Iyo musana wakagadzirwa nemapfupa anonzi vertebrae, netambo yemuzongoza ichimhanya nemumugwagwa wepasipakati pakati. Tambo inoumbwa netsinga. Iyi midzi yemitsipa yakapatsanurwa kubva patambo uye inofamba pakati peiyo vertebrae munzvimbo dzakasiyana dzemuviri. Kana iyi midzi yemitsipa ikavezwa kana kukanganiswa, zviratidzo zvinotevera zvinozivikanwa se, radiculopathy. El Paso, TX. Chiropractor, Dr. Alexander Jimenez anotyora pasiradiculopathies, pamwe neyavo zvinokonzera, zviratidzo uye kurapa.

• Mutsara unopinhwa unogona kuitika munzvimbo dzakasiyana dzomukona (cervical, thoracic kana lumbar).
• Zvinowanzoitika kukonzeresa kwegomba panobuda mitezo yemutsinga, inogona kubva stenosis, bone spurs, disc herniation nezvimwe zvinhu.
• Zviratidzo zvinosiyana asi zvinowanzobatanidza kurwadziwa, kushaya simba, kupera uye kurira.
• Zviratidzo zvinogona kutarisirwa nemishonga isingashandi, asi chirwere chiduku chinogona kubatsira.

Radiculopathy

Kuwandisa & Pathogenesis

• Dhayi yakarongedzerwa inogona kurondedzerwa seanniation ye nucleus pulposus kuburikidza nemagetsi e annulus fibrosus.
• Nyaya dzakawanda dzinokanganisa dzinoitika mumakore makumi matatu nemakumi mana ehupenyu apo nucleus pulposus ichiri gelatinous.
• Iko nguva yakawanda yezuva inobatanidza nekuwedzera simba pane diski ndiyo mangwanani.
• Munharaunda yechiparadzi, zvipfeko zvinowanzobuda kuburikidza nechiremera chinongononoka kusvika kumashure endline, uko kunonoka kwemazuva ekupedzisira kunopera.

Epidemology

Lumbar Spine:

• Symptomatic lumbar disc herniation inowanikwa munguva yeupenyu yevamwe 2% yevanhu vakawanda.
• Inenge 80% yevanhu vanozoona kurwadziwa kwekusuruvara kukuru munguva yechirongwa chehanied.
• Mapoka ari pangozi yakakura yekudzivirira kwe intervertebral discs vanhu vaduku (makore anorema emakore 35)
• chokwadi sciatica chaizvoizvo inokura muga 35% yevarwere vane disc herniation.
• Kwete, zvisingaiti, sciatica inokura 6 kusvika ku10 makore mushure mokutanga kwemarwadzo ekurwadziwa.
• Nguva yehutambudzo hwekudzokera shure inogona kufanana nekudzokorora kudengenyeka kwemagetsi e annular anotsamwisa mutsara we sinuvertebral asi haagumisi kubudiswa kwekadhi.

Epidemology

Cervical Spine:

• Ivhareji yechirwere chegore ye radiervichuse iri pasi pe0.1 ne1000 vanhu.
• Pure soft disniation herniations hazviwanzovi kudarika zvakaoma kubata (spondylosis) sechikonzero chekurwadziwa kukuru kwemaoko.
• Mune chidzidzo chevarwere ve395 vane nerve midzi isina kukodzera, radiculopathies yakaitika mumuromo wemakondomu uye lumbar spine mu 93 (24%) uye 302 (76%), maererano.

Pathogenesis

• Kugadziriswa mu intervertebral disc biomechanics uye biochemistry kwekufamba kwenguva kunokanganisa dhi function.
• Dhikanisi haikwanise kushanda sepakati pezvisikwa zvegungwa kana sekubatana kwepasi rose.

Pathogenesis - LUMBAR SPINE

• Izvo zvikamu zviviri zvakajairika zve disc discloniation ndeL4-L5 uye L5-S1, iyo nhoroondo ye 98% wezvionda; hutachiona hunogona kuitika paL2-L3 uye L3-L4 asi kazhinji isiri.
  Yose zvayo, 90% ye disc discs are in the L4-L5 and L5-S1 levels.
• Kurapa maziviro paL5-S1 kazhinji kunokanganisa kutanga kwesarral root root, nejoni paL4-L5 level inowanzomanikidza chikamu chechishanu mumakumbo, uye kuchenesa paL3-L4 kakawanda kunosanganisira yechina lumbar root.

