Kusiyana kwa Dongosolo la Herniated
Pakati pa discectomy, zidutswa za disnicted wa disnicted yomwe imayika pamphepete kapena pamtsempha wamtsempha amachotsedwa opaleshoni. Maganizo amachitika pamene dothi la herniated likupweteka komanso / kapena zizindikiro zina kuphatikizapo kufooka, kufooka kapena kugwedeza magetsi pansi pa mwendo umodzi kapena mkono.
Pamene diseni ya herniated ndiyoyambitsa, zizindikirozi zimatchedwa radiculopathy, koma ambiri omwe si achipatala amawatcha monga sciatica .
Pamene muli ndi discectomy, zonse kapena mbali ya lamina , yomwe ndi malo a fupa kumbuyo kwa vertebra, imayenera kuchotsedwa. Izi ndizothandiza dokotala wa opaleshoni kufika ku mitsempha ndi ma disc. Malingana ndi kuchuluka kwa fupa lomwe lachotsedwa, mbali iyi ya ndondomeko ikhoza kukhala ndi mayina awiri. Laminectomy imachotsa lamina zonse, pamene hemilaminectomy imachotsa theka la lamina.
Kodi Discectomy Idafunika Liti?
Nthaŵi zambiri, njira zowonongeka monga mankhwala , mankhwala, kapena injini za steroid zimayesedwa asanachitidwe opaleshoni. Kwenikweni, kafukufuku wa herniated amachiritsa popanda opaleshoni konse - koma izi zikhoza kufika chaka. Kukhala ndi discectomy kungachepetse nthawi yanu yamachiritso. Ngati ululu wanu uli wolimba, kapena zofooka / zowonongeka zimaonekera, discectomy ikhoza kusankha bwino, koma ngati zizindikiro zanu ndi zochepa kapena zochepa, mankhwala onsewa angakhale osowa.
Mulimonse momwemo, kambiranani ndi dokotala wanu zizindikiro ndi zosankha zanu.
Microdiscectomy
Microdiscectomy ndiyo njira yowonongeka yochepa yomwe imachitidwa panthawi yopuma. Kanyumba kakang'ono kamene kamapangidwira khungu ndi tizilombo ting'onoting'ono timene timapanga tizilombo timayika mpaka atakafika ku diski. Opaleshoni yonse imachitika kudzera mu zipangizo.
Pakati pa microdiscectomy, minofu siidulidwa monga momwe zilili panthawi yotseguka ya discectomy; mmalo mwake iwo achotsedwa panjira.
Chifukwa chaichi, nthawi ya machiritso imakhala yofulumira komanso yopweteka kwambiri kusiyana ndi njira yotseguka.
Tsegulani Discectomy
Tsegulani discectomy ndi opaleshoni yam'mbuyo . Zichitika kuchipatala pansi pa anesthesia. (Mwinamwake muyenera kungokhala m'chipatala tsiku limodzi.)
Kutsegula discectomy kumaphatikizapo kupanga makilogalamu omwe amakhala pafupi "1 kutalika, minofu imayenera kudulidwa kuti dokotala athandizidwe kupita ku diski." Monga tafotokozera pamwambapa, izi zikutanthauza nthawi yochulukitsa machiritso opita opaleshoni. Pambuyo pa njira zotseguka zingakhale zopweteka kwambiri, komanso.
Zina kusiyana ndi kusiyana ndi zovuta pa nthawi yopita kuchipatala, njira ziwirizi zikufanana.
Kafukufuku wochepa wa 2011 wofalitsidwa mu Journal of Orthopedic Surgery (wochokera ku Hong Kong) anapeza kuti discectomy yotseguka komanso discectomy yomwe imakhala yochepa kwambiri imathandizanso kuthetsa zizindikiro. Koma, olemba amati, opaleshoni yochepa yomwe imakhalapo imafunikira kanthawi kochepa kuchipatala, poyamba amabwerera kuntchito ndikubwereranso kwa vuto loyambirira.
Izi zati, olembawo amachenjeza kuti njira zochepa zowonongeka za discectomy zimakhala zovuta kwambiri kwa dokotalayo, ndipo zimafunikanso kuphunzitsidwa.
Kusankha Dokotala Wopaleshoni kwa Discectomy
Mafupa onse am'thupi amachititsa opaleshoni yammbuyo, kuphatikizapo zopanda pake.
Mtundu uliwonse wa dokotala adzakonzekera bwino ntchitoyo. Kusankhidwa kwa dokotala wa opaleshoni wa discectomy kumatsikira kuwonetsetsa kwa luso laumwini. Musazengereze kufunsa mafunso ambiri musanasankhe yemwe adzachita ndondomekoyi.
Mphamvu za Zovuta
Discectomy amagwira ntchito pafupifupi 80 mpaka 90 peresenti ya nthawiyo ndipo nthawi zambiri imathandiza kupweteka kwa mwendo ndi zizindikiro zina. Ubwino wa discectomy umakhala wosasunthika pa nthawi - phunziro lomwe linafalitsidwa m'magazini ya Spine linapeza kuti odwala ambiri opaleshoni anali ndi ululu wopweteka kwambiri ngakhale patatha zaka 10.
