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Ton thuong do thoat vi dia dem cot song co

Dot song co binh thuong.

Thoat vi dia dem cot song co cung voi hoi chung dau cac re than kinh deu co nguon goc co ban do thoai hoa dia dem - cot song co, thuong duoc goi chung la “Hoi chung co - canh tay”.

Thoat vi dia dem cot song co tuy co ty le thap hon thoat vi dia dem cot song that lung nhung lai dong vai tro rat he trong vi no truc tiep uy hiep tuy song co va chen duong di cua he dong mach dot song - than nen bao dam nuoi duong nao bo (dai nao, tieu nao...). Khong nhung the, he than kinh thuc vat o vung nay lai duoc phan bo rat phong phu va tiep xuc rat khang khit voi he dong mach song - nen boi hai chuoi hach giao cam co cung bi tac dong.

Sau day la mot so bieu hien thuong gap do thoat vi dia dem cot song co

Hoi chung co - canh tay la gi?

Hoi chung co - canh tay la hoi chung dau do dia dem cua doan cot song co doan C5-C7, co dac diem la dau va roi loan cam giac khoi phat tu cot song co lan toi chi tren, it nhieu mang tinh chat phan bo than kinh theo dai. Phan lon co kem cac trieu chung cua hoi chung co cuc bo. Tuy theo phan nao cua nhanh than kinh bi xam pham ma co nhung bieu hien dau, roi loan cam giac va van dong tuong ung. O giai doan dau, xuat hien cac trieu chung pha tron dau gay voi sai lech tu the. Tren co so cua dau lan theo doc dai da bi xam pham, dong thoi cung xuat hien roi loan cam giac o vung nay. Truong hop co chen ep lon thi bi giam cam giac nong (cam giac te bi) theo dai da, con phanlon khi cac nhanh, re than kinh bi kich thich lai thay bieu hien vung dai da tang cam giac nong.

Nguoi benh co cam giac cang va sung ban tay, ma khach quan khong the nhan biet duoc, lai thuong kem theo tim tai dau chi va lanh chan tay, chung to co them roi loan than kinh giao cam. Co the han che van dong vai, nhung khong phai la do viem quanh khop ba vai - canh tay.

Teo co thuong phat hien thay o khu vuc tren vai, co Delta va cac co thuoc khu vuc canh tay, cang tay, co khi ca o ban tay, tuy theo pham vi va muc do ton thuong. Hoi chung co - canh tay co the xuat hien theo nhieu kieu. Hoi chung co - canh tay thuong do thoat vi dia dem cot song co (loai mem) va do cau truc xuong (choi xuong do thoai hoa) cua mom moc cua dot song (con duoc goi la “thoat vi cung”).

Dau canh tay do loi va thoat vi dia dem

Thoat vi dia dem cot song co gay dau.

Loi dia dem hay thoat vi dia dem co la do mot tac nhan gay chen ep “mem” cac re than kinh, it gap hon so voi cung loai o cot song that lung. Loi dia dem co thuong gap o vi tri sau - ben chen ep re than kinh, gay dau, tu the sai lech cot song co va nhung thieu hut than kinh. Loi dia dem la do vong soi bi nhan nhay troi ra o diem yeu nhat lam rach dut mot so lop cua vong soi, tuc la vong soi chua bi choc thung hoan toan. Tren co so cua thoai hoa dia dem, loi dia dem keo dai, vong soi dia dem da bi suy yeu duoi tac dong cua tai trong qua nang, khong can doi, hay do tu the van dong cot song co bat loi, vuot qua gioi han cua truong - van dong hoac chan thuong nhan nhay choc thung vong soi va thoat ra ngoai khoang dia, gay thoat vi dia dem co. Do suc cang phong cua dia dem o nguoi tre chua bi suy giam nhu o nguoi cao tuoi nen thoat vi dia dem thuong xay ra o tuoi 30-45. Cac trieu chung xuat hien cap tinh: dau canh tay theo dai da thuoc vung re than kinh bi xam pham, tu the sai lech manh me cua dau va cot song co bao gio cung o tu the gu. Ho, hat hoi deu lam dau tang len. Chi co chup tuy co hay chup cat lop vi tinh, chup cong huong tu moi xac dinh chan doan chinh xac thoat vi dia dem.

