Contents
Umgudu wenziwe ngamathambo e-24, ebizwa ngokuba yi-vertebrae, ehlanganiswe phezulu. La mathambo omgulane adibeneyo, ekudaleni umsele wokukhusela intambo yomgogodla. Phakathi kwe-vertebra nganye i-discs-intervertebral discs egcwala amanzi echaphazelekayo. Ngexesha, nangona kunjalo, ezi i-disk, i-jelly-like-like disks iqala ukuhlaziya, apho i-nucleus yediski ye-intervertebral iqhubelela ngokubhekiselele kwindandatho yayo yangaphandle, ebangela intlungu ephantsi. Ngezantsi, siza kubonisa iintlobo ezahlukeneyo zeedisiti kunye nokuxoxa ngezizathu, iimpawu kunye neendlela zokonyango.
Iphepha elithi "I-Nomenclature kunye nokuhlelwa kwe-lumbar disc pathology, iingcebiso zemisebenzi edibeneyo ye-North American Spine Society, i-American Society of Spine Radiology kunye ne-American Society ye-Neuroradiology," yapapashwa kwi-2001 kwi-Spine (� Lippincott, Williams & Wilkins). Ibhalwe nguDavid Fardon, MD, kunye noPierre Milette, MD, kwaye ivunywe ngokusemthethweni yi-American Society of Spine Radiology (ASSR), i-American Society of Neuroradiology (ASNR), kunye neNorth American Spine Society (NASS). Injongo yayo yayikukukhuthaza ukucaca ngakumbi kunye nokungaguquguquki kokusetyenziswa kwesigama somqolo, kwaye isebenze le njongo kakuhle ngaphezu kweminyaka elishumi. Ukususela kwi-2001, kukho ukuguquka okwaneleyo ekuqondeni kwethu i-lumbar disc ukubonisa imfuno yokuhlaziywa kunye nokuhlaziywa koxwebhu lokuqala. Uxwebhu oluhlaziyiweyo luthiwe thaca apha, kwaye lumele iingcebiso zemvumelwano yemibutho yangoku edityanisiweyo ye-ASSR, ASNR, kunye neNASS. Eli nqaku libonisa utshintsho oluhambelana neengcamango zangoku kwi-radiologic kunye nokhathalelo lweklinikhi.
Ukubonelela ngemithombo ekhuthaza ukuqonda okucacileyo kwegama lesigama se-disc lumbar phakathi kweekliniki, i-radiologists kunye nabaphandi. Bonke abachaphazelekayo bafuna imimiselo eqhelekileyo yeemeko eziqhelekileyo kunye nezobuchwephesha zee-lumbar diss ezingasetyenziswa ngokuchanekileyo nangokuzimeleyo kwaye ngokufanelekileyo zisebenzise izigulane ezineengxaki ze-disc.
Eli nqaku liquka ukuhlaziywa kweencwadi.
Uphando lwePublics lwenziwe ngeencwadi eziphathelele kwi-disc lumbar. Amalungu eqela lomsebenzi ngamnye kwaye ahlaziywe ngokubanzi uncwadi kwaye ahlaziywe iphepha le-2001. Uxwebhu oluhlaziyiweyo lwangeniswa ukuhlaziywa kwiibhodi ezilawulayo ze-ASSR, ASNR, kunye ne-NASS. Emva kokuhlaziywa kwakhona ngokubhekiselele kwingxelo evela kwiibhodi ezilawulayo, eli nqaku livunyiwe ukuba lipapashwe ngamabhodi olawulo ezi ntlu zintathu, njengommeli weengcebiso zengqungquthela zoluntu.
Eli nqaku linika ingxoxo yeengcambu zokuxilongwa ezicetyiswayo malunga ne-lumbar disc: eqhelekileyo; Ukutshatyalaliswa kokuzalwa / okuphuhliswayo; ukutshabalalisa; ngxakini; ukusuleleka / ukuvutha; neoplasia; kunye / okanye i-morphological variant of uncertain value. Eli nqaku linika i-glossary yemigomo ephathelene ne-lumbar disc, ingxoxo ecacileyo yale migaqo, kunye nokusetyenziswa kwabo okucetywayo. Imigomo ichazwa njengolukhethiweyo, engabhekiswanga, engagqitywanga, kunye noqhagamshelwano. Imizekeliso ehlaziyiweyo iveza ngokucacileyo amagama athile. Iinkcazo zengxelo ezinikezela isiseko seengcebiso zeqela leqela zifakiwe.
Siye sahlaziya kwaye sahlaziywa uxwebhu oluthi, ukususela kwi-2001, lunikeze i-nomenclature eyamkelekileyo ngokubanzi enceda ukugcina ukuhambelana nokuchaneka kwinkcazo yeempawu ze-anatomic kunye ne-physiologic ye-disc ye-lumbar eqhelekileyo kunye engaqhelekanga kwaye isebenza njengenkqubo yokwahlula kunye nokunika ingxelo. yakhelwe phezu kweso sigama.
Ukufakela kwangasese, Iintsizi zengqungquthela, I-Disc bulge (i-disk disc), Ukuchithwa kwe-disc, Ukuxiliswa kwe-disc, Ukukhutshwa kwe-Disc, I-disenclature ye-disc, Ukukhutshwa kwe-Disc, Indawo yokuphakamisa indawo, i-Lumbar intervertebral disc
I-nomenclature kunye nokuhlelwa kwe-lumbar disc pathology consensus, epapashwe kwi-2001, yimizamo yokubambisana ye-North American Spine Society (NASS), i-American Society of Spine Radiology (ASSR) kunye ne-American Society of Neuroradiology (ASNR), iye yakhokela i-radiologists. , oogqirha, kunye noluntu olunomdla ngaphezu kweminyaka elishumi [1]. Olu xwebhu luphumelele uvavanyo lwexesha. Ukuphendula inyathelo elivela kwi-ASSR, iqela labasebenzi bogqirha bomgogodla ukusuka kwi-ASSR, i-ASNR, kunye ne-NASS ihlolisise kwaye iguqule uxwebhu. Olu xwebhu luhlaziyiweyo lugcina ifomathi kunye noninzi lolwimi lwentsusa, kunye neenguqu ezihambelana neengcamango zangoku kwi-radiologic kunye nokhathalelo lweklinikhi. Uhlenga-hlengiso lujongene ikakhulu noku kulandelayo: uhlaziyo kunye nokwandiswa kweSibhalo, isiGaba-magama, kunye neeReferensi ukuhlangabezana neemfuno zangoku; uhlaziyo lweMifanekiso ukunika ingcaciso enkulu; ugxininiso lwegama elithi ��i-annular fissure�� endaweni ��iinyembezi zonyaka��; ukucokiswa kweenkcazelo ��ebukhali�� kunye ��engapheliyo�� disc herniations; ukuhlaziywa kokwahlula phakathi kwe-disc herniation kunye ne-asymmetrically bulging disc; ukupheliswa kweeThebhile ngokuthanda ukucaciswa okukhulu kwiSibhalo esihlaziyiweyo kunye neMifanekiso; kunye nokucinywa kwecandelo leNgxelo kunye neKhowudi ngenxa yotshintsho oluthe rhoqo kwezo zenzo, eziqwalaselwa ngcono zezinye iimpapasho. Ziliqela ezinye izilungiso ezincinci ezenziweyo. Olu hlaziyo luya kuhlaziya i-nomenclature esebenzayo esebenzayo, eyamkelekileyo kwaye isetyenziswe jikelele ngokucinga kunye noogqirha bezonyango.
Oogqirha bafuna imigaqo esemgangathweni yeemeko eziqhelekileyo kunye neepathologic zeediski ze-lumbar [2, 3, 4, 5]. Imigaqo enokutolikwa ngokuchanekileyo, ngokungaguquguqukiyo, nangokuchaneka okufanelekileyo ibaluleke kakhulu ekunxibelelaneni ngezimvo ezifunyenwe kumfanekiso woxilongo lwezonyango kunye nokwenza izigqibo ngonyango. Nangona ukuqonda okucacileyo kwegama le-disc phakathi kwee-radiologists kunye neekliniki kugxininiso lwalo msebenzi, ukuqonda okunjalo kunokuba kubaluleke kakhulu, nakwizigulane, iintsapho, abaqeshi, i-inshurensi, ii-jurists, abacwangcisi bezentlalo kunye nabaphandi.
Kwi-1995, iqela leqela le-multi-disciplinary force elivela kwi-NASS libhekiselele ukungaphumeleli kwimigqaliselo eqhelekileyo esetyenziswayo ichaza iimeko ze-disc lumbar. Icacise imiqulu emininzi yengxaki [6, 7, 8, 9, 10, 11] kwaye yenza iziphakamiso ezinzulu malunga nokumisela. Umsebenzi walo wawushicilelwe kwipapasho ye-NASS kunye ne-American Academy ye-Orthopedic Surgeons [9]. Umsebenzi wawungazange uvunywe ngenye indlela ngemibutho emikhulu kwaye yayingabonakali njengobunyanisiweyo ngemibutho ye-radiology. Uninzi lwangaphambili [3, 7, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19] kunye nezinye ezilandelayo [20, 21, 22, 23, 24, 25] imizamo ejongene nemiba, kodwa yayingenakubalwa kwaye akukho namnye owafumene ukwamkelwa okubanzi.
Nangona inzame ye-NASS 1995 yayiyeyona ibanzi ngelo xesha, yahlala inentsilelo ekucaciseni izihloko ezithile eziphikisanayo, ingenalo unyango lweminye imiba, kwaye ayizange ibonelele ngeengcebiso zokumisela umgangatho kunye nokunika ingxelo. Ukujongana neemfuno eziseleyo, kunye nethemba lokuqinisekisa ukuqinisekiswa okwaneleyo ukuba kubangele imigangatho yendalo yonke, imibutho edibeneyo (i-Co-Chairs David Fardon, MD, kunye noPierre Milette, MD) yenziwe yi-NASS, ASNR, kunye ne-ASSR, okubangelwa inguqulelo yokuqala yoxwebhu ��I-Nomenclature kunye nokuhlelwa kwe-lumbar disc pathology�� [1]. Ukusukela ngoko, ixesha kunye namava acebisa imfuno yohlaziyo kunye nohlaziyo loxwebhu lokuqala. Uxwebhu oluhlaziyiweyo lunikezelwe apha.
Imigaqo-jikelele ekhokela umqulu wasezantsi ungatshintshi kule nguqulelo. Iinkcazo zisekelwe kwi-anatomy ne-pathology, ngokukodwa njengoko ziboniswe kwizifundo zokucinga. Ukuqaphela ukuba ezinye iinkqubo, ngeemeko ezithile, zingenakukwazi ukubonelela, ukuchazwa kwemiqathango akuxhomekeke kuyo okanye kuthetha ukuba yixabiso leemvavanyo ezithile. Iingcaciso zokuxilonga azenzelwe ukuba zichaze iziganeko zangaphandle ze-etiologic ezifana neentlungu, azibonakalisi ulwalamano neempawu, kwaye azichazi okanye zithetha imfuno yonyango oluthile.
Imisebenzi yamandla, kokubili yangoku kunye neyokuqala, isebenza kumzekelo onokunyuka ukusuka kwinjongo ephambili yokubonelela ngeengxelo zeengcamango zophando. Isiphumo sinikeza uluhlu olulula lwemigangatho yokuxilonga, enokunyulwa, ngaphandle kokuphikisana, kwii-subclassifications ezichanekileyo. Xa kunika ingxelo ye-pathology, amazinga okungaqiniseki aya kubhalwe njengaleyo kunokuba athathele iinkcazo zemigaqo.
Yonke imigaqo esetyenziselwa ukuhlengahlengiswa kunye ne-subclassification ichazwa kwaye ezo nkcazelo zilandelwa kuwo wonke umzekelo. Ngenjongo efanelekileyo, ezinye iilwimi zesiNgesi ezikhoyo zinikezelwa izichaso ezahlukeneyo kwizinto ezifumaneka kwezinye izichazi-magama. Imisebenzi yamandla inikezela uludwe kunye nokuhlelwa kwemigangatho ephakanyisiweyo, kodwa, ukuqonda uhlobo lwezenzo zolwimi, xubusha kwaye lufake kwi-Glossary, esetyenziswa ngokuqhelekileyo kunye nemigqaliselo engekho phantsi kunye neengcaciso ezingapheliyo.
Nangona imigaqo kunye neninzi yeenkcazo zolu xwebhu zinokwenziwa ngokulula kwi-colervical and throat sporsal, kugxininisa kwi-lumbar spine. Nangona ukucaciswa kwemiqathango enxulumene nezinto eziphambili, ubungakanani bomngcongolo womgogodla, kunye nesimo seengxube ze-neural ziyadingeka, lo msebenzi unqamle kwingxoxo ye-disc. Ngona kunjalo akusoloko kunokwenzeka ukuxoxa ngokupheleleyo ngentetho ye-anatomical and pathologic ngaphandle kokubhekiselele kwiimpawu kunye ne-etiology, iinkcazo ngokwazo zimela uvavanyo lokuzimela ngaphandle kwe-etiology, iimpawu, okanye unyango. Ngenxa yokugxila kwi-anatomy ne-pathology, lo msebenzi awucacisi ezithile ze-syndromes ezinokliniki ezinokuthi zihlobene ne-lumbar dis pathology [26].
Ukukhokelwa yiyo migaqo, sibuye sihlaziye kwaye sihlaziye umqulu othi, kusukela 2001, unikeze isiqununu esamkelekileyo esisebenzayo kuzo zonke iindidi zokubonwa, ezijongene nomxholo, umxholo, ukuthembeka, intlangano kunye nolwalamano lwendawo ye-disc lumbar; kwaye isebenza kwinkqubo yokuhlelwa kunye nokunika ingxelo ezakhiweyo kuloo nqununu.
Ezi ngcebiso zikhoyo zamacandelo okuxilonga kunye namacandelo afanelekileyo okujoliswe kukwahlula kunye nokunika ingxelo ngeengcamango zokucinga. Isigama esisetyenziswe kuzo zonke iindidi ezicetywayo kunye namacandelori ahlala ehambelana nenkcazo echazwe kwiNgxoxo kunye neenkcazelo ezikhethiweyo ezikhoyo kwiGlosari.
