Opaleshoni Yamakono Kuti Chotsani Dothi la Herniated
Discectomy ndi opaleshoni yomwe imachitidwa kuchotsa tchire la herniated kuchokera mumtsinje wa msana . Pamene chiwombankhanga chimachitika, chidutswa cha mphutsi yachibadwa chamtsempha chimachotsedwa. Chidutswa chimenechi chikhoza kutsutsana ndi msana wamtsempha kapena mitsempha yomwe ili pafupi ndi chingwe cha msana. Kupsyinjika kumeneku kumayambitsa zizindikiro zomwe zimakhala ndi ma discs a herniated, kuphatikizapo kupsinjika kwa magetsi , kufooka ndi kumangirira , ndi kufooka.
Mankhwala opaleshoni a disc heniated ndi kuchotsa chidutswa cha spinal disc chimene chimayambitsa kupweteka kwa mitsempha. Njirayi imatchedwa discectomy. Opaleshoni yachibadwa imatchedwa discectomy yotseguka. Discectomy yotsegulidwa ndi opaleshoni kumene dokotalayu amagwiritsa ntchito kachipangizo kakang'ono ndikuyang'ana pa diseniyo yakeyo kuti athetse chigudulicho ndi kuthetsa vutoli.
The Procedure
A discectomy imagwira pansi pa anesthesia. Kuchita opaleshoni kumatengera pafupifupi ola limodzi, malingana ndi kukula kwake kwa deta, kukula kwa wodwalayo, ndi zina. A discectomy amachitika ndi wodwalayo atagona pansi, ndi kumbuyo kumbuyo.
Pofuna kuchotsa chidutswa cha disni ya herniated, dokotala wanu adzapangitsanso kutsogolo pakati pa msana wanu. Kutengeka kumakhala pafupifupi masentimita atatu m'litali. Dokotala wanu ndiye amachotsa mosamala kwambiri minofu kutali ndi fupa la msana wanu.
Pogwiritsira ntchito zipangizo zamakono, dokotala wanu akuchotsa pang'ono ndi fupa ndi ligament kumbuyo kwa msana. Gawoli la ndondomekoyi limatchedwa laminotomy.
Pambuyo pang'onopang'ono phokoso ndi ligament, dokotala wanu angathe kuwona, ndi kuteteza mitsempha ya m'mimba. Katundu wa disni akapezeka, chidutswa cha diseni cha herniated chikuchotsedwa.
Malinga ndi maonekedwe ndi chikhalidwe cha otsalawo, zowonjezera zamabuku zingachotsedwe ndi kuyembekezera kupeĊµa chidutswa china cha disk kuchokera ku kuyesa mtsogolo. Disiyo ikayeretsedwa kuchokera kumadera ozungulira mitsempha, incision imatsekedwa ndipo bandeji imagwiritsidwa ntchito.
Kubwezeretsa
Odwala nthawi zambiri amadzutsidwa kuchokera ku opaleshoni ndi kupititsa patsogolo kwa ululu wawo wammimba; Komabe, sizodabwitsa kuti zizindikirozi zimatenga masabata angapo kuti zichoke pang'onopang'ono. Ululu wozungulirika ndi wamba, koma kawirikawiri umayendetsedwa ndi mankhwala opweteka pakamwa. Odwala nthawi zambiri amatha usiku umodzi kuchipatala koma nthawi zambiri amamasulidwa tsiku lotsatira. Lumbar corset brace ingathandize ndi zizindikiro zina za ululu koma sizingakhale zofunikira nthawi zonse.
Ntchito zofatsa zimalimbikitsidwa pambuyo pa opaleshoni, monga kukhala pansi ndikuyenda. Odwala ayenera kupewa kunyamula zinthu zolemetsa, ndipo ayesetse kuti asagwedezeke kapena kupotoza msana. Odwala ayenera kupewa ntchito yovuta kapena kuchita masewera olimbitsa thupi kufikira atachotsedwa ndi adokotala.
Ngozi
Vuto lofala kwambiri la discectomy ndilo kuti pali mwayi kuti chidutswa china cha disk chidzakonzekeretsa komanso chidzachititse zizindikiro zomwezo m'tsogolomu. Ichi ndi chomwe chimatchedwa chidziwitso chatsopano, ndipo chiopsezo cha izi chikuchitika pafupifupi 10-15%.
Odwala ambiri amapeza mpumulo wa zizindikiro zawo kuchokera ku discectomy. Komabe, kupambana kwa ndondomekoyi ndi pafupifupi 85-90%, kutanthauza kuti 10% mwa odwala omwe ali ndi discectomy adzakhalabe ndi zizindikiro zosalekeza. Odwala omwe ali ndi zizindikiro kwa nthawi yayitali asanachite opaleshoni, kapena kuchepa kwakukulu kwa ubongo (monga kufooketsa kwakukulu) ali pa chiopsezo chokwanira chosachiritsidwa.
Zoopsa zina za opaleshoni zimaphatikizapo kuthamanga kwa msana, kupha magazi, ndi matenda. Zonsezi nthawi zambiri zimatha kuchiritsidwa koma zingafunike kupititsa nthawi yaitali kuchipatala kapena opaleshoni yowonjezera.
Njira Zina Zopangira Opaleshoni Zachidwi Zochepa
Njira zatsopano zingalole dokotala wanu kuchita opaleshoni yotchedwa microdiscectomy ndi endoscopic discectomy.
Kachilombo ka microdiscectomy ndi opaleshoni yaching'ono yosavuta yomwe imagwiritsira ntchito zipangizo zamakono komanso zochitika zochepa. Dokotala wa opaleshoni wotchedwa endoscopic discectomy amagwiritsa ntchito zipangizo zamakono komanso kamera kuti achotse diseni ya herniated kudzera m'maganizo ochepa kwambiri.
Mapuloteni otchedwa microdiscectomy ndiwo ndondomeko yomwe imakwaniritsa cholinga chomwecho monga discectomy yotseguka, kuchotsa disenictomy, koma imagwiritsa ntchito kamangidwe kakang'ono. M'malo moyang'anitsitsa chidutswa cha diseni cha herniated ndikuchichotsa, dokotala wanu amagwiritsa ntchito kamera kuti apeze chidutswacho ndi zida zapadera kuti azichotse. Ndondomekoyi siingayesetse kuti anesthesia iwonongeke ndipo imatha kupyolera mu kapangidwe kakang'ono kamene kamakhala ndi mitsempha yochepa. Dokotala wanu amagwiritsa ntchito x-ray ndi kamera kuti "awone" komwe kukonza kwake kuli, ndi zida zapadera kuti achotse chidutswacho.
Microdiscectomy ndi endoscopic microdiscectomy ndizofunikira pazinthu zina, koma osati. Odwala ena amatumikiridwa bwino ndi discectomy ya chikhalidwe. Pamene lingaliro lachidziwitso mwamsanga ndilobwino, ndikofunika kwambiri kuti opaleshoniyi ichitidwe bwino. Choncho, ngati discectomy yotseguka ndi yoyenera pazochitika zanu, ndiye kuti njira zowonongeka zosafunika siziyenera kuchitika. Kambiranani ndi dokotala ngati opaleshoni yochepa yosawonongeka ingakhale yoyenera kwa inu.
Zotsatira:
Mathews HH ndi Long BH "Njira Zomwe Zidakali Zosakaniza za Chithandizo cha Intervertebral Disk Herniation" J Am Acad Orthop Surg March / April 2002; 10: 80-85.