Intervertebral Foramen: Ẹnu-ọna si Ilera Ọpa ẹhin

Fun awọn ẹni-kọọkan ti n wa lati mu ilera ilera ọpa ẹhin wọn dara, le ni oye anatomi ti intervertebral foramen ṣe iranlọwọ ni atunṣe ipalara ati idena?

Intervertebral Foramen

Foramen intervertebral, aka foramen neural, jẹ ṣiṣi laarin awọn vertebrae nipasẹ eyiti awọn gbongbo ara eegun ọpa ẹhin sopọ ati jade si awọn agbegbe ara miiran. Ti foramina ba dinku, o le fi titẹ kun lori awọn gbongbo ara ti o wa nitosi ati ni ayika wọn, nfa awọn aami aisan irora ati awọn ifarabalẹ. Eyi ni a mọ bi neuroforaminal stenosis. (Sumihisa Orita et al., 2016)

Anatomi

• Awọn vertebrae ni ninu awọn ọwọn ọpa-ẹhin.
• Wọn ṣe aabo ati atilẹyin ọpa ẹhin ati pupọ julọ iwuwo ti a gbe sori ọpa ẹhin.
• Foramen jẹ fọọmu kanṣoṣo, ati foramina ni fọọmu pupọ.

be

• Ara jẹ ti o tobi, apakan yika ti egungun ti o ṣe awọn vertebra kọọkan.
• Ara ti vertebra kọọkan ni a so mọ oruka egungun kan.
• Bi awọn vertebrae ti wa ni tolera lori ara wọn, oruka naa ṣẹda tube nipasẹ eyiti ọpa ẹhin n kọja. (Ile-ẹkọ giga Amẹrika ti Awọn oniṣẹ abẹ Orthopedic 2020)

1. Ṣiṣii foramen intervertebral wa laarin gbogbo awọn vertebrae meji, nibiti awọn gbongbo nafu ti jade kuro ni ọpa ẹhin.
2. Foramina nkankikan meji wa laarin awọn meji ti vertebrae kọọkan, pẹlu ọkan ni ẹgbẹ kọọkan.
3. Awọn gbongbo nafu ara n lọ nipasẹ awọn foramen si iyoku ti ara.

iṣẹ

• Foramina intervertebral jẹ awọn ijade lati eyiti awọn gbongbo nafu kuro ni ọpa ẹhin ati ẹka jade si iyoku ti ara.
• Laisi foramen, awọn ifihan agbara nafu ko le tan kaakiri si ati lati ọpọlọ si ara.
• Laisi awọn ifihan agbara nafu, ara ko le ṣiṣẹ ni deede.

ipo

Ipo ti o wọpọ ti o le ni ipa lori neuroforamina jẹ stenosis ọpa-ẹhin. Stenosis tumo si dín.

• Aisan ọpa ẹhin jẹ (kii ṣe nigbagbogbo) nigbagbogbo ibajẹ ti o ni ibatan ọjọ-ori ti o ni nkan ṣe pẹlu arthritis. (Ile-ẹkọ giga Amẹrika ti Awọn oniṣẹ abẹ Orthopedic, 2021)
• Stenosis le waye ninu ọpa ẹhin, ti a mọ ni stenosis canal ti aarin, ati foramina.
• Irora ti a mu nipasẹ neuroforaminal spinal stenosis ati idagbasoke egungun ti o ni ibatan si arthritis / awọn spurs egungun / osteophytes ti o wa ninu ọkan tabi diẹ ẹ sii foramen rub lodi si gbongbo nafu ti o kọja nipasẹ aaye, nfa irora radicular.
• Irora ti o tẹle pẹlu awọn itara miiran, bi tingling tabi numbness, ni a mọ ni radiculopathy. (Young Kook Choi, 2019)

1. Awọn aami aisan akọkọ jẹ irora.
2. Numbness ati / tabi tingling le wa da lori ipalara naa.
3. Neurogenic claudication waye bi abajade ischemia tabi aini sisan ẹjẹ si awọn ara ati ni igbagbogbo ṣafihan pẹlu iwuwo ninu awọn ẹsẹ.
4. O jẹ igbagbogbo ni nkan ṣe pẹlu stenosis aarin kuku ju stenosis foraminal.
5. Pupọ awọn ẹni-kọọkan ti o ni stenosis ọpa ẹhin ni rilara ti o dara julọ nigbati o ba rọ tabi tẹ siwaju ati buru nigbati wọn ba ẹhin wọn.
6. Awọn aami aisan miiran pẹlu ailera ati/tabi iṣoro nrin. (Seung Yeop Lee et al., Ọdun 2015)

itọju

Itọju Stenosis ṣe ifọkansi lati yọkuro irora ati dena awọn aami aiṣan ara lati ṣẹlẹ tabi buru si. Awọn itọju Konsafetifu ni a ṣeduro ati pe o le munadoko pupọ.
Awọn wọnyi ni:

