Uzibona njani iintlungu zeradicular, ezomileyo kunye neqela?

I-Lumbosacral nerve root isuka kwi-spinal canal kwi-plexus ye-sacral, kunye nokuqokelela kwe-trunk ye-nerve sciatic, ngoko ke xa kukho naziphi na ezintathu ezibandakanyekayo, kunokubangela iimpawu kunye neempawu ezifanayo. Ikakhulu ibonakala kwiintlungu ezinqeni nasemilenzeni, ukuphazamiseka, ukunyakaza kunye nokungasebenzi kakuhle kwe-reflex kunye novavanyo oluchanekileyo lokuphakamisa umlenze ochanekileyo, njl., Ezinye zeempawu zihlala zinzima kubaqalayo ukuzibona, ezikhokelela ekuxilongeni kakubi. Enyanisweni, iindawo ze-pathoanatomical kunye neempawu zezilonda ezintathu azihambelani. Ngaphandle kweemeko ezinqabileyo apho ezimbini okanye ezintathu zinokuthi zenzeke ngaxeshanye, ezi mpawu zihlala zimanye kwaye zahlukile.

Iintlungu ezibuhlungu zixhaphake ngokuqhelekileyo kunye ne-lumbar disc herniation, i-lumbar spinal stenosis (kubandakanywa ne-lateral fossa stenosis), kunye ne-lumbar spinal tumors.

(1) Intlungu yeParavertebral: Iimpawu eziphambili zeentlungu ze-radicular yintlungu ye-paravertebral kunye nemitha yemitha kumalungu angaphantsi ngenxa yokubandakanyeka kwangaxeshanye kwi-dorsal kunye ne-lateral amasebe eengcambu ze-nerve ze-spinal zegment echaphazelekayo. Intlungu eyomileyo kunye neentlungu zeqela azibonakali kunye neentlungu ezinkulu.

(2) Ukunciphisa i-lumbar spine movement: I-Lumbar spinal stenosis ikakhulu imida yokwandiswa kwangasemva, ngelixa imiba ye-lumbar disc inokunciphisa i-lumbar back extension, i-front flexion, kunye ne-flexion yecala elichaphazelekayo. Izicubu ze-Intradural nazo zinokubangela amanqanaba ahlukeneyo okunciphisa ukuhamba kwe-lumbar spine kwizigaba ezahlukeneyo zesifo. Nangona kunjalo, iintlungu ezomileyo kunye neentlungu ze-plexiform azibonisi olu phawu.

(3) Uvavanyo lwe-Cervical flexion: Zhao Dinglin et al. yenze uvavanyo lwe-flexion yomlomo wesibeleko kwizigulane ze-200 ezineentlungu ezibuhlungu, kwaye izinga elifanelekileyo lalingaphezulu kwe-95%. Oku kungenxa yokuba umqolo womlomo wesibeleko ukwimeko yokujikeleza phambili, okwandisa uxinzelelo kunye noxinzelelo kwiingcambu ze-nerve ezichaphazelekayo ngokusebenzisa i-dural sac kunye ne-root cuff, ekwandisa intlungu. Uphononongo alufumananga ubungqina beentlungu ezomileyo okanye intlungu ye-plexiform.

(4) Iimpawu ze-spinal nerve root localization: Ukuvakalelwa, ukunyakaza, kunye ne-reflexes yeengcambu ze-spinal nerve ineempawu ezicacileyo zendawo ngokuxhomekeke kwi-spinal ganglia. Ngokomzekelo, ukuvakalelwa kwesikhumba se-dorsal kwinzwane yokuqala kunye neyesibini yonyawo kungenakuvinjelwa yingcambu ye-lumbar nerve, ngelixa umgca wecala lonyawo kunye nenzwane encinci ingenandawo yingcambu ye-sacral 1. Iintlungu ezibuhlungu, ukuphazamiseka kwengqondo, kunye ne-reflexes zibandakanyeka ngakumbi kunoluhlu lweentlungu ezomileyo kunye neentlungu zeqela.

Kwixesha elidlulileyo, ukuxilongwa kweklinikhi yeentlungu ezomileyo zazibizwa ngokuqhelekileyo ngokuthi 'sciatica' okanye 'i-sciatic neuritis'. Nangona kunjalo, i-scholarship yamva nje icebisa ukuba izilonda ze-pelvic outlet ye-nerve ye-sciatic, ezifana ne-tumor, adhesions, i-pudendal muscle compression, kunye nokuvuselela ukudumba, zezona zinto zibangela intlungu eyomileyo. Iimpawu eziphambili zeentlungu ezomileyo azichatshazelwa luvavanyo oluzimeleyo kwaye lubonakaliswe ngokungabikho komswakama.