Iindidi zokuxilonga zisekelwe kwi-pathology. I-disc ye-lumbar nganye ingahlelwa ngokubhekiselele kwelinye, kwaye ngamanye amaxesha ngaphezu kweyodwa, kwezi ndidi zokuxilonga zilandelayo: eziqhelekileyo; ukwahluka kokuzalwa/kophuhliso; ukuwohloka; ukwenzakala usulelo/ukudumba; i-neoplasia; kunye/okanye ukwahluka kwemophologic kokubaluleka okungaqinisekanga. Uluhlu ngalunye loxilongo lunokwahlulwa ngokwemigangatho eyahluka-hlukeneyo yobungcali ngokolwazi olukhoyo kunye nenjongo ekufuneka inikezelwe. Idatha ekhoyo yokuhlelwa ngokweendidi inokukhokelela intatheli ukuba ichaze utoliko ��nokwenzeka,�������� okanye���eluqinisekileyo.
Qaphela ukuba ezinye iinjongo kunye neenkcazo ezichazwe apha ngezantsi azikhuthazwa njengegama elikhethiweyo, kodwa zibandakanyiweyo ukuququzelela ukutolika kweelwimi zangaphandle kwaye, kwezinye iimeko, ukusetyenziswa kakubi. Imigqaliselo ingachazwa njengoko ikhethwayo, ingakhankanyiweyo, okanye ingagqithwanga. Amagama angagqibekanga ngokuvisisana nemibutho yomsebenzi yombutho akufanele isetyenziswe ngendlela echazwe.
Ngokuqhelekileyo ichaza iidiski eziqhelekileyo ngokwemvelo, ngaphandle kokuqwalaselwa kwimixholo yeklinikhi kwaye ingabandakanywa utshintsho olwenzayo, oluphuhlisayo, okanye oluguquguqukayo olungathi, kwezinye iimeko (umzekelo, ukuguga okuqhelekileyo, i-scoliosis, i-spondylolisthesis), kuthathwa njengesiqhelo sesiganeko (umzekeliso. 1).
Udidi lokutshintshana lokuzalwa / oluphuhlisayo luquka ii-diss ezingenakuqhelekanga okanye ezenzile utshintsho kwi-morphology yazo njengokuba zilungele ukukhula okungavamile komgudu, njengokwi-scoliosis okanye i-spondylolisthesis.
Utshintsho oluguquguqukayo kwiidiski lufakwe kwicandelo elibanzi elibandakanya amacandellar annular fissure, de degeneration, and herniation.
Iifissures ze-annular zikwahlula phakathi kweefayili ze-annular okanye ukuhlukana kweefayili ze-annular ukusuka kwii-attachments zabo kwithambo le-vertebral. Iifissures ngamanye amaxesha zihlelwa ngokuqhelaniswa kwazo. I-��i-fissure ye-concentric� kukwahlulwa okanye ukuchithwa kwee-annular fibers ezihambelana ne-peripheral contour ye-disc (Umfanekiso 2). I �� radial fissure� kukwahlulwa okuthe nkqo, ngokuthe tye, okanye okuthe tye kwe (okanye ukurenta ngaphakathi) kwinucleus ephuma kwinucleus ngokweperipheral ukuya okanye ngapha kwe-annulus. I-"Fissure enqamlezayo" yi-fissure ye-radial ejoliswe ngokuthe tye, kodwa igama ngamanye amaxesha lisetyenziswa ngendlela encinci ukubhekisela kwi-fissure ejoliswe ngokuthe tye elinganiselwe kwi-peripheral annulus enokubandakanya ukwahlulwa kwemicu ye-annular ukusuka kwithambo le-apophyseal. Xa kuthelekiswa iintanda ezibanzi zonyaka, kunye nokunwebeka komda oshiyekileyo we-annular, ngamanye amaxesha ukuquka ukuqhawuka kweqhekeza le-annular, ngamanye amaxesha kuye kubizwe ngokuba "zizithuba zonyaka," ligama elitsha nelingamkelwanga njengomgangatho [27]. Igama elithi ��fissures� lichaza uluhlu lwezi zilonda kwaye alithethi ukuba isilonda sisiphumo sokwenzakala.
Ukusetyenziswa kwegama elithi ��iinyembezi�� kunokungaqondwa kakuhle kuba umzekeliso wezinye iinyembezi unentsingiselo yokwenzakala, engafanelekanga kulo mongo. Igama elithi ��fissure� ligama elichanekileyo. Ukusetyenziswa kwegama elithi ��iinyembezi� kufuneka kutyhafiswa kwaye, xa livela, kufuneka kuqondwe ukuba lidla ngokuthetha isithethantonye ��ukuqhekeka�� kwaye lingabonisi iziphumo zokwenzakala. Inguqulelo yoqobo yolu xwebhu ichaze ukhetho lwegama elithi ��fissure�� kodwa iwathatha la magama mabini njengaphantse abe sisithetha-ntonye. Nangona kunjalo, kolu hlaziyo, igama elithi "izinyembezi" silithatha njengosetyenziso olungekho mgangathweni.
Ukuhlaziywa kungabandakanya nayiphi na okanye zonke ezi zinto zilandelayo: i-dessicis, i-fibrosis, ukucuthwa kwendawo yediski, ukusabalalisa i-annulus ngaphaya kwendawo yediski, ukuhluma (oko kukuthi, i-fissures annular), ukuchithwa kwe-mucinous ye-annulus, i-intradiscal gas [28], i-osteophyte ye-vertebral apophyses, iziphene, utshintsho oluvuthayo, kunye ne-sclerosis yamacwecwe okugqibela [15, 29, 30, 31, 32, 33, 34].
I-Herniation ichazwa ngokubanzi njengento yokufuduka kwendawo okanye ekugxilwe kuyo kwi-disc material ngaphaya kwemida ye-intervertebral disc space. I-disc material ingaba yi-nucleus, i-cartilage, i-apophyseal bone eqhekezayo, izicubu ze-annular, okanye nayiphi na inhlanganisela yayo. I-disc space ichazwa i-craniad kunye ne-caudad ngamacwecwe okuphela komzimba we-vertebral kwaye, ngokujikelezayo, ngamaphethelo angaphandle e-vertebral ring apophyses, ngaphandle kwe-osteophytes. Igama elithi ��localized�� okanye ��focal�� libhekisela ekwandisweni kwezinto zediski ngaphantsi kwe-25% (90) ye-periphery yediski njengoko ijongwa kwi-axial plane.
Ubukho be-disc ye-disc ehamba ngaphaya kwemida ye-apophyses ye-ring, kuyo yonke i-circumference ye-disc, ibizwa ngokuba yi-"bulging" kwaye ayithathwa njengoluhlobo lwe-herniation (Umfanekiso 3, Phezulu Phezulu). I-asymmetric bulging ye-disc tissue enkulu kune-25% ye-disc circumference (Umfanekiso 3, Ngezantsi), ehlala ibonwa njengento yokulungelelanisa ukukhubazeka okukufutshane, nayo, kungekhona uhlobo lwe-herniation. Ekuvavanyeni ukuma kwediski kwi-herniation kwi-axial plane, ukuma kwee-vertebrae ezimbini ezikufutshane kufuneka kuthathelwe ingqalelo [15, 35].
Iidiski ze-Herniated zingabalwa njenge-protrusion okanye extrusion, ngokusekelwe kwimizimba yezinto ezifudumeleyo.
Ukhuselo lukhoyo ukuba umgama omkhulu phakathi kweemida zeediski ezibonisa ngaphandle kwendawo yediski zingaphantsi komgama phakathi kweengcambu zesiseko sezinto ezinokuxhuma eziphuma ngaphandle kwendawo yediski. Isiseko sichazwa njengokuba ububanzi bezinto ezixubileyo kumgama ongaphandle we-disk indawo yokuvela kuyo, apho izinto ezixubileyo zishiya ngaphandle kwendawo yediski ziyaqhubeka kunye neengxelo zediski ngaphakathi kwidiski (Fig. 4). I-Extrusion ikhoyo xa, ubuncinane enye indiza, nayiphi na ibanga eliphakathi kwemida yeengxoxo ze-disc ngaphaya kwendawo yediskithi mkhulu kunomgama phakathi kwemida yesiseko sezinto zediski ngaphaya kwendawo yediski okanye xa kungekho ukuqhubeka okukhoyo phakathi iimpahla zediski ngaphaya kwendawo yediski kwaye ngaphakathi kwendawo yediski (umzobo 5). Ifomu lokugqibela lokugqithisa libhekiselele ngakumbi okanye lifakwe phantsi njengento yokucwangcisa ukuba i-diskiced disc material ilahlekelwe ngokuqhubekayo kunye ne-disc yomzali (umzobo 6). Ixesha lokufuduka lingasetyenziselwa ukubonakalisa ukufuduka kwezinto ezixubileyo ngaphandle kwendawo yokudityaniswa. Iidiski ze-Herniated kwi-craniocaudad (ebonakalayo) isalathiso ngokusebenzisa isithuba kwi-platinum ye-vertebral end plate isetyenziswe njenge-intravertebral herniations (i-Schmorl nodes) (umzobo 7).
Iingxoxo ze-Disc zingabandakanywa ngokukhethekileyo njengoko ziqulethwe, ukuba isahlulo esinqumlayo sifikelelwe yimibhobho yangaphandle kunye / okanye i-longitudinal long liginal, okanye ingaxhaswanga xa ingekho nasiphi na isimbozo. Ukuba iindawo ezisemagqabini e-disk protrusion zihamba kakuhle kwi-axial computed tomography (CT) okanye i-imagination magontic resonance (MRI), ngoko-ke i-disc ye-displaced material iqulethwe yi-longitudinal ligament, kwaye mhlawumbi iimbumba ezimbalwa ezingasemva (21, 35, 36, 37]. Ukuba umda ongasemva we-disk protrusion awunasigxina, u-herniation akunakunceda. Izicubu ze-displaced disklaced zichazwa ngokubakho ngendawo, umthamo, kunye nomxholo, njengoko kuxoxwa kamva kule xwebhu.
Iskimu esicwangcisiweyo sokwahlula okubonakalayo ukusuka kwi-extrusion kuxoxwa kwiCandelo leNgxoxo.
Uluhlu lwentlungu lubandakanya ukuphazamiseka kwediski ehambelana nobungqina bomzimba kunye / okanye bokucinga bokuphuka kobundlobongela kunye / okanye ukuchithwa kwaye akubandakanyi ukulimala okuphindaphindiweyo, igalelo elingaphantsi kobundlobongela obunobundlobongela kwinkqubo yokunciphisa, ukuhlukana kwe-apophysis yendandatho ngokubambisana nayo. i-disc herniation, okanye i-disc engaqhelekanga ngokudibanisa ne-degenerative subluxations. Ingaba okanye akukho ��ukulimala okungaphantsi kobundlobongela kubangele okanye kubekwe phezulu kwinguqu eguquguqukayo sisigwebo sekliniki esingenakwenziwa ngokusekelwe kwimifanekiso yodwa; ngoko ke, ngokombono wenkcazo yemifanekiso, ii-discs ezinjalo, ngokungabikho kobungqina obubonakalayo bokubonakaliswa kokulimala kobundlobongela obuhambelanayo, kufuneka kuhlelwe njengokunciphisa kunokuba kubuhlungu.
Udidi lokuvuvukala / usulelo luquka ukusuleleka, ukusuleleka-ukutshatyalaliswa kwe-discitis, nokuphendula okuvuthayo kwi-spondyloarthropathy. Kwakhona iquka spondylitis yokuvuvukala yecala lokugqibela le-subchondral kunye nomongo wethambo obonakaliswe nguTshintsho lweMRI I-MRI [29, 30, 38] kwaye ngokuqhelekileyo idibaniswa neenguqu ezinokukhubazeka kwe-pathologic kwi-disc. Ukwenza lula ukwenziwa kocwangciso lwecandelo, udidi luquka izimo ezingafaniyo; Ngoko ke, xa imvume yedatha, ukuxilongwa kufuneka kuhlulwe ngamacandelo afanelekileyo.
Iinguqu zaseprayimari okanye iimetriki zesimo se-diski ezibangelwa ukugula kakubi zigaba njenge-neoplasia, kunye neentlobo eziphantsi kweenkcukacha ezifanelekileyo.
Nangona uninzi lwama-cysts e-intraspinal luvela kwimvelaphi ye-meningeal okanye ye-synovial, ubuncinci buvela kwi-disc kwaye benze i-paradiscal mass engenazo izinto zenyukliya. Ukuphuma kwegazi kunye / okanye i-edema, engahambelani nentlungu okanye enye imvelaphi eyaziwayo inokudala i-paradiscal mass okanye inokunyusa ubungakanani bezinto zediski ze-herniated. I-cysts enjalo kunye ne-hematomas ingabonwa ngokukhawuleza kwaye ingahambelani nenye i-pathology okanye ingaba yinxalenye ye-disc pathology engapheliyo.
Amaxesha apho idatha ibonisa i-morphology engavumelekanga yediski, kodwa apho idatha ingaphelelanga ngokwaneleyo ukuxhasa udidi lokuxilonga lunokuhlulwa ngokwezigaba ezingafaniyo.
Olu xwebhu lunikeza isiqununu esiququzelela inkcazo yokupasa, i-endoscopic, okanye i-cadaveric iziphumo kunye nokufundwa kweengcamango; kwaye, kunye ne-caveat ejongana kuphela ne-morphology ye-disc, yenza kube lula ukunxibelelana kwezigulane, iintsapho, abaqeshi, abaqhankqalazi, kunye nabasemagunyeni bezomthetho kunye noluntu kunye nemvume yokuqokelela idatha ethembekileyo yocwaningo.
