Zifukwa Zokonzanso Zimapangitsa Opaleshoni

2 Opaleshoni Yachiwiri

Kukonzanso opaleshoni ya msana kungaoneke kukhala kofunikira ndi dokotala (kapena inu) ngati muli ndi zizindikiro pambuyo poyambirira, kapena muli ndi zizindikiro zatsopano. Koma mungadziwe bwanji ngati mukufunadi opaleshoni yachiwiriyo? Onani mndandandawu kuti muyambe kafukufuku wanu.

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Kudzudzula kwadzidzidzi kobwerezabwereza

Ngati, pambuyo pa discectomy, mutakhalenso ndi sciatica, kupweteka pansi mkono wanu, kapena zizindikilo zina zamatenda, mukhoza kukhala ndi mimba yambiri. Kukambirana kobwerezabwereza kumabwereza mobwerezabwereza vuto lomwe linayambitsa opaleshoni poyamba.

Zokhudzana: Zizindikiro za Cervical Radiculopathy

Discectomy imachotsa zokhazokhazo (zomwe zimatchedwa zidutswa) zomwe zasokonezedwa pang'ono kapena kwathunthu kuchokera ku diski yaikulu. Mudakali ndi diski yanu, ndipo nkutheka kukonza gawo lomwe lasiyidwa.

Zokhudzana: Kodi Fragment Yotani?

Dr. D. D. D. Auerbach, Chief of Surgery Surgery ku Bronx-Lebanon Hospital Center ku New York City, akuyerekezera discectomy kudya chidutswa cha cheesecake, makamaka kwa iwo omwe ali ndi chidwi chokhudzana ndi zokomazi.

Pamene mukuyang'ana mwachidwi pazochitika zowakomera, akuti, mwayi ndi cheesecake udzakhala wosiyana ndi chidutswa chachikulu. Ena amapita pamphepete, ena akhoza kumera pamphepete mwa mbale, ndipo ena amatha kugwa kwathunthu. Mmenemo, anthu ambiri amatha kutaya zidutswa zomwe zimagwa pa mbale, koma pitirizani kudya chidutswa chachikulu.

Kuyerekezera kwa discectomy kumagwira ntchito mofananamo: Zosagwiritsidwa ntchito zimachotsedwa kuchoka ku chimangidwe chachikulu, kusiya dala lanu lonse, kapena keke yaching'ono.

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Pseudoarthrosis

Pseudoarthrosis ndi mawu omwe amamasulira kusowa kwa mafupa osapitirira pasanathe chaka chimodzi pambuyo pa opaleshoni ya msana.

Pseudoarthrosis ndi wamba, amapezeka mpaka 68 peresenti ya lumbar fusions, malinga ndi Auerbach. Mwa izi, pakati pa 6 ndi 36% zimafuna kubwezeretsanso, akuti.

Zinthu zina zomwe zingathandize pakukula kwa pseudoarthrosis mutatha opaleshoni yanu yoyamba ikuphatikizapo:

• Chikhalidwe cha matenda anu oyambirira
• Mtundu wa hardware (kapena kusowa kwawo) ukuikidwa
• Mtundu wa fupa wamatabwa , ngati ulipo, wogwiritsidwa ntchito
• Makhalidwe anu a thanzi ndi chikhalidwe. Mwachitsanzo, ngati mumasuta kapena mutenga corticosteroids , mungapangitse chiopsezo chanu cha pseudoarthrosis.
• Ngati muli ndi kusakanikirana kwa msana mumene mulibe mbale, zojambula kapena zipangizo zina.

Mu chaputala chake ponena za kuchitidwa opaleshoni yachipatala yothandizira zachipatala, buku lakuti The Textbook of Spinal Surgery, Edition 3 , Auitbach cites maphunziro omwe amasonyeza kuti fusions yopangidwa popanda kukhazikitsidwa kwa hardware ingapangitse chiopsezo cha pseudoarthrosis ndi 70%. Nambalayi ndi yotsika kwambiri - 10% - chifukwa cha masewera a msana omwe amagwiritsira ntchito hardware, iye akusimba.

Zambiri

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Matenda Odziwika Kwambiri

ASD, kapena malo omwe ali pafupi ndi kuchepa kwao, ndi chikhalidwe chomwe kusintha kwamasamba kumapezeka pamagulu a msana pamwamba ndi / kapena pansipa pomwe opaleshoni ya kumbuyo yatha.

Auerbach akuti pamene ASD imachitika, imachita zimenezi patatha pafupifupi zaka ziwiri kapena zambiri zopanda ululu.

Zokhudzana: Kodi Chigawo Chowonjezereka N'chiyani?

Akatswiri sadziŵa bwinobwino ngati ndi opaleshoni ya kumbuyo kapena kusintha kwa chilengedwe cha kusintha kwa msana kumayendetsedwe ka ASD.

Frank Cammisa, Jr., MD, Chief of the Spine Service ku chipatala cha opaleshoni yapadera ku New York, akunena zinthu zina osati njira yopaleshoni yomwe ingakhale ikugwira ntchito pa chitukuko cha kusintha kwazomwe timatcha ASD. "Nthawi zambiri, ASD imatchedwa kuti wodwala ali ndi kusakanikirana, komabe, ngakhale wodwalayo asanakhale ndi kusakanikirana angakhalebe ndi kusintha kosasintha pamlingo winanso."

