Les névralgies sciatiques

Transcription

Les névralgies sciatiques
1(95$/*,(66&,$7,48(6
/D VFLDWLTXH GpILQLW WRXWH GRXOHXU GDQV OH WHUULWRLUH GX QHUI VFLDWLTXH UDFLQHV
/6HWFRUUHVSRQGGRQFjXQV\PSW{PHHWQRQjXQHPDODGLH
'DQVODPDMRULWpGHVFDVLOV¶DJLWG¶XQFRQIOLWGLVFRUDGLFXODLUHHWFRUUHVSRQGj
XQH VFLDWLTXH FRPPXQH G¶RULJLQH GLVFDOH ,O QH IDXW SDV RXEOLHU OHV DXWUHV
pWLRORJLHVjGRQWOHVSOXVIUpTXHQWHVVRQWWXPRUDOHVHWLQIHFWLHXVHV
(3,'(0,2/2*,(
7UqVIUpTXHQWHVFKH]O¶DGXOWHHQYLURQFDVDQHQ)UDQFHDYHF
LQWHUYHQWLRQV
&KH] O¶HQIDQW OD VFLDWLTXH GLVFDOH HVW UDUH HW O¶pWLRORJLH GRPLQDQWH HVW
WXPRUDOH
5$33(/$1$72023$7+2/2*,48(
/HGLVTXHLQWHUYHUWpEUDOHVWFRQVWLWXpGHGHX[pOpPHQWVHVVHQWLHOV OH QXFOHXV SXOSRVXV IRUPDWLRQ RYRwGH JpODWLQHXVH HW KRPRJqQH
HQWRXUpGH
O¶DQQXOXVIDLWGHODPHOOHVILEUHXVHV
/HV OLJDPHQWV ORQJLWXGLQDX[ FRPPXQV DQWpULHXU HW SRVWpULHXU HQWRXUHQW OH
GLVTXHjVDSpULSKpULH/HOLJDPHQWFRPPXQSRVWpULHXUHVWULFKHPHQWLQQHUYp
/H GLVTXH DVVXUH OD VWDELOLWp YHUWpEUDOH GX IDLW GH OD WUDPH VHUUpH GHV ILEUHV
DQQXODLUHV SHUPHW SDU VRQ FDUDFWqUH GpIRUPDEOH OD PRELOLWp GX UDFKLV LO
DPRUWLWOHVFKDUJHVHWOHVFKRFV
/DGpWpULRUDWLRQGXGLVTXHVXUYLHQWGHIDoRQSK\VLRORJLTXHjSDUWLUGH
DQV " PDLV HVW DFFpOpUpH SDU OHV WUDXPDWLVPHV OHV HIIRUWV UpSpWLWLIV
SURIHVVLRQQHOV RX VSRUWLIV O¶REpVLWp OD GpILFLHQFH GH OD PXVFXODWXUH ORPER
DEGRPLQDOHOHVWURXEOHVVWDWLTXHVGXUDFKLVOHVDIIHFWLRQVPpWDEROLTXHV$X
QLYHDX GX QXFOHXV RQ D XQH GpJpQpUHVFHQFH ILEUHXVH IUDJPHQWDWLRQ HW
DWURSKLH$XQLYHDXGHO¶DQQXOXVRQDO¶DSSDULWLRQGHILVVXUHVGDQVOHVTXHOOHV
SHXYHQW PLJUHU GHV IUDJPHQWV GH QXFOHXV F¶HVW OD KHUQLH GLVFDOH 6RXV OD
SRXVVpH GH OD KHUQLH OH OLJDPHQW FRPPXQ SRVWpULHXU HVW UHVSRQVDEOH GH OD
GRXOHXU UDFKLGLHQQH HW GH OD FRQWUDFWXUH UpIOH[H F¶HVW OH OXPEDJR &HWWH
