Kutulutsa magazi kumakhala kuvulaza komwe anthu amatha kusokoneza malo omwe amakhala pakati pa mafupa a msana (wotchedwa intervertebral disc space) amathamangitsidwa, kapena kusunthira, kudutsa malo omwewo.
Ngakhale kutulutsa magazi kumakhudza pafupifupi msinkhu uliwonse, mumapezeka kumbuyo kwenikweni. Ichi ndi chifukwa chakuti msana wamtunduwu umakhala ndi ubweya wa thupi pamene umachokera pamutu kupyola msana. Momwemo, zipangizo zomwe zimakhala m'mbuyo-kuphatikizapo discs - zili pangozi yovulazidwa.
Pano pali zomwe muyenera kudziwa ponena za kudziletsa.
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Kutanthauzira Malangizo KumatanthauzaPamene chiwombankhanga chimatuluka, makina a kunja kwa msana , omwe, atakhala otsika, ali ndi zakuthupi zozizwitsa, zomwe zimatulutsa. Mitundu yapansiyi imatchedwa annulus fibrosus; Madzi amkati amatchedwa " core pulpus" .) Malinga ndi momwe digiti yanu imayambira, mbali ina yamadzi imatha kuthawira pamtunda wa mitsempha, imayambitsa zizindikiro.
Chidziwitso chokhalira misozi ndi njira imodzi yomwe nsonga za annulus fibrosus zimatha kuwonongeka, ndipo (patapita nthawi) zikhoza kukhala malo ochoka pamutu. Nthawi zambiri misozi imalira chifukwa chosowa, makamaka pamene kusauka kumakhala chinthu; Kuvulazidwa ndi chifukwa china.
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Chizindikiro ChakudziwitsaPamene phokoso lamkati lomwe limachokera ku diski yoyenera limakhudzana ndi mitsempha ya mitsempha , mwina mumamva kupweteka kwambiri. Mukhoza kupeza zizindikiro zina, kuphatikizapo kufooka, kufooka, kapena kugwedezeka kwa magetsi kapena kutengeka kwa magetsi komwe kumayenda pansi pa mwendo kapena mkono.
Pamene zizindikirozi - zomwe zimachitika chifukwa cha radiculopathy , matendawa a matenda a msana mizu - amachititsa zizindikiro m'milingo, anthu nthawi zambiri amatcha sciatica .
Zizindikiro za matenda a Herniated zimasiyana malinga ndi msana umene umathandiza kuti ziwonongeke. Mwachidziwitso, mutha kukhala ndi zizindikiro zodziwika bwino , monga momwe tafotokozera pamwambapa.
Kodi zizindikiro zazikuluzikulu, zomwe zimachitika pafupi kwambiri ndi msana wamtsempha, zimayambitsa zizindikiro zomwe zimakhudza chimodzi mwazinthu zanu?
Yankho likuchokera pa momwe thupi limakhalira. Nthambi ya mitsempha yamtsempha kuchokera kumalo awo pamtunda womwe uli pakatikati pamtunda wa m'mimba mpaka m'mitsempha yaing'ono ndi yaying'ono yomwe imazungulira thupi lonse. Mitsempha iliyonse imagwirizanitsidwa ndi dera lapadera la thupi, ndipo mitsempha yomwe imachokera ku gawo limakhudza malo awo okha. Madera amenewa amatchedwa dermatomes for transmission nerve transmission, ndi myotomes kwa mitsempha kuthamanga kwa magalimoto, kapena kuyenda, maganizo.
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Kodi muli pangozi chifukwa cha chidziwitso?Kutulutsa chidziwitso nthawi zambiri kumabwera osati kuchokera ku chochitika china monga kuvulazidwa kapena kupsinjika, koma kuchokera tsiku ndi usana mumakhala moyo wanu. Zomwe zimadziwika kuti zimakhala zovuta zomwe zimayambitsa vutoli zimaphatikizapo kusuta, kunenepa kwambiri, kusauka bwino, komanso kukhala ndi malo ogwira ntchito monga dalaivala wamagalimoto kapena wogwira ntchito ku ofesi, kapena kukhala ndi ntchito yopangira ntchito yomwe imafuna kubwereza msana wanu.
