Mavuto Otsutsa Achinyamata Athawa Amatha Kubwerera ku Mavuto Osabwerera Kumbuyo
Mbali yokhala wothamanga wothamanga ndiyo kuyang'anira kuvulala. Nditakumana ndi achinyamata othamanga omwe akukumana ndi kuvulazidwa kwa nthawi yoyamba, ndimakonda kulankhula nawo za kuphunzira kuvulaza, komanso kusawalola kuti apindule kwambiri. Wopikisano aliyense yemwe wapambana bwino wapanga izi mwa kuphunzira kupeŵa kuvulaza, kubwezeretsa kuvulala, ndi kusamalira kuvulala. Kaya ndinu sukulu ya sekondale kapena wothamanga mpira wa masewera, sindikukayikira kuti muli ndi nkhani (kapena ziwiri, kapena zitatu ...) kuti mudziwe za kuvulala kumene mwakumana nawo mu masewera anu.
Ngati pali vuto limodzi lomwe likuwoneka kuti likudetsa nkhawa kwambiri tsogolo la wothamanga, zikuwoneka kuti ndizovuta. Kupweteka kwa msana, matenda a msana, ndi nkhani zovuta zimayambitsa mantha kwa othamanga chifukwa cha zifukwa zingapo, kuphatikizapo zotsatirazi:
- Choyamba, pali zinsinsi zambiri. Makina a msana, minofu ndi mitsempha yozungulira mzere wa msana, ndipo zovuta za thupi lino zimapangitsa kuti kumvetsetsa kwa msana kumavuta kwa madokotala ndi odwala mofanana.
- Chachiwiri, mavuto ambiri a msana alibe mankhwala ophweka. Kawirikawiri palibe mapiritsi kapena ndondomeko yomwe ingathandize kuthetsa ululu.
- Chachitatu, kuchira kungatenge nthawi yaitali. Kwa othamanga, kuleza mtima kawirikawiri kumakhala kopindulitsa, ndipo maseŵera, machitidwe kapena maphunziro sangaoneke ngati zosaloleka.
Pa zifukwa zonsezi, ndipo mwinamwake ena, othamanga m'magulu onse akukhudzidwa akapezeka ndi vuto la msana.
Koma kodi zikutanthauzanji kuti mupeze kuti muli ndi vuto la msana? Kodi masiku anu a masewera amatha? Kodi akatswiri a maseŵera angabwerere ku masewera? Kodi ochita masewera a koleji ayenera kuwapachika? Malinga ndi kafukufukuyo, yankho lake ndi lodziwika bwino: ambiri othamanga amatha kubwerera ku masewera omwewo asanawononge. Ndipotu, ngakhale akatswiri ochita masewera amadzimadzi amathamanga mobwerezabwereza kuchokera kumalo amtundu wambiri omwe amapezeka pamtunda.
Kotero musataye mtima, mungafunikire kuphunzira kulamulira matenda anu, mungakhale ndi rehab kwambiri patsogolo panu, koma ndizotheka: ndinu wothamanga. Pano mungaphunzire za zina mwazidzidzidzi zomwe zimagwira mpikisano wamasewera, komanso zomwe mungachite kuti muthe kubwereranso kuvulala.
Lumbar Disc Herniation
Mlomo wa msana umapangidwa ndi mafupa opangidwa ndi makoswe, otchedwa vertebrae, ataphatikizidwa pamwamba pa wina ndi mzake. Mbali ya m'munsi ya ndondomeko ya msana imatchedwa mphalapala. Mtundu uliwonse wamtsempha wamtsempha umagawanika ndi mitsempha yotchedwa intervertebral disc. Disi iyi imathandiza kuti mupeze mphamvu ndipo nthawi yomweyo imalola kuyenda pakati pa vertebrae.
Ma disksticbral disks amatha kuvulala, ndipo sali okonzeka bwino kuti azikonzekera okha. Dipatimentiyi imakhala ndi magazi ochepa kwambiri omwe amachititsa kuti zinthu zowonongeka ziwonongeke nthawi zambiri thupi limakhala lovuta kuchiritsa palokha.
Mtundu wowonongeka kwambiri wa disc umatchedwa herniation . Pamene mafinya amapezeka, zina mwazitsulo zakuthambo zimathamangitsidwa kutali ndi malire ake, ndipo zimatha kutsutsana ndi mizu ya msana ndi msana. Zizindikiro zowonjezereka za intervertebral disc herniation ndi zizindikiro za kusokonezeka kwa mitsempha monga kupweteka, kusowa, ndi kufooka kupitirira pansi pamapeto . Kupweteka kumbuyo si chizindikiro chofala kwambiri cha disc disc.
