Mgbu na mpaghara lumbar bụ ọrịa mgbu na-emekarị na-eme ihe n'èzí. 30-60% nke ndị bi na mba ndị mepere emepe na-ata ahụhụ site na mgbu azụ na-aga n'ihu, na ruo 80% nke mgbu azụ niile na-eme na mpaghara lumbar (lumbar azụ). Ndị ọgbọ niile nwere ike ịta ahụhụ site na mgbu azụ azụ, mana ọnụ ọgụgụ kachasị elu na-apụta n'etiti afọ 30 na 60.
Mgbu na mpaghara lumbar n'ihi ọrịa
Ihe mgbu dị ala bụ ihe mgbaàmà na-enweghị isi nke nwere ike ịkpata ya n'ọtụtụ ihe kpatara ya. Ndị dọkịta na-amata ọdịiche dị n'etiti ọrịa mgbu mgbu nke isi na nke abụọ. Ọtụtụ ihe mgbu na mpaghara lumbar dabeere na musculoskeletal morphofunctional mgbanwe (primary lumbar pain syndrome). Ndị a bụ ọnya degenerative-dystrophic nke ọkpụkpụ azụ:
Ihe nwere ike ịkpata ọrịa ọrịa mgbu dị ala nke abụọ:
- Ọkpụkpụ mbụ na metastatic nke vertebrae, eriri afọ, oghere retroperitoneal.
- Ọkpụkpụ vertebral.
- Ọrịa na-efe efe nke vertebrae na intervertebral discs (ụkwara nta, brucellosis, epidural abscess).
- Ọrịa mkpali na-adịghị efe efe (ankylosing spondylitis, Reiter's syndrome, rheumatoid ogbu na nkwonkwo).
- Ọkpụkpụ metabolic (osteoporosis, osteomalacia).
- Ihe mgbu na-eto eto (scoliosis).
- Ọgba aghara ọbara ọgbụgba (stroke).
- Ọrịa nke eriri afọ tract (atypical N'ezie nke nnukwu appendicitis, eriri afọ obstruction).
- Ihe mgbu na-ezo aka na ọrịa nke akụkụ pelvic (gụnyere colic renal, ọrịa gynecological na-efe efe, dị ka chlamydia, gonorrhea, trichomoniasis, ureaplasmosis, adnexitis).
Mgbu na mpaghara lumbar nwekwara ike ịdị oke ma ọ bụ na-adịghị ala ala, na ihe kpatara ya bụ mmebi nke ọkpụkpụ azụ ma ọ bụ mgbọrọgwụ akwara. Enwere ike ibugharị mgbu site na akụkụ dị omimi:
- akụrụ;
- pancreas;
- eriri afọ;
- akụkụ pelvic;
- ụbụrụ retroperitoneal.
Nnukwu mgbu na mpaghara lumbar
Mgbatị dị ukwuu. A na-etinye ihe mgbu na mpaghara azụ azụ azụ n'oge spasm ha, nke na-akpata mgbochi na mmegharị ahụ. Enweghị ntugharị nke mgbu na mpaghara ukwu ma ọ bụ nsọtụ ala.
Ọkpụkpụ vertebral. Ọtụtụ mgbe, nke a bụ nsonaazụ nke mmerụ ahụ mgbe ọ na-ehulata ma ọ bụ daa n'ụkwụ, ma otu ihe ahụ nwere ike ịbụ na-enweghị mmerụ ahụ ma ọ bụ na-enwe obere trauma ma ọ bụrụ na onye ọrịa ahụ nwere usoro skeletal na-emetụta, osteoporosis, Cushing's syndrome, hyperparathyroidism, myeloma, metastases nke ụbụrụ ọjọọ na ọkpụkpụ, ọrịa Paget.
Ntugharị nke diski intervertebral na mpaghara lumbar. Mgbaàmà nke ọrịa a na-agụnye mgbu na mpaghara lumbar, ọnọdụ a na-amanye, na njedebe na-agagharị. A na-egosi ntinye nke mgbọrọgwụ akwara na usoro pathological site na: mgbu radicular, na-abụkarị otu akụkụ; nsogbu uche (paresthesia, hyperesthesia ma ọ bụ hypalgesia); ebelata ma ọ bụ na-anọghị Achilles ma ọ bụ ikpere reflex.
Ọrịa Facet. Mkpakọ nke mgbọrọgwụ na ọpụpụ ya site na ọkpụkpụ azụ azụ na-akpata mgbu na-egbuke egbuke nke na-adịghị akpata mmebi diski. Unilateral facet syndrome, nke a na-ejikọtakarị na mgbọrọgwụ L5, na-eme mgbe akụkụ elu na nke ala nke nkwonkwo intervertebral na-ebuwanye ibu, nke na-agụnye mbelata nke ọwa mmiri intervertebral ma ọ bụ foramen.
