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Opaleshoni Yogwiritsa Ntchito Zizindikiro za RadiculopathyKachilombo koyambitsa matenda a chiberekero kangakhale kobvuta kunena, koma ngati mwakumanapo, mukudziŵa bwino zizindikiro zake. Izi zimaphatikizapo kupweteka, kufooka, kufooka ndi / kapena mphamvu zamagetsi zomwe zimatsika pansi.
Kachilombo ka radialpathy ndi chikhalidwe chomwe chimapangitsa kuti m'mimba mwanu mumphuno umodzi wa mitsempha wambiri umakhumudwitse kapena kupanikizika. Zitha kuyambitsa matenda a herniated, nyamakazi yamtsempha kapena stenosis kapena zina.
Mizu ya mitsempha ya m'mimba ndi mitsempha ya mitsempha yomwe imatuluka m'kati mwake. Pali mbali imodzi kumbali iliyonse ya msana. Kuchokera muzu, mitsempha ya ming'alu imafika kumadera onse a thupi kuti ikatumizire mauthenga a zowawa komanso kuyenda.
Kodi mukufunikira opaleshoni ya radiosispathy?
Yankho laling'ono ndilo, ngakhale malinga ndi kafukufuku wa chiberekero cha chiberekero cha 2011, chofalitsidwa ndi chipatala cha opaleshoni yapadera (m'magazini yawo) nthawi zambiri, odwala amatha bwino popanda.
Olembawo akuti onse opaleshoni osachita opaleshoni angathandize odwala kupewa njira zowonongeka.
Koma, amati, opaleshoni ikhoza kukhala yofunikira pamene radiculopathy yanu ikuphatikizidwa ndi kuwonongeka kwa kayendedwe kapena kupweteka kopweteka kumene sikungayang'anire chisamaliro chosamalidwa, kapena kupita kwa nthawi.
Zifukwa zina zoyenera kuchitidwa opaleshoni, zomwe olembawo amavomereza, ndizoti zizindikiro za radiculopathy zimalephera ndipo khosi lanu limakhalanso losakhazikika.
Ngati zina mwa zochitikazi zikufotokozera zomwe mwakumana nazo, mungafunike kudziwa kuti ma opaleshoni amtundu wanji amachitidwa kawirikawiri kwa anthu omwe ali ndi kachilombo koyambitsa matendawa. Kuwongolera kumene tatchula pamwambapa kumalongosola mitundu iwiri ya njira zowonongeka. Izi zikufotokozedwa pambuyo pake m'nkhaniyi.
Mtundu wachitatu wa opaleshoni, disc arthroplasty, ndi watsopano, koma umasonyeza malonjezo ambiri. Tidzakambirana za izi.
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Disc Arthroplasty - Kodi Muyenera Kupitiriza Kusunthira Mumsana?Dokotala arthroplasty, limodzi mwa mayina ambiri operekedwa opaleshoni yowonongeka, ndi njira yatsopano yothetsera kuchepetsa zizindikiro za radiculopathy. Amagwiritsidwa ntchito kwambiri m'khosi kusiyana ndi kumbuyo kwenikweni, ngakhale kupanga zipangizo zamakono zochepetsera kumbuyo kumakhalanso makampani amphamvu. Mwina chifukwa chake magulu ambiri amtundu wa arthroplasties amachitika m'khosi kusiyana ndi kumbuyo kwake ndi kuti khosi limadzipangira kumbuyo, kapena kutsogolo, kumene opaleshoni ambiri amawakonda. (Izi zikufotokozedwa mwatsatanetsatane mu gawo lotsatira.)
Monga momwe dzina limasonyezera, mu ndondomeko yotsatiramo, pulojekiti yomwe imapangidwira kufanana ndi mawonekedwe a masoka achilengedwe imalowetsedwa kuti ikhale m'malo mwa yomwe yatha. N'zoona kuti deta yakale imachotsedwa, ndipo deralo liyeretsedwe musanayambe kujambula.
Disc arthroplasty imatchedwanso "opaleshoni yoyendetsa msana." Mitundu yowonjezera yowonjezera yowonjezereka imaphatikizapo kusakaniza dera, zomwe zimachotsa mwayi wokasuntha dera lomwelo kachiwiri, pokhapokha ndondomekoyo itatha.
