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椎间盘突出 – 香港微創腦及脊椎神經外科手術中心

椎间盘

我们的椎间盘令人体脊柱有着灵活的活动,它也充当了我们脊柱的减震器或坐垫。
椎间盘的中心和内部是由水份合凝胶填充而成的核心(有如汽车轮胎的内胆相同部分),周边则是外环形的纤维层(如轮胎的橡胶外层)。

一个年轻而健康的椎间盘

在许多方面,椎间盘类似于汽车的轮胎。只要椎间盘保持年轻及有充足的水份,它就有足够的内压力来支撑我们身体的重量。一个年轻而健康的椎间盘,在MRI的T2影像会被显示为白色,而且有着正常的厚度。

一个老化且不健康的椎间盘

然而,由于以下种种原因:

  1. 我们人体在27岁后的自然衰老和退化
  2. 椎间盘长期的磨合和捞损:日常活动,例如:长时间坐着,重量负荷,运动时对脊椎的震荡压力和扭曲….等等。
  3. 脊椎损伤:因运动或家务的受伤、职业工伤、意外受伤…等等。

以上的种种原因,会令椎间盘中央凝胶填充的核心部分出现脱水、干涸现象(在MRI T2影像上,由白色变得灰或黑色,而且厚度会下降),它的内压力及承托也会下降,成为一个老化而扁平的汽车轮胎。

然而在身体体重和日常活动的压力下,椎间盘侧壁外环形的纤维层(如轮胎的橡胶外层) 就会开始变得单薄及产生裂㾗,正如人们看到当汽车轮胎溜气及变得扁平一样,此后各种脊柱问题及病征就开始了:

Conditions of intervertebral disc

各种脊柱问题可能会导致的病征如下:

  1. 颈椎问题可能有晕眩或恶心的感觉。
  2. 脊椎变得僵硬及谨直。
  3. 中央轴心性的疼痛:头痛,颈痛,腰痛….等等。
  4. 神经根受压性的疼痛:头痛,肩膀,手,臀部或腿部的疼痛,如坐骨神经痛…..等等。
  5. 神经根受压性的感觉障碍:麻木,刺痛,针刺感,削弱感觉的肩膀,四肢,臀部….等等。
  6. 神经根受压性的运动障碍:四肢的局部肌肉无力。
  7. 不正常的步态:跛行,不稳定的步姿;步行时脚部易于被地面拖住,步态不稳和不平衡….等等。
  8. 排尿频率高和无力,夜尿多,甚至小便失禁….等等。
  9. 便秘或排便无力,甚至大便失禁….等等。
  10. 影响性功能或男仕阴茎勃起功能….等等。
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