Mukapeza opaleshoni ya kumbuyo, ndikuganiza kuti nthawi yatha, chinthu chomaliza chomwe mukuyembekezera ndi vuto lina. Tsoka ilo, pafupifupi opaleshoni iliyonse imabwera ndi chiopsezo cha mavuto , zomwe zingakuchititseni kupweteka kapena zizindikiro zina pambuyo pake. Chinthu chimodzi choterechi cha opaleshoni ya msana ndi epidural fibrosis, kapena kupweteka pa malo opaleshoni.
Mwachidule
Epidural fibrosis ndi dzina loperekedwa kwa scarring limene limapezeka pambuyo pa opaleshoni ya kumbuyo.
Ndi chimodzi mwa zifukwa zingapo zomwe zimayambitsa matenda omwe amalephera kuchitidwa opaleshoni (chilembo: FBSS.) Epidural fibrosis ndiye chifukwa chowopsya cha onse; amapezeka mpaka 91 peresenti ya odwala opaleshoni yotsatira.
Koma pali uthenga wabwino: Epidural fibrosis sizimabweretsa ululu kapena zizindikiro zina nthawi zonse. Ndipotu, kwa anthu ena, sizimakhudza miyoyo yawo ya tsiku ndi tsiku kapena kupweteka konse. Phunziro la 2015 lomwe linatulutsidwa mu nyuzipepala Insights Imaging linapeza kuti funso loti kaya zizindikiro zikuwoneka bwanji kapena zingakhale zogwirizana ndi momwe kufalikira kuliri.
Phunziro lina la 2015, nthawiyi lofalitsidwa mu Asian Spine Journal, linapeza kuti epidural fibrosis ingawononge kupweteka kwa anthu 36 peresenti omwe ali ndi vuto la opaleshoni lakumbuyo. Ndipo pamene 36 peresenti ndi chiwerengero chachikulu cha odwala, ndi kutalika kwa 91 peresenti.
Epidural fibrosis ndi ofanana ndi matenda osiyana siyana kusiyana ndi arachnoiditis .
Choyamba, epidural fibrosis imakhudza chitseko chamtundu wa msana (chimanga chokhazikika,) pamene arachnoiditis imapita kumalo ozama kwambiri mu arachnoid nembanemba. Mofanana ndi nsalu yapamwamba pamwamba pake (komanso pansi pamtundu) pansi pamtundu wa arachnoid ndipo imateteza mitsempha yomwe imakhala ndi msana.
Kusiyanasiyana kwina ndikuti epidural fibrosis imayambitsidwa ndi opaleshoni ya kumbuyo; koma opaleshoni yammbuyo ndi chimodzi mwa zifukwa zingapo zomwe zimayambitsa arachnoiditis. Ndipo potsiriza, kutupa kungakhale chomwe chimayambitsa minofu yowopsya, yomwe ingabweretse mitsempha ya msana-yowawa kwambiri komanso yovuta kuchiza.
Mapangidwe
Kodi nchiyani chomwe chikuchitika pa msana wanu mukapeza kachilombo kakang'ono? Yankho limeneli, kawirikawiri, limagwirizana ndi malo a msana wanu wotchedwa mitsempha ya msana.
Ma opaleshoni ambiri omwe amaperekedwa chifukwa cha kupweteka kumbuyo ndi kupweteka mwendo ndi laminectomy (wotchedwanso opaleshoni yachinyengo ) kapena discectomy . Njira ziwirizi zimapangidwira kuthetsa mavuto a mitsempha ya msana pamene imachokera mu msana. (Kuvulala monga disk ya herniated , komanso kusintha kosasintha kwa msana kungapangitse zipangizo zosiyanasiyana-monga zidutswa zogawanika kapena mafupa osakanikirana, ndi okhumudwitsa, mizu ya mitsempha.)
Izi zikutanthawuza kuti nthawi zambiri, opaleshoni ya msana ikugwira ntchito pafupi ndi dera lanu la mitsempha. Chifukwa chakuti adzalingalira kuchotsa zinthu (zidutswa zazing'ono zomwe sizinalipo kapena fupa la fupa lomwe likuyandikira kwambiri mitsempha), ndiye kuti adzakhala okondweretsa kwambiri.
Chifukwa chaichi, bala lidzapangidwa monga gawo la opaleshoni yanu.
Kuwopsya ndizochitika mwachibadwa pa chilonda chilichonse chimene chimasokoneza thupi, ndipo dera lozungulira mitsempha yanu ya msana pakapita opaleshoni ndi chimodzimodzi. Zomwezo ndizofanana ndi zomwe zimachitika mukagwada; Mwa kuyankhula kwina, chitukuko cha epidural fibrosis chikufanana ndi nkhanambo yomwe imapanga bondo pambuyo povulaza koyamba. Nkhanambo, ndi epidural fibrosis, ndizochirengedwe zachilengedwe.
