Kulira kwapakati pazinthu ndikumaphatikizapo opaleshoni ya msana yomwe inaphimbidwa ndi chingwe cha msana (wotchedwa dura mater).
Dural sac misonzi sichinthu chosokoneza. Mu kafukufuku wawo wa 2017, akatswiri ofufuza a ku China amanena kuti dural sac misonzi ingayambitse kupweteka kwa madzi, mitsempha, mitsempha ya mitsempha komanso zovuta kwambiri.
Kodi Mtundu Wopereka Opaleshoni Wamtundu Wotani Umayambitsa Misozi Yakale Yakale?
Yankho ndilo, zimadalira. Olemba achi China anapeza njira zosiyanasiyana zomwe zingayambitse.
Komabe, kawirikawiri misozi imakhala ikuchitika kawirikawiri ndi opaleshoni ya msana. Kuchita opaleshoni ya msana wamtundu wambiri kumakhala pamndandanda umenewo, kumatsatiridwa ndi kusakanikirana kwa msana, ndipo potsirizira pake kusokonezeka kwapakati pazambiri (kwa spinal stenosis).
Kuchita opaleshoni ya opaleshoni komanso opaleshoni imodzi yokha ya opaleshoni imachititsa kuti pang'onopang'ono chiwerengero chochepa cha misozi, chilankhulo.
Zojambula pamakalata odwala omwe amalembedwa m'magazini ya March 2016, Clinical Neurology ndi Neurosurgery, adapeza kuti misozi imakhala ikudziwika kawirikawiri kwa anthu omwe anali ndi zotsatira zosauka kuchokera ku opaleshoni ya msana yomwe inachotsedwa. Nthawi zambiri monga izi, malinga ndi olemba olemba mabuku, zimakhala ngati kuti misozi yowakomera imaimira chithunzi chosauka.
Olemba mabuku a Clinical Neurology and Neurosurgery amanena kuti misozi imakhala ikuchitika nthawi zambiri pa mlingo L5 / S1.
Amanenanso kuti pokhapokha ngati mbali ina ya khunguyo imachotsedwa, wodwalayo sali pachiopsezo cholira.
Kupewa Kulira Kwambiri - Dokotala wa Opaleshoni ndi Mavuto Anu
Ngakhale kwa dokotala wa opaleshoni ali ndi manja amatsenga, ndi kovuta kuti asasokoneze thumba lomwe lili ndi msana. Nthano yomwe imayika msana wamtsempha si wolimba ngati fupa, khungu kapena minofu, Dr.
Auerbach, Chief of Surgery Surgery ku Bronx-Lebanon Hospital Center ku New York City, akundiuza. "Ndizovuta komanso zosavuta."
Ngakhale njira yanu ya dokotala ndi scalpel (kapena chida china) chingakhale chomwe chimapangitsa kuti misozi, zikhalidwe zomwe zakhalapo kale ndi / kapena zofooka zingapangitse ngozi yanu. Mwachitsanzo, kugwiritsa ntchito steroids, kukhala ndi shuga, kapena kusuta zonse kumawonjezera chiopsezo chanu. N'chimodzimodzinso ngati muli ndi vuto la msana, monga: spondylolisthesis, stenosis , scoliosis, kapena kyphosis .
Mzipatala Sindimakonda Kufotokozera Zowonjezera Kulira Zowonjezera Mtengo
Kulira modzidzimutsa ndi chimodzi mwa mavuto omwe amachitidwa opaleshoni yammbuyo. Koma zipatala zambiri zimawoneka kuti zimachedwetsa kulengeza misonzi yomwe imapezeka m'mabungwe awo. Pachifukwa ichi komanso zifukwa zinanso, chiwerengero cha misozi sichidziwikiratu.
Monga momwe zilili, chiŵerengero cha chiŵerengero cha kafukufuku chimafotokozedwa muzofukufuku zosiyana. Zinthu zingapo zingayese kusiyana: chifukwa cha opaleshoni (stenosis, herniated disc, scoliosis, synovial cysts, etc.), kaya opaleshoniyo inali yoyamba, yachiwiri, yachitatu, ndi zina.
Pansi pamunsi, phunziro la Januwale 2011 lofalitsidwa ku Neurosurgery likufufuza opitirira 108,000 opaleshoni ya msana yomwe inapeza 1,6% mwa iwo omwe adamva misozi.
Pamwamba, Medscape ikusimba kuti kafukufuku wa 1989 wofalitsidwa mu Spine anawerengetsera chiwerengero cha chiwongoladzanja cha 17,4% cha misozi m'madera owerengera okhala ndi anthu 481 omwe anachitidwa opaleshoni.