KHUQLHGLVFDOHHQWUDvQHODFRPSUHVVLRQG¶XQHUDFLQHQHUYHXVH&HFRQIOLWGLVFR
UDGLFXODLUH HVW j O¶RULJLQH GH OD VRXIIUDQFH GH O¶pOpPHQW QHUYHX[ F¶HVW OD
VFLDWDOJLH /D KHUQLH HVW UDUHPHQW PpGLDQH OH SOXV VRXYHQW ODWpUDOH
FRPSULPDQWOD UDFLQHSDVVDQW HQ UHJDUG SDUIRLVOD KHUQLH JDJQH OH WURX GH
FRQMXJDLVRQ\SpQqWUHKHUQLHIRUDPLQDOHRXPrPHOHGpSDVVHKHUQLHH[WUD
IRUDPLQDOH 'DQV TXHOTXHV FDV OD KHUQLH SHXW PLJUHU DX GHVVXV RX DX
GHVVRXVGHO¶HVSDFHGLVFDO
'H JURVVHV KHUQLHV VRQW UHVSRQVDEOHV GH FRPSUHVVLRQ GH SOXVLHXUV UDFLQHV
HQWUDvQDQWXQV\QGURPHGHODTXHXHGHFKHYDOGHVFDV5DUHPHQWOD
KHUQLHSHXWSHUIRUHUODGXUHPqUHHWVHORFDOLVHUHQLQWUDGXUDO
',$*1267,&326,7,)
&OLQLTXH
,QWHUURJDWRLUHSUpFLVHOHWHUUDLQkJHSRLGVWDLOOHSURIHVVLRQOHVDQWpFpGHQWV
ORPEDOJLHV OHV FDUDFWqUHV GH O¶pSLVRGH DFWXHO DQFLHQQHWp OHV
FLUFRQVWDQFHVGpFOHQFKDQWHVPRGHGHGpEXWOHWUDMHWUDGLFXODLUH/RX6
O¶LQWHQVLWpGHODGRXOHXUOHU\WKPHGHODGRXOHXUTXLHVWPpFDQLTXHV¶DVVXUH
GHO¶DEVHQFHGHWURXEOHVVSKLQFWpULHQVHWGHWURXEOHVPRWHXUV
([DPHQ UHFKHUFKH DWWLWXGH DQWDOJLTXH GH GLPLQXWLRQ GH OD PRELOLWp
UDFKLGLHQQH GH ]RQH pOHFWLYHPHQW GRXORXUHXVH j OD SUHVVLRQ GH GpILFLW
PRWHXUGHGpILFLWVHQVLWLIG¶DQHVWKpVLHHQVHOOHGHWURXEOHVGHVUpIOH[HVGH
GRXOHXU j O¶pOpYDWLRQ GX PHPEUH LQIpULHXU VLJQH GH /DVqJXH VL ƒ IRUWH
FRPSUHVVLRQUDGLFXODLUH
&RPSOpWHUO¶H[DPHQVRPDWLTXH
3DUDFOLQLTXH
+pPRJUDPPHHW96VRQWQRUPDX[
5;GXUDFKLVYpULILHO¶LQWpJULWpGXVTXHOHWWHRVVHX[SUpFLVHOHVLqJHGXFRQIOLW
GpSLVWHXQHDQRPDOLHFRQJpQLWDOH
7UDLWHPHQW
'HYDQW XQH VFLDWLTXH G¶LQWHQVLWp PR\HQQH HW VDQV UHWHQWLVVHPHQW
QHXURORJLTXHOHWUDLWHPHQWHVWDYDQWWRXWPpGLFDO
5HSRV
$QWDOJLTXHV$,16 P\RUHOD[DQWVLQILOWUDWLRQVGHFRUWLFRwGHV
*pQpUDOHPHQW OD GRXOHXU V¶DPHQGH /D SUpYHQWLRQ GHV UpFLGLYHV UHSRVH VXU
XQH UHSULVH SURJUHVVLYH GH O¶DFWLYLWp SURIHVVLRQQHOOH DVVRFLpH j GH OD
UppGXFDWLRQ NLQpVLWKpUDSLTXH SRXU DFTXpULU OHV ERQV JHVWHV HQ SDUWLFXOLHU OH