Ukwahlulahlula idiski ��okuqhelekileyo�� kuthetha ukuba idiski iphuhliswe ngokupheleleyo kwaye iqhelekile kwaye ayinalo naluphi na utshintsho lwesifo, ukwenzakala, okanye ukuguga. Kuphela i-morphology, kwaye kungekhona imeko yeklinikhi, iqwalaselwa. Ngokweklinikhi "eqhelekileyo" (asymptomatic) abantu banokuba neentlobo ezahlukeneyo zokufunyaniswa kwemifanekiso engenabungozi, kubandakanywa ukuhlukahluka kokuzalwa okanye uphuhliso lweediski, ukukhutshwa okuncinci kwe-annuli, i-deiccation ehlobene neminyaka, i-osteophytes yomzimba wangaphambili kunye ne-lateral marginal vertebral body, ukuvelela kwezinto eziphathekayo. ngaphaya kwepleyiti enye yokuphela ngenxa yokuxinana komzimba omnye we-vertebral ngokubhekiselele kumzimba we-vertebral osondeleyo (ingakumbi eqhelekileyo kwi-L5�S1), njalo njalo [39]. Ngeli nqaku - i-morphology-based nomenclature kunye nokuhlelwa, nangona kunjalo, iidiski ezinjalo azithathwa njengezinto eziqhelekileyo, kodwa kunokuba zichazwe ngeempawu zabo ze-morphologic, ezizimeleyo kwikliniki yazo ngaphandle kokuba kuchazwe ngenye indlela.
Kukho isivumelwano ngokubanzi malunga neentlobo ezahlukeneyo zokulahleka kwengqibelelo ye-annulus, njenge-radial, i-transverse, kunye ne-centric fissures. Yu et al. [40] ibonise ukuba i-annular fissures, kubandakanywa i-radial, i-concentric, kunye neentlobo ezinqamlekileyo, zikhona phantse kuzo zonke iidiski ezichithwayo [41]. Ukuba i-disc iphelelwe ngamanzi kwi-MRI scan, kunokwenzeka ukuba kukho ubuncinane enye okanye i-fissures encinci kwi-annulus. Ngokulinganiselweyo, iintanda zonyaka ezilathiswe ngokugqibeleleyo, kunye nowolulo lomda oshiyekileyo wonyaka, ngamanye amaxesha obandakanya ukuqhawuka kweqhekeza le-annular, ngamanye amaxesha kuye kubizwe ngokuba �izikhewu zonyaka,�� nangona eli gama litsha kwaye lingamkelwanga njengomgangatho [27 ].
Amagama athi "i-annular fissure" kunye "nezinyembezi zonyaka" zisetyenziswe kwiziphumo kwi-T2-weighted MRI scans of localized high intensity zones (HIZ) ngaphakathi kwe-annulus [30, 42, 43, 44]. Iindawo ezinoxinzelelo oluphezulu zimele ulwelo kunye/okanye izicubu zegranulation kwaye zinokuphucuka ngegadolinium. Ukuqhekeka kwenzeka kuzo zonke iidiski eziwohlokayo kodwa azibonakali zonke njenge-HIZs. I-Discography ityhila ezinye iifissures ezingabonwanga yi-MRI, kodwa ayizizo zonke iifissures ezibonwa nge-discography. Inkcazo yeziphumo zomfanekiso ichanekile kakhulu xa inqunyelwe ekubonweni kwe-HIZ okanye i-fissure ebonakaliswe kwi-discographically, kunye ne-caveat eqondakalayo ukuba kukho ukuhambelana okungagqibekanga kunye ne-HIZs, imifanekiso ye-discogram, kunye ne-anatomically seen fissures.
Ukusukela emva phaya kuxwebhu lwe-NASS luka-1995, ababhali bacebise ukuba ezo zilonda zibizwe ngokuthi ��fissures�kunokuba �iinyembezi,�� ikakhulu ngenxa yenkxalabo yokuba igama elithi �iinyembezi�matic��������������������������" [9, 30, 45, 46]. Ngenxa yokungaqondwa kakuhle kwegama elithi �iinyembezi zonyaka,�� kunye nokucingelwa okulandela ukuba ukufunyaniswa kwe-annular fissure kubonisa ukuba kuye kwakho ukwenzakala, igama elithi �inyembezi zonyaka� kufuneka lithathwe njengelingekho mgangathweni kunye � ibe lelona gama likhethwayo. Ukujonga ukubonwa kwe-annular fissure ayithethi ukulimala okanye iimpawu ezinxulumene nazo, kodwa ichaza nje utshintsho lwe-morphologic kwi-annulus.
Ngenxa yokuba kukho ukudideka ekuhlukeni kweenguqu zenkqubo ye-pathologic eguquguqukayo kwi-disc ukusuka kubadala abaqhelekileyo [17, 31, 47, 48, 49], ulwahlulo "i-disc degenerated" lubandakanya zonke iinguqu ezinjalo, ngoko ayifuni. ukunyanzelela umbonisi ukuba ahlule i-pathologic kwisiphumo esiqhelekileyo sokuguga.
Iimbono zento eyenza inkqubo yokuguga eqhelekileyo yomqolo iye yachatshazelwa kakhulu zizifundo ze-postmortem anatomic ezibandakanya inani elilinganiselweyo leesampuli, ezivunwe kwii-cadavers ezivela kumaqela ahlukeneyo eminyaka ubudala, kunye neembali zonyango ezingaziwayo kunye nokucingelwa kokungabikho kweempawu ze-lumbar [23, 50, 51, 52, 53, 54, 55, 56, 57]. Ngeendlela ezinjalo, utshintsho lwe-pathologic lubhideka lula kunye nemiphumo yokuguga okuqhelekileyo. U-Resnick no-Niwayama [31] bagxininisa iimpawu ezihlukeneyo zeenkqubo ezimbini eziphazamisayo ezibandakanya i-disc intervertebral eyayichazwe ngaphambili nguSchmorl noJunghanns [58]; ���spondylosis deformans,�� echaphazela kakhulu i-annulus fibrosus kunye ne-apophyses ekufutshane (Umfanekiso wesi-8, eKhohlo) kunye ne-intervertebral osteochondrosis, echaphazela kakhulu i-nucleus pulposus kunye neplate yomqolo kunye ne-vertebral ebanzi i-annulus fibrosus enokuthi ilandelwe yi-atrophy (Umfanekiso 8, Ekunene). Nangona u-Resnick no-Niwayama bachaza ukuba imbangela yamacandelo amabini yayingaziwa, ezinye izifundo zibonisa ukuba i-spondylosis deformans sisiphumo sokuguga okuqhelekileyo, ngelixa i-intervertebral osteochondrosis, ngamanye amaxesha ibizwa ngokuba yi-disc deteriorated disc, iziphumo ezivela kwi-pathologic ecacileyo, nangona kungenjalo. ngokuqinisekileyo i-symptomatic, inkqubo [29, 31, 42, 59, 60].
Amagatya okuchithwa kwediskrikhi asetyenziswe ngokusekelwe kwi-morphology epheleleyo yee-midsagittal i-lumbar spine (i-Thompson scheme) [19]; Ukujonga ukujonga ingqibelelo yengaphakathi ye disc (i-Dallas classification) (umzobo 9) [42]; Ukubonwa kwe-MRI yomnquba womzimba we-vertebral utshintsha utshintshi (i-XMUMX], (Fig. 30); kunye nezinguquko ze-MRI ezibonakalisiwe kwi-nucleus (i-Pfirrmann i-classification) [10]. Ukuguqulwa okuhlukene kwezi zicwangciso kuye kwacetyiswa ukuba kuhambelane neemfuno ezithile zeklinikhi kunye nophando [61, 17, 35, 62].
Iimfuno zendlela eziqhelekileyo zenza okuyimfuneko isigama sokuxilonga esichaza izinto ezixubileyo ngaphandle kwendawo yediski ye-intervertebral. I-disc ye-Herniated, i-nniyus nucleus pulposus (i-HNP), i-diskips disc, i-dislapsed disc (isetyenziswe ngokungafaniyo), i-diskips disc (isetyenziswa ngokungafaniyo), kunye ne-bulging disc (isetyenziswe ngokungaqhelekanga) zonke zisetyenzisiweyo kwiincwadi ngeendlela ezahlukeneyo zokubonisa ukuhamba izinto ezixubileyo ngaphaya kwe-interspace. Ukungabikho kokuqonda okucacileyo intsingiselo yale migaqo kunye nokungabikho kwencazelo yemida ekufuneka ibekwe kwixesha eliqhelekileyo elide lidale ukudideka okukhulu kwiinkqubo zonyango kunye nokuzama ukulinganisa iinjongo zophando.
Ukuxilongwa ngokubanzi kokufuduswa kwezinto zediski, igama elilodwa elisetyenziswa ngokuqhelekileyo kwaye lidala ukudideka okuncinci yi-"herniated disc". , kunye ne-annulus eqhekekileyo) zizinto eziqhelekileyo zezinto ze-disc displaced [64]. �Ukukrazuka� kwenza umfanekiso wokukrazuka kwaye ke ngoko kunentsingiselo engakumbi ye-etiology ebuhlungu kunokuba �herniation,�� ehambisa umfanekiso wokufuduka endaweni yokuphazamiseka.
Nangona ��protrusion�� isetyenziswe ngababhali abathile ngendlela engaqhelekanga ukubonisa nakuphi na ukufuduswa, eli gama linentsingiselo eqheleke kakhulu esetyenziswayo ethe ngqo igcinelwe yona. ��Iprolapse, esetyenziswe njengegama eliqhelekileyo, elifana nentsingiselo ethile ye-protrusion, okanye ukubonisa ukufuduka okungaphantsi kwezinto zediski ezikhutshiweyo, ayisetyenziswa rhoqo ngendlela yokubonelela ngentsingiselo ethile kwaye ithathwa njengeyona nto ibhetele. ezingekho mgangathweni, ngokuthobela amagama angqale ngakumbi ��protrusion�� kunye ��extrusion.��
Ngokungabandakanyi amanye amagama, kunye nezizathu zokulula kunye nokusetyenziswa okuqhelekileyo, �idiski ye-herniated� lelona gama liqhelekileyo libonisa ukufuduswa kwezinto zediski. Eli gama lifanelekile ukubonisa udidi oluqhelekileyo lokuxilonga xa ubhekisela kwidiski ethile kunye nokubandakanya iintlobo ezahlukeneyo zokufuduka xa uthetha ngamaqela eediski. Eli gama libandakanya iidiski ezinokuthi zibonakaliswe ngokufanelekileyo ngamagama athile ngakumbi, afana ��idiskhi ephumayo�� okanye �idiski ekhutshiweyo.�� Igama elithi �herniated disc,�� njengoko kuchaziwe kulo msebenzi, libhekiselele ekufuduselweni kwendawo yendawo ye-disc. i-nucleus, i-cartilage, ithambo le-apophyseal eliqhekezayo, okanye izicubu eziqhekezayo ze-annular ngaphaya kwendawo ye-intervertebral disc. ��I-Localized�� ichazwa njengengaphantsi kwe-25% yesangqa sediski. I-disc space ichazwa, i-craniad kunye ne-caudad, ngamacwecwe okuphela komzimba we-vertebral kwaye, ngepheriphera, ngamaphethelo e-apophyses ye-vertebral ring, ngaphandle kwe-osteophyte formation. Le nkcazo ithathwa njengento esebenzayo, ngakumbi ukuchazwa kwezifundo ze-imaging, kunenkcazo ye-pathologic efuna ukuchongwa kwezinto ze-disc ezinyanzeliswe ngaphandle kwendawo eqhelekileyo ngokusebenzisa i- annular defect. Ukufuduswa kwezinto ze-disc, mhlawumbi ngokuphuka okanye i-defect kwi-bony end plate okanye ngokubambisana neziqhekeza eziqhekekileyo zeendonga eziqhekekileyo ze-vertebral body, zingachazwa njenge-disc �herniated disc, nangona inkcazo enjalo kufuneka ihambisane nenkcazo yokuphuka. ukuze ugweme ukudideka kunye ne-primary herniation ye-disc material. Ukufuduswa kwezixhobo zediski ukusuka kwindawo enye ukuya kwenye ngaphakathi kwendawo, njengokuba ukufuduka kwe-intraannular ye-nucleus ngaphandle kokufuduka ngaphaya kwe-interspace, ayithathwa njenge-herniation.
Ukuze kuthathelwe ingqalelo ��herniated,�� izinto zediski kufuneka zisuswe kwindawo yazo eqhelekileyo kwaye zingameli nje ukukhula okufunyenwe ngaphaya kwemida ye-apophyses, njengoko kunjalo xa izicubu ezixhumeneyo zikhula kwizikhewu phakathi kwe-osteophytes okanye xa izicubu ze-annular zisuswa. ngasemva kwe-vertebra enye njengendlela yokulungelelanisa kwi-subluxation. I-Herniation, ngoko ke, inokwenzeka kuphela ngokubambisana nokuphazamiseka kwe-annulus eqhelekileyo okanye, njengokuba kwimeko ye-intravertebral herniation (i-Schmorl node), i-defect kwi-plate body end plate.
Iinkcukacha zoyilo lwangaphakathi lwe-annulus zihlala zingabonwa nangowona mgangatho ubalaseleyo we-MRIs [21]. Ukwahlula kwe-herniation kwenziwa ngokuqwalasela ukufuduka kwezinto zediski ngaphaya kwemida ye-apophysis yendandatho ethi ��focal�� okanye ��indawo,��intsingiselo engaphantsi kwe-25% yesangqa sediski. Umgca we-25% we-cutoff usekwe ngendlela yengqungquthela yokubolekisa ngokuchanekileyo kwisigama kwaye ayichazi i-etiology, ngokumalunga neempawu, okanye izibonakaliso zonyango.