• Disc heniation inogonawo kukura muvatana vakwegura.
• Nhengo dze disc dzinokonzera kudzvinyirira muvatana vakwegura inoumbwa ne annulus fibrosus uye zvikamu zve cartilaginous endplate (hard disc.)
  Irotilage inodzingwa kubva mumutumbi wemhuka.
• Kugadzirisa kweimwe yezvinokonzera kushandiswa pazvivako zveuseri zvinoda resorption ye nucleus pulposus.

• Disc discorption chikamu chemaitiro ekuporesa chaiwo akabatanidzwa ne disc disclaimer.
• Iko kunatsiridza kukwanisa kubvisa zvidhina zvine mikana yekugadzirisa zviratidzo zvemakiriniki nokukurumidza.
• Kugadziriswa kwemashoko ekudzidzira akabatanidzwa kunobatanidza nekuwedzera kwakakonzerwa nekupinda mukati ma macrophage uye kugadzirwa kwematrix metalloproteinases (MMPs) 3 uye 7.
• Nerlich neshamwari dzinotsanangura maitiro epapgocytic masero muzvinyorwa zvinopesana intervertebral discs.
• Tsvakurudzo yakaratidza masero akachinjwa masero emunharaunda panzvimbo pokupinda macrophage.
• Degenerative discs dzine masero anowedzera pakupfuurira kwavo kupera.

Pathogenesis - CERVICAL SPINE

• Mukutanga kwe1940s, mamiriyoni emishumo yakaonekwa umo chirwere chepervical intervertebral disc herniation ne radiculopathies chakatsanangurwa.
• Pane kuwirirana kwakananga pakati pematomu emucheto wepervical spine uye nzvimbo uye pathophysiology yedecon lesi.

• Mairi masere emiromo yecervical mizinga inobva kuburikidza ne intervertebral foramina iyo inopeteredzwa nemaitiro ne intervertebral disc uye posterolaterally nejoka zygapophyseal.
• Inamina ndiyo yakakura pane C2-C3 uye inoderera muhukuru kusvikira C6-C7.
• Iyo mitsetse inotora 25% kuti 33% ye volume yeforamen.
• Mucherechedzo weC1 unobva pakati pe occiput uye atlas (C1)
• Zvose midzi yakadzika inopfuura pamusoro pemudzimai wavo wekervical vertebrae (iyo C6 muC5-C6 interspace), kunze kweC8, inobva pakati peC7 na T1.
• Chiyero chekuwedzera chakasiyana chinokanganisa ukama hwesipinha nemutsipa wemidzi uye chirwere chepervical spine.

• Nyaya dzakawanda dzinonzi disc disclaimer dzinoitika posterolaterally uye kune varwere vanopoteredza makore gumi ehupenyu, apo nucleus ichiri gelatinous.
• Nzvimbo dzinowanzozivikanwa dzekutora mazita ake ndeyeC6-C7 uye C5-C6.
• C7-T1 uye C3-C4 disc herniations ndezvishoma (pasi pe15%).
• Disc herniation yeC2-C3 haina kuwanikwa.
• Varwere vaiva nepamusoro-soro cervical disc protrusions muC2-C3 munharaunda dzine zviratidzo zvinosanganisira kurwadziwa kwebhobhoccipital, kurasikirwa kwesimba, uye paresthesias pamusoro pechiso uye ruoko rumwe chete.
• Kusiyana nemakumbo emakwenzi ake, cervical herniated diss inogona kukonzera myelopathy muwedzerwa nekurwadziwa kukuru nemhaka yehutachiona hwepelinha munharaunda yekervical.
• Izvo zvisingazivikanwi zvinyorwa zvinobatsira mune nzvimbo yekuputika ma discs.
• Nhengo isina kuvharwa inotungamirira kutungamira zvakadzingwa zvinyorwa zvenguva pfupi, uko kusungirirwa kwekambo kunogona kuitika zvakare.

• Disc herniation inowanzo kukanganisa iyo nerve midzi yakanyanya kuverengerwa kune yakapihwa disc nhanho; semuenzaniso, iyo C3-C4 disc inokanganisa yechina kervical nerve midzi; C4- C5, yechishanu kervical nerve midzi; C5-C6, yechitanhatu kervical nerve midzi; C6-C7, wechinomwe remuromo wemutsipa mudzi; uye C7-T1, yechisere kervical nerve nerve.