Kutsekemera kwa lumbar intervertebral disc kungakhale vuto lalikulu kwambiri. Ngati diski ikukakamiza pakatikati pa mitsempha ya m'mimba, pali zinthu ziwiri zomwe zimatchedwa cauda equina syndrome ndi matenda a conus medullaris omwe angathe kuchitika. Izi ndizovuta kuzizindikira, monga zotsatira za chithandizo cha mankhwala zimakhala zovuta kwambiri ngati pali kuchedwa kwa mankhwala opaleshoni. Zizindikiro za mikhalidwe imeneyi zingaphatikizepo kusakhoza kulamulira matumbo kapena chikhodzodzo, ndi kufooka pamimba. Ngakhale kuti zikhalidwezi ndizovuta kwambiri za disni herniation, ndizo zomwe zimafunika kupezeka mofulumira ndikuchiritsidwa bwino.
Chithandizo cha opaleshoni n'chothandiza kwa oposa 90 peresenti ya othamanga omwe amapereka lumbar disc herniation. Kawirikawiri mankhwala oletsa kupweteka kumathandiza kuchepetsa zizindikiro za kutupa koopsa. Mankhwala a oral oral steroid sanasonyezedwe kuti amachiritsa bwino kuposa placebo. Mankhwalawa ndi mankhwala omwe ali ofunikira kuwathandiza kubwezeretsa msana ndi mphamvu zam'mbuyo , ndipo ndikuyembekeza kupewa mavuto ena mumsewu. Ngati zizindikiro zimakhala zovuta kulamulira, jekeseni wa epidural steroid ingagwiritsidwe ntchito ndipo nthawi zambiri imakhala ndi zotsatira zabwino.
Chithandizo cha opaleshoni chimakhala chosungidwa kwa othamanga omwe samasintha pakapita masabata osachepera asanu a mankhwala osamalidwa. N'zochititsa chidwi kuti kafukufuku sanawonetsere kusiyana kwakukulu kwa nthawi yaitali kuti abwerere ku maseŵera, kuthamanga kwa masewera othamanga, kapena zotsatira za mankhwala a lumbar disc herniation poyerekeza chithandizo cha opaleshoni ndi chithandizo chopanda chithandizo. Mwachiwonekere, ambiri odwala, ngakhale athamanga otchuka, ayenera kuyamba ndi mankhwala opanda chithandizo. Mosasamala mtundu wa mankhwala, pafupifupi 90 peresenti ya othamanga amabwerera kuntchito yawo yovulaza.
Matenda a Disagenerative Disc
Matenda opatsirana pogonana ndi ovuta kwambiri, onse ochita maseŵera, komanso osakhala ndi moyo. Dongosolo lopangidwa mozungulira la intervertebral disc limapangidwa makamaka ndi madzi, ndipo ndi chinachake chonga mphalaswe. Dothi lochepetsetsa limatayika kwambiri madzi ake, ndipo limakhala lolimba, limakhala ndi mphamvu zochepa zedi ndi kayendetsedwe kabwino.
Zinthu zofunika kwambiri pa chitukuko cha matenda osokoneza ubongo zikuwoneka kuti ndi okalamba komanso zimayambira. Ochita masewera achikulire amakhala ovuta kwambiri kudwala matenda osokoneza bongo, ndipo awo omwe ali ndi mbiri ya banja ya matenda opatsirana a msana amakhala ovuta kwambiri. Komabe, pali umboni wotsimikizira mfundo yakuti maseŵera achiwawa angathandizenso kukulitsa zizindikiro zoyambirira za matenda osokoneza bongo.
Matenda opatsirana pogonana amapezeka kuti ndi othamanga omwe amadandaula chifukwa cha ululu wammbuyo ndipo pamapeto pake amaphunzira masomphenya, mwina kuphatikizapo ma-ray ndi ma MRIs. Ambiri othamanga onse omwe amapezeka kuti ali ndi matenda osokoneza bongo amatha kusamalidwa ndi chithandizo chopanda chithandizo. Chithandizochi chimaphatikizapo mankhwala opatsirana pogwiritsidwa ntchito pamutu ndi kukulitsa msana. Cholinga chake ndi kupititsa patsogolo mphamvu ya minofu yomwe ili pafupi ndi msana kuti ikhale yowonjezereka kwambiri ndi ma disk.