Ngati chovulala chimachititsa kuti asokonezeke, mwina ukhoza kukhala chifukwa chokhala ndi vuto lopotoka, kapena chifukwa chokumanikitsani mwamphamvu mwadzidzidzi kuti mutenge thupi (lomwe ndilo kutsogolo kwa mzere wa msana.)
Ukalamba umasewera mbali yaikulu pa chiopsezo cha munthu kuti adziwitse, komanso. Pamene tikulamba, timakonda kuwonjezereka kusintha kwazitsamba m'magulu athu a msana, zomwe zingayambitse misozi ndi chisudzo. N'zochititsa chidwi kuti kafukufuku wina wofalitsidwa m'chaka cha 2002 wotchedwa Surgical Neurology anapeza kuti malo a disk herniation amasintha pamene anthu akula. Kumene kulimbikitsidwa kwambiri kwa achinyamata kumachitika kumbuyo, ndipo pokhala ndi zaka zowonjezereka, zimakhudza kwambiri msana, molingana ndi phunzirolo.
Ma discs amakhalanso owuma pamene amakalamba, omwe amatanthauza okalamba ndi okalamba, ang'onoang'ono angakhale otsalira pamtambo wofewa, womwe umakhala wovulaza kwambiri.) Kufufuza kwa 2012 ku British Journal of Neurosurgery kunapeza kuti kupweteka kwa disc, imodzi mwa magawo anayi a herniation, kuti akhale osowa mwa anthu okalamba.
Mmalo moyeretsa, anthu achikulire amayamba kutaya ma diski ndi ululu wa discogenic .
Ndipo mukhulupirire kapena ayi, chikhalidwe chanu chimakhudza chiopsezo chanu, ndi amuna omwe ali otetezeka kwambiri kuposa akazi.
Pambuyo pa zifukwa zomwe tazitchula pamwambapa, mavuto omwe analipo kale omwe analipo, makamaka mabala okhudzidwa ndi kuvulala kwa mkwapu, amatha kukupangitsani kuti mumveke.
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Kusanthula Dongosolo la HerniatedMofanana ndi mavuto ambiri a msana, kugwiritsira ntchito diski ya herniated kumaphatikizapo mbiri yachipatala, yomwe mudzafunsidwa kufotokozera zizindikiro zanu mwatsatanetsatane, ndi kuunika kwa thupi. Madokotala ambiri amapanga chimodzi kapena zambiri zojambula zojambula zojambula ngati MRI, mayeso a kuperekera mitsempha ndi ena, komanso.
Kuti muzindikire kuwonongeka kwa mitsempha, yomwe ingabwere kuchokera ku disniatiation, dokotala wanu akhoza kuyesa zowawa pa tsamba lililonse (lofotokozedwa pamwambapa) msinkhu.
Pozindikira zizindikiro zokhudzana ndi kupanikizika ndi / kapena kukwiya kwa mizu ya msana, mwachitsanzo, kupweteka, mphamvu zamagetsi, kufooka ndi / kapena kupweteka kumene kumatsika pansi mwendo kapena mkono - pachimake china - dokotala akhoza kufufuza zizindikilozo mitsempha yeniyeni ya msana kapena mizu yomwe imakhudzidwa. Izi ndizomwe zimapangidwira.
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Kuchiza KuchizaNgakhale kuti opaleshoni ya discectomy nthawi zambiri imathandiza kuthetsa ululu kuchokera ku herniation, kuyembekezera ndi thandizo lachipatala kungakhale njira ina. Izi zimagwira ntchito kwa anthu ena chifukwa patapita nthawi, chinthu chomwe chimachokera ku diski chimayambitsanso thupi.
Funsani dokotala wanu kuti mudziwe njira yabwino yothandizira.