• Haasi tsvina yega yega yakaratidza chiratidzo.
• Kubudirira kwezviratidzo kunoenderana nekuchengetedza simba remugero wepelinha, kuvapo kwekuputika, ukuru hwemharavha, uye kuvapo kwechirwere chinokonzera sora seansteophyte.
• Mukudhirika kwedhisiki, kuburitswa kwezvinhu zvenyukireya kunoguma nekukakavara pane annular fibers uye kumanikidza? Pane iyo dura kana nerve midzi inokonzera kurwadziwa.
• Uyewo kukosha ndeyemadiki maduku e sagittal diameter, bony cervical mumugwagwa.
• Vanhu vari mukati mavo vane dhonic cervical herniated disc inokonzera kukanganiswa kwemotokari kune chinetso chechiberekiti chekudzivirira kana chirwere chepinini stenotic.

Clinical History - LUMBAR SPINE

• Kiriniki, kunyunyuta kukuru kwemurwere kurwadziwa kwakapinza, kwakasununguka.
• Muzviitiko zvizhinji panogona kunge kune nhoroondo yapfuura yezvikamu zvepakati pezvakaitika zvekunzwa kurwadziwa kwakanyanya.
• Iyo kurwadziwa kwete kwete kumashure chete asi kunowedzerawo pasi pasi petsoka mukuparadzirwa kweatomic kwehutachiona hwemutsipa.
• Inowanzorondedzerwa sepakadzika uye yakakosha uye ichifambira mberi kubva kumusoro zvichidzika mumakumbo akabatanidzwa.
• Kubva kwayo kunogona kunge kwakanyanyisa kana kuti kamwe-kamwe uye kunobatanidza nekuputika kana kunyorera manzwiro emutsana.
• Dzimwe nguva, apo sciatica inokura, kurwadziwa kwemugumo kunogona kugadzirisa nokuti kamwe chete kana gore racho risati rapera, zvingave risisati rava pasi pematambudziko.
• Disc herniation inouya nekuedza kwechimbichimbi apo truru inoshandura kana kuchinjwa.
• Pane imwe nguva, varwere vane L4-L5 disc herniation vane kurwadziwa kwekugomera. Mukudzidza kwevarwere ve512 lumbar disc, 4.1% aiva nekunzwa kurwadziwa.
• Pakupedzisira, the sciatica inogona kusiyanisa zvakasimba; zvinogona kuva zvakanyanya zvokuti varwere vanenge vasingakwanisi kuenda uye ivo vachanzwa kuti musana wavo "wakavharwa".
• Kune rumwe rutivi, kurwadziwa kungave kwakagumira kune bhudzi rakashata iro rinowedzera mukukanda nekuda.
• Marwadzo akaipisisa munzvimbo yakanyatsogadziriswa uye anonunurwa nekuwedzerwa kweganda rembiru.
• Nenzira, varwere vane herniated discs vave nekurwadziwa kukuru nokugara, kutyaira, kufamba, kuvhara, kunyunyuta, kana kushungurudza.

Clinical History - CERVICAL SPINE

• Kurwadziwa kwemaoko, kwete kurwadziwa kwemutsipa, ndiko kunyunyuta kukuru kwemurwere.
• Zvinorwadza zvinowanzoonekwa sekutangisa mumutsipa uye zvichibva zvichibva kune ino kusvika kune rimwe, ruoko uye shanduko uye kazhinji zviri muruoko.
• Kutanga kwekurwadziwa kukuru kunowanzowedzera, kunyange kunogona kuitika kamwe kamwe uye kuitika mukubatana nekubvarura kana kushungurudza manzwiro.
• Sezvo nguva ichipfuura, ukuru hwemaoko kunorwadza zvakajeka kudarika iyo yemutsipa kana kurwadziwa kwepamupa.
• Iyo kurwadza kwemaoko kunogonawo kushandiswa muhutano uye kusabvumira chero kushandiswa kwemaoko; iyo inogona kubva pakurwadziwa kwakanyanya kusvika kumapfudzi akaoma, akaputika mumisungo yemaoko.
• Zvinorwadza zvinowanzova zvakasimba zvokuti zvinomutsa murwere usiku.
• Uyezve, murwere angave achinyunyuta pamusoro pemusoro wepamusoro pamwe nemaspasm musumbu, izvo zvinogona kubuda kubva pamucheto womukati kusvikira pasi pezvinyorwa.
• Uturu hunogona kuenderera mberi mubhokisi uye kutevedzera angina (pseudoangina) kana kuti kufupa.
• Zviratidzo zvakadai sekurwadziwa kwemarwadzo, marwadzo omumakumbo, kusaremera kwemakumbo, kushungurudzika kwepabonde, kana kusagadzikana zvinoreva kudzvinyirira kwemupinha (Myelopathy).

