腰痛与腰椎间盘突出症(英文).ppt

LOWER BACK PAIN AND HERNIA OF INTERVERTEBRAL DISC 腰痛和腰椎间盘突出症 Structural support and balance for upright posture Protection Spinal cord and nerve roots Flexibility of motion in six degrees of freedom Cranial - the head or towards the head Caudal - the tail or towards the tail Anterior - the front section or towards the front Posterior - the back section or towards the back Ventral - the front or anterior surface Dorsal - the back or posterior surface Vertebral Structures Pedicle notches Anterior Arch Vertebral body Anterior 1/3 pedicles Vertebral Structures Articular processes Lumbar Vertebrae Vertebral Structures Intervertebral Disc The FUNCTIONAL UNIT of the spine Comprised of: Two adjacent vertebrae Intervertebral disc Connecting ligaments Two facet joints and capsules Intervertebral Disc Fibrocartilaginous joint of the motion segment Makes up ? the length of the spinal column Present at levels C2-C3 to L5-S1 Allows compressive, tensile, and rotational motion Largest avascular structures in the body Intervertebral Disc Annulus Fibrosus Outer portion of the disc Intervertebral Disc Nucleus Pulposus Intervertebral Disc Largest avascular structure Blood supply by diffusion through end plates Damage to the blood supply leads to degradation of the disc Anatomy and Degenerative Change Intervertebral Disc The Intervertebral Disc Has two roles Shock absorber of axial forces Pivot point in motion segment Intervertebral Disc Ligaments Spinal Ligaments Bands or sheets of tough, fibrous tissue that connect bones, cartilage, or other structures Become active when stressed to maximum range of motion Protect the joints from being hyperflexed The Intervertebral Disc and Degenerative Change Two major components of IVD Annulus fibrosis: thick, fibrous “radial tire” Lamellae Nucleus pulposus: ball-like gel The Intervertebral Disc (IVD) and Degenerative Change By age 50, 95% of people show lumbar disc degeneration Not all have symptoms Significant changes to IVD are: Water and pr