Spine knowledge - Intervertebral Disc

INTERVERTEBRAL DISC (IVD) are located between the concave articular surfaces of the vertebral body endplates. IVDs form the most important and unique articulating system in the spine, allowing for multiplanar motion.

These fibrocarilaginous, composite structures make up one fourth of the total length of the spinal column. Discs are present from the C2-C3 interbody space to the L5-S1 interbody space. There is no disc between the skull (C0) and the atlas (C1), nor is there a true disc between the atlas (C1) and the axis (C2).

Intervertebral discs are the cartilaginous joints of motion segments. A motion segment is composed of two adjacent vertebrae, the disc between them, the connecting capsular facet joints and the ligamentous structures attached to the vertebrae.

Each disc permits slight flexion, extension, lateral flexion, rotation and some circum-duction. Movement at a single motion segment is limited, but since motion segments are stacked on top of each other, considerable movement throughout the spine is possible. The greatest range of motion occurs in the cervical and lumbar areas, with smaller degrees of motion in the thoracic region.

Intervertebral discs are the largest avascular (without blood supply) structures in the human body. The discs are composed of the annulus fibrosus and the nucleus pulposus.

 

 

 

 

 

 

Reference information: 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.

意外創傷高危行業易引發 脊椎神經痛宜及早診斷

本 港受痛症困擾的人多不勝數，除肌肉筋骨痛外，不少人是因意外創傷或從事高危行業而引發脊椎神經痛，若未有恰當處理，可影響患者日常生活及工作，更會出現失 眠、焦慮抑鬱，甚至自殺等情緒問題。有骨科醫生提醒市民，若持續腰背疼痛，必須盡快尋求醫生協助，及早診斷找出痛楚根源，以便對症下藥。

    

神經痛是一種較複雜的痛症，患者的神經線末稍或中樞神經系統，因損傷或功能失調，出現不正常的生理反應，錯誤將訊息傳遞至痛楚中心。骨科專科醫生張啓然表示，意外創傷也是導致脊椎神經受損的主要原因之一，而脊髓曾受創傷的人士，亦有多達六至七成人隨後會被確診患上神經痛。

他稱，脊椎受損神經痛患者在病發時，患處有如被針刺、火燒或觸電感覺，劇痛難忍，痛楚可能會持續六個月以上，由於患者經常感到疲倦乏力，生活質素大受影響，亦可能無法工作，情緒會變得十分沮喪，甚至出現失眠、抑鬱症或厭世念頭。

除 了創傷性原因外，港人缺乏運動，長期坐在辦公室工作，故亦很容易出現脊椎神經痛。張啓然稱，很多辦公室工作人士，長期使用電腦，上半身向前傾，坐姿不良造 成腰背受壓，加上操勞過度，令腰椎負荷增加，脊椎神經受創的風險亦增加，加上近年市民經常低頭使用智能電話或平板電腦，亦令肩頸承受壓力。長期勞損下，容 易出現椎間盤退化，繼而令神經受壓引致疼痛。除辦公室一族外，多種從事其他高危行業或活動的人士亦容易出現脊椎神經損傷。

由於癌症、感染、腰椎間盤突出症、脊髓血管病、髓內腫瘤、多發性硬化症等，也可引致脊椎神經痛，但很多患者卻誤解痛症不是病，只自行服食止痛藥物，忽略求醫的重要性。因此，張啓然建議，腰背痛楚持續一至兩周，應盡快求醫，及早診斷，排除其他疾病，並對症下藥。

容易出現脊椎神經痛的高危行業：
建築工人及其他體力勞動人士／交通及執勤警員／電單車及單車送貨員／職業運動員或運動愛好者／售貨員／從事飲食業人士／長期使用電腦工作人士

張啟然 骨科專科醫生

 

 

 

 

 

參考資料: www.am730.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。

骨刺很可怕嗎？(下)

 

 

腿部麻痹必须留意

約有八成的成年人在一生中會遇到一次嚴重的腰痛，如果疼痛並非持續性，則可以透過注意姿勢以及增加適量的運動去改善；然而，如果疼痛持續的話，則有可能是椎間盤向椎管突出，壓住神經，形成了坐骨神經痛。這種病症在三十至五十歲的人群中最常見。