Kuongorora Kwepanyama - LUMBAR SPINE

• Kuongororwa kwepanyama kucharatidza kuderera kwemafambiro ekufamba kwemugumo we lumbosacral, uye varwere vanogona kunyorera kune rumwe rutivi sezvavanoedza kupfugama mberi.
• Rutivi rwe disc disclodiation rinowirirana nechinzvimbo chechikoro che scoliotic.
• Zvisinei, huwandu hwepamusoro kana kuti chirongwa chekudzivirira hachiwirirane nehuwandu hwezvinyorwa.
• Pachivande, varwere vanofamba ne antalgic gait iyo iyo inobata mitsipa yakabatanidzwa inogadziriswa kuitira kuti vaise soro shoma sezvinobvira pamucheto.

• Neurologic Examination:

• Kuongororwa kwepfungwa kunokosha zvikuru uye kunogona kubvumira uchapupu huripo hwehutano hwemitsipa (Tinofanira kuongorora kuongororwa kwakajeka, simba remuviri, uye kuongorora kwekunzwa kwemurwere).
• Mukuwedzera, dambudziko rekushaya simba rinogona kunge risina kukosha kwenguva yechechi nokuti rinogona kunge rakabatana nekurwiswa kwekare kune imwe nzvimbo.
• Kugadzikana kwemunhu wepelinha midzi midzi kunokonzera kuchinjwa mumotokari, manzwiro, uye zvakajeka.
• Apo yekutanga sacral midzi inomanikidzwa, murwere angave ane gastrocnemius-asiye utera uye haakwanisi kuramba achisimudza pamakumbo etsoka iyo.
• Atrophy yemhuru inogona kunge yakabatana, uye chikwata (Achilles) reflex inowanzopera kana kusisipo.
• Kurasikirwa kunofadza, kana kuripo, kazhinji kunowanzovharirwa kunzvimbo yakatarisa yemhuru uye rutivi rwechipiri rwetsoka.

• Kubatanidzwa kwechishanu kumagetsi emiromo kunogona kutungamirira kuutera mukuwedzera kwechigunwe chikuru uye, mune dzimwe nguva, kushaya simba kweeverters uye dorsiflexors yetsoka.
• Chikanganiso chekunzwa chinogona kuonekwa pamusoro pekunze kwegumbo uye kukanganisa kworutsoka kusvika kunechigunwe chikuru

• Nekunyanya kwechina yechina lumbar nerve root, mutsara we quadriceps unobatwa; murwere angaona utera mukuwedzerwa kwemabvi, izvo zvinowanzobatanidzwa nekusaziva.
• Atrophy yekudya kwehudyu inogona kunyorwa. Kurasikirwa kunofadza kungave kuri pachena pamusoro pechirwere chechigunzva chehudyu, uye patellar tendon reflex inogona kuderedzwa.

 

• Nerve root sensitivity inogona kushandiswa nemhando ipi zvayo inoita kukakavara.
• Chirwere chakajeka-kusimudza (SLR) ndiyo iyo inonyanya kushandiswa.
• Uyu muedzo unoitwa nemurwere supine.

Kuongorora Kwepanyama - CERVICAL SPINE

Neurologic Examination:

• Kuongororwa kwepfungwa yezvirwere kunoratidza kusagadzikana ndicho chinhu chinonyanya kubatsira chekuongorora chirwere-up, kunyange zvazvo kuongorora kunogona kugara kwakasununguka pasinei nehupenyu husingaperi hwemuitiro.
• Kuvapo kweatrophy kunobatsira kunyora nzvimbo yechironda, pamwe nekusingaperi.
• Kuvapo kwekuzviisa pfungwa kunofanirwa kunowanzooma kunzi kududzira uye kunoda murwere akabatana uye anobatana kuti ave wekliniki inokosha.

