Anatomy 結構
Structurally it was from the base of the neck to buttock. It comprises of 12 thoracic vertebrae with a pair of ribs attached to each level, 5 lumbar verterbae with a intervertebral disc in between each of them. The last fused vertebrae is called sacrum. Together with the pelvic bone, it forms a bony ring where the hips attached to.
從結構上說，它是從頸的底部到臀部。它由12個胸椎，5個腰椎和骶骨組成。每節胸椎附有一對肋骨。每節椎骨之間有一個椎間盤。骶骨跟盆骨形成了一個環，髖關節就銜接上。
Pathology 毛病
Disease 病變
The followings are common pathologies in spine
以下是常見脊椎病變
- Spinal stenosis 椎管狹窄
- Discogenic back pain 椎間盤背痛
- Collapse Fracture 壓縮性骨塌
- Spondylolisthesis 脊椎前移
- Infection 感染
Investigation 評估
MRI is usually required and dynamic X-ray might be indicated. Occasionally, nerve conduction study would be needed.
通常需要拍磁力共震片，並且可能需要作動態X光檢查。某些情況需安排神經功能測試。
Management 治療
Conservative treatments are indicated for majority of cases. They included,
- Physiotherapy
- Chiropractor
- TCM practitioner
- Prescribed Exercise
- Medication
For cases failed conservative treatments, intervention would be indicated.
For patients with neurological deficit lasting more than 6 weeks or witnessed deterioration, surgical intervention might be advocated.
絕大多數病人只需採取保守治療。他們包括
- 物理治療
- 脊醫
- 中醫
- 處方運動
- 藥物（口服及外敷）
對於保守治療無效的病例，會改為介入治療，例如打針。
對於持續超過6週或惡化的神經受損的患者，醫生往往會建議手術，以保神經功能。
Common Interventions include
- Epidural injection of steroid
- Radiofrequency Ablation of L2 dorsal root ganglion (RFA DRG)
- Nucleoplasty
- Vertebroplasty
- Discectomy
- Fusion
常見的介入性治療包括
- 硬膜外注射類固醇
- 腰2背根神經節射頻消融術（RFA DRG）
- 核成形術
- 椎體成形術
- 椎間盤切除術
- 椎體融合術