• Itọju ailera ara
• Acupuncture ati Electroacupuncture
• Chiropractic
• Ti kii-abẹ decompression
• Ifọwọra ifọwọra
• Awọn oogun egboogi-iredodo ti kii ṣe sitẹriọdu / awọn NSAIDs
• Awọn adaṣe ti a fojusi ati awọn isan
• Awọn abẹrẹ Cortisone. (Ile-ẹkọ giga Amẹrika ti Awọn oniṣẹ abẹ Orthopedic, 2021)
• Iṣẹ abẹ kii ṣe pataki nigbagbogbo.

Sibẹsibẹ, dokita kan le ṣeduro iṣẹ abẹ fun ẹni kọọkan ti o ni iriri:

• Radiculopathy - irora, awọn pinni ati awọn abẹrẹ, awọn imọlara itanna, ati / tabi ailera ti nlọ si isalẹ apa tabi ẹsẹ kan (Jon Lurie, Christy Tomkins-Lane, ọdun 2016)
• Neurogenic claudication ni ẹhin isalẹ (Jon Lurie, Christy Tomkins-Lane, ọdun 2016)
• Myelopathy ni ọrun ati / tabi oke tabi aarin-ẹhin (awọn aami aiṣan myelopathy jẹ ibatan ọpa-ẹhin ati waye ni stenosis ti aarin ti aarin) (Cleveland Clinic. Ọdun 2021)
• Irora ti ko lagbara

Awọn ilana iṣẹ abẹ oriṣiriṣi pẹlu:

• Decompression laminectomy – kan yiyọ awọn ikole ti egungun ninu ọpa-ẹhin.
• Iṣọkan ọpa ẹhin – nigbati aisedeede wa ti ọpa ẹhin tabi stenosis foraminal ti o lagbara.
• Sibẹsibẹ, ọpọlọpọ awọn ọran ko nilo idapọ. (Ile-ẹkọ giga Amẹrika ti Awọn oniṣẹ abẹ Orthopedic, 2021)

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Gbongbo Awọn okunfa Ọpa Stenosis

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jo

Orita, S., Inage, K., Eguchi, Y., Kubota, G., Aoki, Y., Nakamura, J., Matsuura, Y., Furuya, T., Koda, M., & Ohtori, S. (2016). Lumbar foraminal stenosis, stenosis ti o farapamọ pẹlu ni L5/S1. Iwe akọọlẹ European ti iṣẹ abẹ orthopedic & traumatology: orthopedie traumatologie, 26 (7), 685-693. doi.org/10.1007/s00590-016-1806-7

Ile-ẹkọ giga Amẹrika ti Awọn oniṣẹ abẹ Orthopedic. (2020). Awọn ipilẹ ọpa ẹhin (OrthoInfo, Ọrọ. orthoinfo.aaos.org/en/diseases–conditions/spine-bases/

Ile-ẹkọ giga Amẹrika ti Awọn oniṣẹ abẹ Orthopedic. (2021). Atẹgun ọpa-ẹhin Lumbar (OrthoInfo, Oro. orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/

Choi YK (2019). Lumbar foraminal neuropathy: imudojuiwọn lori iṣakoso ti kii ṣe iṣẹ abẹ. Iwe akọọlẹ Korean ti irora, 32 (3), 147-159. doi.org/10.3344/kjp.2019.32.3.147

Lee, SY, Kim, TH, Oh, JK, Lee, SJ, & Park, MS (2015). Lumbar Stenosis: Imudojuiwọn Laipẹ nipasẹ Atunwo ti Awọn iwe-iwe. Iwe akọọlẹ ọpa ẹhin Asia, 9 (5), 818-828. doi.org/10.4184/asj.2015.9.5.818

Lurie, J., & Tomkins-Lane, C. (2016). Itoju ti stenosis ọpa ẹhin lumbar. BMJ (Clinical iwadi ed.), 352, h6234. doi.org/10.1136/bmj.h6234

Cleveland Clinic. (2021). Myelopathy (Ile-ikawe Ilera, Oro. my.clevelandclinic.org/health/diseases/21966-myelopathy