Mokokotlo oa lumbar, kapa mokokotlo oa lumbosacral, o bolela karolo ea mokokotlo e ka morao morao, kaholimo ho sacrum. Sebaka se tsamaeang haholo ebile se ts'ehetsa mokokotlo kaofela, se sebelisoa haholo letsatsi le leng le le leng mme ka linako tse ling se hlaseloa ke botsofali pele ho nako. Hape, mokokotlo oa lumbar hangata ke sebaka sa bohloko, lisosa tsa tsona li ka ba ngata.

Lentsoe mokokotlo le bolela mokokotlo. E entsoe ka pokello ea li-vertebrae tse fapaneng: li-vertebrae tse 7 tsa mokokotlo, li-vertebrae tse 12 tsa mokokotlo (kapa thoracic), li-vertebrae tse 5 tsa lumbar, sacrum e entsoeng ka li-vertebrae tse 5 tse kopantsoeng mme qetellong coccyx e entsoe ka li-vertebrae tse 4.

Lumbar spine e bua ka karolo e tlase, e tsamaeang ea mokokotlo, e kaholimo ho sacrum. E entsoe ka li-vertebrae tse hlano tsa lumbar: L1, L2, L3, L4 le L5 vertebrae.

Li-vertebrae tsena tse hlano li hokahane ebile li boletsoe ka morao ke likarolo tsa likarolo, le ka pele ke li-vertebral discs. Pakeng tsa vertebra ka 'ngoe, metso ea methapo e tsoa ka masoba a bitsoang foramina.

Mokokotlo oa lumbar o hlahisa arch ea concave ho ea ka morao, e bitsoang lumbar lordosis.

Joalo ka mokokotlo o mong kaofela, mokokotlo oa lumbar o sireletsa lesapo la mokokotlo ho fihla ho L1-L2 vertebrae, ebe methapo ea mokokotlo e tsoang L1-L2.

Ka matla, ka lebaka la sebaka seo e leng ho sona, mokokotlo oa lumbar o ts'ehetsa mokokotlo o mong le o mong hape o tiisa ho tsamaea ha oona. E boetse e bapala karolo ea "absorber" e nyarosang le kabo ea mojaro lipakeng tsa noka le serope. Matšoao a mokokotlo oa mokokotlo, ao hape a bitsoang mesifa ea mokokotlo, e atolohang ka mahlakoreng ka bobeli a mokokotlo e thusa ho imolla khatello e teng mokokotlong.

Ka lebaka la ho rarahana ha 'mele, methapo ea methapo eo e nang le eona, litšitiso tsa letsatsi le letsatsi tse e ts'ehetsang empa le botsofali ba mmele ba likarolo tse fapaneng, mokokotlo oa lumbar o ka angoa ke mafu a mangata. Mona ke tsa mantlha.

Mahlaba a khutšoanyane

Mahlaba a morao haholo ke sekhele bakeng sa mahlaba a tlase a morao. Litlhahisong tsa eona tsa morao-rao mabapi le taolo ea mahlaba a bohloko ba morao, HAS (Haute Autorité de Santé) e hopola tlhaloso ena: "Mahlaba a tlase mokokotlong a hlalosoa ke bohloko bo teng lipakeng tsa lehare la thoracolumbar le lesaka le tlase la gluteal. E ka amahanngoa le radiculalgia e tsamaellanang le bohloko ho leoto le le leng kapa a mabeli a tlase ho dermatomes e le 'ngoe kapa ho feta. "

Ka ts'ebetso, re ka khetholla:

• bohloko bo tloaelehileng ba mokokotlo, bo khetholloang ke bohloko bo bohloko ba morao bo se nang matšoao a tlhokomeliso. Maemong a 90%, bohloko bo tloaelehileng ba ho opeloa ke mokokotlo bo fetoha ntle le libeke tse ka tlase ho tse 4 ho isa ho tse 6, ho hopola HAS;
• bohloko bo sa foleng ba morao, ke hore, mahlaba a morao a morao a fetang likhoeli tse 3;
• "bohloko bo boholo ba mokokotlo" kapa bohloko bo bohloko ba mokokotlo, kapa lumbago ka puo ea letsatsi le letsatsi. Ke bohloko bo bohloko, ba nakoana hobane hangata bo bakoa ke motsamao o fosahetseng, ho jara mojaro o boima, boiteko ba tšohanyetso ("phetho ea liphio" e tummeng). 

