Prolapse of lumbar intervertebral disc

First, what is the lumbar disc herniationHuman intervertebral disc because of the effects of age, strain and external force, leading to the

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First, what is the lumbar disc herniation

Human intervertebral disc because of the effects of age, strain and external force, leading to the rupture of annulus, nucleus from the rupture protrusion or extrusion, compression of the lumbar nerve or nerve root, and leg pain, numbness and a series of neurological symptoms, known as lumbar disc herniation. It is necessary to point out that "sciatica" this common disease actually is most frequently caused by lumbar disc herniation.

Two, the characteristics of lumbar intervertebral disc

Adult spine length of about 70 cm, with the increase or decrease. It is the body's "beam", or "axis", composed of cervical, thoracic and lumbar spine, sacrum and coccyx. The intervertebral disc is a disc like structure called the intervertebral disc. The intervertebral disc is composed of a fibrous ring, a nucleus pulposus, and a transparent cartilage plate. The "cake" of about 8 - 10 mm thick, the upper and lower sides is vertebral cartilage; central "stuffing" is a gelatinous nucleus, wrapped around the "pie" is a dense fiber ring.

Three, the role of lumbar intervertebral disc

The main function of the intervertebral disc is to connect the vertebral body, strengthen the stability of the spine, absorb the shock and make the spine flexible. Lumbar intervertebral disc and cervical and thoracic intervertebral disc features are similar, with limbs in the interventional spine under the weight of the trunk, and maintain normal physiological posture of the whole body, all kinds of movement of the trunk, lumbar disc plays a special function, specific functions are as follows:

1, to maintain the height of the spine, maintain height, with the development of the vertebral body, intervertebral disc growth, thus increasing the length of the spine.

2, connecting the upper and lower intervertebral disc of the two vertebral body, and make a certain degree of activity between the vertebrae.

3, the same force bearing surface of the vertebral bodies, even interbody still have a certain inclination, but through the nucleus semi liquid components to the disc under the same stress.

4, buffer effect. (1) due to the elastic structure especially the nucleus has plasticity, under pressure to make the variable flat, the average force can be transferred to the fiber ring and the cartilage in each direction; (2) is the main structure of spinal shock absorption, plays a role of elastic cushion, made by falling or shoulder back suddenly, the waist load, cushion to transmission, to protect the spinal cord and brain nerve function.

5, to maintain a certain distance from the lateral facet and height.

6, to maintain the size of the intervertebral foramen, under normal circumstances, the size of the intervertebral foramen is 3 to 10 times the diameter of the nerve root.

7, maintain the spinal curvature, intervertebral disc thickness of different parts of a lumbar intervertebral disc in the same thickness of the front, rear thin, make lumbar physiological lordosis.

Four, the common cause of lumbar disc herniation

1, it suddenly load or load suddenly increased. The waist, especially fast bending, lateral bending or rotation, is the main reason for the formation of fibrous ring rupture.

2, lumbar trauma: violence is strong, did not cause fracture and dislocation, it is possible to make the degenerative nucleus pulposus prominent.

3, improper posture: get up, stand up and other daily life and some of the work, if the waist in flexion position, suddenly to an external rotation action, easy to cause the nucleus pulposus prominent.

In 4, abdominal pressure: abdominal pressure and intervertebral disc herniation have a certain relationship, sometimes even in severe coughing, sneezing, constipation, spurts can occur when there is nucleus pulposus.

5, cold wet: cold or wet can cause small vascular contraction, muscle spasm, the intervertebral disc pressure increase, may also cause degeneration of the intervertebral disc rupture.

To avoid the above factors can largely prevent the purpose of.

Five, the common types of lumbar disc herniation

1, syndrome type:

(1) blood stasis type of leg pain such as thorn, fixed pain, day light night heavy pitch, inconvenience, zhuance cannot cough increased, there would knot drowning, irritability, dry mouth. Dark purple tongue or petechiae, sunken pulse.