Chithandizo chodziletsa pa lumbar herniated disc chingakhale kupumula; kumwa mankhwala opweteka, minofu yotsegula komanso / kapena mankhwala oletsa kupweteka ; kukhala ndi jekeseni wa epidural steroid ; ndi / kapena mankhwala opatsirana. Cholinga cha chithandizo chamankhwala (chidutswa cha mankhwala mu dongosolo losamalirako mankhwala) ndi mankhwala opatsirana ndi kuchepetsa ululu. Mankhwala othandizira thupi angathandizenso kuwonjezera luso lanu logwira ntchito ndi kupeĊµa kuvulala kwina.
Kumbukirani kuti kupita kuchipatala sizomwe zimakuchitikirani. Ngakhale dongosolo lanu lachipatala lingakhale ndi njira zosiyana, kuchita pulogalamu yanu ya kunyumba monga momwe mukufunira ndizofunikira kuti muthe kupeza zotsatira zabwino. Izi zinati, kuphatikiza mankhwala - osati kuganizira za mtundu umodzi - kungakuthandizeni kuti muchedwe.
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Kuchiza OpaleshoniNgati mukuyesa mankhwala opitirira masabata asanu ndi limodzi koma simukupeza kupuma ndi kupweteka kwa thupi, muyenera kukhala nthawi yoganizira opaleshoni yatsopano. Kawirikawiri, discectomy kapena discectomy ndi msinkhu wachisanu ndipangidwe kwa herniation.
Kupititsa patsogolo mu sayansi ya zaumoyo kwachititsa kuti pakhale opaleshoni yapamtunda yosautsa (MIS.) Ubwino wa MIS ndi zochitika zing'onozing'ono komanso nthawi zochiritsira mwamsanga. (Zing'onozing'ono zomwe zimagwiritsidwa ntchito zingathe kumasulira zochepa zochepa).
Ndipo, malinga ndi olemba a 2017 ndondomeko yowonongeka, kupindula kwakukulu kwa MIS kwa opaleshoni odzikuza kumakhala kosavuta kugulitsa.
Kodi muyenera kusankha chiyani?
Cholinga chimenecho chimapangidwa mwa mgwirizano ndi dokotala, koma ndemanga yomwe yatchulidwa pamwambayi ikuyerekeza umboni wa MIS komanso opaleshoni yotseguka kuti ayankhe funso ili. Ofufuzawa adapeza kuti umboni wabwino kwambiri suwathandiza kuchitidwa opaleshoni yochepa pochita opaleshoni yotseguka, ndipo izi zinali zowona pazitsulo komanso m'mbuyo.
Komano ndemanga ya 2014 Cochrane Back Group yomwe inafanananso MIS ndi opaleshoni yam'mbuyo - nthawi ino yothandizira zizindikiro za m'mbuyo pokha - zapeza kuti MIS sangathetsere ululu wa m'mimba komanso / kapena kupweteka kwapakhosi komanso kuchitidwa opaleshoni. Ndemangayi inapezanso zovuta zina za rehospitalization ndi opaleshoni ya msana. Kusiyana kwakukulu pakati pa mitundu iwiri ya opaleshoniyi kunali kochepa, komabe.
> Chitsime
> Akazi okhumudwa, R. Lumbar akunena kuti: Kukula kumawonjezeka ndi msinkhu. Opaleshoni Neurol. Sept. 2002. https://www.ncbi.nlm.nih.gov/pubmed/12480218
> Kutulutsa magazi. Physiopedia website. https://www.physio-pedia.com/Disc_Herniation
> Rasouli MR, Minimally invasive discectomy ndi microdiscectomy / lotseguka discectomy kwa chizindikiro cha lumbar disc herniation. Msonkhano wa Cochrane Rev. Sept 2014. https://www.ncbi.nlm.nih.gov/pubmed/25184502
> Werndle MC, kumvetsera mwachidwi kwa okalamba. Br J Neurosurg. April 2012 https://www.ncbi.nlm.nih.gov/pubmed/22077584