世界脊椎日来了,你知道哪节脊椎易受伤?

2015-10-16 郑丹 生命时报

原标题:世界脊椎日来了,你知道哪节脊椎最易受伤?10月16日是世界脊椎日,很多人可能不知道人一共有多少块脊椎,但对脊椎病却熟悉得不能再熟悉了,因为颈椎痛、腰痛,甚至是由此带来的头痛、腿痛,每天都在困扰着大部分人。据统计,全球范围内,美国每年被脊椎病缠身的人约有540万;英国平均每1000名男性中,每年因此病不能工作的天数为627天,女性为347天。在中国,80%左右的人都不同程度地有过腰痛或腿痛的

原标题:世界脊椎日来了,你知道哪节脊椎最易受伤?

10月16日是世界脊椎日,很多人可能不知道人一共有多少块脊椎,但对脊椎病却熟悉得不能再熟悉了,因为颈椎痛、腰痛,甚至是由此带来的头痛、腿痛,每天都在困扰着大部分人。据统计,全球范围内,美国每年被脊椎病缠身的人约有540万;英国平均每1000名男性中,每年因此病不能工作的天数为627天,女性为347天。在中国,80%左右的人都不同程度地有过腰痛或腿痛的病史。据一项调查显示,中青年的脊椎病发病率正在急速上升:30—40岁的人群中,59.1%人患有颈腰椎病;50—60岁的人群中,患者达到71%;而60岁以上的人群,发病率高达82%。

我们的脊椎到底怎么了?中国工程院院士、中华医学会骨科学分会主任委员、北京协和医院骨科主任邱贵兴教授在接受采访时发出呼吁,脊椎病和人的生活方式有很大关系,人们不能总是被动地被脊椎病困扰,应该主动出击。而对脊椎了解得越早,越能早预防,发病率才会越来越低。为此,记者采访了多位专家,教大家从上到下认识脊椎。

人的脊椎骨一共有26节,其中,1—7节为颈椎。卫生部中日友好医院骨科主任李子荣教授告诉记者,在所有脊椎中,颈椎的活动度最大,也最容易发生劳损,再加上长时间低头工作、生活方式及枕头使用不正确等因素,颈椎病已越来越多地困扰着人们,最突出的表现就是肩颈疼痛、上下肢麻木、头晕、耳鸣、恶心、心悸等。

7节颈椎里,第1、2、7节形状最特殊。寰椎作为第一节颈椎,和枕骨在韧带的帮助下形成了人体最坚强、最稳定的关节,牢牢地固定着装载智慧的大脑袋。而第二节枢椎和寰椎形成的关节,是脊椎各关节中灵活性最好的,我们要扭头,主要靠的是它。不过,灵活性好,稳定性就差一些,外伤时寰枢关节很容易受损。比如很多人乘车时会不知不觉睡着了,一旦急刹车,头颅在没有支点的情况下,最容易受伤的就是寰枢关节。第7节颈椎,称为大椎,它的棘突是重要的体表骨性标志。



虽然这几节颈椎容易受伤,但常见的颈椎病倒与它们无关,而是主要表现在3—6节椎体间,因为低头、抬头,是这4节颈椎的主要任务。很多人都想不到,颈椎每天的关节活动达几十万次,这么大的“工作量”,很容易形成退行性病变。比如,长时间低头会造成颈部肌肉疲劳、痉挛,反复的痉挛最终会导致颈椎变直甚至后凸,形成了当下困扰很多人的“办公室病”。

李子荣教授指出,对于颈椎病,人们由于不了解存在很多预防误区,比如有些人以为,摇头、扭脖子可以缓解颈椎痛,实际上,这些动作又增加了颈椎的“工作量”,加重了关节磨损,因此完全错误。锻炼颈部肌肉是防治颈椎病操作性最强、最有效的方式,而正确的方法就是遵循“抗阻力”原则。锻炼时,应朝着与平时前屈姿势相反的方向去做,比如向后仰,或锻炼“飞燕展翅”。另外,李子荣说,不会枕枕头也是引起颈椎病的常见原因。枕头的形状、放置的位置、高度,以及不枕枕头等生活习惯都可能引发颈椎病,使睡眠时颈椎仍处于向前曲的状态。最好的方法是,把枕头放置在颈后,而不是后脑勺下。枕头不要太高,也不要太低,以符合个人生理曲度为宜。

胸椎,保持平衡最安全

胸椎占脊椎的第8—19节。中国人民解放军306医院骨科副主任、全军脊柱外科中心副主任马华松主任医师告诉记者,与颈椎向前曲不同,胸椎是向后凸的。12块胸椎和12根肋骨构成了一个“笼子”,保护着心脏、肺脏等重要器官。这种稳定的结构,让日常生活中胸椎发生损伤的风险较小。胸椎最容易受的伤害,是重体力活导致的胸椎关节错位等。此外,还有青少年易发生的胸椎脊柱侧弯。

