What is lumbar disk disease?

脊柱由33块椎骨组成，这些椎骨被海绵状的椎间盘隔开. The spine is divided into 4 areas:

• Cervical spine. The first 7 vertebrae, located in the neck

• Thoracic spine. The next 12 vertebrae, located in the chest area

• Lumbar spine. The next 5 vertebrae, located in the lower back

• Sacral spine. The lowest 5 vertebrae, located below the waist, 包括组成尾骨(尾骨)的4块椎骨

腰椎由下背部的5个骨节组成, which is where lumbar disk disease occurs.

• Bulging disk. 随着年龄的增长，椎间盘可能会失去液体并变得干燥. As this happens, 海绵状椎间盘(位于脊柱骨部分之间，起到“减震器”的作用)被压缩. This may lead to the breakdown of the tough outer ring. 这使得核，或环的内部，凸出. This is called a bulging disk.

• Ruptured or herniated disk. As the disk continues to break down, or with continued stress on the spine, 内髓核实际上可能从髓环破裂. This is a ruptured, or herniated, disk. 椎间盘材料的碎片会压迫位于椎间盘后面的神经根. 这会导致疼痛、无力、麻木或感觉变化.

Most disk herniations happen in the lower lumbar spine, 特别是在第四和第五腰椎之间以及第五腰椎和第一骶椎之间(L4-L5和L5-S1水平).

What causes lumbar disk disease?

腰椎间盘疾病是由正常椎间盘结构的改变引起的. Most of the time, 磁盘疾病是由于老化和磁盘内部发生的正常故障而发生的. 有时，严重的损伤会导致正常的椎间盘突出. Injury may also cause an already herniated disk to worsen.

Who is at risk for lumbar disk disease?

Although age is the most common risk, 缺乏体育活动会导致背部和腹部肌肉无力, which may not support the spine properly. Back injuries also increase when people who are normally not 积极参加过度剧烈的活动. 需要举重和扭曲脊柱的工作也会导致背部受伤.

What are the symptoms of lumbar disk disease?

腰椎间盘疾病的症状取决于椎间盘突出的位置和它所压迫的神经根. These are the most common symptoms of lumbar disk disease:

• Intermittent or continuous back pain. 运动、咳嗽、打喷嚏或长时间站立可能会使情况恶化.

• Spasm of the back muscles

• Sciatica. 这种疼痛从背部或臀部附近开始，然后沿着腿到小腿或脚.

• Muscle weakness in the legs

• Numbness in the leg or foot

• Decreased reflexes at the knee or ankle

• Changes in bladder or bowel function

腰椎间盘病的症状可能与其他健康状况相似. Always see your healthcare provider for a diagnosis.

How is lumbar disk disease diagnosed?

In addition to a complete medical history and physical exam, you may have one or more of the following tests:

• X-ray. 这种测试使用不可见的电磁能量束来产生内部组织的图像, bones, and organs onto film.

• MRI. This procedure uses a combination of large magnets, radiofrequencies, 以及一台不用x射线就能生成人体器官和结构详细图像的计算机.

• Myelogram. 该手术将染料注入椎管，使其结构在x射线上清晰可见.

• CT scan. 这种成像程序使用x射线和计算机技术来制作身体任何部位的详细图像, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

• Electromyography (EMG). 这个测试测量肌肉对神经刺激肌肉的反应或电活动. This tests to see if there is any associated nerve damage.

• Discogram. 这个过程使用一根针在x射线引导下插入椎间盘.

How is lumbar disk disease treated?

典型地，保守疗法是治疗腰椎间盘疾病的第一线疗法. This may include a mix of the following:

• Bed rest

• 适当的身体力学教育(以帮助减少疼痛恶化或损害椎间盘的机会)

• 物理治疗，可能包括超声波、按摩、调理和锻炼项目

• Weight control

• Use of a lumbosacral back support

• Medicine to control pain and relax muscles

如果这些措施失败，你可能需要手术切除椎间盘突出. Surgery is done under general anesthesia. 你的外科医生会在你的下背部椎间盘突出的地方做一个切口. 一些脊柱后部的骨头可以被移除以进入椎间盘. 你的外科医生将移除椎间盘突出的部分和任何额外的松动的椎间盘.

After surgery, 在康复期间，您可能会被限制活动数周，以防止再次椎间盘突出. Your surgeon will discuss any restrictions with you.

Spine Surgery Q&A with Hamid Hassanzadeh, M.D.

- Watch on YouTube

What are possible complications of lumbar disk disease?

腰椎间盘疾病可引起背部和腿部疼痛，干扰日常活动. 它会导致腿部无力或麻木，以及肠道和膀胱控制困难.

What can I do to prevent lumbar disk disease?

Maintaining a healthy weight, participating in regular exercise, 保持良好的姿势可以降低你患腰椎间盘疾病的风险. 吸烟会增加椎间盘突出的风险，应停止吸烟.

Living with lumbar disk disease

Conservative therapy requires patience. 但坚持你的治疗计划可以减轻背痛，并最大限度地减少疼痛恶化或损害椎间盘的机会. 保守措施和手术都需要时间才能见效.

When should I call my healthcare provider?

如果你的疼痛加剧，或者如果你开始有排便或膀胱控制困难，请立即打电话给你的医疗保健提供者.

Key points about lumbar disk disease

• 当脊柱下背部的椎间盘从脊柱骨区之间突出或突出时，可发生腰椎间盘病.

• 腰椎间盘病会引起腰痛、腿痛和虚弱，运动和活动会加重疼痛.

• 治疗的第一步是减轻疼痛，降低进一步损伤脊柱的风险.

• 如果更保守的治疗失败，可以考虑手术.