(2) arthralgia syndrome type

Cold dampness type lumbar pain, cold limbs weakness, according to a fixed location, sometimes feel numbness in the lower limbs heavy, cold pain drama, heat pain reduction, to urinate Qing long. Pale tongue, thin white or greasy moss, pulse tight.

Rheumatic pain in lumbar pain, lower limb, skin numbness, pain, no fixed place, walk up, related to changes in the weather, with a bad cold. Pale tongue, thin white or thin yellow, thin pulse.

(3) kidney deficiency type

Kidney yang deficiency lumbago continuous limp, cold limbs, numbness, Jiuzhibuyu, hi hi rub, meet what rauh. Often accompanied by lower abdomenal pain, pale, chills, shortness of breath and fatigue. The tongue is light, the moss is thin and the pulse is weak.

Kidney yin deficiency lumbago and flabby, numbness, Jiuzhibuyu, meet what work. Often accompanied by upset insomnia, dry mouth, facial flushing, hot feeling. Red tongue, less moss, pulse string breakdown.

2, pathological type: bulge type, fracture type, free type

3, the American Academy of orthopaedic surgeons that are classified according to morphology: type I: degeneration; prolapse; type II: type III: prominent; type IV: prolapse; V: ossification.

Six, how to judge whether suffering from lumbar disc herniation

Lumbar disc herniation is the development of degenerative changes in the intervertebral disc on the basis of. Therefore, before the occurrence of lumbar disc herniation, it may be due to degenerative changes in the intervertebral disc to produce a series of prodromal symptoms, these symptoms are not specific, and therefore not unique to the lumbar disc.

1, acute low back pain: here refers to the low back pain is different from engaged in sports or heavy physical work, accidentally sprained waist and the back pain. It is caused by a number of minor movements, so the patient is often mistaken for "flash waist", without regard to.

2, repeated onset of low back pain: in the lumbar intervertebral disc degeneration and instability of the intervertebral joint or the extension of the joint after the case, the patient can have repeated attacks of low back pain. The intermittent period between each attack ranging from a few days to several months. This patient, due to the degeneration of the intervertebral space after the joint has been in a state of hyperextension, so the spinal column, such as the extension of the action is likely to occur when the joint capsule injury, and induce the occurrence of lumbar disc herniation.

3, chronic low back pain: part of the patient after the pain of acute back pain, gradually formed a persistent chronic low back pain. This kind of low back pain is often aggravated after coughing and straining.

These symptoms are indicative of the potential of lumbar disc herniation, but also do not have the specificity, hope that patients with such symptoms can be treated properly.

Common in young people in lumbar disc herniation, especially in manual workers or multiple workers sitting for a long time. Patients suffering from lumbar disc herniation can be a variety of clinical symptoms due to age, gender, duration of illness and the location of the highlights, the common clinical manifestations are as follows:

1, low back pain: the pain in the leg before, also appear at the same time. The pain is mainly in the lower lumbar or lumbosacral region, the main cause of pain is because of the intervertebral disc after the stimulation of the outer ring and posterior longitudinal ligament in the sinus nerve fibers produced. The pain is more prominent in the lumbar spine.

2, lower limb radioactive pain due to lumbar disc herniation occurred in 4, 5 and 5 waist lumbar 1 sacral vertebra clearance, while the sciatic nerve was 4, 5 from lumbar and sacral nerve root 1-3, so the lumbar disc herniation patients with sciatica or first hips, gradually radiation to the outer side of thigh lateral leg, foot, dorsal and lateral plantar and toe. The central protrusion is often caused by bilateral sciatica. Radiating pain when coughing, sneezing and defecation intra-abdominal pressure when a line increased. Leg pain in low back pain is one of the main signs of lumbar disc herniation.