YHUURXLOODJHORPEDLUH
(Q FDV GH SHUVLVWDQFH GH OD VFLDWLTXH PDOJUp XQ WUDLWHPHQW PpGLFDO ELHQ
FRQGXLWXQWUDLWHPHQWFKLUXUJLFDOHVWLQGLTXp
)250(6&/,1,48(6
6FLDWLTXHV© FKLUXUJLFDOHV ªG¶RULJLQHGLVFDOH
&HUWDLQHVIRUPHVGHVFLDWLTXHSHXYHQWFRQGXLUHUDSLGHPHQWjXQHFKLUXUJLH
7DEOHDX[FOLQLTXHV
6FLDWLTXHVK\SHUDOJLTXHV
6FLDWLTXHVDYHFWURXEOHVPRWHXUV
6FLDWLTXHVDYHFV\QGURPHGHODTXHXHGHFKHYDOGpILFLWSOXULUDGLFXODLUHDYHF
DXPD[LPXPSDUDO\VLHGHVPHPEUHVLQIpULHXUVDQHVWKpVLHHQVHOOHWURXEOHV
VSKLQFWpULHQV
%LODQUDGLRORJLTXH
7'0 SHUPHW GH YRLU OD KHUQLH O¶DUWKURVH SRVVLEOH FDQDO pWURLW V¶DVVXUH GH
O¶DEVHQFHGHWXPHXU
,50 SRXUGpWHUPLQHUDSUqVFKLUXUJLHVLILEURVHRXUpFLGLYHVLFRQWLQHQFHGX
OLJDPHQWYHUWpEUDOFRPPXQSRVWpULHXU
5DGLFXORJUDSKLH XWLOHGDQVO¶pYDOXDWLRQG¶XQHGRXOHXUDSUqVFKLUXUJLHILEURVH
RXUpFLGLYHUpDOLVDWLRQGHFOLFKpVG\QDPLTXHVHQSRVLWLRQGHERXW
7UDLWHPHQW
&KLUXUJLH GpERXFKH VXU XQ FXUHWDJH GLVFDO HW RX IRUDPLQRWRPLH /D
UppGXFDWLRQHQFHQWUHVSpFLDOLVpHVWXWLOH
&RPSOLFDWLRQVGHODFKLUXUJLH UDUHV
LPPpGLDWHV EUqFKHV GXUDOHV DYHF IXLWHV GH /&5 IDX[ N\VWHV
DUDFKQRwGLHQV SODLHV GH UDFLQHV SODLHV YDVFXODLUHV DUWqUH LOLDTXH
SULPLWLYH j O¶RULJLQH G¶XQ FKRF KpPRUUDJLTXH RX DERXWLVVDQW j OD
ILVWXOH DUWpULR YHLQHXVH GH GpFqV SODLHV YLVFpUDOHV LOpRQ
FRORQDSSHQGLFHXUHWqUHYHVVLH
jFRXUWWHUPH LQIHFWLRQVSDULpWDOHVVSRQG\ORGLVFLWHVGHVFDV
FRPSOLFDWLRQVYHLQHXVHVWKURPERHPEROLTXHV
j ORQJ WHUPH UpFLGLYH PrPH F{Wp PrPH QLYHDX GHV FDV
1RXYHOOHKHUQLHjXQpWDJHDGMDFHQWGHVFDV
&KLPLRQXFOpRO\VH RXQXFOpRO\VHODVHU VXMHWV MHXQHVKHUQLHV QRQ FDOFLILpHV
QRQH[FOXHVGHYROXPHPRGpUp
$XWUHVIRUPHVFOLQLTXHVG¶RULJLQHGLVFDOH
6FLDWLTXHVWURQTXpHV
6FLDWLTXHVELODWpUDOHVVRXYHQWSDUKHUQLHPpGLDQH
6FLDWLTXHVjEDVFXOH
6FDLWLTXHV GH ODIHPPH HQFHLQWHIDYRULVpHSDU K\SHUORUGRVH OH UHOkFKHPHQW
