Kusintha kwa Dothi la Cervical
Zosankha, zosankha. Dokotala wanu akuti mukufunikira opaleshoni ya pamtima chifukwa mwakhala mukukumva ululu ndi / kapena mapiritsi ndi singano pansi pa mkono umodzi, osatchula zizindikiro zina zokhudzana ndi matendawa. Amakuwuzani kuti opaleshoni yowopsa kwambiri chifukwa cha matendawa ndi amtundu wa chiberekero wamtundu wa chiberekero (FDDF).
Ndipotu, ACDF ndiyeso ya nthawi yaitali opaleshoni - komanso opaleshoni yapamtima yomwe imachitika kawirikawiri.
Zokhudzana: Dziwani za ACDF
Koma ndiye doc ikudziwitsani kuti chifukwa ACDF imaphatikizapo kusakanikirana (chimodzi kapena zingapo) zigawo zosiyana siyana, mutha kupereka mphamvu pamutu wanu opaleshoni - kwathunthu. Osati kokha, akukuuzani, koma kachiwiri, chifukwa cha kusungunuka, mumayambitsa chiwopsezo chokhala pafupi.
Kenaka dokotala wanu akunena za izi kapena mwapeza pofufuza zambiri kuti njira yowonjezeredwa yothandizira ena yathandizira anthu ena, makamaka ku Ulaya.
Koma, kodi ndondomeko yamtundu wathunthu ndi yani?
Kugwiritsa ntchito chida chonsecho ndi njira yatsopano yomwe imagwiritsira ntchito njira yoyenera - zomwe zikutanthauza kuti dokotalayo akudula kutsogolo kwa khosi lanu osati mmbuyo - kuti mutenge malo anu odwala ndi chojambula. Amagwiritsidwa ntchito kuthetsa ululu wa radiosispathy ndi / kapena ululu wa discogenic. Amagwiritsidwanso ntchito pa opaleshoni yowonanso.
Zokhudzana: Kodi Traction Spurs ndi Chiyani?
Kulemba kwathunthu kwa diski kumapita ndi maina ena angapo, komanso. Izi zimaphatikizapo: Kugwiritsa ntchito ma disti, ma disti arthroplasty, totulutsa disth arthroplasty, ndi chiberekero chotchedwa arthroplasty kapena chiberekero chotsitsimutsa. Mukapangidwa kumbuyo kwenikweni, amatchedwa lumbar disc arthroplasty kapena lumbar dis replacement.
FYI, arthroplasty ndi dzina lina lolowetsa m'malo kapena kukonzanso. Zowonjezera za m'malo osungiramo zida zimaphatikizapo TDR (totengeka m'malo mwake) ndi TDA
Chinthu chimodzi chothandizira kubwezeretsa chiberekero, malinga ndi Caridi, Pumberger, Matthais, ndi Hughes (m'nkhani yawo ya 2011 yotchedwa "Cervical Radiculopathy: Review," imene inalembedwa mu nyuzipepala ya Hospital for Surgery ). kutalika pakati pa mafupa awiri oyandikana ndi msana, pamene panthaŵi imodzimodziyo akusunga luso lolowa limodzi.
Monga ndondomeko yatsopano ku US (yomwe yakhazikitsidwa kwambiri ku Ulaya,) mukhoza kudabwa ngati TDA ikugwira ntchito, ndi zomwe zili mmwamba ndi zochepa.
Kafukufuku wochuluka, kuphatikizapo bungwe lina lachipatala lachipatala lingapereke mawonekedwe obiriwira kumalo atsitsi. Mwachitsanzo, bungwe la North American Spine Society linanena kuti mufupikitsa, chifukwa chokhala ndi ubongo wosakwatiwa, ACDF ndi totally arthroplasty zingakhale zochiritsira zofanana.
Zokhudzana: Discectomy
Rao, ndi. al. anapeza kuti chipangizo cha cervical dis replacement choposa ACDF m'njira zingapo. Kufufuza kwawo 2015 komwe kunafalitsidwa mu Archives of Orthopedic Trauma Surgery ndipo inali ndi mutu wakuti, "Cervical disc arthroplasty motsutsana ndi chiberekero cha cervical discectomy ndi kusakanizidwa kwa chithandizo cha matenda a chiberekero cha chiberekero.
