Makhalidwe a malonda
1. Chiuno chingathe kusunthidwa. Wogwira ntchitoyo ayenera kugwira mutu wa wodwalayo ndi dzanja limodzi ndikugwira mwendo wa miyendo yonse yapansi mwamphamvu ndi dzanja lina kuti msana ukhale kyphotic ndikukulitsa malo a msana momwe angathere kuti amalize kubowola. 2. Kapangidwe ka minofu ya msana ndi kolondola ndipo zizindikiro za pamwamba pa thupi ndizodziwikiratu: pali vertebrae yonse 1 ~ 5 ya msana (vertebral body, vertebral arch plate, spinous process), sacrum, sacral hiatus, sacral Angle, superior spinous ligament, interspinous ligament, yellow ligament, dura mater ndi omentum, komanso subomentum, epidural space ndi sacral canal zopangidwa ndi minofu yomwe ili pamwambapa: posterior superior iliac spine, iliac ridge, thoracic spine process ndi lumbar spine process zimatha kumveka bwino. 3. Maopaleshoni otsatirawa ndi otheka: mankhwala oletsa ululu m'chiuno, kupunthwa kwa lumbar, kutsekeka kwa epidural, kutsekeka kwa mitsempha ya caudal, kutsekeka kwa mitsempha ya sacral, kutsekeka kwa mitsempha ya lumbar sympathetic 4. Zowona zenizeni za kupunthwa kwa lumbar: Pamene singano yoboola ifika pa ligament yachikasu yoyerekezeredwa, kukana kumawonjezeka ndipo pamakhala kulimba, ndipo kuphulika kwa ligament yachikasu kumakhala ndi kukhumudwa koonekeratu. Ndiko kuti, mu epidural space, pali kupanikizika koipa (panthawiyi, jakisoni wa madzi oletsa ululu ndi epidural anesthesia): pitirizani jakisoni wa singano udzaboola dura ndi omentum, padzakhala kumva kwachiwiri kwa kulephera, ndiko kuti, mu subomentum space, padzakhala kutsanzira kutuluka kwa madzi muubongo. Njira yonseyi imatsanzira mkhalidwe weniweni wa kupunthwa kwa lumbar lumbar.