Amagama athi ��bulge�� okanye ��bulging�� abhekisa kukwandiswa ngokubanzi kwezicubu zediski ngaphaya kwemida ye-apophyses [65]. I-bulging enjalo ibandakanya ngaphezu kwe-25% ye-circumference ye-disc kwaye ngokuqhelekileyo yandisa umgama omfutshane, ngokuqhelekileyo ngaphantsi kwe-3 mm, ngaphaya kwemida ye-apophyses (Umfanekiso 3). ��I-Bulge�����bulging�� ichaza uphawu lwemophologic yezizathu ezahlukeneyo ezinokwenzeka. I-Bulging ngamanye amaxesha inguqu eqhelekileyo (ngokuqhelekileyo kwi-L5�S1), inokubangelwa kwi-disc degeneration okanye kwi-vertebral body remodeling (njengoko kubangelwa yi-osteoporosis, i-trauma, okanye i-deformity yesakhiwo esisondeleyo), inokwenzeka nge-ligamentous laxity ekuphenduleni ukulayisha. okanye intshukumo ye-angular, ingaba yinkohliso ebangelwa yi-posterior central subligamentous disc protrusion, okanye ingaba yinto ekhohlisayo ukusuka kwi-avareji yomthamo (ngokukodwa kunye nemifanekiso ye-axial ye-CT).
I-Bulging, ngokwenkcazo, ayikho i-herniation. Ukusetyenziswa kwegama elithi ��bulging�� kwidiski akuthethi naluphi na ulwazi lwe-etiology, prognosis, okanye imfuno yonyango okanye kuthetha ubukho beempawu.
I-disc inokuba, ngaxeshanye, ngaphezulu kwe-herniation enye. I-disc herniation ingaba khona kunye nolunye utshintsho oluphazamisayo, ukuphuka, okanye ukungaqhelekanga kwidiski. Igama elithi �herniated disc� alithethi naluphi na ulwazi lwe-etiology, ngokunxulumene neempawu, ukuxilongwa, okanye imfuno yonyango.
Xa idatha yanele ukwenza ulwahlulo, i-disc ye-herniated inokubonakaliswa ngakumbi ��protruded�� okanye ��extruded. Azithethi ukuba ulwazi lwendlela utshintsho lwenzeke ngayo.
I-Disc protrusions igxininise okanye iindawo ezingaqhelekanga zomda we-disc ezibandakanya ngaphantsi kwe-25% ye-disc circumference. I-disc ��protruded�� ukuba umlinganiselo omkhulu phakathi kwemida yezinto zediski ezibonisa ngaphaya kwendawo yediski ingaphantsi komgama phakathi kwemida yesiseko saloo nto idiski ephuma ngaphandle kwendawo yediski. Isiseko sichazwa njengobubanzi bezinto zediski kumda wangaphandle wendawo yediski yemvelaphi, apho i-disc ye-disc ikhutshwe ngaphaya kwendawo ye-disc iyaqhubeka kunye ne-disc ye-disc ngaphakathi kwendawo yediski (Umfanekiso 4). Igama elithi ��protrusion� lifanelekile kuphela ekuchazeni izinto zediski ze-herniated, njengoko kuxoxwe ngazo ngaphambili.
Igama elithi ��extruded�� lihambelana nentsingiselo yolwimi lwento enyanzelwayo ukusuka komnye ummandla ukuya komnye ngomngxuma [37, 64]. Ngokubhekiselele kwi-disc, uvavanyo lwe-extrusion sisigwebo sokuba, ubuncinane kwindiza enye, nayiphi na umgama omnye phakathi kwemida yezinto zediski ngaphaya kwendawo yediski inkulu kunomgama phakathi kwemida yesiseko esilinganiswe ngokufanayo. indiza okanye xa kungekho kuqhubeka kukho phakathi kwezinto zediski ngaphaya kwendawo yediski kwaye ngaphakathi kwendawo yediski (umzobo 5). Izinto zediski ezigqithisiweyo ezingenakho ukuqhubeka kunye nediski yemvelaphi zingabonakaliswa ��i-sequestrated�� [53, 66] (umzobo 6). I-disc ehluthiweyo yi-subtype ye ��idiski ekhutshiweyo���������������� kodwa, ngokwenkcazo, ayinakuze ibe ��idiski ekhutshiweyo”. ukubizwa ��kufuduka,��igama eliluncedo ekutolikweni kwezifundo zemifanekiso kuba kuhlala kungenzeki kwimifanekiso ukwazi ukuba ngaba kuqhubeka kukho.
Ukwahlula okukhankanywe ngasentla phakathi kokukhutshwa kunye nokugqithiswa kwaye phakathi kwezinto eziqulethwe kunye ezingakhange zixhomekeke kusekelwe kwisenzo esiqhelekileyo kunye nokwamkelwa ngokubanzi kweenkcazo kwiinguqulelo zangaphambili zalolu xwebhu. Olunye udidi lwezinto ezichaseneyo, ezixhaswa ngabasebenzi abathile abahloniphekileyo, zichaza ukugqithiswa ngokungenakuxhaswa kunye nokunyanzelisa njengengcinezelo yesithintelo, kungakhathaliseki ukuba ubukhulu bomlinganiselo wesiseko ukuya kwintsimi ye-disc. Kule miqobo, i-extrusion ye-disc ingaqatshelwa ngobungqina bomgca oqhubekayo we-signal low low engqonge i-disc. Bathi i-imaging ephambili ekhoyo ivumela ukuba lo mgaqo wobuhlukeko nokuba ubukho okanye ukungabikho kwe-containment kunomsebenzi ophezulu kliniki kunokwenziwa kwe-morphology yezinto ezifudumeleyo [35].
Ingaba indlela yabo iya kungqineka iphezulu kunendlela ekhuthazwayo ngoku iya kumiselwa luphononongo lwexesha elizayo. Ukusetyenziswa komahluko phakathi ��iprotrusion����extrusion��kunyanzelekile kwaye abanye abakhi-mkhanyo banokukhetha ukusebenzisa, kuzo zonke iimeko, igama eliqhelekileyo ��herniation. ukuqhubeka, umthamo, ukubunjwa, kunye nendawo ye-disc displaced material.
Izinto ze-disc ze-Herniated zingaba ��ziqulathe�� okanye ��ukungathintelwanga. I-Fluid okanye nayiphi na i-contrast efakwe kwi-disc ene-"equlethwe" i-herniation ayiyi kulindeleka ukuba ivuze kwi-canal ye-vertebral. Nangona i-posterior longitudinal ligament kunye / okanye i-membrane ye-peridural ingagubungela ngokuyinxenye izicubu ze-disc ezikhutshiweyo, iidiski ezinjalo azithathwa ngokuba "ziqulathe" ngaphandle kokuba i-longitudinal ligament ingaguquki. Ukulinganiselwa kobugcisa beendlela ezikhoyo zokucinga ezingabonakaliyo (CT kunye ne-MRI) zihlala zithintela ukuhlukana kwezinto eziqulethwe kwi-disc engabonakaliyo. I-CT-discography ayisoloko ivumela umntu ukuba ahlukanise ukuba ngaba i-herniated components of disc iqulethwe, kodwa kuphela ukuba kukho unxibelelwano phakathi kwendawo yediski kunye ne-vertebral canal.
Iqhekeza le-disc elifuduke ngamanye amaxesha libonakaliswa njenge-��free.�� i-��free i-��free i-ragment ye-��Ukuqhutywa i-�� doundcontited.�� i-disc fregment ye-��free �. I-disc ingaba ��ingenakunqandwa,�� ngokulahlekelwa kwengqibelelo ye-posterior longitudinal ligament kunye ne-annulus yangaphandle, kodwa inokuqhubeka phakathi kwe-disc ye-herniated / displaced disc kunye ne-disc yemvelaphi.
Igama elithi ��migrated�� idiski okanye iqhekeza libhekiselele ekufudusweni kwezinto ezininzi ezisusiweyo kude nesithuba sokuvula kwi-annulus apho izinto eziye zakhutshwa khona. Amanye amaqhekeza afudusiweyo aya kuthinjwa, kodwa igama ��ukufuduka�� libhekisa kuphela kwisikhundla hayi ekuqhubekekeni.
Amagama athi ��capsule�� kunye ��subcapsular�� asetyenziswe ukubhekisa kwisithintelo ngendibaniselwano engachazwanga ye-annulus kunye neligament. Le migaqo ayikhethwanga.
Ngokubhekiselele ngokuthe ngqo kwi-posterior longitudinal ligament, abanye ababhali baye bahlula imathiriyeli yediski esusiweyo njenge-subligamentous, � � extraligamentous, � � transligamentous, �����������������������������������������������������������������ligamentous). njengento elingana ��equlethwe.��
Iskimu sokuchaza iqondo le-canal compromise eveliswa yi-disc displacement kufuneka ibe yinto esebenzayo, inenjongo, ichaneke ngokufanelekileyo, kwaye ihambelana neklinikhi. Isikimu esilula esizalisekisa imilinganiselo sisebenzisa imilinganiselo emibini-dimensional ethathwe kwicandelo le-axial kwisayithi ye-compromise enzima kakhulu. Ukuchaphazeleka komjelo ongaphantsi kwesinye esithathwini somjelo kwelo candelo �kuphakathi,�� phakathi kwesinye nesibini esithathwini ��phakathi,�� kwaye ngaphezulu kwesibini esithathwini ‘sibukhali.������ isicelo sokubandakanyeka kwinkundla.
Ukubonakaliswa okubhaliweyo okunjalo kuchaza kuphela indawo ecacacisiweyo kwinqanaba elinye kwaye ungacingi ngokubaluleka kwezinto eziphathekayo; ukusondela, ukunyanzeliswa, kunye nokuphazamiseka kwezakhiwo ze-neural; okanye ezinye izinto ezinokubaluleka, apho umbonisi angakongeza iinkcukacha ngokuchazwa okulandayo.
Ukubunjwa kwezinto ezikhutshwe kwiindawo ezifudumele kungabonakaliswa ngokwemiqathango enjenge-nyukliya, i-cartilaginous, bony, i-calcified, i-ossified, i-collagenous, i-scarred, ichitshiweyo, i-gaseous, okanye i-liquefied.
Ukubaluleka kweklinikhi ehambelana nokuqwalaselwa komthamo kunye nokubunjwa kuxhomekeke kulungelelaniso kunye nolwazi lweklinikhi kwaye alukwazi ukuchithwa kwi-morphologic data kuphela.
UBonneville ucebise inkqubo yealphanumeric eluncedo kwaye elula yokuhlela, ngokwendawo, indawo yeengqungquthela zediski eziye zafudukela kwi-horizontal or sagittal plane [6, 13]. Esebenzisa imida ye-anatomic eqhelekileyo koogqirha, uWiltse ucebise enye inkqubo [14, 67]. Izowuni ze-Anatomic�� kunye ��amanqanaba�� achazwa kusetyenziswa ezi phawu mhlaba zilandelayo: umda ophakathi we-articular facets; i-medial, i-lateral, ingaphezulu, kunye nemida engezantsi ye-pedicles; kunye neenqwelomoya ze-coronal kunye ne-sagittal kumbindi wediski. Kwinqwelo-moya ethe tye (i-axial), ezi mpawu zomhlaba zinquma imida yendawo ephakathi, i-subarticular zone (i-lateral recess), i-foraminal zone, i-extraforaminal zone, kunye ne-anterior zone, ngokulandelanayo (Umfanekiso we-11). Kwi-plane ye-sagittal (craniocaudal), bamisela imida yezinga le-disc, inqanaba le-infrapedicular, i-pedicular level, kunye ne-suprapedicular level, ngokulandelanayo (umzobo 12). Indlela ayichanekanga njengoko imizobo ibonisa ngenxa yokuba imida yemida efana neengqungquthela zangaphakathi kunye neendonga ze-pedicles zigobile, kodwa indlela ilula, iyasebenza, kwaye isetyenziswa ngokufanayo.
Ukuhamba ukusuka kumbindi ukuya kwicala lasekunene kwindiza ye-axial (ethe tyaba), indawo inokuchazwa njengendawo esembindini, ephakathi, ephakathi, i-subarticular yasekunene, i-foraminal yasekunene, okanye i-extraforaminal yasekunene. Igama elithi � paracentral�� alichanekanga kancinane kunokuchaza ��umbindi osekunene�� okanye �ushiywe esembindini,�� kodwa luluncedo ekuchazeni amaqela eediski abandakanya zombini, okanye xa uthetha ngokungekho sikweni, xa icala lingabalulekanga. Ukunika ingxelo ngoqwalaselo lomfanekiso wecwecwe elithile, ��ekunene embindini�� okanye �ukhohlo esimbindini� kumele kuthabathele indawo ukusetyenziswa kwegama elithi � paracentral. i-extraforaminal.��
Kwinqwelo ye-sagittal, indawo ingachazwa njenge-discal, infrapedicular, suprapedicular, okanye pedicular. Kwinqwelo ye-coronal, indawo yangaphambili, ebudlelwaneni kwi-disc, ithetha ukuhamba kwinqanaba le-midoronal yekota.
Phawula:�Amanye amagama neengcaciso ezibandakanyiweyo kolu luhlu lweenkcazelo azikhuthazwa njengesigama esikhethwayo kodwa zibandakanyiwe ukulungiselela ukutolikwa kolwimi lweenkobe kunye, kwezinye iimeko, ukusetyenziswa ngokungafanelekanga. Iinkcazelo ezikhethwayo zidweliswe kuqala. Iinkcazo ezingekho mgangathweni zibekwe kwizibiyeli, kwaye ngokwemvumelwano yamandla omsebenzi wombutho, akufuneki zisetyenziswe ngendlela echazwe ngayo. Amanye amagama abhalwe njenge-colloquial, kunye nokuchazwa ngakumbi malunga nokuba athatyathwa njengengakhethwanga okanye engekho mgangathweni.
Ukukhishwa kwe-disc acute:I-disc herniation yesehlo samva nje. Qaphela: i-paradiscal inflammatory reaction kunye nomqondiso oqaqambileyo we-disc material kwi-T2-weighted images iphakamisa ukunyanzeliswa kwesihlobo. Noko ke, olo tshintsho lusenokuqhubeka kangangeenyanga. Ke, ukungabikho kolungelelwaniso lweklinikhi kunye / okanye izifundo ze-serial, akunakwenzeka ukuza kuthi ga ngoku ngokuchanekileyo ngokucinga xa kwenzeka i-herniation. I-disc ye-herniated acutely inokuba nesignali ecacileyo kwi-T2-weighted MRI ulandelelwano kune-disc apho i-disc material ivela [46, �59,�64,�68]. Qaphela ukuba i-herniation enzima kakhulu inokugqithwa kwi-herniation ekhoyo ngaphambili. I-acute disc herniation inokubuyela ngokukhawuleza ngaphandle konyango oluthile. Bona: i-disc herniation engapheliyo.
