Klinička slika i liječenje lumboishijalgije

master's thesis

• Title (english): Clinical features and treatment of lumboischialgia
• Author: Boris Fras
• Mentor: Porin Perić (mentor)
• Committee member: Nadica Laktašić Žerjavić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Porin Perić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Physical Medicine and General Rehabilitation); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Physical Medicine and Rehabilitation

Abstract

Bol u donjem dijelu leđa vrlo je učestala među populacijom i smatra se da čini trećinu svih reumatskih bolesti. Ishialgija se pojavljuje kod 1-3% opće odrasle populacije. Između trupova kralježaka se nalaze intervertebralni diskovi koji su građeni od središnjeg želatinoznog dijela, nucleus pulposus, okruženog fibroznim prstenom, anulus fibrosus. Poremećaji intervertebralnog diska smatraju se najčešćim uzrokom boli u donjem dijelu leđa i radikularne boli. Kod dijagnosticiranja ovog stanja možemo koristiti se anamnezu, fizikalni nalaz, slikovne prikaze, minimalno invazivne dijagnostičke postupke poput segmentalne blokade živaca i neurofiziološka ispitivanja. Postoji nekoliko provocirajućih testova na donjim ekstremitetima u kojima određeni položaji ekstremiteta mogu umanjiti ili povećati lumbosakralnu radikularnu bol, te tako ukazati na određenu patologiju. Magnetna rezonancija(MR) je metoda izbora za dijagnozu lumboishijalgije zbog toga što dobro prikazuje meka tkiva. Za razlikovanje oštećenja perifernog živca od oštećenja spinalnog korijena koristimo elektrofiziološke metode, a kada želimo odredit na kojoj se razini u kralježnici nalazi patološki proces koji uzrokuje bol koristimo segmentalnu blokadu živaca. Liječenje je u akutnoj fazi bolesti uvijek konzervativno. Ukoliko se ono ne pokaže učinkovitim prelazi se na kirurško liječenje koje može biti klasično i minimalno invazivno.

Abstract (english)

Low back pain is common among population and it makes up to one third of all rheumatic diseases. Sciatica appears in 1% -3% of the general adult population. There are intervertebral discs between the vertebral bodies that are made of the central gelatinous part, nucleus pulposus, surrounded by fibrous ring, anulus fibrosus. Intervertebral disc disorders are considered to be the most common cause of pain in the lower back and radicular pain. In diagnosing this condition we can use patient history, physical examination, imaging techniques and minimally invasive diagnostic procedures such as segmental nerve blockage and neurophysiological examination. There are several provocative tests at the lower extremities in which some extremity positions can reduce or increase lumbosacral radicular pain and point to a particular pathology. Magnetic Resonance (MR) is the method of choice for diagnosing lumbosacral radicular syndrome because the soft tissue is shown well. To differentiate the peripheral nerve pathology from spinal nerve root pathology, we use electrophysiological methods. When we want to determine at which level of the spine is pathological process, which causes pain, we use segmental nerve blockage. Treatment in the acute phase of the disease is always conservative. If it does not prove effective, it is recommended to start considering a surgical treatment. Surgical approach can be classical and minimal invasive.

• Keywords: lumboishilagija; dijagnoza; liječenje
• Keywords (english): lumboischialgia; diagnosis; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:395659
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Pohranitelj objekta je unio ključne riječi
• Created on: 2018-12-27 09:18:13