Lumbar disc herniation

Sesepa sa herniated se bonts'oa ke ho phatloha ha nucleus pulposus, karolo ea gelatinous ea disc ea intervertebral. Hernia ena e tla hatella methapo e le 'ngoe kapa ho feta, e baka bohloko ba mokokotlo kapa bohloko seropeng ho latela sebaka sa hernia. Haeba vertebra ea L5 e amehile, hernia e tla baka sciatica e khetholloang ke bohloko seropeng, e theohele leotong ho leba monoaneng o motona oa leoto.

Osteoarthritis ea Lumbar

Osteoarthritis, eo e le khopotso ke lefu le holofatsang la lefufuru, e ka ama manonyeletso lipakeng tsa methapo e 'meli. Lumbar osteoarthritis e kanna ea se ke ea baka matšoao, hobane e ka lebisa ho kholo ea masapo a bitsoang li-osteophyte tseo, ka ho halefa ha methapo, li ka bakang bohloko ba mokokotlo.

Lumbar spinal stenosis kapa kanale e moqotetsane ea lumbar

Lumbar stenosis ke ho fokotseha ha kanale e bohareng ea mokokotlo, kapa mokokotlo oa lumbar, o nang le methapo ea methapo. Hangata e amana le lilemo, mme e baka bothata ba ho tsamaea ka maikutlo a bofokoli, ho ba shohlo, ho hlohlona maotong, sciatica e etsahalang nakong ea phomolo kapa nakong ea boiteko, mme hangata, ho holofala. ya bohlokwa bo batlang bo le tlase ba maoto le matsoho a tlase kapa mesebetsi ya sphincter.

Lumbar disc lefu

Lefu la degenerative disc, kapa disc degeneration, le tšoauoa ka ho tsofala pele ho nako ha disc ea intervertebral le ho felloa ke metsi 'meleng o bohareng oa gelatinous. Diski e a pepetoa mme methapo ea methapo ea halefa, e bakang bohloko mokokotlong o ka tlase. Lefu la degenerative disc le boetse le nkuoa e le sesosa se ka sehloohong sa bohloko ba morao bo tlase.

Ho senyeha lumbar scoliosis

Degenerative lumbar scoliosis e iponahatsa e le ho holofala ha mokokotlo. E tloaelehile haholo ho basali, haholo-holo ka mor'a ho khaotsa ho ilela khoeli. E iponahatsa ka bohloko ba mokokotlo le mokokotlong, e phatsima seropeng, hangata e eketseha ka ho tsamaea. Degenerative lumbar scoliosis ke phello ea lintlha tse ngata: ho hloleha ha disc ho eketsoang ho hloka molumo oa mesifa, ho fokola ha masapo hammoho le ho fokola ha mokokotlo oa mokokotlo.

Ho senyeha ha li-spondylolisthesis

Lefu lena le amanang le botsofali ba tlhaho ba mokokotlo le iponahatsa ka ho thellela ha vertebra e 'ngoe ka lehlakoreng le leng, ka kakaretso L4-L5. Lumbar canal stenosis le matšoao a eona a latela.

Ho robeha ha lumbar

Ho robeha ha mokokotlo ho ka hlaha nakong ea tšusumetso e matla haholo (kotsi ea 'mila haholo). Ho robeha ha lesapo la mokokotlo ho ka amahanngoa le kotsi ea mokokotlo le / kapa methapo ea methapo, kotsi eo ka nako eo e bang ho holofala. Ho robeha hona ho ka ba le botsitso, 'me ha ho fallisoa hoa bobeli ho baka kotsi ea methapo.

Mahlaba a khutšoanyane

Litlhahisong tsa eona tsa morao-rao mabapi le taolo ea bohloko bo tloaelehileng ba morao, HAS e hopola hore boikoetliso ba 'mele ke kalafo ea mantlha e lumellang phetoho e ntle ea lefu lena. Physiotherapy le eona e bontšitsoe. Mabapi le kalafo ea lithethefatsi, hoa hopoloa "hore ha ho setlhare se thethefatsang se ipakileng se sebetsa nakong e mahareng ho nts'etsopele ea tlhaselo e matla ea mahlaba a morao, empa taolo eo ea li-analgesic e fumaneng mangolo, ho qala ka boemo ba analgesics I (paracetamol, NSAIDs), e ka ba kenngwa tshebetsong ho imolla litlhaselo tse bohloko ”. HAS e boetse e totobatsa "bohlokoa ba tlhokomelo ea lefats'e ea mokuli ea tsejoang e le" bio-psycho-social ", a ela hloko boiphihlelo ba mokuli le litlamorao tsa bohloko ba hae (litekanyo tsa 'mele, kelello le maemo a bophelo)".