I-disc yokuguga:�idiski ebonisa nayiphi na imiphumo eyahlukeneyo yokuguga kwidiski. Ukulahleka komthamo wamanzi ukusuka kwi-nucleus kwenzeka ngaphambi kokuba i-MRI itshintshe, ilandelwa ukuqhubela phambili kwe-MRI ibonakaliswe utshintsho oluhambelana nokulahleka okuqhubekayo kwamanzi kunye nokunyuka kwe-collagen kunye nokudibanisa i-proteoglycans. Jonga ukuhlelwa kwePfirrmann.
Ukufakela kwangasese:Ukwahlula phakathi kweentsinga ze-annular, ukwahlukana kweentsinga ezifakwe kwi-vertebral body, okanye ukwahlukana kweentsinga ezinwebeka ngokujikelezayo, ngokuphambeneyo, okanye ngokuthe ngqo, okubandakanya enye okanye ezininzi zeeleyile ze-annular lamellae. Qaphela ukuba amagama ��fissure�� kunye ��iinyembezi� bezisoloko zisetyenziswa ngokufanayo kwixesha elidlulileyo. Igama elithi ��iinyembezi�� alifanelekanga ukusetyenziswa ekuchazeni iziphumo zomfanekiso kwaye akufuneki lisetyenziswe (ikrazula: engekho mgangathweni). Akukho gama libonisa ukulimala okanye lithetha naluphi na ulwazi lwe-etiology, akukho gama lithetha naluphi na ulwalamano kwiimpawu okanye ukuba i-disc inokuba yi-generator yentlungu, kwaye akukho gama lithetha nayiphi na imfuno yonyango. Bona kwakhona: i-gap annular, i-annular rupture, i-annular tear, i-concentric fissure, i-HIZ, i-radial fissure, i-fissure enqamlezayo.
Umngcipheko wonyaka� (i-nonstandard): i-focal attenuation (CT) okanye i-signal (MRI) engaqhelekanga, ehlala i-triangular kwimilo, kwindawo yangasemva ye-disc, mhlawumbi imele ukwandiswa kwe-fissure ye-annular eqondiswe kwi-radially, i-bilateral annular fissures kunye ne-avulsion ye-annular ephakathi. iqhekeza, okanye ukuvuthuluka kwendawo ekugxilwe kuyo ye-macerated annulus.
Ukuqhawula kwangaphambili:�ukuphazamiseka kwemicu ye-annulus ngokwenzakala ngesiquphe. Olu luxilongo lweklinikhi; ukusetyenziswa kwegama akufanelekanga kwinkcazo yemifanekiso ecocekileyo, endaweni yoko kufuneka igxininise kwinkcazo eneenkcukacha yeziphumo. I-annulus eqhekekileyo ngu�hayi�into enye ��ukuqhekeka konyaka,�� okanye �ukugqabhuka kwediski.��
Iinyembezi ezincinci, ikhefu eliqhekekileyo�(engekho mgangathweni): bona ukuqhekeka kwe-annulus kunye nokugqabhuka kwe-annulus.
Ukufuduka kwangaphambili:� ukufuduka kwezicubu zediski ngaphaya kwendawo yediski ukuya kwindawo yangaphambili.
Indawo yangaphandle:�indawo yeperidiscal engaphambili kwinqwelomoya ephakathi kumzimba we-vertebral.
I-Anulus, i-annulus (ifomfusti ye-annulus fibrosus):�I-multilaminated fibrous tissue eyenza iperiphery yendawo nganye yediski, incamathele, i-craniad kunye ne-caudad, ukuphelisa i-plate cartilage kunye ne-apophyseal bone iringi kunye nokudibanisa embindini kunye ne-nucleus pulposus. Qaphela: mhlawumbi i-anulus okanye i-annulus ilungile upelo. UNomina Anatomica usebenzisa zombini ezi ndlela, ngelixa iTerminologia Anatomica ithi �� anulus fibrosus�� [22]. IFibrosus ayinayo enye indlela echanekileyo yopelo; I-fibrosis inentsingiselo eyahlukileyo kwaye ayichanekanga kulo mongo.
Umxube we-Asymmetric:Ubukho obungaphezulu kwe-25% ye-annulus yangaphandle ngaphaya komjikelezo we-vertebrae esondeleyo, ecacileyo ngakumbi kwicandelo elinye le-periphery ye-disc kunomnye, kodwa ingagxili ngokwaneleyo ukuba ibonakaliswe njenge-protrusion. Qaphela: i-asymmetric disc bulging yi-morphologic observation enokuthi ibe nezizathu ezahlukeneyo kwaye ayithethi i-etiology okanye ukudibanisa neempawu. Bona iqhuma.
I-Balloon disc (i-colloquial, nonstandard):Ukusabalalisa ukwanda okubonakalayo kwe-disc kwizinga eliphezulu-eliphantsi ngenxa yokugoba kwe-vertebral end plates ngenxa yobuthathaka bethambo njenge-osteoporosis enzima.
IsiSekelo (se disc disc)� indawo enqamlezileyo yezinto zediski kumda wangaphandle wendawo yediski yemvelaphi, apho i-disc ye-disc ngaphaya kwendawo yediski iqhubeka kunye ne-disc ye-disc ngaphakathi kwendawo yediski. Kwi-craniocaudal direction, ubude besiseko abukwazi ukudlula, ngenkcazo, ukuphakama kwendawo ye-intervertebral. Kwi-imaging ye-axial, isiseko sibhekisela kububanzi kumda wangaphandle wendawo yediski, yemvelaphi yayo nayiphi na into ye-disc edlula ngaphaya kwendawo yediski.
IDiski�(i-colloquial, nonstandard): bona idiski emnyama.
I-disc bulging, bulge (isibizo [n]), isibinzana (isenzi [v])
Phawula:Ukudumba kukujongwa komjikelo wediski yangaphandle kwaye ayiloxilongo lukhethekileyo. I-Bulging iye yachazwa ngokungafaniyo kwi-redundancy ye-annulus, okwesibini kwilahleko yobude bendawo yediski, i-ligamentous laxity, ukuphendula ekulayisheni okanye ukunyakaza kwe-angular, ukulungiswa kwakhona ekuphenduleni i-pathology esondeleyo, i-herniation engaziwayo kunye ne-atypical, kunye nokukhohlisa ukusuka kwi-avareji yevolumu kwi-CT axial. imifanekiso. I-symmetric bulging yangasemva kwediski isenokuba sisiphumo esiqhelekileyo kwi-L5�S1. I-Bulging inokuthi okanye ingabonisi utshintsho lwe-pathologic, ukwahluka kwe-physiologic, okanye ukuqhelekileyo. I-Bulging ayilona uhlobo lwe-herniation; iidiski ezaziwa ngokuba yi-herniated kufuneka zifunyanwe njenge-herniation okanye, xa kufanelekile, njengeentlobo ezithile ze-herniation. Bona: i-disc ye-herniated, i-disc ephumayo, i-disc ekhutshweyo.
I-diski ecacisiweyo:Ukubala ngaphakathi kwendawo yediski, ingabandakanyi i-osteophytes kwi-periphery yendawo yediski.
Cavitation:Izithuba, ama-cysts, imingxuma, okanye imingxuma eyenziwe ngaphakathi kwinucleus kunye ne-innulus yangaphakathi ukusuka ekuwohlokeni kwediski.
Bona i-disc yocingo.
Ummandla ophakathi:Ummandla ongaphakathi komsele we-vertebral phakathi kweenqwelomoya ze-sagittal ngokusebenzisa imida ephakathi ye-facet nganye. Qaphela: umbindi wendawo ephakathi yindiza ye-sagittal phakathi kwe-vertebral body. Izowuni kulo naliphi na icala lenqwelomoya esembindini are�ephakathiKunyeekhohlo, ezikhethwa ngamagama xa icala liyaziwa, njengaxa ubika iziphumo zemifanekiso yediski ethile. Xa icala lingachazwanga, okanye lidityaniswe ngokumelwa kokubini ekunene nasekhohlo, igama elithi�iipacentral� ifanelekile.
I-disc ye-disc:Ulwahlulo lweklinikhi ukuba i-disc herniation ihlala ixesha elide. Akukho zinkcazo ezivunyiweyo jikelele zezithuba ezahlula phakathi kwe-acute, subacute, kunye ne-disc herniations engapheliyo. I-serial MRIs eveza i-disc herniations engatshintshiyo kwimbonakalo ngokuhamba kwexesha inokubonakaliswa njengento engapheliyo. I-Disc herniations ehambelana nokubala okanye igesi kwi-CT inokucetyiswa njengento engapheliyo. Nangona kunjalo, ubukho be-calcification okanye igesi abukhuphi i-disc ye-herniated acutely. Qaphela ukuba i-acute disc herniation inokuthi ifakwe kwi-disc engapheliyo. Iimpawu ze-magnetic imaging imaging iimpawu zinokuthi, ngezihlandlo ezinqabileyo, zivumele ukwahlulwa kwe-disc herniations ebukhali kunye nengapheliyo [16, �59,�64]. Kwiimeko ezinjalo, izinto eziphathekayo ze-disc ze-herniated zingabonakala zikhanya ngakumbi kune-disc yemvelaphi kwi-T2-weighted sequences [46,�59,�61]. Kwakhona, bona i-disc-osteophyte complex.
Ukucacisa i-osteophyte:I-Bony outgrowth ephuma ngokusondeleyo kwi-disc margin, ukusuka kwi-vertebral body apophysis, eqondiswe, ngokucwangciswa kokutshatyalaliswa, ukuya kwindawo ehambelanayo ye-vertebral body echasene ne-disc.
I-disc okanye i-nucleus yeCollagenized:� idiski apho i-mucopolysaccharide ye-nucleus ithathelwe indawo yi-fibrous tissue.
Idibano yokuthetha, ukunxibelelana (n), ukunxibelelana (v)� (i-nonstandard): unxibelelwano lubhekiselele ekuphazamisekeni kwi-periphery ye-disc annulus, evumela ukugqithiswa kwamahhala kwe-fluid injected ngaphakathi kwe-disc ukuya ngaphandle kwe-disc, njengoko kunokubonwa ngexesha le-discography. Ayidibanisi ��engaqulathwanga.�� Bona ��idiski equlethweyo� kunye ��icwecwe elingaqulathwanga.��
Ukukhangela okukodwa:I-fissure ye-annulus ebonakaliswe ngokuhlukana kwee-annular fibers kwi-plane ngokuhambelana ngokuhambelana ne-curve ye-periphery ye-disc, ukudala izithuba ezizaliswe ngamanzi phakathi kwe-annular lamellae ekufutshane. Bona: iintanda zemitha, iintanda ezinqamlezileyo, i-HIZ.
I-herniation, i-containment (n), iqulethe (v)
I-disc engaphantsi kwe-annulus ngokupheleleyo, kodwa phantsi kwe-posterior longitudinal ligament eyahlukileyo, iqulethwe. Ukutyunjwa ��kuqulethwe������kungaqukwanga� kuchaza ukunyaniseka kwezakhiwo ze-ligamentous ezijikeleze i-disc, ulwahlulo oluhlala lukhona kodwa alusoloko lunokwenzeka ngomfanekiso ophezulu. Kwi-CT kunye ne-MRI scans, i-herniations equlethwe ngokuqhelekileyo inomda ogudileyo, ngelixa i-herniations engapheliyo idla ngokuba nemida engaqhelekanga ngenxa yokuba i-annulus yangaphandle kunye ne-posterior longitudinal ligament iye yangenwa yi-disc material [35,�37]. I-CT-discography nayo ayisoloko ivumela umntu ukuba ahlukanise ukuba ngaba i-herniated components of disc iqulethwe, kodwa kuphela ukuba kukho unxibelelwano phakathi kwendawo yediski kunye ne-vertebral canal.
Ukuqhubeka:� ukudityaniswa kwezicubu zediski ezifudusiweyo ngebhuloho yezicubu zediski, nangona zincinci, kwizicubu ngaphakathi kwediski yemvelaphi.
Udidi lweDallas� (ye-postdiscography imaging): isistim esetyenziswa ngokuqhelekileyo kwinqanaba le-annular fissuring ebonwa kwi-CT imaging yeediski emva kwe-discography. I-Dallas Grade 0 iqhelekile; IBakala 1: ukuvuza kochasaniso kwisinye esithathwini esingaphakathi kwi-annulus; IBakala 2: ukuvuza kochasaniso kwisibini esithathwini esingaphakathi kwi-annulus; IBakala 3: ukuvuza kubo bonke ubukhulu be-annulus; IBanga lesi-4: umahluko wandisa ngokujikeleza; IBanga lesi-5: uthelekiso lokuthelekisa luphumela kwisithuba se-epidural (Jonga i-discogram, i-discography).
Idiski yomnyama�(i-colloquial, nonstandard): i-disc ene-nucleus ebonisa ukuhla kokuqina komqondiso kwimifanekiso enobunzima be-T2 (emnyama), ngokuqhelekileyo ngenxa ye-desiccation ye-nucleus yesibini ukuya kwi-degeneration. Kwakhona: idiski emnyama (colloquial, nonstandard). Bona: ukuhla kwediski, ukuhlelwa kwePfirrmann.
I-disgenerated disc, i-degeneration (n), iyancipha (v)
Isifo se-disgenerative�(igama elingaqhelekanga xa lisetyenziswa njengenkcazo yomfanekiso): imeko ebonakaliswe ngokubonakaliswa kwe-disc degeneration kunye neempawu ezicingelwa ukuba zihambelana nezo zenguqu eziguqukayo. Qaphela: unxibelelwano lwe-causal phakathi kweenguqu eziguqukayo kunye neempawu zihlala zinzima ukuhlukana kwekliniki. Igama elithi "isifo se-disc degenerative" lithwala imiphumo yokugula okunokuthi kungafanelekanga ukuba kuphela okanye izikhombisi eziphambili zokugula zivela kwizifundo ze-imaging, kwaye ngoko eli gama alifanele lisetyenziswe xa kuchazwa ukufunyaniswa kwemifanekiso. Igama elikhethwayo lenkcazo yokubonakaliswa kwemifanekiso ��idiski eyonakeleyo�� okanye ��ukuwohloka kwediski,��kunokuba ��isifo sediski esiwohlokayo.��
Ukulahla�Ukwahlulwa kweentsinga ze-annular ezijikelezayo kunye neenqwelo-moya ezihambelana nomda wediski, obonisa i-fissure concentric ye-annulus.
