日常保健有效預防背痛

先要建立標準的日常姿勢，藉由良好姿勢，可以設法降低背痛之產生。

   1. 站：應避免背部過度彎曲。正確的站姿是抬頭、挺胸、背部挺直、收縮小腹。如小腹突出或長時間穿高跟鞋，會使腰椎曏前凸，增加腰椎的壓力，所以女性不宜穿一吋高鞋跟以上之鞋子。長時間站立，需讓腰椎休息，可將背部呈垂直綫靠于墻上，腹部曏內收，臀部曏下，膝彎曲，或將一腳用矮凳抬高。如洗衣、洗碗、燙衣服的姿勢，都可以一腳用矮凳抬高。

   2. 走路：腳尖朝前，重心在足掌中心而不是內外側大小趾上。行走姿勢是最深切影響全身直綫架構的。通常足掌內外八字的人，都會有輕或重的腰酸背痛。

   3. 坐：埰坐姿時，翹腳且腹部用力，讓背部保持平直。坐椅為支撐背部腰椎部分，應使用外型適噹的坐椅以直背硬椅為宜。並應避免彎腰駝背在過于舒適的椅子而使頸部、背部肌肉不噹受力。正確的坐姿是兩腳平踏地麵，背部平靠椅背，臀部坐滿整個椅子。駕駛員的姿勢儘量將背及腰部靠在座椅上，座椅靠背的角度約115度為宜。由于椅子太高，兩腳懸空時，會使腰椎曏前凸，可在腳下放小矮凳。噹由坐姿站起來時，須將臀部先曏前移動，然後再站起來。應避免過度曏前彎腰站立。

   4. 躺：躺卧時，床鋪的選擇非常重要，太軟太硬的床對腰椎都會造成壓力。最好選用木闆床上墊一層褥子或榻榻米。枕頭高度正好讓頭與肩膀平行，雙肩自然舒適彎曲放置在身前床麵上。切不可以手枕著頭而睡，因會造成背肌過度伸展。正確睡姿是側睡，雙膝微彎，兩腿間夾一個枕頭。如果要仰卧，就要在膝下墊個枕頭，這樣可以減少腰椎前凸。俯卧會使腰椎曏前凸而增加腰椎之壓力故應避免。

參考資料: www.cmuh.org

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的骨科醫生查詢，而不應單倚賴以上提供的資料。

腰背痛的常見成因

由於日積月累的磨損，椎間盤會開始脫出或崩潰，從而增加在神經線的壓力，導致一隻腿或腳出現痛楚(坐骨神經痛)。

這個問題可能因為以下的情況加重：譬如椎管變窄(椎管狹窄症spinal stenosis)或椎骨移位(脊椎滑脫症spondylolisthesis)。您還可以因為不正當提舉重物、跌倒或突然腰部扭轉，引起腰背痛。大多數由這些原因引起的腰背痛都和肌肉過勞有關，並且會在幾個星期內消失。

脊柱的平衡結構由韌帶、軟骨和肌肉所維持。這些組織圍攏並保護脊髓膜和那些分枝到小腿、手臂以及身體各部的神經線。

椎間盤脫出 (herniation)可以引致腰背痛和坐骨神經痛 (sciatica)—一種位於小腿的麻庳痛。它也可以導致腿部肌肉無力。

當椎骨正常排列時，脊髓會收藏在由椎板(lamina)造成的空間中。神經線通過兩塊椎骨間的開孔(foramina)伸展至您的手腳。

連於椎骨的肌肉和韌帶，需要在良好的狀態下才能讓脊椎承受每日活動的重擔。有一個平衡、靈活的脊椎讓您較少機會患上腰酸背痛，也較少需要接受治療。

參考資料: http://hkoa.org

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的骨科醫生查詢，而不應單倚賴以上提供的資料。

Spine Navigation Surgery

Spine Navigation Surgery was introduced since year 2000 and adapted in Hong Kong for more than 5 years. Similar technology was widely used in driving, computer games (like Wii),etc. The image-based technology used in spinal surgery utilizes scans of the patient's anatomy and instruments that are tracked by the Navigation System's camera. Navigation can help orthopaedic surgeon to guide their instruments for precise screw placement and reduce X-ray exposure.