• Apo mutezo wechitatu wechiberekeri unomanikidzwa, hapana kuchinja kwemafambiro uye simba rekudzivirira kunogona kuonekwa.
• Hurwa hunoyerera kumusana wemutsipa uye kutarisa mastoid uye pinna ye nzeve.
• Kubatanidzwa kwechina yekervical nerve midzi kunotungamirira kusingaoneki kuonekwa kushanduka kwemaitiro kana kushaya simba.
• Hurwa hunoyerera kumusana wemutsipa uye hukuru hwehutachiona.
• Dzimwe nguva, marwadzo anoyerera kumusvingo wepamusoro wemapfupa.
• Zvinorwadza zvinowanzowedzererwa nemitsipa yakawedzera.
• Kusiyana nechetatu nechina yekervical nerve midzi, yechishanu kusvika kwechisere yekervical nerve midzi ine motokari inoshanda.
• Kushanda kwechishanu kervical nerve midzi kunoratidzika nekushaya simba kwepafudzi kubatwa, kazhinji pamusoro peiyo 90 degree, uye kushaya simba kwefudzi kuwedzera.
• Iyo biceps reflexes inowanzoora mwoyo uye marwadzo anobuda kubva kumativi emutsipa kusvika kumusoro kwepafudzi.
• Kupera kwekunzwa kunowanzoonekwa munharaunda yakatarisa ye deltoid, iyo inomiririra nzvimbo inokwanisa kuzvidzivirira mumasero e-axillary.

• Kubatanidzwa kwechitanhatu chepervical nerve root inobvisa biceps musimba utera pamwe nekuderedza brachioradial reflex.
• Iyo kurwadziwa zvakare inopenya kubva pamutsipa pasi pasi pechipfuva chechipiri chechipiri uye shanduko kusvika kune rumwe rutivi rworuoko rwechipiri (index finger, mirefu refu, uye chigunwe).
• Unhu hunoitika pane dzimwe nguva mumucheto we index index, nzvimbo inochengetedza yechitanhatu chepervical nerve root.

• Kugadzikana kwechinomwe chepervical nerve root inounza mafungiro echinangwa mumaruva anoedza kuongorora pamwe nekurasikirwa kwesimba mumatutu emakumbo, anowedzera huta.
• Marwadzo kubva pachilonda ichi anobuda kubva pamusana wechipfuva pamutsipa pasi nepakati penharaunda kusvika pakati pomunwe.
• Kuchinja kunofadza kunowanzoitika pamucheto wepakati wemunwe, nzvimbo inochengetedza mutsara wechinomwe.
• Varwere vanofanirawo kuongororwa nemapapular, iyo inogona kuitika neC6 kana C7 radiculopathies.

• Pakupedzisira, kubatanidzwa kwechisere yekervical nerve root ne-heniated C7-T1 disc inounza kushaya simba kwemuviri wemhuka.
• Kubatanidzwa kwakadai kunogona kutungamirira kukurumidza kushamiswa kwemisungo yakasiyana-siyana nekuda kwehukuru hwemasimba aya.
• Kurasikirwa kwe interossei kunotungamirira mukurasikirwa kukuru kwemaoko akanaka.
• Kwete mafungiro anowanikwa nyore nyore, kunyange zvazvo flexor carpi ulnaris reflex inogona kuderedzwa.
• Ukurwadziwa kukuru kubva pamusere wechisere mushure mhondi inotanga kusvika kumuganhu wekupedzisira ruoko uye chindori neminwe duku.
• Icho chidimbu chemunwe muduku chinowanzoratidza kuratidzika kwekunonoka.

• Kuora kunorwadza kwakanyanya kune imwe yekodhivha yekervical disc inogona kubviswa nekudzikinurwa kwesimba rakabata.
• Kunyange zvazvo zviratidzo izvi zvichibatsira panguva ino, kusavapo kwavo voga hakubvisi mutsara wehutachi.

Laboratory Data

• Kuongororwa kwechiremba testatory laboratory (kuverenga ropa, makemikari panels erythrocyte sedimentation rate [ESR]) inowanzoonekwa nevarwere vane disc disc.

• Electro diagnostic Testing

• Electromyography (EMG) inowedzera kuongorora kwekuongorora kwepanyama.
• Kunyanya kushandiswa kweEMG ndiko kuongororodza radiculopathies mumatambudziko ekunyangadza kwemaurologic.
• Zvidzidzo zveEEMG zvingave zvakanaka mune varwere vane mushumo kuisa mumiriri.