Kupweteka kwapadera kumachitika pakati pa masabata 6 ndi 12 mutatha opaleshoni.
Njira
Tiyeni tifufuze pang'ono kuti timvetsetse machiritsowa pamene akugwiritsidwa ntchito ku disectomy kapena laminectomy.
Pambuyo pa opaleshoni ya kumbuyo, zinthu zambiri zingachitike pansi pa nyumbayi.
Choyamba, chimodzi mwa zigawo zitatu za msana wako (chophimba chamkati chomwe chimatchedwa "malo osungira") chingathe kuumirizidwa. Chachiwiri, imodzi kapena zingapo za mitsempha yanu ingakhale "yothamanga" (mwachitsanzo, womangirizidwa.) Ndipo chachitatu, chifukwa cha zinthu ziwiri kapena zonsezi, magazi opatsirana mu mitsempha ndi / kapena ubongo wa spinal madzi amasiya. Cerebrospinal fluid, yomwe imadziwikanso ndi CSF, ndi madzi omveka bwino, omwe amazungulira pakati pa ubongo ndi msana pamsana pakati pa arachnoid mater ndi omwe amamera. Ntchito yake ndi kumangirira ndi kuteteza zigawo za pakatikati zamanjenje (zomwe zimapangidwa ndi ubongo ndi msana) zokhazokha.
Pofika m'chaka cha 2016, ofufuza akukambiranabe momwe, komanso ngakhale, kupweteka kwa msana kapena pafupi ndi mitsempha ya msana kumagwirizana ndi kupweteka ndi zizindikiro zina mukhoza kuuza dokotala wanu zachipatala mutatha opaleshoni yanu. Nkhaniyi mu Asian Spine Journal yomwe yatchulidwa pamwambapa inapeza kuti olemba ena amati palibe ayi-awiriwo sanena chilichonse. Koma ena, a Asian Spine Journal amavomereza, atsimikiza kuti kufalikira kwina ndi kuzungulira mitsempha ya mitsempha (mosiyana ndi nsalu zomwe zimatchulidwa kumadera amodzi) zimakhala ndi ubale ndi zizindikiro.
Ether njira, pamene mabala apanga, palibe mankhwala enieni abwino. Dokotala wanu angafune kubwereranso ndikutsuka zipserazo ndi endoscope, koma izi zingapangitse kuti zikhale zovuta kwambiri komanso zowopsya.
Pachifukwa ichi, njira yabwino yoperekera epidural fibrosis ndikuteteza, kapena kuchepetsa kupangidwe kwa chilonda.
Mmene njirayi ingakhalire pakalipano, mu 2016, ikugwira ntchito mufukufuku, makamaka pa zinyama m'malo mwa anthu. Maphunzirowa amayesa mankhwala kapena zipangizo makamaka pa makoswe, ndiyeno kuyerekeza ziphuphu ndi gulu la gulu lolamulira (makoswe omwe sapeza mankhwala kapena zipangizo zomwe zimagwiritsidwa ntchito kwa iwo.)
Degree
Chinthu chimodzi chimene sayansi yakhala ikugwirizana ndi zizindikiro ndi ululu ndi mlingo wa fibrosis. Epidural fibrosis ikhoza kugwiritsidwa ntchito kuchokera ku 0, yomwe imayimira minofu yachibadwa yomwe ilibe kachilombo konse ku Gawo lachitatu. Gawo lachitatu ndilo vuto lalikulu la fibrosis, lomwe lili ndi minofu yomwe imatenga 2/3 ya dera lomwe linagwiritsidwa ntchito ( pa vuto la laminectomy.) Kalasi 3 imatha kuwonjezereka ku mitsempha ya mitsempha, pamene Maphunziro a 1 ndi 2 sakuchita. Maphunziro atatu a ma Grade amalembedwa ndi zizindikiro ndi zopweteka kuposa ma Gulu 1 ndi 2.
Maphunziro a magulu a 1 amayamba kukhala ofatsa, ndipo amapangidwa ndi timagulu tomwe timapangidwira pamtunda, womwe uli pamtambomo womwe umatchulidwa pamwambapa. Mabala a Grade 2 ali ochepa, opitirira, ndipo amatenga zosakwana 2/3 za laminectomy. Kamodzi kaamba kafika pa Gulu lachiwiri, limakhala lopitirira, kutanthauza zochepa ngati zingwe zilipo.
Kudziwa
Dokotala wanu akhoza kulamula kuti MRI ipeze matenda enaake omwe mungakhale nawo. Vuto ndilo, nthawi zambiri, kupweteka sikungakhoze kuwonedwa ndi mtundu uwu wa mayeso ojambula ojambula. Kotero ngati muli ndi zizindikiro, ndipo MRI ikubwerera molakwika, mungafunike kupeza kachilombo ka epiduroscopy.