3, numbness and paresthesias after lumbar disc herniation, contact area can be caused by nerve root compression and involve local compression, fibers and vascular compression of nerve root itself is caused by ischemia and hypoxia, the involved nerve root innervation area of pain and numbness and abnormal feeling. The 4, 5 lumbar intervertebral disc herniation in 5 lumbar nerve root and appeared at the back of the thigh, lateral leg, foot dorsal and dorsolateral toe numbness anomaly. Lumbar 5 sacral intervertebral disc herniation can be involved in the back of the skin of the 4, 5 toes, paresthesia is abnormal. If the intervertebral disc protrusion compression or irritation of the paravertebral sympathetic nerve fibers, can reflex caused by lower limb vascular wall contraction and lower limb chills, cold, weakening phenomena of dorsal artery of foot.

4, muscle paralysis: lumbar disc herniation compression nerve root time is older, can cause nerve root ischemia and hypoxia degeneration and nerve paralysis, muscle paralysis. The 4, 5 lumbar disc herniation, lumbar 5 nerve root paralysis by anterior tibial muscle, peroneal muscle, extensor pollicis longus and extensor digitorum muscle paralysis. The lumbar 5 sacral 1 disc, 1 sacral nerve root involvement paralysis and leg muscle paralysis.

5, intermittent claudication due to intervertebral disc herniation with nerve root compression, caused by nerve root hyperemia, edema and ischemia, when walking, blocked the spinal vertebral venous plexus congestion, aggravate the nerve root and spinal cord vascular congestion expansion, but also increased the pressure on the nerve root and the emergence of intermittent claudication and pain.

6, spine posture change: lumbar disc herniation after more than 90% of patients with varying degrees of functional scoliosis, most convex to the affected side, a small number of convex to the healthy side, the main visual prominence and nerve root relationship. Lateral bending can relax the nerve root and relieve pain. If the protrusion is in front of the nerve root, the spine is convex to the affected side; the protrusion is in the medial part of the nerve root, and the spine is convex to the contralateral side. Side bend is a kind of protective measure to reduce the protrusion to the nerve root.

The final diagnosis of lumbar disc herniation, determine the location and extent of the prominent, it should be selected for lumbar CT, MRI (magnetic resonance imaging) or lumbar myelography for further examination.

Seven, suffering from lumbar disc herniation after how to do

1, bed rest: in the first few days of acute lumbar disc herniation, the patient's subjective symptoms are very serious, this time should rest in bed. The use of bed rest in the treatment of lumbar disc herniation, the method is relatively simple, patients do not need too much expertise can be carried out at home. But there are still many problems should be noted in bed rest, if not resolved, the effect can not be guaranteed.

(1) lying in bed. Specifically is the wood bed mattress or mattress thin, brown bed hard can.

(2) when the patient is lying on his back, he can add a thin pad to the waist or keep the knees and hips to maintain a certain degree of flexion. Prone position, the mattress to flat, in order to avoid excessive waist extension.

(3) strict adherence to bed rest. Even if the symptoms relieved after a period of time to wear waistline to get out of bed, you can not do any flexion movements. If the patient is unable to stay in bed because of inconvenience, it will affect the curative effect.

(4) the most difficult thing to do in bed rest is to get up and down on the bed. If the patients can't accept recumbent position, pee, crutch or by hand and go to the toilet. Don't sit up in bed stool, because the waist excessive flexion of intervertebral disc after more process. Of course, in bed for a period of time, such as massage, acupuncture, physical therapy and other methods of comprehensive treatment, will achieve better results.

2, family lumbar traction pelvic traction method is a simple and safe treatment of spinal traction. With hard bed, traction belt around the waist with fixed pelvis, with each side is connected with a traction rope to bed foot, or with double skin traction of lower extremity leads the traction rope traction rope through the pulley hanging on each side of 5 ~ 10kg weight, the foot of the bed elevation 10 ~ 15cm to produce anti traction. Traction can be 24 hours uninterrupted, traction weight can be gradually increased. General bed 3 ~ 4 weeks, with the improvement of symptoms can be allowed to get up a little every day activities, and gradually increase the amount of activity, and then consolidate the efficacy of 2 to 3 months. If the foot is not raised, the upper part of the body must be fixed for the traction of the lower limb.

 

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