Pali umboni wochepa wosonyeza kugwiritsa ntchito mankhwala ena. Mankhwala am'malamulo ndi jekeseni ya epidural sanawonetseke kuti ndi othandiza. Mankhwala ena monga machiritso, machiritso, masitera, ndi ena akhala akugwiritsidwa ntchito m'mbiri yakale, koma palibe umboni wosonyeza kuti izi zimasintha malingaliro a nthawi yaitali. Ochita masewera ambiri amalumbirira ndi mankhwalawa, ndipo ambiri amakhala otetezeka kwambiri. Wothamanga aliyense akhoza kukhala wosiyana kwambiri, ndipo ndi zomveka kuyesa njira zosiyana zothandizira kuti mupeze zoyenera kwa inu.
Mankhwala opaleshoni siwothandiza kwa anthu omwe ali ndi matenda osokoneza ubongo, ndipo kawirikawiri amakhala osungirako masewera omwe sangathe kubwerera ku masewera atatha miyezi isanu ndi umodzi (ngati siitali nthawi yaitali) ya chithandizo chopanda chithandizo. Ngakhale kwa othamanga awa, chithandizo cha opaleshoni chimakhala ndi zotsatira zowonjezereka mwa kupeza akatswiri othamanga ku masewera. Chithandizo chochita opaleshoni cha matenda osokoneza bongo chimaphatikizapo ndondomeko ya fusion. Pali madokotala ena opanga opaleshoni omwe amagwiritsa ntchito mawotchiwa, ngakhale kuti kugwiritsiridwa ntchito kwa disk m'malo ochita masewera olimbitsa thupi sikunayambe kufufuzidwa mwachindunji.
Spondylolysis
Spondylolysis ndi kubwereza ntchito mobwerezabwereza ku fupa la vertebrae la msana. Matendawa amapezeka chifukwa cha kubwezeretsa kachilomboka, ndipo amachititsa kuti phokoso likhale lopweteka la mbali ina ya vertebrae yotchedwa pars interarticularis. Ngati spondylolysis imapezeka pambali yoyanja ndi kumanzere ya mzere wa msana, chikhalidwe chomwe chimayambitsa kusakhazikika kwa vertebrae, chotchedwa spondylolisthesis , chingachitike.
Spondylolysis ndi yowonjezereka m'maseŵero enaake kuphatikizapo masewera olimbitsa thupi, kuthamanga, kumenyana, ndi kukweza zolemera. Ngakhale zikhoza kuchitika kwa othamanga achinyamata m'maseŵera ena, ndizofala kwambiri pazinthu zomwe tanenazi. Kaŵirikaŵiri, kupwetekedwa mtima uku kwa pars interarticularis kumachitika muunyamata, ndiyeno kumakhala chizindikiro cham'tsogolo. Kawirikawiri, pamene ntchito zowonjezera zikuwonjezeka kusukulu ya sekondale kapena masewera olimbitsa thupi, kapena ngakhale pambuyo pake, spondylolysis imakhala yodabwitsa kwambiri. Zitha kukhalapo kwa zaka khumi kapena kuposerapo, koma zimangokhala zovuta pamene ntchito zowonjezera zikuwonjezeka ndi wothamanga atachedwa zaka makumi awiri kapena makumi awiri.
Chizindikiro chofala kwambiri cha spondylolysis ndi zowawa zokhudzana ndi ntchito. Pamene matendawa amatchedwa spondylolisthesis amapezeka, zimakhala zosavuta kukhala ndi zizindikiro za mitsempha zowononga kupweteka, kufooka, ndi kufooka kumadutsa mwendo. Nthawi zina matendawa amatha kupangidwa ndi x-ray test, koma nthawi zina kusokonezeka maganizo kungawoneke pa CT scan kapena MRI. Kuyeza kwa CT kumathandizanso pamene mukuyesa kuchiza matenda opatsirana mu msana.
Chithandizo nthawi zambiri chimayamba ndi kusintha kwa ntchito ndi mankhwala. Ngati zatsimikiziridwa kuti chovulazidwa posachedwapa, osati chovulaza chakale, madokotala ena adzasankha kuti amuthandize wothamanga kuti ayesetse kuchiritsa mafupa. Panthawiyi pamene chovulala chikugwidwa mu gawo lovuta, machiritso a spondylolysis amatha kufika 90 peresenti. Ngati chovulalacho sichitha, chitsimikizo cha machiritso odzidzimutsa ndi otsika, ngakhale pamene nsalu yayamba.
