelwa isipiliyoni sesiguli kanye nemiphumela yobuhlungu baso (ubukhulu bomzimba, obungokwengqondo nobenhlalo nobungcweti)".

I-disc ye-Herniated

Ukwelashwa kolayini wokuqala kuyizimpawu: ama-analgesics, izidakamizwa ezilwa nokuvuvukala, ukungena ngaphakathi. Uma ukwelashwa kwehluleka, kungahlinzekwa ngokuhlinzwa. Inqubo, ebizwa ngokuthi i-discectomy, ifaka phakathi ukususa i-hernia ukuze kucindezelwe impande yezinzwa ecasukile.

I-Lumbar stenosis

Ukwelashwa kolayini wokuqala kudla ngoludala: ama-analgesics, ama-anti-inflammatories, ukuvuselelwa, ngisho ne-corset noma ukungena. Uma ukwelashwa kwehluleka, kungahlinzekwa ngokuhlinzwa. Inqubo, ebizwa nge-laminectomy noma ukukhishwa kwentambo yomgogodla, ifaka phakathi ukususa i-vertebral lamina ukukhulula umsele womgogodla.

Isifo se-disgenerative

Ukwelashwa kolayini wokuqala kuyizimpawu: ama-analgesics, izidakamizwa ezilwa nokuvuvukala, ukungena ngaphakathi, ukuvuselelwa kokusebenza. Ukuhlinzwa kuzobhekwa uma kwenzeka ukwehluleka ukwelashwa nokukhubaza ubuhlungu nsuku zonke. I-Lumbar arthrodesis, noma i-fusion yomgogodla, iqukethe ukususa i-disc eyonakele bese ubeka idivaysi yezokwelapha phakathi kwama-vertebrae amabili ukugcina ukuphakama kwediski.

I-degenerative lumbar scoliosis

Ama-analgesics, imishanguzo elwa nokuvuvukala nemijovo kwakha ukwelashwa okuyizimpawu komugqa wokuqala. Uma kwenzeka ukwehluleka nobuhlungu obuthakathaka, kungahlolisiswa ukuhlinzwa. I-arthrodesis izobe ihlose ukuhlanganisa isiteji se-vertebral esedlulele ngokweqile futhi icindezele izimpande zezinzwa.

Ukuqhekeka kweLumbar

Ukwelashwa kuncike ohlotsheni lokwephuka kanye nomonakalo ohlotshaniswa nemizwa noma cha. Ukuhlinzwa kuzohlose, kuya ngecala, ukubuyisa ukuzinza komgogodla, ukubuyisa ukwakheka kwe-vertebra ephukile, ukucindezela izakhiwo zezinzwa. Kulokhu, kusetshenziswa amasu ahlukene: i-arthrodesis, ukunwetshwa komgogodla, njll.

I-spondylolisthesis ehlukumezayo

Uma kwenzeka ukwehluleka kokwelashwa (ama-analgesics, izidakamizwa ezilwa nokuvuvukala nokungena), i-arthrodesis ingacatshangelwa.

I-lumbar spine x-ray

Lokhu kuhlolwa okujwayelekile kuhlola i-morphology ephelele yomgogodla. Kuvame ukunikezwa njengokwelashwa komugqa wokuqala wezinhlungu ezisezingeni eliphansi. Kwenza kube lula ukuthola ubukhona bezilonda eziwohlokayo (i-lumbar osteoarthritis), ukucindezelwa kwe-vertebral noma ukungahambi kahle komzimba kwe-vertebrae, ukungajwayelekile kwe-statics (scoliosis) noma ukushelela kwe-vertebrae. Ngakolunye uhlangothi, akwenzeki ngaso sonke isikhathi ukuthi kutholakale ukuphuka kwe-vertebral. Ama-discs, intambo yomgogodla, izimpande zemizwa eyizakhiwo ezinemisebe (zivumela ama-X-ray ukuthi adlule), i-x-ray yomgogodla we-lumbar ayikhombisi amadiski e-herniated noma ama-pathologies womgogodla.

I-MRI yomgogodla we-lumbar

I-MRI ukuhlolwa okujwayelekile komgogodla we-lumbar, ikakhulukazi ukuthola izifo zomgogodla. Ivumela ukubona ngeso lengqondo ngobukhulu obu-3 izingxenye zamathambo nezingxenye ezithambile: umgogodla, umgudu, idiski, izimpande zemizwa. Futhi ngaleyo ndlela kutholakale izifo ezahlukahlukene zomgogodla we-lumbar: i-disc ye-herniated, isifo se-disenerative disc, i-disc protusion, i-lumbar stenosis, ukuvuvukala kwamapuleti we-vertebral, njll.

I-lumbar spine CT scan

I-lumbar CT scan noma i-computed tomography ukuhlolwa okujwayelekile uma kwenzeka kuphuka umgogodla. Ingabuye ihlolisise i-disc ye-herniated, ihlole izinga le-lumbar stenosis, ithole i-vertebral bone metastases. Kubuye kubekwe ngokuvamile njengengxenye yokuhlolwa kokuhlinzwa kokuhlinzwa komgogodla, ikakhulukazi ukuhlola isikhundla semikhumbi.