(1) Amanqaku oxinzelelo: Ezi ikakhulu zibekwe kwindawo yokuphuma ye-pelvic, ngakumbi malunga nendawo yokutsiba iringi. Iintlungu ze-radioactive kumalungu asezantsi zenzeka xa kusetyenziswa uxinzelelo olunzulu lwengingqi, kwaye uluhlu lwayo ngokucacileyo lukhulu kuneentlungu ezinzulu. Ngokumalunga ne-60% yecala lesifo lihamba kunye ne-rouge point (ikhosi ye-nerve ye-tibial) kunye ne-peroneal point (ikhosi eqhelekileyo ye-peroneal nerve) uxinzelelo kunye neentlungu ezibuhlungu. Akukho xinzelelo olucacileyo kunye neentlungu ze-percussion kwindawo ephantsi ye-lumbar.

(2) Uvavanyo lokujikeleza kwemilenze engaphantsi: Uvavanyo lokujikeleza kwangaphakathi lulungile ukuba lubangelwa kuphela ukubambelela kokuphuma. Ukuba i-pudendal muscle nayo ibandakanyeka, ukujikeleza kwangaphandle kukwalungile.

Iimpawu zendawo eyomileyo zibonakaliswa njenge-sensory, motor, kunye ne-reflex deficits kwi-nerve ye-tibial kunye ne-peroneal nerve innervation area. Uluhlu lokubandakanyeka lubanzi kwaye lukhawulelwe kwiingcambu zentsholongwane yomgogodla ngaphakathi kwendawo ye-lumbar 4 ukuya kwi-sacral 2.

(4) I-Plantar numbness: Iziphazamiso ze-root sensory zihlala zingabandakanyi yonke indawo yesityalo. Nangona kunjalo, ngokutsho kukaZhao Dinglin kunye nezinye izibalo, ngaphezu kwe-90% yeentlungu ezibuhlungu ezomileyo zibonisa ukuphazamiseka kwesityalo.

Intlungu ye-Plexus: inokubangelwa ngamathumba, ukudumba okungapheliyo, kunye nezifo ze-adnexal kwi-pelvis, ezinokuchaphazela i-plexus ye-sacral kwaye zibangele iimpawu. Ezona mithambo-luvo zixhaphakileyo yi-sciatic nerve trunk, i-femoral nerve trunk, kunye ne-higher gluteal nerve.

(1) Intlungu ye-Multi-stem: Kwimeko efanayo, i-sciatica, ithanga, i-sacral kunye neentlungu zedolo zingabakho. Ezi zimpawu zingenzeka ngaxeshanye okanye ngokutshintshana, kuxhomekeke kubukhulu bezilonda. Kusenokubakho umahluko kwiqondo lokubandakanyeka phakathi kwemithambo yemithambo-luvo emininzi.

(2) Uvavanyo lwe-Lumbosacral percussion: Umahluko phakathi kolu vavanyo kunye neentlungu ezibuhlungu kukuba xa i-percussion isetyenziselwa ummandla we-lumbosacral, isigulane asifumani nje intlungu kodwa siziva sikhululekile. Ngokwahlukileyo, izilonda ezihlala kwindawo ye-pelvic zibangela intlungu, zihlala zibuhlungu.

(3) Ukuhlolwa kwe-pelvic: Intlungu ye-pelvic ixhaphake kakhulu kwizigulane zabasetyhini; ngoko ke, uviwo lwe-gynecological luyimfuneko ukuba lungabandakanyi izifo ze-gynecological ngaphambi kokwenza ukuxilongwa. Ukongeza, ukungabandakanyi amathumba, i-pelvic palpation kwaye, ukuba kuyimfuneko, kufuneka kwenziwe uvavanyo lwangasese. I-Orthopantomograms kunye neefilimu ze-oblique ze-pelvis kufuneka zithathwe emva kwe-enema yokucoca. I-Barium enema okanye i-cystography ingasetyenziselwa abo barhanelwa ukuba banamathumba amathumbu okanye umchamo.

(4) Utshintsho lwe-Reflex: I-knee reflex kunye ne-Achilles tendon reflex ingaba buthathaka okanye ilahleke ngaxeshanye.