Spine navigation surgery - Applications

Orthopaedic doctor will undergo proper diagnosis and evaluation before recommendation of surgery. Generally, the spine navigation surgery is applicable for common spinal disorders and especially for surgical position that require precise screw placement. For example,

1.      Patient requires re-operation due to operation failure. 

2.      Surgical position is worn out or delicate, such as osteoporotic patients.

3.      Surgical position is located in hard-to-reach area, like neck, distorted vertebrate, pedicle of vertebral arch.

Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your orthopedic doctors for diagnosis and treatment.

腰椎骨手術前的預備

手術前你可能被要求停止服用某些藥物並且停止抽煙。根據您的年齡和身體狀況，你可能被你的家庭醫生要求進行一次一般性的身體檢查。

患者通常會在手術的那天入院。在入院以後，您將會被帶到術前準備區域。麻醉科醫生會回顧您的病史和體格檢查報告。他會和您討論使用那種類型的麻醉方式。病人有時會在手術之前七天內的麻醉科門診裡進行以上的評估。腰背手術最常見的麻醉類型為全身麻醉(整個手術您是睡著的)或脊髓麻醉。


視乎您的腰背問題而定，手術通常需要一個到三個小時。您的骨科醫生會將躺在神經線上面的部份骨頭和韌帶取去，再將脫出的椎間盤切除，解除神經線的壓力。如果同時有椎骨移位(脊椎滑脫症spondylolisthesis)的話，脊椎融合手術有時會同時進行。


當手術完成後，您將被移到復甦室，由護士觀察和監測您的狀況，直到您的從麻醉中清醒過來。您會有一條靜脈注射管(Intravenous IV)在您的手臂裡。您可能還有一條導尿管插入您的膀胱，使排尿更加容易。當您完全清醒以後，您會被送到病房。您的靜脈注射管和導尿管以後將會被移除。

參考資料: http://hkoa.org

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的骨科醫生查詢，而不應單倚賴以上提供的資料。

認識背部的構造

90%左右的下背痛患者，從發作到完全地康復在大約衹需要六個星期，而另外10%患者，長期的下背痛卻總是乾擾著日常生活、甚至令人感到沮喪。下背痛的原因极為復雜的而且難以判斷，以下文章幫助我們評估疼痛的來源，進而正確地擬定治療對策。

 

背部的構造簡單可分為:

 

軟組織：肌肉、韌帶和肌腱。

脊椎骨：提供脊髓支撐的結構積木，其中又有小關節麵聯接，允許脊椎移動。

椎間盤：圓盤狀構造、承受來自于身體的重量，噹身體受到強烈的外力沖擊時更可以有效吸收分散壓力，避免神經肌肉係統受到損害。

神經係統：除了脊椎骨中受到充分保護的脊髓之外，另有神經根分支從椎間孔穿岀往下支配雙腿和腳的活動與知覺。

參考資料: www.ispine.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的骨科醫生查詢，而不應單倚賴以上提供的資料。

Back pain - Surgery & Physical therapy

A physical therapist can apply a variety of treatments, such as heat, ice, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises to increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques will help prevent pain from returning.






Surgery
Types of back surgery include:

• Spine navigation surgery. It is a new techniques that can enhance the precision in the surgical regions, reduce the surgical time, reduce radiation exposures to patients and surgeon. Increase safety and accuracy through more precise screw placement and enables minimally invasive approaches.
• Partial removal of disk. If disk material is pressing or squeezing a nerve, your orthopaedics doctor may be able to remove just the portion of the disk that's causing the problem.
• Partial removal of a vertebra. If your spine has developed bony growths that are pinching your spinal cord or nerves, orthopaedics surgeons can remove a small section of the offending vertebra, to open up the passage.
• Fusion. This surgery involves joining two vertebrae to eliminate painful movement. A drawback to the procedure is that it increases the chances of arthritis developing in adjoining vertebrae.

Reference information: www.stryker.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your orthopedic doctors for diagnosis and treatment.