Kuongorora Radiographic - LUMBAR SPINE

• Nzira x-rays inogona kuva yakakwana mumurwere ane zviratidzo uye zviratidzo zvehutano hwemutsipa.

• Computed Tomography

• Radigraphic tsananguro neT CT scan inogona kuratidza disc bulging asi inogona kusawirirana nehuwandu hwehutano hwehuipi.

• Magnetic Resonance Imaging

• MR imaging inobvumirawo kutaridzika kwezvinyama zviduku, kusanganisira discs mumutambo wechipfuva.
• Herniated discs inowanikwa nyore nyore neR MR kuongorora.
• MR imaging ndiyo nzira inobatsira yekuona kwenguva yakareba uye yekare inonzi disc heniations.

Kuongororwa Kwemavara - RUDZIMBO DZOKUTANGA

• X-rays

• Nzira x-mazai angave akazara zvakakwana kune varwere vese han acute herniated cervical disc.
• Zvakare, 70% yevakadzi vasingatauri uye 95% yevanhu vasina kumira pakati pezera remakore e60 nemakore 65 vane uchapupu hwehutachiona hwehutachiona hwepamusoro pa plain roentgenograms.
• Maonero anowanikwa anosanganisira anteroposterior, lateral, kuruka, nekuwedzerwa.

• Computed Tomography

• CT mvumo yekuona zvakananga zvekunyorwa kwezvivako zvemashure uye naizvozvo zvakanyanya kunyanya kudarika myelography.
• Kubatsirwa kweTCT pamusoro pekuita myelography kunosanganisira kuonekwa kwakanaka kwezvinhu zvisina kukwana zvakadai seforaminal stenosis uye zvisiri izvo zvinokonzera myelographic block, kuderera kwemairasi, uye pasina nzvimbo yekurapa.

• Magnetic Resonance

• MRI inobvumira kutaridzika kwakanakisisa kwezvinyama zviduku, kusanganisira mabheti ake aine mutsara.
• Chiyero hachisi chisina kunaka.
• Mune chidzidzo chevarwere ve34 vane zvipembenene zvechirwere, MRI yakafanotaura 88% yezvipembenene zvinopupurirwa zvinoratidzwa zvichienderana 81% for myelography-CT, 58% chekunyora, uye 50% nokuda kweC CT chete.

Kusiyanisa Kuziva - LUMBAR SPINE

• Kutanga kufungidzirwa kwekodhi rehanied kunowanzoitwa pamusana pezvakaitika uye kuongorora kwepanyama.
• Mavara eraraographs omukomana we lumbosacral haawanzowedzere kuongororwa asi anofanira kuwanikwa kuti abatsire kutonga zvimwe zvinokonzera marwadzo zvakadai sehutachiona kana tumarara.
• Mimwe miedzo yakadai seM MR, CT, uye myelography inogutsikana nemasikirwo uye inogona kutsausa painoshandiswa sekuongorora kuongorora.

Spinal Stenosis

• Murwere ane spinal stenosis angatamburawo nemarwadzo anorwadza anokwira kumativi ekumusoro.
• Varwere vane spinal stenosis vanowanzove vakwegura kudarika avo vane ma-disni herniated vanobudirira.
• Nenzira, varwere vane spinal stenosis vane ruzivo rwepamusoro kunorwadza (pseudoclaudication = neurogenic claudication) mushure mekufamba kune imwe nzvimbo isingazivikanwi.
• Vanonyunyutawo nezvekutambudzika kunowedzera kuburikidza nekumira kana kutambanudza musana.
• Radiographic tsanangudzo inowanzobatsira mukuparadzanisa vanhu vane disc herniation kubva kune vane bony hypertrophy inosangana nepinalinal stenosis.
• Mune chidzidzo chevarwere veC1,293, kupera kwepasipenosis stenosis uye herniated intervertebral discs 17.7% hwevanhu.
• Kuora kukuru kunogona kukonzerwa nehuwandu humwe hutachiona hwehutano mumunhu.