Koma ndi chidziwitso chojambula, chiwongolerochi chiyenera kusungidwa. Koma pakuzindikira malonjezano opulumutsidwa otsimikiziridwa sizitsimikiziridwa kuti ndizitsiru, ndipo nkutheka kuti mungachite opaleshoniyi ndipo mutulukamo simungathe kusuntha khosi lanu.
Mofananamo ndi njira zina zamagulu, zimagwiritsidwa ntchito pokonzetsa ma discolore pofuna kuthetsa ululu wa chiberekero ndi ululu wa discogenic. Amagwiritsidwanso ntchito pa opaleshoni yowonanso.
Kodi Arthroplasty Yotani Amagwirizanitsa ndi Zovala Zowonjezera Zambiri?
Kodi disc ya arthroplasty ndiyo njira yabwino kwambiri yoyesera ndi yowona msana?
Pulezidenti adakalipobe, koma akatswiri pa lipoti la Medscape kuti, kuyambira chaka cha 2014, palibe umboni wokhalapo wosonyeza kuti kusunga kayendetsedwe kameneka - mwayi waukulu woperekedwa ndi otsutsa - zotsatira zopewa, kapena kuchepetsa kusintha kosasintha pamwamba ndi pansipa malo opaleshoni.
Kutentha kwa mtundu umenewu kumatchedwa gawo loyandikana nalo kapena ASD , ndipo chiopsezo chake ndi mfundo yokakamiza ya opaleshoni ina. Kuchepetsa kuthekera kwa ASD kuwonetsetsa m'magulu pamwamba kapena pansi pa malo oyambirira otsekemera msana ndi, malingana ndi otsutsa otsutsa, chifukwa disc arthroplasty inakhazikitsidwa poyamba.
Kuchokera nthawi imeneyo, maphunziro ochuluka a kafukufuku ndi ndemanga za maphunziro atulutsidwa. Kafukufuku wa zotsatira za nthawi yaitali ya disc arthroplasty yomwe inafalikira mu June 2016 ya Spine inapeza kuti zaka 7 ndi 10 zogwiritsidwa ntchito, zipangizozi zidakalibe ntchito ndipo zotsatira za arthroplasty zinali zofanana ndi za njira zamakono za ACDF za radiculopathy zizindikiro, nthawi yomweyo.
Kafukufuku wina wa Shangguan, wofalitsidwa mu magazini ya March 2017 ya PLoS One , adapeza kuti disc arthroplasty yafupikitsa nthawi yomwe odwala anali opaleshoni, ndipo zinapangitsa kuti azitha kuyenda bwino pa malo opaleshoni.
Zina kusiyana ndi miyeso iwiriyi, zotsatira za opaleshoni zowonjezera zowonjezera zinali zofanana kapena zofanana ndizo za ACDF, koma osati bwino. Miyeso imeneyi ikuphatikizapo kuchuluka kwa magazi panthawi ya ndondomeko, kupweteka kwa khosi ndi mkono kumbuyo, komanso mavuto, otchedwa "zochitika zovuta" zomwe zimadzera pambuyo pake, komanso pambuyo pake.
Ndipo potsiriza, nthawizina sizingakhale zophweka ngati kukhala ndi dala limodzi lokha m'malo mwake. Kawirikawiri anthu omwe ali ndi kachilombo ka radiosis kapena ululu womvetsa chisoni amafunika kukonza pa mlingo umodzi.
Kufufuza kwa 2017 komwe kunafalitsidwa mu European Spine Journal yomwe inafotokoza disc arthroplasty ndi ACDF pambali ziwiri zoyandikana zinapeza njira zomwe zingakhale zofanana mogwirizana ndi zotsatira zowonjezera. Izi zinkati, odwala omwe amayendayenda anali abwino kwambiri mwa iwo omwe anali ndi diski yawo m'malo mwake.
Koma ngakhale ndi zotsatira izi, olembawo amachenjeza kuti kugwiritsa ntchito chipangizo m'malo mwa msinkhu umodzi wa msana kumawoneka "kutsutsana."
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Anterior Cervical Discectomy ndi popanda FusionAnterior Cervical Discectomy
Choyamba, ndipo chowoneka chofala kwambiri, opaleshoni ya zizindikiro za pulogalamu ya radiculopathy ndi kachilombo koyambitsa matenda a chiberekero, aka ACD. Mu opaleshoniyi, diski imachotsedwa kuti itithandize kuthetsa mavuto pa mizu ya msana.