Idiski ecacisiweyo
I diski (disk):Isakhiwo esiyinkimbinkimbi esakhiwe yi-nucleus pulposus, i-annulus fibrosus, i-cartilaginous end plates, kunye ne-vertebral body ring apophyseal attachments of annulus. Qaphela: uninzi lweempapasho zolwimi lwesiNgesi zisebenzisa upelo ��disc�� rhoqo kune ��disk�� [1,�20,�22,�69,�70]. UNomina Anatomica utyumba izakhiwo njenge ��disci intervertebrales�� kunye neTerminologia Anatomica njenge ��discus intervertebralis/intervertebral disc� [22,�70]. (Jonga ��inqanaba lediskhi�� ngokunika amagama kunye nokufakwa kweenombolo kwidiski ethile).
Ubude beDiski:� Umgama phakathi kweenqwelomoya zeeplati zokugqibela zemizimba ye-vertebral craniad kunye ne-caudad ukuya kwidiski. Ukuphakama kwediski kufuneka kulinganiswe embindini wediski, kungekhona kwi-periphery. Ukuba kulinganiswe kumda ongasemva okanye wangaphambili wediski kumfanekiso we-sagittal womqolo, oku kufuneka kucaciswe ngokucacileyo ngolo hlobo.
Nqanaba leDiski:�Inqanaba le-disc kunye ne-vertebral canal phakathi kweenqwelo ze-axial ngokusebenzisa iiplate ze-bony ze-vertebrae craniad kunye ne-caudad kwi-disc echazwe.
Disc of origin:� idiskhi apho iqhekeza elisusiweyo livela khona. Isithethantonye: idiski yomzali. Qaphela: ekubeni amaqhekeza afudusiweyo ahlala equlethe izicubu ngaphandle kwe-nucleus, i-disc yemvelaphi ikhethwa kwi-nucleus yemvelaphi. Idiski yomzali isithethantonye, kodwa i-colloquial ngakumbi kwaye ayikhethwanga.
Indawo yendawo:Isithuba esilinganiselweyo, i-craniad kunye ne-caudad, ngamacwecwe okugqibela e-vertebrae kunye ne-peripherally ngasemiphethweni ye-vertebral body ring apophyses, ngaphandle kwee-osteophytes. Isithethantonye: indawo yediski ye-intervertebral. Jonga inqanaba ��disc�� ngokunika amagama kunye nokubalwa kweediski.
I-discogenic vertebral sclerosis:Ukwanda kokuxinana kwamathambo kunye nokubala kufuphi neepleyiti zokuphela kwe-vertebrae, i-craniad kunye ne-caudad, kwi-disc ephantsi, ngamanye amaxesha ehambelana ne-intervertebral osteochondrosis. Ibonakaliswe kwi-MRI njengohlobo lwe-Modic�III.
Discogram, discography:�Inkqubo yokuxilonga apho izinto ezichaseneyo zifakwe kwi-nucleus ye-disc kunye nesikhokelo se-radiographic kunye nokuqwalaselwa, ehlala ilandelwa yi-CT / discogram. Inkqubo ihlala ihamba kunye nemilinganiselo yoxinzelelo kunye novavanyo lwempendulo yentlungu (i-discography evuselelayo). Iqondo le-annular fissuring echongiweyo nge-discography inokuchazwa luhlelo lwe-Dallas kunye nokuguqulwa kwayo (Jonga ukuhlelwa kwe-Dallas).
I-disc-osteophyte complex:I-intervertebral disc displacement, nokuba i-bulge, i-protrusion, okanye i-extrusion, ehambelana nemigodi ye-calcific okanye i-ossification. Ngamanye amaxesha kuthiwa yidiski enzima okanye i-disc engapheliyo (engakhethwanga). Ukwahlula kufuneka kwenziwe phakathi kwe-��spondylotic disc herniation,�� okanye ��i-calcified disc herniation�� (engakhethwanga), iintsalela ze-disc herniation endala; kunye ������spondylotic bulging disc,�� i-wide-based bony ridge ekucingelwa ukuba inxulumene nediski engapheliyo.
I disklaced disc� (i-nonstandard): i-disc apho izinto ze-disc zingaphaya kwemida yangaphandle ye-apophyses ye-vertebral body ring (ngaphandle kwe-osteophytes) ye-craniad kunye ne-caudad vertebrae, okanye, njengokuba kwimeko ye-intravertebral herniation, ingene kumzimba we-vertebral. ipleyiti yokuphela.
Qaphela: i-diskiced disc iyona gama eliqhelekileyo elingazichazi ulwazi lwe-pathology engundoqo, isizathu, ubudlelwane kunye neemfuno zonyango. Eli gama liquka, kodwa alikhawulelwanga, ukukhutshwa kwe-disc kunye nokufuduka kwidiski. Jonga: i-disni ye-herniated, i-disk disc.
I membrane:�Bona inwebu yeperidural.
Ummandla ogqithisiweyo:�ummandla weperidiscal ngaphaya kweplani yesagittal yeencam ezisecaleni zeepedicles, engenamda osecaleni ochazwe kakuhle, kodwa ngokuqinisekileyo ungasemva kommandla ongaphambili. Isithethantonye: ��indawo ethe qelele, �� ngokunjalo �indawo ekude�� (engekho mgangathweni).
Extraligamentous:�ngasemva okanye ecaleni kwithambo elingasemva longitudinal. Qaphela: i-disc ye-extraligamentous ibhekisela kwi-disc ye-disc ekhutshweyo ehlala ngasemva okanye esecaleni kwi-posterior longitudinal ligament. Ukuba i-disc idlulile nge-posterior longitudinal ligament, ngamanye amaxesha ibizwa ngokuba yi-"transligamentous" okanye "perforated" kwaye ukuba nge-peridural membrane, ngamanye amaxesha ihlanjululwa ukuba "i-transmembranous".
I-disc eyongeziweyo, i-extrusion (n), i-extrude (v):I-disc ye-herniated apho, ubuncinane indiza enye, nayiphi na umgama omnye phakathi kwemida yezinto zediski ngaphaya kwendawo yediski inkulu kunomgama phakathi kwemida yesiseko se-disc ngaphaya kwendawo yediski kwindiza efanayo. okanye xa kungekho kuqhubeka kukho phakathi kwezinto zediski ngaphaya kwendawo yediski kwaye ngaphakathi kwendawo yediski. Qaphela: inkcazo ekhethiweyo iyahambelana nomfanekiso oqhelekileyo we-extrusion, njengokugxothwa kwezinto ezivela kwisitya kunye nangaphaya kwendawo yokuvula. Ukufuduka ngaphaya kwe-annulus yangaphandle yezinto zediski kunye naluphi na umgama phakathi kwemida yayo enkulu kunomgama phakathi kwemida yesiseko ihlukanisa i-extrusion kwi-protrusion. Ukwahlula i-extrusion ukusuka kwi-protrusion nge-imaging kwenziwa kakuhle ngokulinganisa imiphetho yezinto ezisusiweyo kunye nokuqhubeka okuseleyo kunye nediski yemvelaphi, kanti ubudlelwane besahlulo esisusiweyo kwi-aperture edlulile kuyo ibonwa ngokukhawuleza ngotyando. Iimpawu ze-protrusion kunye ne-extrusion zingaba kunye, apho i-disc kufuneka ihlulwe njenge-extruded. Iidiski ezongeziweyo apho konke ukuqhubeka kunye nediski yemvelaphi kulahlekile kunokubonakaliswa ngakumbi ��kuhluthwa. , idiskhi eveleyo.
Qaphela: Enye inkqubo ixhaswa zezinye ezihlonitshwayo zeradiologists ezikholelwa ukuba inesicelo esingcono sonyango. Esi sikimu sichaza idiski eyongeziweyo njengesithethantonye �idiski engaqulathwanga� kwaye ayisebenzisi imilinganiselo ethelekisekayo yesiseko ngokuchasene nezinto ezisusiweyo. Ngolu ngcaciso, i-disc extrusion inokuchongwa ngokubakho komgca oqhubekayo wokuqina kwesignali ephantsi ejikeleze i-disc herniation. Uphononongo lwexesha elizayo luya kuqinisekisa ngakumbi ubunyaniso bale ngcaciso ingenye. Bona: idiski equlethwe.
Indawo ephakamileyo yomda:�ummandla weperidiscal ngaphaya kweplani yesagittal yecala elisecaleni le-pedicle, engenamda osecaleni ochazwe kakuhle, kodwa ngokuqinisekileyo ungasemva kommandla ongaphambili. Isithethantonye: ��indawo ye-extraforaminal.��
Ukuqhawula i-annulus:�jonga i-annular fissure.
Ummandla we-Foraminal:�ummandla ophakathi kweenqwelomoya ezidlula kwimiphetho ephakathi kunye necala leepedicles. Qaphela: indawo yeforaminal ngamanye amaxesha ibizwa ngokuba ��pedicle zone�� (engekho mgangathweni), nto leyo inokubhida kuba indawo ye-pedicle isenokuthi ibhekiselele kwimilinganiselo kwinqwelomoya yesagittal phakathi komphezulu nongezantsi womphezulu wepedicle enikiweyo ebizwa ngokufanelekileyo ngokuba ��inqanaba le-pedicle.�� Indawo yeforaminal ikwabizwa ngokuba ��indawo esecaleni�� (engekho mgangathweni), nto leyo enokubhidanisa kuba indawo esecaleni inokubhidaniswa kunye ��ummandla osecaleni � (i-barticular). ) kwaye inokuthetha ummandla we-extraforaminal okanye indawo ebandakanya zombini iindawo zeforaminal kunye ne-extraforaminal zone.
Isiqendu samahhala
Qaphela: ��idiski ethengisiweyo�� kunye ��iqhekeza lasimahla�� ziphantse zafana. Xa ubhekisela kwimeko ye-disc, ukwahlula njenge-extruded kunye ne-subcategorization njengoko i-sequestrated ikhethwayo, kanti xa ubhekisela ngokukodwa kwiqhekeza, i-fragment yamahhala ikhethwayo.
Igalelo lokususa:�jonga isithuba sonyaka.
I-diski enzima (edibeneyo):Ukufuduswa kwediski apho isahlulo esisusiweyo siye safumana i-calcification okanye i-ossification kwaye inokudityaniswa ngokusondeleyo ne-apophyseal osteophytes. Qaphela: igama elithi ��hard disk�� lidla ngokusetyenziswa xa kubhekiswa kumqolo womlomo wesibeleko ukwahlula iinguqu ezingapheliyo zehypertrophic kunye ne-reactive kwiperiphery yediski ukusuka kwi-extrusion ebukhali yeethishu ezithambileyo, ubukhulu becala zenyukliya. Jonga: i-disc herniation engapheliyo, i-disc-osteophyte eyinkimbinkimbi.
I-disc ye-Herniated, i-herniation (n), i-herniated (v):Ukufuduswa kwendawo okanye okugxilwe kwi-disc ngaphaya komda oqhelekileyo we-intervertebral disc space. Qaphela: ��i-localized�� okanye ��focal�� ithetha, ngendlela yengqungquthela, ngaphantsi kwe-25% (90�) yomjikelezo wediski.
Izinto ze-disc ze-Herniated zingabandakanya i-nucleus pulposus, i-cartilage, ithambo le-apophyseal eliqhekezayo, okanye i-annulus fibrosus tissue. Imida eqhelekileyo yendawo yediski ye-intervertebral ichazwa, i-craniad kunye ne-caudad, ngamacwecwe okugqibela omzimba we-vertebral kunye ne-peripherally ngamaphethelo e-vertebral body ring apophyses, ngaphandle kwe-osteophytic formations. I-disc ye-Herniated ngokuqhelekileyo ibhekisela ekufudukeni kwezicubu ze-disc ngokuphazanyiswa kwi-annulus, ngaphandle kwe-intravertebral herniations (i-Schmorl nodes) apho ukufuduka kuhamba nge-vertebral end plate. Iidiski ze-Herniated zinokuphinda zifakwe kwi-subcategorized njenge-protruded okanye i-extruded. Ngamanye amaxesha i-disc ye-Herniated ibizwa ngokuba yi-HNP, kodwa igama elithi "herniated disc" likhethwa ngenxa yokuba izicubu zediski ezifudukayo zihlala zibandakanya i-cartilage, i-bone fragments, okanye izicubu ze-annular. Amagama ��prolapse�� kunye ��ukuqhawuka�� xa kubhekiswa kwiidiski zedisni azikho mgangathweni kwaye ukusetyenziswa kwazo kufuneka kuyekwe. Qaphela: ��herniated disc� ligama elingabhekiseli kulwazi lwe-pathology esisiseko, unobangela, ubudlelwane neempawu, okanye imfuno yonyango.
I-nucleus pulposus�(HNP, engakhethwanga): bona idiski ye-herniated.
Indawo ephakamileyo yamandla (HIZ):Indawo yokuqina okuphezulu kwi-T2-weighted MRIs yediski, ehlala ngokuqhelekileyo kwi-annulus yangaphandle. Qaphela: I-HIZs ngaphakathi kwendawo yangasemva ye-annular ingabonisa ubukho be-annular fissure ngaphakathi kwe-annulus, kodwa le migaqo ayifani. I-HIZ ngokwayo ingamela i-fissure yangempela ye-annular okanye ngenye indlela, inokumela izicubu ze-vascularized fibrous (izicubu ze-granulation) ngaphakathi kwe-substance ye-disc kwindawo ekufutshane ne-fissure. Ukuboniswa kwe-HIZ akuthethi ukuba i-etiology ebuhlungu okanye ukuba i-disc ingumthombo wentlungu.