Facet Syndrome

• Facet syndrome chimwe chinokonzera kurwadziwa kunorwadza shure kunogona kusanganiswa nehutachiona hwehurombo kune zvivako kunze kwezvakagadzirwa ne lumbosacral musana.
• Kuita zvekuita kwezvivakwa zvepamusoro muhutano hwakabatana zvinokonzera marwadzo kukura.
• Mune mamiriro ezvinhu akawanda, kurwadziwa kunowanikwa panzvimbo yehutano hwakakanganiswa uye kunowedzera nekuwedzera kwepamusoro (kumire).
• Chinhu chakadzika, chisingarangarirwi, kushungurudzika kunorwadza kunogonawo kuonekwa mubatanidzwa we sacroiliac, mabako, uye makumbo.
• Nzvimbo dze sclerotome dzakagadziriswa dzinoratidza chimiro chakafanana chemu embryonic sechikamu chinoputsika chakabatanidzwa.
• Varwere vane marwadzo echipiri kune rumwe rutivi rwechirwere chirwere pamwe chete vanogona kuve nekununurwa kwezviratidzo ne apophyseal injection yekare inobata maitiro anesthetic.
• Ichokwadi chechikamu chechikamu chechirwere chakabatana mukugadzirwa kwemarwadzo kumashure nemakumbo kunoramba kuchigadziriswa.
• Zvimwe zvinokonzera zvinokonzera sciatica zvinosanganisira congentenial kusagadzikana kwe-lumbar nerve midzi, kunze kwekunyora kweropa (sachigaro mumusana wemapuranga kumashure), uye kusuruvara kwemitsipa (piriformis syndrome).
• Kana zvisingawanzoitiki, chirwere cheservic or thoracic lesion inofanira kutaridzirwa kana lumbar spine yakajeka nezvisina kunaka.
• Zvirwere zvinokonzera sciatica (neural tumors kana zvirwere, somuenzaniso) zvinowanzobatanidzwa ne systemic zviratidzo pamwe nekurwadziwa kwemitsipa mune kugoverwa kwemavara.

Kusiyanisa Kuongororwa - CERVICAL SPINE

• Hapana hutano hwekuongorora hunenge huripo pakiriniki kuongororwa kwekodhivha yekervical disc.
• Kuongororwa kwepanguva yekodhivha yekervical yakagadzirwa nehutano uye kuongorora kwepanyama.
• Zuva re x-ray rinowanzove risina ruzivo, kunyange dzimwe nguva dhoni nzvimbo yakaderera kune inenge yafungidzirwa interspace kana kuti inaminal kuderedza mitambo yeblique inoonekwa.
• Kukosha kwei-ray ndeyekusiya zvimwe zvinokonzera kurwadziwa kwemutsipa uye maoko, zvakadai sehutachiona uye chirwere.
• MR imaging uye CT-myelography ndiyo inonyanya kuongorora mvumo ye disc disclaimer.
• Cervical disc herniations inogona kukanganisa zvivako kunze kwehutano hwemasinga.
• Disc heniation inogona kukonzera kushandiswa kwemudziyo (vertebral artery) inobatanidza ne vertebrobasilar artery kusakwana uye kuratidzika semafungiro akajeka uye chirwere.

• Zvimwe zvinokonzera zvinokonzera kurwadziwa kunofanira kuiswa kunze.
• Chinyanya kukosha ndechimwe chimiro chekudzvinyirira pane nhengo dzomumativi.
• Kudzvinyirira kwakadaro kunogona kuitika pahomboni, forearm, kana kuti wrist. Muenzaniso ndekumanikidzika kwemasero emukati ne carpal ligament inotungamirira ku carpal tunnel syndrome.
• Iyo yakanakisisa kuongororwa muedzo kuti utonge kunze kweizvi zveruzhinji neuropathies EMG.
• Kuwedzeredza kwekutengesa paruoko rwechipiri kune zviremara zvinorema kunogona kukonzera kurwadziwa kukuru kunze kwekudzikisa kuora kwehutano hwemasinga.
• Mutsara wesimbi usingaoneki unofanirwa kuonekwa kana zviratidzo zvekutsvaira mutezo zviripo pamwe chete ne radiculopathies.
• Mutsara wemutsara weshungu zvakadai s syringomiaa anozivikanwa neMRI, uye chirwere chemoto chinonzi neuron chinozivikanwa ne EMG.
• Multiple sclerosis inofanira kufungwa mumurwere ane radiculopathies kana zviratidzo zvenyama zvinoratidza zvipembenene pamusoro peforamen magnum (optic neuritis).
• Mune mamiriro asingawanzocheki, zvipembenene zveparietal lobe zvinowirirana neruoko zvinogona kutevedzera zvakagadziriswa nemirairo yechirwere radiculopathies.

Kukuvadza Medical Clinic: Therapy Therapy & Chiropractic