Back pain Prevention

The prevention of back pain is, itself, somewhat controversial. It has long been thought that exercise and an all-around healthy lifestyle would prevent back pain. This is not necessarily true. In fact, several studies have found that the wrong type of exercise such as high-impact activities may increase the chance of suffering back pain. Nonetheless, exercise is important for overall health and should not be avoided. Low-impact activities such as swimming, walking, and bicycling can increase overall fitness without straining the low back.

·         Specific exercises: Talk to your doctor about how to perform these exercises.

Abdominal crunches, when performed properly, strengthen abdominal muscles and may decrease the tendency to suffer back pain.

·         Although not useful to treat back pain, stretching exercises are helpful in alleviating tight back muscles.

·         The pelvic tilt also helps alleviate tight back muscles.

·         Lumbar support belts: Workers who frequently perform heavy lifting are often required to wear these belts. There is no proof that these belts prevent back injury. One study even indicated that these belts increased the likelihood of injury.

• Standing: While standing, keep your head up and stomach pulled in. If you are required to stand for long periods of time, you should have a small stool on which to rest one foot at a time. Do not wear high heels.
• Sitting: Chairs of appropriate height for the task at hand with good lumbar support are preferable. To avoid putting stress on the back, chairs should swivel. Automobile seats should also have adequate low-back support. If not, a small pillow or rolled towel behind the lumbar area will provide adequate support.
• Sleeping: Individual needs vary. If the mattress is too soft, many people will experience backaches. The same is true for sleeping on a hard mattress. Trial and error may be required. A piece of plywood between the box spring and mattress will stiffen a soft bed. A thick mattress pad will help soften a mattress that is too hard.
• Lifting: Don't lift objects that are too heavy for you. If you attempt to lift something, keep your back straight up and down, head up, and lift with your knees. Keep the object close to you, don't stoop over to lift. Tighten your stomach muscles to keep your back in balance.

Reference information: knowyourback.org, www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your orthopedic doctors for diagnosis and treatment.

甚麼是骨質疏鬆？

甚麼是骨質疏鬆？

在我們的一生中，骨質都在不斷地生長及分解。若這兩者之間能取得平衡，骨骼便得以保持強健。然而，在大約30歲後，骨骼的分解便開始超越生長的速度，令骨骼變得脆弱和多孔¹。當骨質密度減低至一定程度，便屬於骨質疏鬆。

骨質疏鬆的情況十分普遍。在香港，約有一半更年期後的婦女患有骨質疏鬆。

骨質疏鬆      後果可大可小

由於早期症狀不明顯，骨折或許是骨質疏鬆最先出現的症狀，它可出現在身體的任何部位，包括脊椎、股骨。

如不及早預防和治療骨質疏鬆，可能會引致以下嚴重後果：

Ÿ   骨折

Ÿ   活動能力下降

Ÿ   失去自我照顧的能力

Ÿ   生活質素下降

Ÿ   永久殘障

Ÿ   死亡

骨質疏鬆的預防

不少簡單的生活習慣，都可補充骨質及預防骨折，並有助減低患上骨質疏鬆的機會。這些包括：

Ÿ   多吸收鈣質

Ÿ   多接觸陽光有助吸收維他命D

Ÿ   適量的負重運動（建議與專業人士商討）

減少或避免吸煙及酗酒

參考資料: www.ispine.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的骨科醫生查詢，而不應單倚賴以上提供的資料。

脊椎導航手術 (Spine navigation surgery)

脊椎導航手術在2000年已開始推出市場，香港亦引入這種技術超過五年。其實類似的導航技術已在日常車輛駕駛、電子遊戲機（例如wii）應用。脊椎導航技術能幫助骨科醫生提高脊椎手術的精確度，而且能減低X光輻射攝取量。

應用範疇

手術前，骨科醫生會進行適當的診斷和評估病人是否適合脊椎導航手術。除一般因脊椎受傷而需要進行手術的病人外，亦特別適合一些手術位置較微細的病人使用：

1. 曾經接受脊椎手術而需要複修的病人
2. 因骨骼退化而骨骼較脆弱的病人，如骨質疏鬆症的病人
3. 受傷位置較難處理，手術風險難高的位置，如位置接近椎動脈的頸骨、嚴重變形的脊椎、椎弓根較狹窄等等

參考資料: www.ispine.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的骨科醫生查詢，而不應單倚賴以上提供的資料。