Umgangatho we-Infrapedicular:� inqanaba phakathi kweeplani ze-axial zamaphethelo angaphantsi kwee-pedicles craniad kwi-disc echaphazelekayo kunye ne-plate ephantsi yokuphela kwe-vertebral body ngaphezu kwediski echaphazelekayo. Isithethantonye: inotshi ephezulu ye-vertebral.
Uphazamiseko lwangaphakathi:�ukungalungelelanisi kwezakhiwo ngaphakathi kwidiski. Jonga i-intraannular displacement
Interspace:�jonga indawo yediski.
I-intervertebral chondrosis:Jonga i-intervertebral osteochondrosis.
I-disvertebral disc:� bona idiski.
Indawo yediski ye-intervertebral:�jonga indawo yediski.
Intervertebral osteochondrosis:Inkqubo ye-degenerative ye-disc kunye ne-vertebral body end plates ebonakaliswe ngendawo ye-disc yokunciphisa, i-vacuum phenomenon, kunye neenguqu ezisebenzayo zomzimba we-vertebral. Isithethantonye: osteochondrosis (nonstandard).
Ukufuduka kwangenaUkufuduswa kwendawo ephakathi, ubukhulu becala inyukliya, izicubu ukuya kwindawo esecaleni ngaphakathi kwendawo yediski, ngokuqhelekileyo ukuya kwi-fissure kwi-annulus. Isithethantonye: (nonstandard) intraannular herniation, intradiscal herniation. Qaphela: i-intraannular displacement ihluke kwi-disc herniation, oko kukuthi, i-herniation ye-disc ibhekisela ekufudukeni kwezicubu zediski ngaphaya kwendawo yediski. I-Intraannular displacement yindlela yokuphazamiseka kwangaphakathi. Xa ubhekisela kwi-intraannular displacement, kungcono ukuba ungasebenzisi igama elithi ��herniation� ukuphepha ukudideka kunye ne-disc herniation.
Ukuhlaselwa kwesikhashana (esingabikhoyo):�jonga ukufuduswa kwe-intraannular.
Uhlalutyo lwangaphandle (olungagqitywanga):�jonga ukufuduswa kwe-intraannular.
Ukunyangwa kwesondo:� imathiriyeli yediski engene kwidura ukuze ilale kwindawo ye-intradural extramedullary.
Intravertebral herniation:� i-disc displacement apho inxalenye yeeprojekthi zediski ngokusebenzisa i-vertebral end plate kwi-centrum ye-vertebral body. Isithethantonye: node yeSchmorl.
Ukuqhaqha�loo nxalenye yezowuni ye-subarticular ephakathi kumda ophakathi we-pedicle. Ibhekisela kuwo wonke ummandla we-cephalad-caudad okhoyo ophakathi kwi-pedicle, apho i-thoracic enenombolo efanayo okanye i-lumbar nerve root ihamba ngokukhawuleza ngaphambi kokuba iphume kwi-nerve root foramen phantsi komda we-caudal we-pedicle. Ayibhekiseli kwi-nerve root foramen ngokwayo. Jonga kwakhona indawo ye-subarticular.
Indawo yomda�(engekho mgangathweni): bona indawo yeforaminal.
Ukukhipha idiski�(engekho mgangathweni): bona idiski yonxibelelwano.
Limbus vertebra:Ukwahlulwa kwecandelo le-vertebral ring apophysis. Qaphela: i-limbus vertebra ingaba yinto engaqhelekanga yophuhliso ebangelwa ukungaphumeleli kokuhlanganiswa kwe-ossifying apophysis kumzimba we-vertebral; i-herniation engapheliyo (i-extrusion) ye-disc kumzimba we-vertebral ekudibaneni kwendandatho ye-apophyseal ye-fusing, ngokuhlukana kwenxalenye yendandatho kunye nokufuduka kwamathambo; okanye ukuphuka ngendandatho ye-apophyseal ehambelana ne-intrabody disc herniation. Oku kwenzeka kubantwana ngaphambi kokuba i-apophyseal ring idibanise kumzimba we-vertebral. Kubantu abadala, i-vertebra ye-limbus akufanele idideke kunye nokuphuka okukrakra. I-vertebra ye-limbus ayithethi ukuba kukho ukulimala kwi-disc okanye i-apophyseal end plate ecaleni.
I-osteophyte yangaphakathi:�iosteophyte ephumela ngaphandle nangaphaya komda weperimeter ye-vertebral end plate apophysis.
Ukutshintsha kweMarrow (yomzimba we-vertebral):�jonga ulwahlulo lweModic.
Ukufuduka kwidiski, ukufuduka (n), ukufuduka (v)
Qaphela: ukufuduka kubhekisela kwisimo se-diskiced disc disc, endaweni yokuqhubeka kwayo kunye neetiski ze-disc ngaphakathi kwirekhodi yemvelaphi; Ngoko ke, akufanelanga ukulandelelana.
Udidi lweModic (Uhlobo I, II, no-III)�[30]: ulwahlulo lweenguqu eziguquguqukayo ezibandakanya iiplate zokuphela kwe-vertebral kunye nemizimba ye-vertebral esondeleyo ehambelana nokuvuvukala kwe-disc kunye nesifo se-disc degenerative, njengoko kubonwa kwi-MRIs. Uhlobo lwe-I lubhekiselele ekunciphiseni ubungakanani besignali kwi-T1-weighted spin echo imifanekiso kunye nokwandisa ubuninzi besignali kwimifanekiso ye-T2-weighted, emele ukungena kweplate yokugqibela ngezicubu ze-fibrovascular, utshintsho oluvuthayo, kwaye mhlawumbi i-edema. Utshintsho lwe-Type I lunokuba lungapheliyo okanye lube bukhali. Uhlobo lwe-II lubhekiselele ekunyuseni kwesignali kwimifanekiso ye-T1-weighted kunye ne-isointense okanye ukunyuka kwe-signal intensity kwimifanekiso ye-T2-weighted, ebonisa ukutshintshwa komnkantsi oqhelekileyo ngamafutha. Uhlobo lwe-III lubhekisela ekunciphiseni ukuqina komqondiso kwimifanekiso yomibini ye-T1-kunye ne-T2, ebonisa i-osteosclerosis esebenzayo (Jonga: i-discogenic vertebral sclerosis).
Icandelo lesigxina:�iyunithi esebenzayo yomqolo. Jonga inqanaba lediski.
I-osteophyte engekhoI-osteophyte eyenzeka kwezinye iindawo ngaphandle kwe-vertebral end plate apophysis. Bona: i-osteophyte ephantsi.
I-disc evamile:�Idiski ephuhliswe ngokupheleleyo neqhelekiyo kwaye akukho zinguqu zibangelwa kukwenzakala, izifo, ukuwohloka, okanye ukuguga. Qaphela: ezininzi ezahlukeneyo zokuzalwa kunye nophuhliso zinokuba yinto eqhelekileyo yeklinikhi; oko kukuthi, abahambelani neempawu, kwaye utshintsho oluthile oluguquguqukayo kwi-disc lunokuba luqhelekileyo ngokuqwalasela i-pathology ekufutshane; nangona kunjalo, ukuhlelwa kunye nokunika ingxelo ngeenjongo zonyango kusetyenziswa kakuhle ukuba iidiski ezinjalo azithathwa njengesiqhelo. Qaphela, nangona kunjalo, ukuba i-disc efunyenweyo ithathwa njengento eqhelekileyo ayithethi isizathu seempawu zekliniki okanye i-symtomatology; inkcazo yalo naluphi na utshintsho lwediski luzimeleyo kwisigwebo seklinikhi malunga nento eqhelekileyo kwisigulane esinikiweyo.
I-nucleus yemvelaphi (engabonisiwe):�inxalenye esembindini, yenyukliya yediski yereferensi, edla ngokusetyenziselwa ukubhekisa kwidiski apho izicubu ziye zasuswa khona. Qaphela: ekubeni amaqhekeza afudusiweyo ahlala equlethe izicubu ngaphandle kwe-nucleus, i-disc yemvelaphi ikhethwa kwi-nucleus yemvelaphi. Isithethantonye: i-disc yemvelaphi (ekhethwayo), i-nucleus yomzali (engakhethwanga).
Osteochondrosis:Jonga i-intervertebral osteochondrosis.
Osteophyte:i-focal hypertrophy yomphezulu wethambo kunye/okanye ukufakwa kwe-ossification yethishu encamathele kwithambo.
IPacacentral:�kwindawo esembindini yasekunene okanye ekhohlo kumjelo we-vertebral. Jonga indawo esembindini. Qaphela: amagama ��ekunene embindini�� okanye ��ekhohlo kumbindi�� akhethwa xa uthetha ngesiza esinye xa icala lingacaciswa, njengaxa unika ingxelo ngeziphumo zenkqubo yomfanekiso. ��I-Paracentral�� ifanelekile ukuba icala alibalulekanga okanye xa lithetha ngeziza ezixubileyo.
Idilesi yomzali�(engakhethwanga): bona idiski yemvelaphi.
I nucleus yomzali�(engakhethwanga): bona i-nucleus yemvelaphi, idiski yemvelaphi.
Izinga lokuhamba:�Isithuba esiphakathi kwee-axial planes kwincam ephezulu nasezantsi ye-pedicle. Qaphela: inqanaba le-pedicular lingaphinda lichongwe ngokubhekisele kwidiski ekuthethwa ngayo ��inqanaba le-pedicular ngasentla�� okanye ���inqanaba le-pedicular elingezantsi��� idiski ekuthethwa ngayo.
I-Perforated (engekho idilesi):�Bona i-transligamentous.
Umlenze wePedidural:� inwebu eethe-ethe, e-translucent encamathela kumphantsi womgangatho onzulu weligament ye-longitudinal yangasemva, kwaye inabela ecaleni nangasemva, irhangqa umjelo wamathambo omqolo ngaphandle kwe-dura. Imithambo ye-Batson plexus ilele kumqolo wenwebu yeperidural kwaye iyigqobhoze ngaphakathi. Isithethantonye: inwebu esecaleni, inwebu ye-epidural.
Udidi lwePfirrmann:Inkqubo yokulinganisa ubunzima beenguqu eziguqukayo ngaphakathi kwe-nucleus ye-intervertebral disc. I-disc ye-Pfirrmann yeBanga le-I inomqondiso ophezulu ofanayo kwi-nucleus kwi-MRI enesisindo se-T2; IBanga lesi-II libonisa umgca ophakathi othe tye we-signal intensity ephantsi kwimifanekiso ye-sagittal; IBanga le-III libonisa ubuninzi obuphezulu kwindawo ephakathi kwe-nucleus kunye nokunyanzeliswa okuphantsi kwimimandla ye-peripheral ye-nucleus; IBanga lesi-IV libonisa ubungakanani besignali ephantsi kwindawo ephakathi kunye nokufiphala kokwahlula phakathi kwe-nucleus kunye ne-annulus; kunye neBanga le-V libonisa isignali ephantsi ehambelanayo engenamahluko phakathi kwenucleus kunye ne-annulus.[61]
I-dislapsed disc, i-prolapse (n, v)�(engekho mgangathweni): igama lisetyenziswa ngokwahlukeneyo ukubhekisa kwiidiski ze-herniated. Ukusetyenziswa kwayo akuqhelekanga kwaye igama alongezi ngokuchanekileyo kwenkcazo yediski, ngoko ke ithathwa njengento engekho mgangathweni kwi-deference to � protrusion�� okanye ��extrusion.
I-disc ekhutshweyo, ukukhutshwa (n), velisa (v):�1. Enye yee-subcategories ezimbini ze-"herniated disc" (enye i-disc) apho i-disc ye-disc idlulela ngaphaya komda we-disc space, ibandakanya ngaphantsi kwe-25% ye-circumference ye-disc margin. njengoko kubonwa kwinqwelomoya ye-axial. Uvavanyo lwe-protrusion kukuba kufuneka kubekho indawo (ngaphantsi kwe-25% ye-circumference ye-disc) ukufuduka kwe-disc tissue kunye nomgama phakathi kwemida ehambelanayo yecandelo elifudusiweyo akufanele libe mkhulu kunomgama phakathi kwemida yesiseko. yezinto zediski ezifudusiweyo kwindawo yediski yemvelaphi (Jonga isiseko sediski esusiweyo). Ngelixa maxa wambi lisetyenziswa njengegama eliqhelekileyo kwindlela echazwa ngayo i-herniation, ukusetyenziswa kwegama elithi ��protrusion�� ligcinelwe ngokufanelekileyo ukucandwa kwe-herniation ehlangabezana nezi nqobo zingasentla. 2. (engaqhelekanga) Naluphi na okanye uhlobo olungachazwanga lwe-disc herniation.
Ukukhwabanisa:Ukuphazamiseka kweentsinga ze-annular ezisuka kwi-nucleus ngaphandle ukuya kwi-periphery ye-annulus, ngokuqhelekileyo kwinqwelomoya ye-craniad-caudad (ethe nkqo), nangona, ngamanye amaxesha, inamalungu e-axial horizontal (transverse). ��I-Fissure�� ligama elikhethwayo kunegama elingekho mgangathweni elithi ��ukukrazula.�� Akukho nalinye igama elithetha ulwazi lokwenzakala okanye enye imvelaphi. Qaphela: Ngamaxesha athile, i-radial fissure idlulela kwinqwelomoya enqamlezileyo ukuze ibandakanye ukuvuswa kweengqimba zangaphandle ze-annulus ukusuka kwindandatho ye-apophyseal. Jonga iintanda ezinzulu, iintanda ezinqamlezileyo.
Rim lesion (engabonakaliyo): Bona i-vertebra yesiqalo.
Ukukhutshwa kwe-annulus, i-annulus ephuliwe:�bona ukugqabhuka komnyaka.
I-disc ekhutshweyo, ukuphuka�(engaqhelekanga): idiskhi ene-herniated. Igama elithi "i-disc ruptured" lisisithethantonye esingafanelekanga se-disc ye-herniated, ukuba singadideki kunye nokuphazamiseka okunobundlobongela kwe-annulus ehambelana nokulimala. Ukusetyenziswa kwayo kufuneka kuyekwe.
