Blood Supply to the 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.

Intervertebral discs have no significant vascular structures. Instead, they receive their blood supply by diffusion through the vertebral body endplates. A network of vessels located centrally in the endplate allows nutrients to diffuse into the nucleus pulposus and annulus fibrosus. Damage to the endplates through injury or disease process may decrease the diffusion of nutrients to the disc with resulting degradation of the disc.

Did You Know That You Are Taller in the Morning?

The upright position of normal posture creates a compression effect on intervertebral discs. This high pressure drives out some of the water content in the nucleus pulposus, decreasing the intervertebral height a few millimetres at each level. However, resting in the horizontal position, the intervertebral discs are relieved of the compressive forces, and water returns to the nucleus pulposus. Intervertebral height is recovered, up to 1.5-2.0 cm in the total length of the spine.

References: www.spine.org,

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.

什麼是脊椎側彎?

在正常情況下，一個人的脊柱排列是接近一直線的。若脊柱變成Ｓ形或Ｃ形(如右圖)，則稱為脊椎側彎，側彎的原因很多，但百分之六十的病例原因至今不明，這也就是我們所稱的特發性(idiopathic)脊椎側彎。脊椎側彎最容易發生在青少年身上，並以女性居多，但經常被忽略，直到腰酸背痛，傷害了脊椎骨才診斷出來。

預防脊椎側彎

• 站立時應兩腳平站，像一般大家最常隨意站的三七步就是不良的站姿。
• 坐著時翹二郎腿是不好的習慣，易造成骨盆歪斜。
• 背包不要長期單肩背負，兩肩輪流分擔重量最好，以防脊椎側彎。
• 撿拾重物宜蹲下取之，直接彎腰會造成脊椎很大的負擔。
• 運動方面如伸展操、散步、游泳等，很適合強化自己的肌肉及骨骼關節。
• 飲食方面，多攝取鈣質，強化骨骼。

參考資料: www.spine.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。

甚麼是脊椎導航手術？

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）中廣泛應用。脊椎導航技術能幫助骨科醫生提高脊椎手術的精確度，而且能減低手術中X光輻射攝取量。

 

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。

手術前骨科醫生會為病人作3D影像掃描，然後將掃描的3D影像與病人脊椎位置進行電腦配對。手術期間，骨科醫生可透過導航技術，即時分析3D配對影像，提高手術的精確度，例如手術螺絲入骨的深度。

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。

Success Stories: Henry - Tumor Removal and Cervical spine Fusion

In 1980 and 2001, I had surgery to remove tumors from my spine. In 2004, I was suddenly in severe, constant pain. Simply getting out of bed each day required a heavy dose of hydrocodone. Unable to perform any task that required sustained attention, I had to rest often and was never comfortable. I was even having difficulty urinating. My quality of life was terrible.

At least this time I had an explanation for my symptoms. I learned that a rare and aggressive cancer, hemangiopericytoma, was causing the recurring tumors that were pressing on my nerves.

Since I had a great deal of scar tissue from my previous surgeries, my then-doctor recommended a non-invasive radiation treatment rather than surgery. I was hesitant about this new technology and sought another opinion. I was referred to Joseph Cheng, MD, at Vanderbilt University in Nashville. Dr. Cheng ordered X-rays, examined me and said he would be able to remove the tumor surgically, even with the extensive scar tissue.

In a 15-hour surgery, the tumor was removed and, because of the previous surgeries, vertebrae in my neck had to be fused and reinforced with pins and plates. I was in a hard body brace for seven weeks. After the removal of the brace, I underwent six weeks of radiation at a hospital near my home.

Unbelievably, I was able to suspend the pain medication immediately after surgery. Each day I became a little stronger and able to do more. Today, I am able to do most activities, including walking three miles a day, volunteering at a local high school and building wooden boats, which is my passion.

參考資料: www.knowyourback.org

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.

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。