Ndipo phunziro la 2017 lofalitsidwa mu magazini ya November 2017 ya Clinical Orthopedics ndi Research Related anapeza kuti oposa makumi asanu ndi atatu mphambu atatu mwa anthu 100 alionse a discectomy odwala anali akuyenda bwino zaka zisanu ndi ziwiri zitatha.
Koma kafukufuku wamaphunziro adapezeka pambuyo pa chaka chimodzi, 25% mwa odwala opaleshoni ndi odwala omwe anali osamala osowa anafunikira (opitilira) opaleshoni yapamwamba. Pambuyo pa zaka khumi, magulu onse awiriwa adalongosola za kuthetsa kwawo kwa nthawi yaitali, koma izi zinali zowona kwa anthu ambiri mu gulu la opaleshoni (69%) kuposa gulu la osamalira (6%).
Mtheradi wa herniation ukhoza kubwereza ndi weniweni. Kufufuza kwa dongosolo la 2015 mwatsatanetsatane kafukufuku, adapeza kuti patapita zaka ziwiri, kupweteka kungabwererenso kwa odwala 25% omwe ali ndi discectomy imodzi. Olemba amanena kuti mwa izi, pafupifupi 6% amafunikira kubwezeretsedwa.
Nkhani yabwino ndi yakuti opaleshoni ya kawirikawiri kawirikawiri kawirikawiri sizimafunika nthawi zonse. Apanso, kafukufuku amasonyeza kuti opaleshoni ndi chisamaliro chosamalirira cha kumatira pambuyo pa discectomy zimakhala ndi zotsatira zofanana ndi mpumulo wopumula.
Zovuta za Zovuta
Kuphatikiza ndi kuthekera kwa reherniation (zomwe takambirana pamwambapa) zoopsa za discectomy zimaphatikizapo matenda, kutuluka m'magazi, kuvulaza kwa msana, komwe kumakhala pafupi ndi msana , kapena kuvulazidwa ndi mitsempha, mitsempha kapena mitsempha.
Mukawona kufiira kapena kutuluka pakamwa kwanu, kupweteka kapena kufooka pansi mkono kapena mwendo, mumakhala wamantha, muli ndi vuto la kukodza kapena mwazi, pitani kuchipatala mwamsanga.
Pambuyo pa Kusokonezeka Kwako
Mutha kukhala ndi ululu pambuyo pa opaleshoni. Ululu wochokera ku disc yako ya herniated ikhoza kukhala kwa kanthaŵi, nayenso.
Ndibwino kuti muyambe kuyenda mwamsanga mutangoyamba kumene. Izi zikhoza kuthandiza kuthamanga msanga, kuteteza minofu yowopsya ndikuyambitsa msana wanu. Pakangotha masabata angapo, muyenera kukwera njinga kapena kusambira. Anthu ambiri amabwerera kuntchito masabata awiri mpaka 8, malinga ndi momwe ntchito yawo iliri. Thandizo la thupi lingakuthandizeni mwamsanga kubwerera kuntchito ndi ntchito zina. Ngati dokotala wanu sakukutumizirani ku PT, mukhoza kumufunsa za izo.
Odwala ambiri, makamaka ndi discectomy yoyamba, amachira.
Zotsatira:
Garg, B., Nagraja, U., Jayaswal, A. Kuchokera kwa discectomy poyera kuti asamaphunzirepo. J Orthop Surg (Hong Kong). April 2011. Kufikira Feb 2016. http://www.ncbi.nlm.nih.gov/pubmed/21519072
Dewing et al. Zotsatira za lumbar microdiscectomy mu achinyamata, otanganidwa kwambiri: chiyanjano ndi mtundu wa herniation ndi mlingo. Mpaka (Phila Pa 1976). Jan 2008.
Atlas et al. Zotsatira za nthawi yaitali zogwiritsira ntchito opaleshoni ndi osasamala za sciatica yachiwiri ku lumbar disc herniation: zotsatira za zaka 10 kuchokera ku maine lumbar spine study. Mpaka (Phila Pa 1976). Apr 2005. http://www.ncbi.nlm.nih.gov/pubmed/15834338
NASS. Tsegulani Discectomy. NASS. Burr Ridge, IL. Zapezeka: Feb 11 10.
Legrand et al. Gawo la French Society for Rheumatology. Sciatica kuchokera ku disk herniation: Chithandizo chamankhwala kapena opaleshoni? Zowonjezereka Fupa. Dec 2007.
Parker S., Mendenhall S., Godil S., Sivasubramanian P., Cahill K., Ziewacz J., McGirt M. Zochitika za Pambuyo Pang'ono Pambuyo Pambuyo Lumbar Discectomy kwa Dothi la Herniated ndi Mmene Zimakhudzira Zotsatira za Odwala. Clin Orthop Relat Res. June 2015. Kufikira Feb 2016. http://www.ncbi.nlm.nih.gov/pubmed/25694267
> Virk, S., ndi. al. Kodi Ndondomeko ya Zosintha Zosintha Zitani Pambuyo pa Discectomy Yaikulu pa National Scale? Clin Orthop Relat Res. Nov 2017.