I-Anatomy ye-Neck ne-Back Back
Iningi lezinzwa ezithumela ulwazi kusuka ebuchosheni lidlulisela ulwazi lolo lugqoko lomgogodla oluhlanganiswe esitokisini sokuzivikela lwe- vertebrae , phakathi kweziphi izivulo (foramina) ezivumela ukuhamba kwezimpande zamanzi. Lezo zinzwa ziqhubeka nokudala isimiso sezinzwa ze-peripheral.
Ngezinye izikhathi lezi zimpande zesisindo zingagcizelelwa ukukhula kwebony kusukela ku-vertebrae, noma ukunyuka kwe-vertebra eyodwa phezu komunye kunciphise ukuvula (ukuqhuma) lapho inzwa igijima khona.
Uma lokhu kwenzeka, izimpande zenzalo zilimala kulokho okubizwa ngokuthi i- radiculopathy . Izimpawu ezivela kuhlukahluka, kuye ngokuthi indawo yomshukela wezinzwa.
I-Anatomy yekholomu ye-Spinal
Ngenkathi kukhona ukuhlukahluka phakathi kwabantu ngabanye, ingxenye enkulu, sonke sinemifino emihlanu entanyeni yethu, okuthiwa i-vertebrae yomlomo wesibeletho. Ngezansi yi-vertebrae ye-thoracic (ehlanganiswe nezimbambo), bese kuthiwa ama-vertebrae amahlanu angama-lumbar. I-vertebra yokugcina i-lumbar ihlanganiswe ne-sacrum, ithambo elikhulu elisiza ukwakha umbuthano we-pelvic.
Ama-vertebrae avame ukufinyezwa phansi kwinombolo nencwadi, ubala kusukela phezulu komgogodla kuya phansi. Isibonelo, i-C5 isho i-vertebra yesihlanu yomlomo wesibeletho kusukela phezulu komgogodla. I-T8 isho i-vertebra ye-thoracic ye-8 phansi ukusuka ku-C7 (i-vertebra yokugcina yomlomo wesibeletho).
Ngokuvamile, izimpande zezinzwa zibizwa ngokuthi ithambo ngaphezu kwazo. Isibonelo, izimpande zomswakama eziphuma phakathi kwe-4th kanye ne-5th vertebrae lumbar zizobizwa nge-L4.
Izinzwa zomlomo wesibeletho zihlukile, nakuba: nakuba kune-vertebrae engu-7 kuphela yesibeletho, kunezinzwa ezingu-8 zomlomo wesibeletho, owokuqala okhona ngaphezu kwe-vertebra yokuqala yomlomo wesibeletho. Ngakho entanyeni, izinzwa zibhalwe ngemuva kwama-vertebrae ngaphansi kwazo. Ukuze kucace, ngokuvamile kungcono ukucacisa izimpande zezinzwa ngokubhekisela kokubili ama-vertebrae, isb (C7-T1), kodwa odokotela abaningi abawenzi lokhu emisebenzini yansuku zonke.
Umgogodla ngokwawo uqobo uhlela ku-L1 kubantu abadala, lapho uphela esakhiweni esibizwa ngokuthi i-conus medullaris. Izinzwa ziqhubeka zinyathela phansi kuleli phuzu, noma kunjalo, zinyuka esikhwameni se-cerebrospinal fluid. Leli qoqo lezinzwa libizwa ngokuthi i-cauda equina, isiLatini "somsila wehhashi," okuyinto izinzwa ezikhululekile zifana ncamashi ziphuma ngaphandle kohlobo lwe-vertebrae lumbar.
Izimpawu zeRadioculopathy
Impande ngayinye yezinyosi eziphuma kulolu cord umgogodla ithatha imiyalezo evela ebuchosheni ukwenza imisipha ethile ihambe, futhi ithola imiyalezo evela ezindaweni ezithile zesikhumba. Ngenxa yalokhu, kunokwenzeka ukuthi kuncishiswe ukuthi yiyiphi i-radiculopathy eyenzekayo, ngokusekelwe ezimpawu ezenzekayo. Ngaphezu kwalokho, i-radiculopathies cishe ibuhlungu ngaso sonke isikhathi, kanti izinkinga eziningi zezinzwa azikho.
