椎間盤突出 HIVD (Herniated Intervertebral Disc)

June 3, 2019

椎間盤突出 HIVD (Hernited Intervertebral Disc)

椎間盤是位於椎軆之間的軟骨,中央有髓核,四周環繞著強韌的纖維環,具有緩衝壓力的作用.

 

病因 :

椎間盤突出的原因很多,如經常搬運重物,跌倒,或重力撞擊,運動傷害,長期姿勢不良,年長後因退化及含水量減少,周圍的纖維環環會因此損傷弱化,導致髓核由韌帶間突出,壓迫或推移到脊神經.

 

椎間盤突出,固有頸椎間盤突出,胸椎間盤突出,腰椎間盤突出三大類,其中以腰椎間盤突出較為常見,特別是第4至第5腰椎,及第5腰椎至第1薦椎關節最容易發生,約佔90%,因其活動性大,故損傷的機會也相對增加.

 

症狀 :

1 當髓核逐漸擠進纖維環裂隙時,患者首先出現的症狀

是腰痛下背痛,或背部僵硬,此時因尚未壓迫到坐骨

神經根,並無下肢麻痛現象.

 

2 重複的復發,或瞬間的重創,將造成纖維環的縫隙擴

大,髓核及纖維往後突出,並擠壓神經根,常造成臀部

痠痛,並放射至大腿後方,小腿外側,甚至於腳背兩側.

 

3 少數嚴重的椎間盤突出時,可造成脊椎管脊椎腔内狹

窄及多數神經壓迫,將可能出現"馬尾症候群",此時會

大小便失禁或滯留,肛門周圍麻木,下肢無力等症狀.

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