Ndipo monga tidzakambirana za m'munsimu, kusakanikirana kumagwirizananso ndi ACD ndipo pamtundu umenewu, mawuwa ndi ACDF.
Kachilombo kameneka kameneka kameneka ndi njira imene dokotalayo amathyola m'khosi kuchokera kutsogolo (kummero kummero, kuti azikhala molondola) kuti afikitse ndi kuchotsa ma discrettebral disc. M'kati mwa chiberekero cha cervical discectomy, minofu ya khosi imachotsedwa kutali kuti iwononge nyumba zingapo, monga, trachea, eophagus, disc, ndi mafupa a msana.
Olemba a ndemanga omwe tamutchula poyamba aja amanena kuti kawirikawiri madokotala ochita opaleshoni amasankha njira yoyenera chifukwa imapereka mpata wabwino kwambiri wobwezeretsa khola lachibadwa, kuti zikhazikitse msana komanso kuti zimasokoneze mitsempha ya msana.
Anterior Cervical Discectomy ndi Fusion
Kuchulukanso kwa chiberekero kumatuluka ndi popanda kusakanikirana, koma madokotala ambiri opaleshoni amakonda kupusitsa.
Izi zinati, "kusokoneza kapena kusagwirana ntchito" chisankho cha opaleshoni ya ACD ya 1 kapena 2 ndizovuta pakati pa akatswiri a msana. Phunziro la 2016 lofalitsidwa mu Journal of Neurosurgery: Zamphepete zinapeza kuti magulu ochulukirapo amakhala opunduka ndi osakanizidwa, ndizoopsa kwambiri pa khosi la pakhosi ndi ululu wa mkono komanso mavuto ena.
Kuikidwa kwa hardware, mwachitsanzo, mbale, zolembera, zojambula ndi zina zomwe ndikuthandizira mwayi wanu wophatikizidwa bwino, malinga ndi olembawo. Olembawo akunena kuti hardware ingathandize kuchepetsa mavuto omwe amapezekapo (kyphosis, makamaka) komanso mavuto ena amtundu wa mafupa.
Kawirikawiri mukakhala ndi msinkhu umodzi, dokotala wanu adzagwiritsa ntchito mbale yamkati. Izi ndizothandiza kuti mutetezeke komanso kuti muteteze bwino.
Koma mavuto akhoza ndipo zimachitika. Pachifukwachi dokotala wanu anganene kuti achotsedwe ku hardware yakale kuchokera ku opaleshoni ya ACDF, yomwe idzafunikanso njira yowonongeka.
Kodi Muyenera Kuvomerezeka ku Fusion ?
Ili ndi funso lonyenga limene limadalira zinthu zosiyanasiyana. Apanso, ngati dokotala wanu akugwira ntchito pa msinkhu umodzi wokha wa msana wanu, yankho lanu likhoza kukhala inde. Koma kafukufuku wa 2012 wofalitsidwa mu Open Orthopedic Journal anapeza zochepa, ngati pali kusiyana pakati pa zotsatira kuchokera ku ACD ndi ACDF. Ofufuza omwewo adapeza umboni wochepa wokha wophatikizidwa ndi ACD (mwachitsanzo, ACDF) opaleshoni inapanga zotsatira zabwino zopaleshoni kuposa zonse za ACD.
Ndi bwino kukambirana zomwe mwasankha ndi madokotala anu opaleshoni bwino, ndipo mutenge kachiwiri ngati muli ndi mafunso kapena nkhawa pa chisankho chofunika ichi.
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Laminoforaminotmy kwa Zizindikiro za Radiculopathy za ChiberekeroOpaleshoni yowonjezereka yowonjezereka ya radiosispathy, yotchedwa posterior cervical laminoforaminotomy, imatenga njira yobwerera, kapena yobwerera.
About Laminoforaminotmy kwa Zizindikiro za Kachilombo ka Radiculopathy Zizindikiro
Musanachoke pa nthawi yoopsyayi, tiyeni tisiyane kuti tidziwe zomwe zimachitika. Monga tafotokozera kale, kumbuyo kumatanthauza njira yochokera kumbuyo, ndipo chiberekero chimatanthauza khosi lanu. Njira yowonongeka - njira yowonongeka koma osati kuchotsa.