马华松说,预防胸椎损伤,最关键的是保持身体“平衡”。不管工作还是运动,身体往一边歪最易让胸椎受伤。比如打网球或羽毛球,都以单臂运动为主,用右臂的人胸椎偏右歪,用左臂的人胸椎偏左歪,特别容易发生上胸椎劳损。对于体力劳动者和老人这些胸椎本来就容易受伤的人来说,平时应该少打球,多进行游泳、跑步等运动。爱打球的年轻人,最好打完后多做几个平衡姿势,对胸椎保健有很好的作用。

腰椎,最“累”的椎骨



腰椎在脊椎的第20—24节,李子荣说,它们可算是整个脊柱里最“累”的椎骨了。它没胸椎稳定,没颈椎灵活,却承担了人整个上半身的重量,不管身体往哪个方向扭,受力的都是腰,这让它发生损伤的几率大大增加。

从侧面看脊柱,它呈波浪形,有4个生理弧形:颈部向前凸、胸向后凸、腰向前凸、骶骨向后凸。在这些生理弯曲中,贯穿着一条重力线。所以5块腰椎里,位置越往下,承担的负荷越重,发生疾病的风险也越高。其中,以被誉为“减震器”的椎间盘损害最常见。

大部分腰椎病都是“坐”出来的。调查显示,常坐在电脑前的“白领”和司机,是腰椎间盘突出最高发的人群。而人在前倾20度坐着时,椎间盘受到的压力最大。当你觉得腰隐隐作痛时,往往已经形成了积累性损伤。在临床中,长期慢性腰痛的人,大约有35%最终会发展为腰椎间盘突出。

要保护你的腰,首先要避免久坐,觉得腰部酸痛了,就赶紧起来走走,伸个懒腰,缓解了再继续工作。座椅最好带靠背,或者在后面放个小垫枕,使之能够稍稍顶住腰部,这样可保持腰部平直,使腰肌充分放松。选桌子也很有学问,最好选前高后低、桌面倾斜的,可以减少工作时腰向前弯的程度。另外,躺在床上看书对眼睛不利,却对腰部休息有益。有腰疾的人,可以适当选择。

其次,李子荣说,站立时直接弯腰拿重物,是很多人易犯的错误。正确的做法是,先下蹲然后拿起物品,将重量放在腿部肌肉上,可减小对腰椎的压力。

第三,床和睡姿都很重要。很多人都知道,腰不好,要选硬一点的床,但在睡姿上就放任自由了。其实护腰的最好睡姿是侧卧,下肢稍弯曲。如果喜欢仰睡,可在膝盖下垫一个枕头,这就是古人所说的“睡如弓”。这种睡姿最利于腰部肌肉放松,减低椎间盘内的压力,使腰椎获得充分的休息。 此外,还有骶骨和尾骨,前者主要增强骨盆强度,二者易发生外伤的骨裂或骨折,平时也要注意保护。

附:不同坐姿下椎间盘压力图



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  1. [GetPortalCommentsPageByObjectIdResponse(id=202730, encodeId=fe22202e304b, content=分析的好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKLHahdVGA0zt2pcAPVRGYgX7xxSdbCyVJIS81d0akb2uCVJS6icq0Urc4s9DlJTviazj2jxtwNgKLw/132, createdBy=48281971445, createdName=糖糖1110, createdTime=Fri May 26 09:03:48 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40019, encodeId=cf0340019a4, content=老毛病,说的容易,要执行就不乐观了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31c1656664, createdName=永圣, createdTime=Wed Oct 21 00:42:00 CST 2015, time=2015-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39803, encodeId=79e13980363, content=确实需要引起重视已经开始腰疼了, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Tue Oct 20 07:05:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39446, encodeId=e3d63944653, content=分析得很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKh7liafwbwia2vZa0DhaL13r4YKfibqM0FcdBd6qREU6L8xBEp7xhM7v4tpxo2WAKcU9UrZ77Hty92w/132, createdBy=f74d1656919, createdName=来去匆匆, createdTime=Mon Oct 19 09:41:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39445, encodeId=fdd0394451d, content=给老妈看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKh7liafwbwia2vZa0DhaL13r4YKfibqM0FcdBd6qREU6L8xBEp7xhM7v4tpxo2WAKcU9UrZ77Hty92w/132, createdBy=f74d1656919, createdName=来去匆匆, createdTime=Mon Oct 19 09:40:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1630485, encodeId=82731630485c8, content=<a href='/topic/show?id=dd238456e9f' target=_blank style='color:#2F92EE;'>#脊椎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84567, encryptionId=dd238456e9f, topicName=脊椎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f80c21536506, createdName=neizongke, createdTime=Sun Oct 18 05:46:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2017-05-26 糖糖1110

    分析的好好

    0

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    2015-10-21 永圣

    老毛病,说的容易,要执行就不乐观了!