Monga tanenera, othamanga ambiri amatha kusintha ndikusintha mwachangu. Pokhapokha patapita nthawi yayitali, msinkhu wa miyezi 6 yokhala ndi chithandizo chopanda chithandizo ayenera kupatsidwa chithandizo chamtundu uliwonse. Njira zothandizira opaleshoni zinasiyana malinga ndi maonekedwe a fupa lopweteka. Ngati mafupa aikidwa bwino, ndiye kuti kukonzanso kupwetekedwa mtima kumatha kuganiziridwa. Ngati kupweteka kwachisokonezo kwasintha kusinthasintha kwa msana (spondylolisthesis), ndiye kuti opaleshoni ya fusion yokhala ndi lumbar ingakhale yachizolowezi chithandizo.
Chisoni Chobwezera
Matenda a minofu ndi mitsempha ya mitsempha ndiyo njira yowonjezereka ya ululu wammbuyo, kuphatikizapo othamanga. Ngakhale kuti zovulalazi sizimayambitsa matenda a kondomu, zimayambitsa zolemala ndi zovuta ndi maseŵera olimbitsa thupi.
Kupanga kupweteka kwa ululu wam'mimba kumaphatikizapo kupenda wodwalayo. Kupweteka kwapweteka kwapweteka kumaphatikizapo zizindikiro zofanana ndi zina mwazinthu zatchulidwa kale. Athamanga amakonda kudandaula za zizindikiro kuphatikizapo kupweteka kwa minofu, kupwetekedwa mtima, kufooka, ndi kuvutika kumene kuli kovuta kuchepetsa.
Kawirikawiri pali maphunziro ojambula monga ma ray-ray kapena MRIs othandiza, ndipo nthawi zambiri, kupeza maphunzirowa kungangopangitsa kuti zikhale zovuta. "Zosayembekezereka" zomwe zimawoneka ndizomwe zimagwiritsidwa ntchito pa ma MRIs, komabe iwo sangakhale okhudzana ndi magwero a mavuto, ndipo kupeza maphunziro nthawi zina kumasokoneza mkhalidwewo ndipo kumapangitsa kuchedwa kwa mankhwala oyenerera kwambiri pamene kugwidwa kwa matenda kukuchitika.
Mankhwala opweteka m'mimba amatha kupindula ndi kukonzekera koyambirira, kuyenda mofatsa kwa msana, komanso kuyesetsa kulimbikitsa mphamvu zazikulu komanso zamoyo zamakono. Olemba matupi angakhale othandiza, monga momwe angaphunzitsire othamanga, makosi amphamvu, ndi ophunzitsa masewera. Ochita masewera ambiri, makamaka ochita masewera aang'ono, sakudziwa kuti akambirane izi ndi makosi awo ndi alangizi awo, pamene kulankhulana bwino kungathandize kuti othamanga omwe ali ndi vuto lakumbuyo angathe kusamalidwa mosavuta.
Mawu Ochokera
Pali zifukwa zambiri zomwe zingayambitse kupweteka kwapweteka kumene kumayambitsidwa ndi vuto la mphalapala. Ngakhale kuti mphalapala zimakhala zokhumudwitsa kwambiri kwa wothamanga ndipo zingayambitse nkhaŵa za kubwerera kumaseŵera, zoona ndizo kuti othamanga ambiri adzachira ndikubwerera kuntchito yawo yonse.
Kuwonjezera apo, mankhwala opaleshoni ndi osiyana, osati lamulo, kuti azitha kulandira mankhwala ambiri a mphuno kwa othamanga. Ndizosavuta kwambiri kuti wothamanga wothamanga adzafunikire opaleshoni kuti azitha msana, ndipo akadzachita apo akadakali mwayi woti abwerere kusewera. Kugwira ntchito ndi othandizira, ophunzitsa, ndi makosi, ndikuonetsetsa kuti onse akugwirizanitsa ndi dokotala ndi wothamanga, amathandizira kubwezera wothamanga masewera awo mwamsanga.
> Zotsatira:
> Hsu WK, Jenkins TJ. "Kulamulira kwa Lumbar Zomwe Mnyamata Wopikisano wa Elite" J Am Acad Orthop Surgery. 2017 Jul; 25 (7): 489-498.