Mawu akuti "lamino" ndi "foramino" amatanthauza malo a msana wam'mimba ndi / kapena khola.
La lamina ndi gawo la mphete ya bony kumbuyo kwa vertebra. La lamina limayendayenda pambali imodzi ya vertebra, kumunsi, pambali imodzi, ya utoto wa kumbuyo.
Mawu akuti foramina amatanthauza dzenje, ndipo pamene akulankhula za msana, amatanthauza mabowo kumbali zonse za mzere wa msana pamagulu onse, opangidwa ndi awiri awiri oyandikana nawo, omwe amadzipangira (1 pamwamba ndi 1 m'munsi).
Nyumba ya foramina mitsempha ya msana, ndipo lamina ndi gawo la fupa lomwe limapanga denga ndi pansi pa foramina.
Ikani Zonse Pamodzi Pamodzi - Kodi Laminoforaminotomy Ndi Chiyani?
Kuzibwezeretsanso kachiwiri, mawu akuti posterior cervical laminoforaminotomy ndi njira imene dokotala amalowerera kumbuyo kwa khosi kuti alowemo, koma osati kuchotsa chimodzi, ziwiri kapena zonsezi m'mphepete mwa msana; Izi zikanakhala lamina, yomwe ili kumbuyo kwa fupa la munthu, komanso chimodzi kapena zingapo m'mabowo pambali.
Ndondomekoyi yachitidwa kuti muthetse mitsempha. Cholinga cha opaleshoni ndicho kulola mitsempha kudzera mwa foramina kuti ichitike mosayembekezereka. Pochotsa mafupa mu lamina ndi / kapena foramina , msana umatchedwanso "decompressed."
Njira Yoposera Yopereka Opaleshoni - Ubwino
Phindu logwiritsa ntchito njira yochepetsetsa ndikuti kusakanikirana sikofunikira ndipo dokotalayo akhoza kusunga bwino msinkhu ndi kuyanjana.
Vutoli ndilo kuchuluka kwa kuponderezana komwe kungakhoze kuchitidwa pa opaleshoni ngati iyi ili yochepa. Chifukwa chake, malinga ndi ndemanga zomwe tazitchula pamwambapa, kugwiritsidwa ntchito bwino kwa njira yowonjezera kungakhale kuchotsa zidutswa zofewa zomwe zimayambitsa matenda osokoneza ubongo m'mimba , zomwe zimatha komanso zimayambitsa matendawa.
Mukafika pazimenezi, kusankha kwa opaleshoni kumakhudzana kwambiri ndi njira ya opaleshoni ya opaleshoniyo komanso kuthekera kwa kusunga mgwirizano wa msana ndi nthawi yoyenera, ndemanga imatsiriza.
Zotsatira
Botelho, Richardo, V., ndi. al. Kusankha kwa Opaleshoni Yabwino Pambuyo pa Mngelo Wokhazikika Pamtundu Wachiberekero Wamtundu wa Disbectomy: Kusanthula Mwadongosolo. Tsegulani Orthop J. Mwezi wa 2012. Zakafika pa Jan 2016.
Caridi, John M., MD, Pumberger, Matthias, MD, Hughes, Aleksandro, P., MD Cervical Radiculopathy: Kubwereza. Chipatala cha Opaleshoni Yapadera. Sept. 2011. Kufikira Jan 2016.
> Zotsatira za Sasso W. Zakale Zomwe Mayi Akukumana nazo Pachilombo cha Cervical Arthroplasty: Cholinga, Chokhazikika, Chokhazikitsidwa. Mphepete. June 2016. https://www.ncbi.nlm.nih.gov/pubmed/27333341
> Shangguan, L. Dziwani za cervical disc arthroplasty motsutsana ndi chiberekero cha cervical discectomy ndi kusakanikirana ndi matenda a chiberekero: • Meta-analysis. PLoS One. March. 2017 https://www.ncbi.nlm.nih.gov/pubmed/28358860
> Zou, S. Anterior cervical discectomy ndi fusion (ACDF) motsutsana ndi chiberekero cha discord arthroplasty (CDA) pa zigawo ziwiri zomwe zimayambitsa matenda opatsirana pogonana: chidule cha mayesero olamuliridwa mosavuta. Eur Spine J. April 2017 https://www.ncbi.nlm.nih.gov/pubmed/27314663