Schmorl node:Bona i-intravertebral herniation.
I-disquestrated disc, ukulandelelana (n), i-sequestrate (v); (ukuhluka: i-disk sequestered disc):� i-disc ekhutshweyo apho inxalenye ye-disc ye-disc ikhutshwe ngaphaya kwe-annulus yangaphandle kwaye igcina unxibelelwano nge-disc tissue kunye ne-disc yemvelaphi. Qaphela: i-disc ekhutshiweyo inokuthi ifakwe kwi-subcategorized as ��sequestrated�� ukuba akukho zicubu zediski zibhuloho isahlulo esisusiweyo kunye nezicubu zediski yemvelaphi. Ukuba nangona uxhulumaniso olusisigxina nge-disc tissue luhlala phakathi kweqhekeza elifudukayo kunye ne-disc yemvelaphi, i-disc ayithathwanga. Ukuba iqhekeza elifudusiweyo alikho uxhulumaniso kunye ne-disc yemvelaphi, kodwa iqulethwe ngaphakathi kwi-membrane ye-peridural okanye phantsi kwesahlulo se-posterior longitudinal ligament engabotshwanga ngokusondeleyo kunye ne-annulus yemvelaphi, i-disc ithathwa njenge-sequestrated. Ukuhluthwa kunye nokuhluthwa zisetyenziswa ngokutshintshanayo. Qaphela: ��idiski ethengisiweyo�� kunye ��iqhekeza lasimahla�� ziphantse zafana. Bona: isiqwenga sasimahla. Xa ubhekisela kwimeko ye-disc, ukwahlula njenge-extruded kunye ne-subcategorization njengoko i-sequestered ikhethwa, kanti xa ibhekisela ngokukodwa kwiqhekeza, i-fragment yamahhala ikhethwayo. Jonga i-sequestrum.
Isiqwenga (esingakhankanyiweyo):� ibhekisela kwizicubu ze-disc eziye zafuduka kwindawo yediski yemvelaphi kwaye ayinakho ukuqhubeka kunye nezinto zediski ngaphakathi kwendawo yediski yemvelaphi. Isithethantonye: isiqwenga sasimahla (esikhethwayo). Jonga idiski ehluthiweyo. Qaphela: ��sequestrum�� (engakhethwanga) ibhekisa kwiqhekeza elizimeleyo ngokwalo, ngelixa idiski ehluthiweyo ichaza imeko yediski.
Spondylitis:�Isifo sokudumba komqolo, ngaphandle kwesifo esiwohlokayo. Qaphela: i-spondylitis ngokuqhelekileyo ibhekisela kwi-spondyloarthropathies evuthayo engabonakaliyo.
Spondylosis:�1. Igama eliqhelekileyo elingaqhelekanga elisetyenziselwa ukuchaza iziphumo ngokubanzi ezichazwe kwiinguqu eziguqukayo kumqolo, ngakumbi ezo zibandakanya utshintsho lwe-hypertrophic kwiiplate ze-apophyseal kunye namalungu e-zygapophyseal. 2. (i-nonstandard) i-spondylosis deformans, apho i-spondylosis ifom efutshane.
Spondylosis deformans:Inkqubo ye-degenerative yomqolo ebandakanya i-annulus fibrosus kunye ne-vertebral body apophysis, ebonakaliswe yi-osteophytes yangaphambili kunye ne-lateral marginal osteophytes evela kwi-apophyses yomzimba we-vertebral, ngelixa ukuphakama kwe-intervertebral disc kuqhelekileyo okanye kuyancipha nje kancinci. Bona ukuwohloka, i-spondylosis.
Indawo engezantsi:ummandla, ngaphakathi kwe-vertebral canal, i-sagittally phakathi kwendiza yemida yangaphakathi ye-pedicles kunye nendiza yemida ye-medial ye-facets kunye ne-coronally phakathi kweeplani ze-posterior surfaces zemizimba ye-vertebral kunye neendawo zangaphambili eziphezulu. iinkalo. Qaphela: ummandla we-subarticular awunakuchazwa ngokuchanekileyo kwimizobo ene-dimensional ezimbini kuba izakhiwo ezichaza iindiza zommandla azilungelelananga. I-recess lateral yiloo nxalenye ye-suarticular zone echazwe ludonga oluphakathi lwe-pedicle, apho ingcambu ye-nerve enenombolo idlulayo ngaphambi kokuba ijike phantsi kodonga olungaphantsi lwe-pedicle kwi-foramen.
Subligamentous:� ngaphantsi kwe ligament yelongitudinal yangasemva. Qaphela: nangona ulwahlulo phakathi kwe-annulus yangaphandle kunye ne-posterior longitudinal ligament ayinakuhlala ibonakala, i-subligamentous inentsingiselo eyahlukileyo kwi-subannular xa ulwahlulo lunokwenziwa. Xa ulwahlulo lungenakwenziwa, i-subligamentous ifanelekile. Ukwahlula okungaphantsi kokungaphezulu, okugqithisiweyo, okanye okunemingxuma. Bona i-extraligamentous, transligamentous.
Ukukhunjulwa:� evalelwe ngaphakathi kwenwebu yeperiod. Qaphela: ngokubhekiselele kwi-disc material displaced, ukubonakaliswa kwe-herniation njenge-submembranous ngokuqhelekileyo ichaza ukuba inxalenye ekhutshweyo ikhutshwe ngaphaya kwe-annulus kunye ne-posterior longitudinal ligament ukwenzela ukuba kuphela i-membrane ye-peridural ityalomali.
I nqanaba eliphezulu:� inqanaba ngaphakathi kwentambo ye-vertebral phakathi kweendiza ze-axial zeplate ephezulu yokuphela kwe-vertebra caudad ukuya kwindawo yediski echaphazelekayo kunye nomda ophezulu we-pedicle yaloo vertebra. Isithethantonye: inotshi ye-vertebral engaphantsi.
Syndesmophytes:Amathambo amancinci kwaye ajonge ngokuthe nkqo aphuma kumzimba omnye we-vertebral ukuya kwelinye kwaye amele i-ossification ngaphakathi kwendawo yangaphandle ye-annulus fibrosus.
Ukuqhawula i-annulus, annouus annulus�(engekho mgangathweni): bona i-annular tear.
Uthotho luka Thompson:� Umlinganiselo we-five-point grading scale of degenerative change in the human intervertebral disc, ukusuka kwi-0 (eqhelekileyo) ukuya kwi-5 (i-degeneration enzima), ngokusekelwe kwi-gross pathologic morphology yamacandelo e-midsagittal ye-lumbar spine.
I-osteophyteUkukhula kwethambo eliphuma kwi-apophysis yomzimba we-vertebral, i-2 ukuya kwi-3 mm ngaphezu okanye ngaphantsi komda we-disc intervertebral, iprojekti kwicala elithe tye.
I-Transligamentous:� ukufuduswa, ngokuqhelekileyo ukukhutshwa, kwezinto zediski ngokusebenzisa i-posterior longitudinal ligament. Isithethantonye: (engekho mgangathweni) (igqobhoziwe). Bona kwakhona extraligamentous, transmembranous.
Ukutshintshwa:�ukushenxiswa kwezinto zediski ezikhutshiweyo ngenwebu yeperidural.
Intsimbi ehambayo:�ukuqhekeka kwe-annulus kwinqwelomoya ye-axial (ethe tye). Xa kubhekiselwa kwi-fissure enkulu kwi-axial plane, eli gama lifana ne-horizontally oriented radial fissure. Rhoqo ��intlaka enqamlezileyo���� ibhekisa kumda, ukwahlulwa kweperipheral yeentsinga ze-annular kubandakanywa nokuncamathela kwi-apophysis. Le mibhobho ye-peripheral echazwe ngakumbi inokuthi iqulethe igesi ebonakalayo kwi-radiographs okanye imifanekiso ye-CT kwaye inokumela ukubonakaliswa kwangaphambili kwe-spondylosis deformans. Jonga i-annular fissure, i-centric fissure, i-radial fissure.
Icon disc:� imathiriyeli yediski esusiweyo engaqulathwanga yi-annulus yangaphandle kunye/okanye i-posterior longitudinal ligament. Jonga ingxoxo phantsi kwediski equlethweyo.
Khubaza i-disc:I-disc ene-imaging efunyenweyo yegesi (ikakhulukazi i-nitrogen) kwi-disc space, ngokuqhelekileyo ukubonakaliswa kwe-disc degeneration.
Utshintsho lomongo lomzimba:Utshintsho lwesignali yomzimba we-vertebral esebenzayo ehambelana nokuvuvukala kwediski kunye nokuncipha kwe-disc, njengoko kubonwa kwi-MRIs. Jonga ulwahlulo lweModic.
Inotshi ye-vertebral (ngaphantsi):I-incisura yendawo ephezulu ye-pedicle ehambelana nenxalenye engezantsi ye-foramen (inqanaba le-suprapedicular).
Inotshi ye-vertebral (phezulu):I-incisura yobuso obungaphantsi kwe-pedicle ehambelana nendawo ephezulu ye-foramen (inqanaba le-infrapedicular).
I-disc ye-herniated ngokuqhelekileyo ikhula ngenxa yokugqoka kunye nokukrazula okuhambelana neminyaka yobudala okanye ukuchithwa kumqolo. Kubantwana kunye nabaselula, iidiski ze-intervertebral zinomxholo ophezulu kakhulu wamanzi. Njengoko sikhula, nangona kunjalo, umxholo wamanzi we-intervertebral discs uyancipha kwaye ezi ziqala ukuncipha ngelixa izithuba phakathi kwe-vertebra ziba zincinci, ekugqibeleni zijika ziguquguquke kwaye zibe zilungele ngakumbi kwi-disc herniation. Ukuxilongwa ngokufanelekileyo kunye nonyango kubalulekile ukuphepha ezinye iimpawu zentlungu ephantsi. Ububanzi bolwazi lwethu bukhawulelwe kwi-chiropractic kunye nokulimala komgogodla kunye neemeko. Ukuxoxa ngalo mbandela, nceda uzive ukhululekile ukubuza uGqr. Jimenez okanye uqhagamshelane nathi apha915-850-0900 .
Ikhutshwe nguDkt. Alex Jimenez
Umqolo obuhlunguSesinye sezona zizathu zixhaphakileyo zokukhubazeka kunye neentsuku eziphosiweyo emsebenzini kwihlabathi liphela. Iimpawu ezibuhlungu zangasemva kwisizathu sesibini esiqhelekileyo sokutyelelwa yi-ofisi kagqirha, ngaphezulu kwenani losulelo oluphezulu lokuphefumla. Phantse iipesenti ezingama-80 zabemi baya kufumana iintlungu zangasemva kube kanye ebomini babo. Umqolo sisakhiwo esintsonkothileyo esenziwe ngamathambo, amalungu, iigaments, kunye nezihlunu, phakathi kwezinye izicwili ezithambileyo. Ngenxa yoku, ukwenzakala kunye / okanye iimeko ezixineneyo, ezinje ngedisni, ekugqibeleni unokukhokelela kwiimpawu zentlungu. Ukulimala kwezemidlalo okanye ukulimala kwengozi yeemoto ngokuqhelekileyo kubangelwa yintlungu yokubuhlungu, kodwa ngamanye amaxesha ukuhamba kwezinto ezilula kunokuba neziphumo ezibuhlungu. Ngethamsanqa, ezinye iindlela zokhathalela unyango, ezifana nokunyamekelwa kwe-chiropractic, kunokunceda ukubuyisela intlungu emva kokusetyenziswa kwemilenze kunye nokunyanzeliswa kwemigaqo, ekugqibeleni ukuphucula intlungu.
Umgangatho wobuchule wokuSebenza *
Ulwazi olulapha ku "I-Lumbar Disc Nomenclature: Version 2.0"Akujoliswanga ukuthatha indawo yobudlelwane obubodwa kunye nomntu oqeqeshiweyo wezempilo okanye ugqirha onelayisensi kwaye akusiyo isiluleko sonyango. Sikhuthaza ukuba wenze izigqibo zezempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye nochwepheshe bezempilo abaqeqeshiweyo.
Ulwazi lweBlog kunye neengxoxo zoMda
Umda wethu wolwazi ilinganiselwe kwiChiropractic, i-musculoskeletal, amayeza omzimba, impilo, igalelo le-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kweentetho zeklinikhi, ezinxulumene ne-somatovisceral reflex clinical dynamics, i-subluxation complexes, imiba yezempilo ebuthathaka, kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo.
Sibonelela kwaye sibonise intsebenziswano yeklinikhi neengcaphephe kumacandelo ahlukeneyo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo lokwenzakala okanye ukuphazamiseka kwenkqubo ye-musculoskeletal.
Iividiyo zethu, izithuba, izihloko, imixholo, kunye nokuqonda zibandakanya imiba yezonyango, imiba, kunye nezihloko eziyelelene kwaye zixhase ngokuthe ngqo okanye ngokungathanga ngqo umda wokuziqhelanisa wethu.
I-ofisi yethu izamile ngokufanelekileyo ukubonelela ngeengcaphulo ezixhasayo kwaye ichonge uphando olufanelekileyo lophando okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zophando ezixhasayo ezifumanekayo kwiibhodi ezilawulayo nakuluntu ngesicelo.
Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez, DC, okanye qha ga mshelana nathi 915-850-0900.
Silapha ukunceda wena kunye nosapho lwakho.
Iintsikelelo
UDkt Alex Jimenez D.C., I-MSACP, RN*, I-CCST, IFMCP*, I-CIFM*, I-ATN*
email: qeqeshi@elpasofunctionalmedicine.com
Ilayisenisi njengoGqirha weChiropractic (DC) kwi Texas & New Mexico*
Texas DC Ilayisensi # TX5807, New Mexico DC Ilayisensi # I-NM-DC2182
Unikwe Ilayisensi njengoMongikazi oBhalisiweyo (RN*) in Florida
Florida License RN Ilayisensi # I-RN9617241 (Nombolo yolawulo. 3558029)
Ubume obubambeneyo: ILayisensi yeeNkcazo ezininzi: Ugunyaziswe Ukuziqhelanisa I-40 States*
UGqr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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