Dau canh tay do choi xuong o mom moc

Do dac diem sinh - co hoc cua dia dem cot song, qua trinh thoai hoa theo tuoi phat trien dan dan, toi tuoi 50 thi da hinh thanh cac gai xuong o than dot va choi xuong o mom moc. Trong quang tuoi doi do neu co cac yeu to ngoai lai (chan thuong, viem nhiem, tu the bat loi khong sinh ly do nghe nghiep hay phong cach sinh hoat, thi se lam tang toc do thoai hoa, tham chi cot song co nhieu em o tuoi thieu nien da co bieu hien thoai hoa nang ne tren phim Xquang. Dieu do noi len vai tro quan trong cua du phong benh ly cot song co.

Tren lam sang, dau canh tay do kich thich re than kinh boi choi xuong o mom moc thuong gap nhieu hon la do thoat vi dia dem. Choi xuong mom moc chia vao lo lien dot gay hep long lo lien dot  con xo hoa dia dem han che bien do van dong cot song co thi chua co bieu hien cac trieu chung cua hoi chung co - canh tay.

Su phoi hop cua hai yeu to long leo doan van dong cot song co voi cac gai xuong la nguon goc phat sinh hoi chung lam sang dong thoi cung la muc tieu giai quyet cua cac bien phap du phong va dieu tri hoi chung co - canh tay. O day, cac trieu chung xuat hien tu tu va khong manh me nhu trong loi va thoat vi dia dem. Bieu hien dau ve dem, cam giac kien bo va te bi dai da tuong ung thuoc cac re than kinh bi xam pham nen con mang thuat ngu “chung dau canh tay ve dem”.

Ngoai ra, o doan cot song co, tuy theo muc do cua tac nhan gay benh vao cac re than kinh tuy co (kich thich, chen ep) se xuat hien hoi chung dau re than kinh - mot re hoac nhieu re, phan lon o mot ben, co khi o ca hai ben.

Dieu tri nhu the nao?

Dieu tri chung: Cac bien phap giam dau va chong viem (thuoc, cham cuu, xoa bop nhe nhang vung co va tay); cac loai thuoc an than, tran tinh than kinh va thu gian co; cac loai thuoc hoat huyet va chong thoai hoa than kinh.

Dieu tri theo nguyen nhan la chu yeu: Cac hoi chung benh ly nay deu do co che benh sinh co hoc. Do do tuy theo tac nhan gay benh (loai cung hay mem), muc do gay ton thuong (kich thich hay chen ep) va tinh chat nguy hai cua co quan hay cac thanh phan lien quan (tuy song, dong mach song hay cac re than kinh) de co bien phap dieu tri thich hop.

Neu chi la kich thich hay chen ep nhe thi dieu tri bao ton la chu yeu: giai doan dau cap tinh thi phai cho bat dong cot song co bang dai co. Sau do neu can thi keo gian cot song co ket hop voi dai co.

Neu chen ep nang vao tuy song co va mach mau than kinh thi phai can thiep phau thuat giai phong bo phan bi chen ep cang som cang tot. Truoc khi chi dinh keo gian cot song co phai chup Xquang de loai tru cac loai benh ly khac cua cot song - tuy song. Truoc khi phau thuat, benh nhan can duoc chup cat lop vi tinh hay cong huong tu.

Dieu tri phuc hoi chuc nang va du phong tai phat

Sau khi benh da duoc xu tri co ban, can tiep tuc lieu trinh dieu tri phuc hoi chuc nang (vat ly tri lieu, xoa bop, van dong lieu phap) tai co so chuyen khoa. De du phong tai phat can sinh hoat hop ly, xac dinh nganh nghe thich hop, tranh chan thuong vao dau va co. Khi phai su dung cot song co trong thoi gian dai can deo dai co.

PGS. Vu Quang Bich