Epidural ọnya. Ọtụtụ mgbe a na-achọta ya na spine thoracic, ọ nwere ike na-esonyere ya na nnukwu mgbu na azụ mgbe ọ na-akụtu ma ọ bụ na-akụ ebe ahụ emetụtara. Na-achọ nyocha ngwa ngwa na mmalite usoro ọgwụgwọ, gụnyere ịwa ahụ, ma ọ bụrụ na enwere ihe ịrịba ama nke mkpakọ ọkpụkpụ azụ. Usoro pathological na nkwonkwo hip nwere ike jikọta ya na mgbu na-egbuke egbuke na mpaghara gluteal na akụkụ dị ala na ọkwa nke nkwonkwo ikpere.
Ihe mgbu ala azụ na-adịghị ala ala
Spondylosis deformans. Spondylosis deformans bụ mgbanwe degenerative na lumbar vertebrae na nguzobe nke ọkpụkpụ na-eme ka ọkpụkpụ azụ dị warara ma tinye nrụgide na mgbọrọgwụ. Ọ bụrụ na mgbu lumbosacral na-egosi na mgbaàmà akwara ozi mgbe ị na-eje ije (mfu nke mmetụta, mmetụta uche ma ọ bụ adịghị ike na njedebe abụọ dị ala), enwere enyo nke ọrịa claudication intermittent jikọtara ya na spine na-ebilite site na mbelata nke ọkpụkpụ azụ. A na-enyocha nchoputa ahụ site na nyocha.
Ankylosing spondylitis. Ekwesịrị ka a na-enyo enyo na ndị na-eto eto nwere ihe mgbu na azụ azụ nke na-agagharị na hips. Nke mbụ, enwere oke ngagharị na isi ike nke ụtụtụ, mbelata mmegharị iku ume nke obi, yana ntughari na ntughari nke spine thoracic. Ihe ịrịba ama X-ray: mbibi na nhazigharị nke nkwonkwo sacroiliac, nguzobe nke a na-akpọ spine "bamboo". Mgbaàmà ndị yiri ya na obere mmegharị na azụ azụ nwere ike ime na:
- ọrịa ogbu na nkwonkwo psoriatic;
- Ọrịa Reiter;
- colitis na-adịghị ala ala.
Tumors na metastases ha, ọrịa metabolic. Iji redio na myelography, ọ dị mkpa ka ewepu ndị na-esonụ pathological ọnọdụ: metastatic carcinoma (ara, ngụgụ, prostate, thyroid, akụrụ, eriri afọ tract), myeloma, lymphoma.
Osteomyelitis. Ihe kpatara ya site na nje bacteria pyogenic (na-emekarị staphylococci) ma ọ bụ Mycobacterium ụkwara nta; A ghaghị ikwenye ma ọ bụ wepụ ohere nke ọrịa ndị a site n'ịchọpụta ESR, x-ray ọkpụkpụ, na nyocha anụ ahụ na tuberculin.
Ọkpụkpụ intradural:
- neurofibroma;
- meningioma;
- lipoma
Ụbụrụ ndị dị n'elu nwere ike ịkpata mgbu na-adịghị ala ala ọbụna tupu mgbaàmà akwara ndị ọzọ apụta. Mgbanwe mgbu na mpaghara lumbar n'ihi ọrịa nke akụkụ ahụ dị n'ime. Mgbe a na-emetụta akụkụ ahụ pelvic, ihe mgbu na-agbanwe na mpaghara sacral, akụkụ nke oghere afọ nke ala - na akụkụ nke lumbar, oghere afọ nke elu - na akụkụ thoracic na elu lumbar. Enweghị mgbaàmà mpaghara ma ọ bụ isi ike na azụ; mmegharị azụ zuru oke anaghị abawanye mgbu.
Ọgwụgwọ
Site na osteochondrosis nke spine lumbar, onye ọrịa ahụ na-enwe mmetụta mgbu na azụ azụ mgbe ọ na-eje ije, ọdụ, na-ebuli ihe dị arọ, ụkwara, imi. Ihe mgbu dị ala na-apụta mgbe ụfọdụ na ụkwụ. N'okwu a, ịkwesịrị ịkpọtụrụ onye na-ahụ maka akwara ozi ngwa ngwa.
Egbula oge ịga leta dọkịta gị ma ọ bụrụ:
- na-enweta mgbu azụ dị ala karịa ihe karịrị ụbọchị 3;
- ihe mgbu mere mgbe mmerụ ahụ gasịrị;
- n'otu oge ahụ ị na-enwe mmetụta mgbu na ala azụ, ala ụkwụ na ụkwụ;
- A na-ejikọta ihe mgbu na azụ azụ na nkwụsịtụ na buttock, apata, ụkwụ, ụkwụ, na mpaghara ukwu.
Mgbu mgbu dị ala bụ ihe mgbaàmà a na-ahụkarị, ọkachasị na ndị agadi. Rheumatism, lumbar osteochondrosis na radiculitis - ọrịa ndị a niile na-akpata nnukwu mgbu na mpaghara lumbar. Naanị nyocha ziri ezi nke ahụ nwere ike igosi nsonaazụ ma nye azịza doro anya banyere ihe kpatara mgbu azụ ala.