Sesepa sa Herniated

Kalafo ea mohala oa pele ke matšoao: li-analgesics, lithethefatsi tse khahlanong le ho ruruha, ho kenella. Haeba kalafo e hloleha, ho ka fanoa ka opereishene. Ts'ebetso, e bitsoang discectomy, e kenyelletsa ho tlosa hernia molemong oa ho nyahamisa methapo ea methapo e tenang.

Lumbar stenosis

Kalafo ea mohala oa pele e ea itšireletsa: li-analgesics, li-anti-inflammatories, tlhabollo, esita le corset kapa ho kenella. Haeba kalafo e sa atlehe, ho ka fanoa ka opereishene. Ts'ebetso, e bitsoang laminectomy kapa lesapo la mokokotlo, e kenyelletsa ho tlosa lamina ea letheka ho lokolla mokokotlo oa mokokotlo.

Lefu la degenerative disc

Kalafo ea mohala oa pele ke matšoao: li-analgesics, lithethefatsi tse khahlanong le ho ruruha, ho kenella, ts'ebetso ea ts'ebetso. Phekolo e tla hlahlojoa ha ho ka etsahala kalafo ea bongaka le ho holofatsa bohloko letsatsi le leng le le leng. Lumbar arthrodesis, kapa mokokotlo oa mokokotlo, o kenyelletsa ho tlosa disc e senyehileng ebe o beha sesebelisoa sa bongaka lipakeng tsa li-vertebrae tse peli ho boloka bophahamo ba disc.

Ho senyeha lumbar scoliosis

Li-analgesics, lithethefatsi tse khahlanong le ho ruruha le liente li theha kalafo ea matšoao a mola oa pele. Haeba ho hloleha le bohloko bo fokolisang, ho ka nahanoa ka ho buuoa. Arthrodesis e tla ikemisetsa ho kopanya mokokotlo o fetelletseng oa 'mele le ho nyahamisa metso ea methapo.

Ho robeha ha lumbar

Kalafo e ipapisitse le mofuta oa ho robeha le tšenyo e amanang le methapo kapa che. Ts'ebetso e tla ikemisetsa, ho latela nyeoe, ho khutlisa botsitso ba mokokotlo, ho khutlisa sebopeho sa 'mele o robehileng, ho ferekanya likarolo tsa methapo. Bakeng sa sena, ho sebelisoa mekhoa e fapaneng: arthrodesis, katoloso ea mokokotlo, jj.

Ho senyeha ha li-spondylolisthesis

Ketsahalong ea ho hloleha ha kalafo (li-analgesics, lithethefatsi tse khahlanong le ho ruruha le ho kenella), ramatiki e ka nahaneloa.

Lumbar mokokotlo oa x-ray

Tlhahlobo ena e tloaelehileng e lekola morpholoji ea mokokotlo ka kakaretso. Hangata e laeloa e le kalafo ea mohala oa pele bakeng sa mahlaba a bohloko ba morao. E nolofalletsa ho lemoha boteng ba lisosa tse holofatsang (lumbar osteoarthritis), khatello ea mokokotlo kapa morphological e sa tloaelehang ea vertebrae, ho sa tloaelehang hoa lipalo (scoliosis) kapa ho thella ha lesapo la mokokotlo. Ka lehlakoreng le leng, ha se kamehla e nolofalletsang ho fumana ho robeha ha lesapo la mokokotlo. Li-discs, mokokotlo oa mokokotlo, methapo ea methapo e le meaho ea mahlaseli (a lumella X-ray ho feta), x-ray ea mokokotlo oa lumbar ha e bontše li-disc tsa herniated kapa li-pathologies tsa mokokotlo.

MRI ea mokokotlo oa lumbar

MRI ke tlhahlobo e tloaelehileng ea mokokotlo oa lumbar, haholo-holo ho bona maloetse a mokokotlo oa mokokotlo. E lumella ho bona likarolo tsa 3 likarolo tsa masapo le likarolo tse bonolo: lesapo la mokokotlo, ligament, disc, methapo ea methapo. Mme ka hona ho fumana mafu a fapaneng a mokokotlo oa lumbar: disc ea herniated, lefu le thellang la disc, ts'ebetso ea disc, lumbar stenosis, ho ruruha ha lipoleiti tsa lesapo la mokokotlo, jj.

Lumbar spine CT e hlahloba

Lumbar CT scan kapa computed tomography ke tlhahlobo e tloaelehileng ha ho ka robeha mokokotlo. E ka boela ea hlahloba disc ea herniated, ea hlahloba boemo ba lumbar stenosis, ea fumana methapo ea methapo ea masapo. E boetse e laeloa ka kakaretso e le karolo ea tlhahlobo ea pele ho ts'ebetso ea ho buuoa ka mokokotlo, haholo ho lekola boemo ba likepe.