    0

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    2015-10-20 cyzj007

    确实需要引起重视已经开始腰疼了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=202730, encodeId=fe22202e304b, content=分析的好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKLHahdVGA0zt2pcAPVRGYgX7xxSdbCyVJIS81d0akb2uCVJS6icq0Urc4s9DlJTviazj2jxtwNgKLw/132, createdBy=48281971445, createdName=糖糖1110, createdTime=Fri May 26 09:03:48 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40019, encodeId=cf0340019a4, content=老毛病,说的容易,要执行就不乐观了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31c1656664, createdName=永圣, createdTime=Wed Oct 21 00:42:00 CST 2015, time=2015-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39803, encodeId=79e13980363, content=确实需要引起重视已经开始腰疼了, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Tue Oct 20 07:05:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39446, encodeId=e3d63944653, content=分析得很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKh7liafwbwia2vZa0DhaL13r4YKfibqM0FcdBd6qREU6L8xBEp7xhM7v4tpxo2WAKcU9UrZ77Hty92w/132, createdBy=f74d1656919, createdName=来去匆匆, createdTime=Mon Oct 19 09:41:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39445, encodeId=fdd0394451d, content=给老妈看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKh7liafwbwia2vZa0DhaL13r4YKfibqM0FcdBd6qREU6L8xBEp7xhM7v4tpxo2WAKcU9UrZ77Hty92w/132, createdBy=f74d1656919, createdName=来去匆匆, createdTime=Mon Oct 19 09:40:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1630485, encodeId=82731630485c8, content=<a href='/topic/show?id=dd238456e9f' target=_blank style='color:#2F92EE;'>#脊椎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84567, encryptionId=dd238456e9f, topicName=脊椎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f80c21536506, createdName=neizongke, createdTime=Sun Oct 18 05:46:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2015-10-19 来去匆匆

    分析得很好

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=202730, encodeId=fe22202e304b, content=分析的好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKLHahdVGA0zt2pcAPVRGYgX7xxSdbCyVJIS81d0akb2uCVJS6icq0Urc4s9DlJTviazj2jxtwNgKLw/132, createdBy=48281971445, createdName=糖糖1110, createdTime=Fri May 26 09:03:48 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40019, encodeId=cf0340019a4, content=老毛病,说的容易,要执行就不乐观了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31c1656664, createdName=永圣, createdTime=Wed Oct 21 00:42:00 CST 2015, time=2015-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39803, encodeId=79e13980363, content=确实需要引起重视已经开始腰疼了, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Tue Oct 20 07:05:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39446, encodeId=e3d63944653, content=分析得很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKh7liafwbwia2vZa0DhaL13r4YKfibqM0FcdBd6qREU6L8xBEp7xhM7v4tpxo2WAKcU9UrZ77Hty92w/132, createdBy=f74d1656919, createdName=来去匆匆, createdTime=Mon Oct 19 09:41:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39445, encodeId=fdd0394451d, content=给老妈看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKh7liafwbwia2vZa0DhaL13r4YKfibqM0FcdBd6qREU6L8xBEp7xhM7v4tpxo2WAKcU9UrZ77Hty92w/132, createdBy=f74d1656919, createdName=来去匆匆, createdTime=Mon Oct 19 09:40:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1630485, encodeId=82731630485c8, content=<a href='/topic/show?id=dd238456e9f' target=_blank style='color:#2F92EE;'>#脊椎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84567, encryptionId=dd238456e9f, topicName=脊椎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f80c21536506, createdName=neizongke, createdTime=Sun Oct 18 05:46:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2015-10-19 来去匆匆

    给老妈看看

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=202730, encodeId=fe22202e304b, content=分析的好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKLHahdVGA0zt2pcAPVRGYgX7xxSdbCyVJIS81d0akb2uCVJS6icq0Urc4s9DlJTviazj2jxtwNgKLw/132, createdBy=48281971445, createdName=糖糖1110, createdTime=Fri May 26 09:03:48 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40019, encodeId=cf0340019a4, content=老毛病,说的容易,要执行就不乐观了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31c1656664, createdName=永圣, createdTime=Wed Oct 21 00:42:00 CST 2015, time=2015-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39803, encodeId=79e13980363, content=确实需要引起重视已经开始腰疼了, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Tue Oct 20 07:05:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39446, encodeId=e3d63944653, content=分析得很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKh7liafwbwia2vZa0DhaL13r4YKfibqM0FcdBd6qREU6L8xBEp7xhM7v4tpxo2WAKcU9UrZ77Hty92w/132, createdBy=f74d1656919, createdName=来去匆匆, createdTime=Mon Oct 19 09:41:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39445, encodeId=fdd0394451d, content=给老妈看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKh7liafwbwia2vZa0DhaL13r4YKfibqM0FcdBd6qREU6L8xBEp7xhM7v4tpxo2WAKcU9UrZ77Hty92w/132, createdBy=f74d1656919, createdName=来去匆匆, createdTime=Mon Oct 19 09:40:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1630485, encodeId=82731630485c8, content=<a href='/topic/show?id=dd238456e9f' target=_blank style='color:#2F92EE;'>#脊椎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84567, encryptionId=dd238456e9f, topicName=脊椎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f80c21536506, createdName=neizongke, createdTime=Sun Oct 18 05:46:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2015-10-18 neizongke

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