I-radiculopathies eminingi ibangelwa ukuguquka okucashile ekwakhiweni kwamathambo wekholomu ye-vertebral. Ama-vertebrae enhlobonhlobo avinjelwe ukuba ashintshwe kakhulu ngenxa yokuthi asekelwa yi-ribcage. Ngenxa yalesi sizathu, ama-radiculopathies avela kakhulu avela emgodini wesibeletho nesibindi.
Radiculopathies yomlomo wesibeletho
Izinzwa ezisuka emthonjeni womgogodla entanyeni ziphuma ku-vertebral foramina ukwakha iphethini ye-intermixing ebizwa ngokuthi i-plexus brachial.
Ukusuka lapho, izinzwa ziqhubeka zikwazi ukugubha isikhumba kanye nemisipha yengalo. Ngezinhloso ezingokoqobo, izimpande ezibaluleke kunazo zonke ezingeni lezingalo ziyi-C5, C6, ne-C7. Kufanelekile ukwazi ukuthi cishe amaphesenti angu-20 yawo wonke ama-radiculopathies omlomo wesibeletho ahlanganisa amazinga amabili noma ngaphezulu.
I-C5: I-deltoid (imisipha yehlombe ephakamisa ingalo emzimbeni) ingenwa yizinzwa ezivela eC5. Ngaphandle kokubuthakathaka kwehlombe, le-radiculopathy ingase ibangele ekungenikeleni emahlombe nasengxeni eliphezulu.
I-C6: I-radiculopathy ye-C6 ingaholela ebuthakathaka kuma-biceps nakuma-extensors wesandla. Ngaphezu kwalokho, kungase kube nokungaqondakali kwezinzwa ezinkomba kanye neminwe ephakathi, kanye nengxenye ye-forearm.
I-C7: Cishe isigamu (amaphesenti angu-46) kuwo wonke ama-raculopathies womlomo wesibeletho afaka lezimpande zomzimba. Ububuthakathaka obuyinhloko buyingxube ye-triceps eqondisa ingalo. Kungase kube khona ukulahleka kokuzwa okuyingxenye yesandla, njengokungathi umunwe.
I-Lumbar Radiculopathies
Izindebe eziphuma e-neural foramina emgodleni we-lumbar ziyaqhubeka zakha i-plexus lumbar, i-anastomosis eyinkimbinkimbi yezinzwa ezihlukahlukene. Ukusuka lapho, lezi zindebe ziyaqhubeka zikhumbule isikhumba nemisipha yomlenze.
I-L4: I- iliopsoas , eguqule umlenze, ingaba buthakathaka, njengoba kungathi ama-quadriceps anweba umlenze emadolweni. Amadolo kanye nengxenye yomlenze ongaphansi angase abe nenombolo.
I-L5: Ikhono lokuphakamisa iphuzu lonyawo phansi lingancipha, futhi indawo ephezulu yonyawo ingase ibe yindima. Lezimpande zezinyosi zihilelekile kumaphesenti angama-40 kuya kwangu-45 ama-radiculopathies okuthiwa yi-lumbosacral.
I-S1: Ikhono lokukhomba unyawo ukuya phansi (njengokungathi uzokuma ku-tiptoe) libuthakathaka, futhi kungenzeka kube khona ukungenwa kwezinyosi ezincane nezinyawo. Lezimpande zezinzwa zihileleke kumaphesenti angama-45 kuya kwangu-50 we-radiospathies yama-lumbosacral.
Sisanda kubukeza isimo sezinzwa eziphuma emthonjeni womgogodla. Ngenkathi sesixoxe ngezinye zezibonakaliso, asikaze siqale ukuhlola izimbangela eziningi ezahlukene ze-neuropathy noma ukwelashwa kwazo. Ngenkathi ubuhlungu obuningi bomhlane buyekela ngokwakho, uma ubuthakathaka bukhula, kuyisibonakaliso sokuthi ukwelashwa okunomthethelo kungase kubizwe.
Imithombo:
Ukuthunyelwa kwe-AR, i-Sander HW, Indlela Yomtholampilo Yokubhekana Nezifo Nezentuthuko: Ukutholakala Kwendawo Ye-Anatomic nokuhlola Ukuhlola. Ukuqhubeka; Umqulu 18, uNgo-1, Februwari 2012
I-Blumenfeld H, i-Neuroanatomy ngokusebenzisa ama-Clinical Cases. I-Sunderland: Abakwa-Sinauer Associates Publishers 2002