Komiti ya ICD -CM Coordination and Maintenance Committee (komiti yomwe imathandiza kwambiri polemba mapulogalamu opeza) inapeza kuti 57 peresenti ya zipatala zomwe adazifufuza zinafotokozera za misozi. Komitiyi imanena kuti 46 peresenti ya zipatala 2,446 zinati palibe misozi yamtundu uliwonse! Zimanenanso kuti zipatala zimapereka lipoti la kuchepetsa misonzi, koma sanena kuti misozi imakhala ikuchitika.
Pitani muyeso.
Ndipo pamene madokotala akuchita opaleshoni ya msana m'mabungwe ambiri a chipatala adayambitsa maphunziro a kafukufuku (zomwe zimakhala zosiyana ndi malipoti otsogolera a zipatala), nthawi zina misozi imakhala 10%.
Komiti ya ICD-CM ikulingalira kuti zipatala izi zimafotokoza pafupifupi theka la misonzi yapakati yomwe imapezeka.
Zomwe Zimapangidwira ndi Mitsempha Yambiri Yamadzimadzi - Zisonyezo ndi Chithandizo
Monga ndinayankhulira kumayambiriro kwa nkhaniyi, zizindikiro za misozi yamkati zimaphatikizapo ziphuphu zamadzimadzi (zomwe zimatchedwa CSF zivulala). Kodi izo zikuwoneka bwanji? Kodi mungadziwe bwanji ngati mutakhala ndi misozi?
Dr. Auerbach akuti ngati muli ndi chifuwa cha CSF, mukhoza kuzindikira kuti madzi akumwa amachotsedwa pa bala lanu lopaleshoni. Mwinanso mumatha kupwetekedwa pamutu pamene mukuimirira ndipo mumamasuka mukakhala pansi. Zizindikiro zina zimaphatikizapo kusintha kwa masomphenya, kunyoza, kusanza kapena chizungulire, Auerbach akuti.
Ngati sichikuchiritsidwa mofulumira komanso bwino, cerebrospinal fluid zidzasokoneza thanzi lanu. Choncho zizindikiro monga zomwe takambirana pamwambazi zimafuna chithandizo chamankhwala mwamsanga.
Zonsezi zimati, misozi yam'midzi imakhala ikugwidwa ndi dokotala wanu panthawi ya opaleshoni ndipo imachiritsidwa pomwepo.
Koma zizindikiro zachedwa zikhoza, ndipo pakali pano, zidzakhala kwa inu kuti muwazindikire ndikuchitapo kanthu. Ngati mukumane ndi zizindikiro zilizonse zomwe zatchulidwa pamwambapa, onetsetsani kuti mukambirane ndi adokotala mwamsanga.
Kuchiza kwa misozi kumaphatikizapo mpumulo wa bedi, kukhetsa, ndipo ngati kutuluka kukupitirira, opaleshoni. Kuchita opaleshoni kwa misozi kumakhala ngati kukungula dzenje. Kuyambira mwezi wa March 2012, opaleshoni yambiri ya misozi imaphatikizapo sutures (stitches), koma njira zamakono zikukonzedwanso.
Chitsime:
> Fang, Z., Chithandizo cha cerebrospinal amatsogolera pambuyo pa opaleshoni ya msana. Chin J Traumatol. April 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392710/
> Guerin P, et. Al., durotomy mwamsanga pa opaleshoni ya msana: Zochitika, machitidwe, ndi mavuto. Ndemanga yowonongeka. Kuvulaza. 2011 Jan 18. [Epub patsogolo pa kusindikiza]. http://www.ncbi.nlm.nih.gov/pubmed/21251652
> Klessinger, S. Zomwe zimachititsa kuti misozi ikhale yambiri pambuyo poti tsambali likhale lokhazikika komanso kuti likhale lofanana ndi zotsatira zake. Clin Neurol Neurosurg. March 2016 Mar http://www.ncbi.nlm.nih.gov/pubmed/26945877
> Shaw, J. Zochitika Zopweteka / Zomwe Zimapangidwira. Komiti ya ICD-9-CM Yokonza ndi Kukonza. March 19-20, 2008. Kuwonetsera kwa Powerpoint.
> Williams, BJ, et. al. Chiwerengero cha durotomy chosakonzekera mu opaleshoni ya msana yochokera pa milandu 108,478. Neurosurgery. Jan 2011. http://www.ncbi.nlm.nih.gov/pubmed/21150757 "