 

通常，在三十至四十歲的時候，我們的脊椎就會開始出現椎間盤不穩，這是因為我們的脊椎在用了這麼長的時間後開始出現松動的情況，所以我們的骨骼會自行進行增生，以保護及穩定我們的脊椎。這些增生的部分便是我們在X 光片中見到的骨刺。所以，大部分的骨刺並不會引起疼痛，毋須太過擔心。

除此之外，隨著年紀的增加，這樣的增生會令椎管變得狹窄，造成神經血液循環變差，在行走時，腿部會出現麻痹的情況，嚴重的甚至持續影響大小二便，這個時候就須要盡快請教醫生的專業意見了。

 

張啟然 骨科專科醫生

 

 

 

 

 

資料來源: www.hkej.com

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。

骨刺很可怕嗎？(上)

曾經有一位老太太帶著她的X 光片氣衝衝地跑來問我： 「我從X 光中見到我有很多骨刺啊！怎麼辦？」經過我的臨床檢查，她只有輕微的腰痛症狀，只須保持適當的運動即可減輕痛楚，並非什麼大問題。





基因決定何時退化



那麼究竟什麼是骨刺呢？骨刺是很嚴重的病嗎？



我在教醫學生的時候，常常問他們： 「你們認為人的脊椎是從幾歲開始退化的呢？」答案五花八門，有學生說四十歲以後，也有人猜說大概五十至六十歲以後，然而，正確答案以上皆非。



事實是，當我們的骨骼成熟後，就立即開始退化的進程了。

正如一輛新車一樣，從它下地那一刻就開始磨損。

兩者之分別在於，人體會新陳代謝，所以我們的身體可以用上好幾十年，甚至一百年；然而，一般的車輛大概卻只能開十年左右。


我的病人當中，須要做椎間盤突出手術的、年紀最小的病人，年僅十三歲。這並非罕見的情況。



那麼，究竟是什麼因素決定我們的骨骼何時開始退化呢？



現階段，我們只知道它是由基因決定的，但是到底是由哪一組基因決定的尚未十分清楚。(續)


 張啟然 骨科專科醫生

 

 






















資料來源: www.hkej.com
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。

What is back pain?

 1.      Degeneration

The rate of degneration is vary from people. Generally, the interverbral disc and joints will become unstable after aged 30, leading to back pain or sciatia caused by nerve compressions.

 

 

2.      Bone Projection / over-growth
Osteophytes (bone spur) form naturally on the back of the spine as a person ages and are a sign of degeneration in the spine. In most cases, the spur are not the source of back pains. However, if the bone projections compress the adjunct nerves and suppress the blood supply to the nerve, the patients would suffer pain in running or standing position.

3.      Others

If back pain caused by tumor/ cancer or bacterial infections, patients may experience persistent pain in back, leading to insomnia and other associated syndromes.



Back pain - prevention
Exercise is an effective way to strengthen your muscles. The strong muscles can help to maintain a correct position of spine. Low-impact activities can increase overall fitness without straining the low back.


Back pain - treatment

1.      Physiotherapy. It can be classified as active and inactive treatment.

Active – effectively strengthen the patient’s muscle through persistent specific exercise.

Inactive – relieve pain in specific position through micro-current therapy



Misconception:

Many patients believe that reductions of physical activity can relieve their pain conditions, however, it is incorrect as physical acticity can help to strengthen your muscle and relieve the pain in long term. You are recommend to consult physiotherapy to personalize an exercise plan for you.






Medication

Depends on the severity of pain, orthopaedic doctor would prescribe oral medications for pain reliever. If needed or pain persist, orthopaedic doctor may recommend for intramuscular or percutaneous injections of nerve blocks to control your back pain.



Surgery

Orthopaedic doctor would recommend for orthopaedic surgery if needed, especially for patients suffering:



i.                    Medications and physiotherapy treatments cannot manipulate the back pain

ii.                  Incontinence caused by nerve compression

iii.                Progressive muscle weakness caused by nerve compression

iv.                No improvement of pain conditions after 4-6 weeks physiotherapy treatment.








references: 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.