ILEUROLJDPHQWDLUHODSULVHGHSRLGV
6FLDWLTXHV DSUqV FKLUXUJLH ILEURVH UpDFWLRQQHOOH FRH[LVWHQFH GH OpVLRQV
DUWKURVLTXHVQRQUpVpTXpHV
6FLDWLTXHVUDGLFXODLUHVG¶RULJLQHQRQGLVFDOH
$UJXPHQWV GpEXW VSRQWDQp U\WKPH LQIODPPDWRLUH DOWpUDWLRQ GH O¶pWDW
JpQpUDO96pOHYpHDQWpFpGHQWVGHQpRSODVLH
1pRSODVLTXH PpWDVWDVH GHFDQFHURVWpRSKLOHVHLQ SRXPRQSURVWDWH UHLQ
WK\URwGH KpPRSDWKLHV PDOLJQHV WXPHXUV SULPLWLYHV EpQLJQHV RX PDOLJQHV
pSLGXULWHFDUFLQRPDWHXVH
,QIHFWLHXVHV VSRQG\ORGLVFLWHV
'DQV OH FDGUH G¶XQ FDQDO ORPEDLUH pWURLW RX G¶XQ VSRQG\OROLVWKpVLV
FRPSOLTXDQWXQHDUWKURVHLQWHUDSRSK\VDLUHSRVWpULHXUH
6FLDWLTXHVWURQFXODLUHV
'XHjXQHDWWHLQWHGXWURQFGXQHUIVFLDWLTXHG¶RULJLQHWUDXPDWLTXHIUDFWXUH
GX EDVVLQ KpPDWRPH IHVVLHU FRPSUHVVLYH WXPRUDOH EpQLJQH RX PDOLJQH
SHOYLHQQHSRVWUDGLTXH
&(48¶,/)$875(7(1,5
/D VFLDWLTXH HVW XQ V\PSW{PH UHFRXYUDQW SOXVLHXUV pWLRORJLHV GRQW OHV
pWLRORJLHVQpRSODVLTXHV
/¶LQGLFDWLRQ FKLUXUJLFDOH HVW SRUWpH GHYDQW XQH VFLDWLTXH UpVLVWDQW DX
WUDLWHPHQW PpGLFDOXQHVFLDWLTXHGpILFLWDLUHVXU OD SODQPRWHXURXGHYDQW XQ
V\QGURPHGHODTXHXHGHFKHYDO
/H U{OHLQILUPLHU 'pSLVWHUOHVWURXEOHVPRWHXUV
'pSLVWHUOHVWURXEOHVVSKLQFWpULHQV
$SUqVLQWHUYHQWLRQYHLOOHUjFHTXHOHSDWLHQWQHV¶DVVH\HSDVTX¶LOUHVSHFWH
OHVFRQVLJQHVGHYHUURXLOODJHORPEDLUH

Documents pareils

Les hématomes intra-cérébraux

Les hématomes intra-cérébraux /RUV GH OD IRUPDWLRQ G¶XQ KpPDWRPH O¶K\SHUSUHVVLRQ ORFDOH HQWUDvQH OD UXSWXUH GHV DUWpULROHV HW FDSLOODLUHV VLWXpV DX YRLVLQDJH LPPpGLDW GX IR\HU LQLWLDO HQWUDvQDQW O¶H[WHQV...

Plus en détail

La hernie discale cervicale

La hernie discale cervicale UpWURSXOVLRQHWODURWDWLRQH[WHUQHGXEUDVWrWHWRXUQpHGXF{WpVDLQ

Plus en détail

La myélopathie cervico arthrosique

La myélopathie cervico arthrosique )RUPHpYROXDQWSDUSRXVVpHV 6(3

Plus en détail