Epiduroscopy ndi mayesero omwe pulojekiti yanu imayikidwa mu malo ovuta kuti dokotala wanu awonetse zomwe zikuchitika mu mitsempha yanu. Ndikofunika kutenga njira yoyezetsa matenda pakalipano chifukwa ululu wanu ukhoza kukhala chifukwa cha chidziwitso china, kusiyana ndi matenda enaake. Pankhaniyi mungafunike opaleshoni ina ; koma ngati zotsatira za epiduroscopy zikuwoneka zovuta, ndipo kupweteka ndikumayambitsa zizindikiro zanu, mwayi simungasowe opaleshoni yachiwiriyo.
Chithandizo
Mwinamwake mukudabwa: Ngati opaleshoni yotsatira sichikhoza kuthetsa ululu wanu wa epdiural fibrosis, mumatani?
Monga ndanenera kale m'nkhani ino, asayansi ndi madokotala sanatuluke ndi mankhwala othandiza chifukwa cha vutoli la vuto la opaleshoni lolephera. Komabe, mankhwala amatha kuperekedwa poyamba-nthawi zambiri mogwirizana ndi mankhwala. Mankhwalawa amathandizira kupweteka komanso kuchita zolimbitsa thupi. Mankhwala operekedwa ndi mankhwalawa ndi Tylenol (acetaminophen,) NSAIDs (mankhwala osamva kupweteka kwambiri, kupweteka kwa gabapentinoids, ndi ena.
Thandizo la thupi lapangidwa kuti likupangitseni mafoni ndipo lingakhale ndi kulimbikitsa, kutambasula ndi kuchita masewera olimbitsa thupi. Kukhala ndi mafoni pamalumiki anu kungathandize kuchepetsa mapangidwe a minofu yowopsya .
Ponena za opaleshoni amapita, kafukufuku wina akufotokoza kuti kawirikawiri amakhala ndi 30 peresenti mpaka 35 peresenti ya kupambana. Osati kokha, koma phunziro lomwelo likunena kuti zizindikiro za odwala 20 peresenti zimaipiraipira. Izi zinati, njira zazikulu zothandizira opaleshoni ya epidural fibrosis ndi adhesiolysis yowonongeka ndi mapepala otchedwa endoscopy.
Pakadali pano, adhesiolysis yowonongeka ili ndi umboni wabwino kwambiri. Mu njirayi, yomwe, mwa njira, imagwiritsidwa ntchito pazifukwa zina za matenda olephera opaleshoni omwe amalephera, komanso mankhwala, omwe nthawi zambiri amamwa mankhwala a steroidal , amalowetsedwa m'deralo pogwiritsa ntchito catheter. Komanso ndi njirayi, kusinthasintha kwa zida sikofunika kuti zithetse.
Matenda a adhesiolysis amathandizidwa ndi Mbali I (umboni wapamwamba kwambiri) wokhudzana ndi mphamvu zake za matenda opaleshoni omwe amalephera kumbuyo, omwe amaphatikizapo epidural fibrosis.
Chithandizo china chomwe dokotala angakupatseni ndi msana wam'mbuyo. Mwa njirayi, chiwerengero chomwe chimalola dokotala wanu kuganiza kuti deralo laikidwa. Nthawi zina lasers amagwiritsidwa ntchito pochiza zilondazo pamene chiwerengerocho chili. Mimba yam'mimba yotchedwa endoscopy imayikidwa ngati Umboni Wachigawo Chachiwiri ndi Wachitatu, ndipo kafukufuku wina apeza kuti ili ndi umboni "wokwanira" wothandiza kuthetsa zizindikiro.
> Chitsime:
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> Helm S., Racz G., Gerdesmeyer L., Justiz R., Hayek S., Kaplan E., Terany M., Knezevic N. Okhazikika ndi Endoscopic Adhesiolysis mu Kugonjetsa Pansi Ndi Pang'ono Kwambiri Kupweteka: Kusanthula Kwambiri ndi Meta -nalysis. Pain Physician. Feb. 2016. https://www.ncbi.nlm.nih.gov/pubmed/26815254
> Helm S., Hayek S., Colson J., Chopra P., Deer T., Justiz R., Hameed M., Falco F. Spinal omwe amagwiritsa ntchito mankhwala osokoneza bongo m'mbuyo mwa matenda opatsirana opaleshoni. Pain Physician. April 2013. https://www.ncbi.nlm.nih.gov/pubmed/23615889
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> Mohi E., Abdel R. Epidural Fibrosis pambuyo pa Lumbar Opaleshoni Yopaleshoni: Kupewa ndi Kuwonetsa Zotsatira. Asia Spine J. Jun 2015. https://www.ncbi.nlm.nih.gov/pubmed/26097652