- Kupambana kopambana poyambitsa zizindikiro za mitsempha.
- Kusungira molimbika kwina pa msinkhu woyendetsedwa.
- Zovuta kapena zovuta zosimbidwa zokhudzana ndi ndondomekoyi.
- Zosafunikira zochitidwa opaleshoni.
Koma ngakhale ndi zotsatira zowonjezera izi, olemba amati, mapindu ena sayenera kutsimikiziridwa, kuphatikizapo kutayika magazi pamene mukuchitidwa opaleshoni, nthawi yaitali mumagwiritsa ntchito chipatala ndikugwira bwino ntchito.
Ren, et al., Mu kafukufuku wawo wa 2014, "Zochitika zapakati pa nthawi yaitali pambuyo pa chiberekero cha chiberekero chotchedwa arthroplasty poyerekezera ndi discectomy ndi kusakanikirana koyambirira: kuwonongeka mwatsatanetsatane ndi kufufuza mayesero olamuliridwa mosavuta," omwe anafalitsidwa ku Ulaya Magazini ya Spine inapezanso opaleshoni yapamwamba ya opaleshoni yowonjezeredwa kuti chiwonongeko chonse chilowe m'malo, poyerekeza ndi ACDF.
Olembawo amanenanso kuti kusintha kwa diski kungabweretse bwino ntchito mkatikati ndi nthawi yaitali.
Koma mosiyana ndi Rao, et. al. (kuchokera pamwamba), Ren ndi ochita kafukufuku akunena kuti ndizochepa zophunzira zomwe zachitidwa kuti zitsimikizire ngati chidziwitso chakuti malo opatsirana pogonana angathandizire kupewa ASD.
Zida kunja kwa Medical Research Sphere
Ku US, chilolezo cha kervical disc pakali pano chikugwiritsidwa ntchito pazitsulo zochepa zokha zochitidwa opaleshoni. Chifukwa cha izi, zikutheka kuti opaleshoni yochepa chabe ya opaleshoni yakhala ikudziwitsa luso kuti odwala awo athe kuwongolera moona mtima.
Mawu pa (intaneti) mumsewu ndikuti anthu ali okonzeka kupita kukapeza dokotala amene akumva bwino. Ndipotu, ambiri amapita ku Ulaya - makamaka Spain ndi Germany kuti akachitidwe.
Mafunso ambiri onena za chitetezo ndi zotsatira sizinayankhidwe. Pali, komabe, zokambirana za "madzi ozizira" zotchedwa ADR Support, zomwe zinayambitsidwa ndi munthu yemwe anali ndi opaleshoni yabwino ya TDR. Anthu omwe ali pamsonkhano umenewu amapereka mayankho owongoka, kuti, popanda kutsimikiziridwa ndi kafukufuku, amachotsedwa mwachindunji kuchokera kwa odwala omwe amangotengeka nawo.
Zotsatira:
Caridi, John M., MD, Pumberger, Matthias, MD, Hughes, Aleksandro, P., MD Cervical Radiculopathy: Kubwereza. Chipatala cha Opaleshoni Yapadera. Sept. 2011. Kufikira Jan 2016.
Sosa lakumwera kwa America. Kuzindikira ndi Kuchiza Chithandizo cha Radiculopathy kuchokera kwa Degenerative Disorders. Sosa lakumwera kwa America. 2010.
Ren, C., Song, Y., Xue, Y., Yang, X. Pakatikati pa zotsatira za nthawi yaitali pambuyo pa chiberekero chotchedwa arthroplasty poyerekezera ndi discectomy ndi kusakanikirana kwapadera: kuyang'anitsitsa ndondomeko yowonongeka kwa mayesero olamuliridwa mosavuta. J. Eur Spine J. 2014 May; 23 (5): 1115-23. lembani: 10.1007 / s00586-014-3220-3. Epub 2014 Feb 11.
Rao, M., Nie, S., Xiao, B., Zhang, G., Gan, X., Cao, S. Cervical disc arthroplasty ndi chiberekero cha kervical discectomy ndi kusakanizidwa kuti azitha kuchiza matenda a chiberekero. mayesero olamuliridwa mosavuta. Arch Orthop Trauma Surg. 2015 Jan; 135 (1): 19-28. lembani: 10.1007 / s00402-014-2122-5. Epub 2014 Dec 5.