腰背痛神经阻滞疗法.pptVIP

腰背痛

腰背痛的原因椎间盘源性纤维环破裂髓核压迫纤维环内的c纤维炎性因子刺激神经临床特点

腰背痛的原因小关节源性小关节功能紊乱小关节退行性变小关节的神经支配脊神经背支内侧支临床表现

腰背痛的神经阻滞疗法

ESI椎间盘源性腰背痛

腰椎小关节注射、内侧支阻滞

腰椎小关节注射、内侧支阻滞

骶髂关节体格检查Gaenslenstestisperformedwiththepatientsupine(ontheback).Thehipjointismaximallyflexedononesideandtheoppositehipjointisextended.Thismaneuverstressesbothsacroiliacjointssimultaneously.

骶髂关节体格检查Patricksteststressesthehipandsacroiliacjoints.Apositivetestproducesback,buttocks,orgroinpain.

腰腿痛的神经阻滞治疗

椎间盘突出

脊神经根受刺激

腰神经根受压的疼痛分布

椎旁神经阻滞选择性神经根阻滞selectivenerverootblock

选择性神经根阻滞selectivenerverootblock

S1block

椎管狭窄、椎间孔狭窄

梨状肌综合症

SpinalRegionReferralAreaConditionMimickedUpperCervicalSpine(neck)C1-C4Backofthehead(occiput),backoftheshoulders,angleofthejaw,faceHeadaches,migraines,jawproblems,trigeminalneuralgia,tensionintheshouldersMiddle/LowerCervicalSpine(neck)C5-C8Arms,forearms,handsandfingersTrappednerveintheneck,tenniselbow,golferselbow,frozenshoulderUpperThoracicSpine(abovethebra-strap)T1-T4Paininthearms,frontoftheupperchest,upperribsTrappednerveintheneck,angina,breathingdifficultiesandotherchestcomplaintsMiddleThoracicSpine(atthebra-strap)T5-T8Upperabdomen,middleribsStomachulcer,gallbladderproblems,trappedwind,indigestion,breathingdifficultiesandotherchestcomplaintsLowerThoracicSpine(belowthebra-strap)T9-T12Lowerabdomen,lowerribs,pelvisandsexualorgansIrritableboweldisorder,pelvicpain,periodpain,paininthesexualorgansUpperLumbarSpineL1-L3Groin,frontoftheupperthighTrappednerveintheback,groinandthighproblems,hipandkneeproblemsLowerLumbarSpineL4-L5Frontoftheinnerandoutershinbone,topofthefootSciatica,shinandfootproblemsSacrumS1-S4Buttocks,perineumPelvicpain,coccydynia

PainType?Diagnosis??Treatment?SimpleSpinalPainSimpleSprain,MuscleSpasm,SegmentalSpinalDysfunctionAcupuncture,TENS,Exercises,ManipulationComplex