Kafukufuku wopangidwa ndi Song, et. Al, akuti, "Chigawo chowonjezereka cha matenda opatsirana: kodi ndi chifukwa cha matenda oyamba kapena kusakanikirana kofanana? Kuyerekeza pakati pa zigawo pafupi ndi zigawo zosakanikirana ndi zosagwirizana," yofalitsidwa mu November 2011 ya European Spine Journal inapeza kuti " Chigawo chapafupi cha matendawa chimakhala chifukwa cha mbiri yakale ya chiberekero cha spondylosis kuposa kukhalapo kwa fusion. "

Zokhudzana: Kodi Cervical Spondylosis n'chiyani?

Auerbach akuti maphunziro a biomechanical amasonyeza kusokonezeka kwina kumayambiriro pafupi ndi kusakanikirana. Chifukwa kusakanikirana kumawonjezereka kwambiri pakati pa mafupa awiri a mgwirizano wa intervertebral , momwe msana wanu umasinthira zikhoza kusinthidwa. Izi zingapangitse kuti zikhale zovuta kuwonjezera kumadera ena a mgwirizanowu.

Iye anati: "Ma discs amanyamulira.

Malingana ndi Auerbach ndi ena, vutoli ndilo chifukwa chachikulu chomwe anthu ambiri ogulitsa ntchito akulimbikitsira chitukuko cha njira zoyang'anira opaleshoni ndi zipangizo . Kupititsa patsogolo mu teknoloji - mwachitsanzo, kubwezeretsa kwasayiti - kuthandiza madokotala kuti athetse vutoli popanda kupereka nsembe m'deralo.

Ngati mukudabwa, pali maphunziro omwe amasonyeza ubwino wokhala ndi chida pamsana pamsana, ngakhale kuti sizinayankhidwe mafunso onse (kuyambira mu 2016). Mwachitsanzo, pofufuza kafukufuku atatu poyerekeza ndi zotsatira za katemera wa kondomu ndi kusakanikirana kwa msana kwa zaka ziwiri pambuyo pake, ofufuza adapeza kuti anthu omwe anali ndi arthroplasty anali 44% ochepa opaleshoni yachiwiri. Phunziro lomwelo silinafotokoze phindu lililonse la arthroplasty pochepetsa kapena kupewa ASD, komabe.

Kuchita opaleshoni yowonjezera kumaphatikizidwa mozama mu nkhani yanga: Kulowa m'malo kwa Cervical Disc

Zambiri

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Bwezerani TDR

Kugwiritsira ntchito chida chonse, chomwe nthawi zambiri chimatchedwa TDR kwaifupi, ndi opaleshoni yatsopano (ku United States, osachepera) yomwe amawonedwa ndi akatswiri ena a msana ngati njira yothetsera opaleshoni ya msana. Zokonzanso zida zakhala zikuchitidwa ku Ulaya kwa kanthawi, koma US akugwiritsa ntchito njirayi pang'onopang'ono.

Chifukwa chakuti malo atsopano ndi atsopano m'dziko lino, ndikuganiza kuti opanga zipangizo komanso madokotala omwe amapanga opaleshoni yopanga upainiya akugwirabe ntchito. Izi zingapangitse chiopsezo chimodzi kapena zingapo zomwe zimachitika chifukwa cha kusinthika.

Auerbach akunena kuti odwala okha mpaka 0-5% amatchulidwa kuti opaleshoni ya msana ikugwirizana ndi njira yoyenera yotsitsiramo. Ngati simunayambe nawo, koma muli ndi zina, akuti, mukhoza kukhala ndi mavuto.

Chimodzi mwa mavuto ambiri omwe amachititsa ku TDR yowonongeka (monga opaleshoni yachiwiri yothandizira nthawi zina amatchedwa) ndi kusokonekera kwa chipangizo. Zitsanzo za kulephera kwa chipangizo zimaphatikizapo kupweteka kwa prosthetic disc yomwe imayikidwa mumsana wanu, kapena pamene chipangizocho chimasintha malo ake (extrudes).

Cammisa akuwonjezeranso kuti chifukwa chosungira chida chimatetezera, kusintha kwachibadwa kumatha kuchitika pamagulu a mbali. Ngati vutoli likumva kupweteka kwambiri, akuti, dokotala wanu anganene kuti msana wamtsempha ndi opaleshoni yanu.

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Mavuto ndi Zida Zamakono

Nthawi zambiri, mumatha kukhala ndi mavuto ndi hardware yomwe imayikidwa mumsana wanu. Izi zikuphatikizapo ma prosthetic discs, monga tatchulidwa pamwambapa, komanso zipangizo zamagetsi zomwe zimagwiritsidwa ntchito pafupipafupi komanso mitundu ina ya opaleshoni yam'mbuyo. Chombocho, monga momwe nthawi zina chimatchulidwira, chimatha, kapena dotolo angakhale atayika pa malo olakwika panthawiyi.

Mtundu umodzi wa vuto la hardware chifukwa cha opaleshoni ya kumbuyo ndi matenda omwe amadziwika kuti "hardware yowawa." Pankhaniyi, zinthu zowonjezereka sizikhala zovuta, Auerbach akuti.

Camissa akunena kuti ululu chifukwa cha matenda a hardware owawa nthawi zambiri amachokera ku minofu yofewa (mwachitsanzo, minofu yanu, mitsempha, matope ndi fascia).

Kuyankhula ndi matenda ovuta a hardware nthawi zina kumafuna opaleshoni kuchotsa zinthu zopweteka. Cammisa amandiuza kuti kuyambiranso opaleshoni ya matenda opweteka a hardware nthawi zambiri chifukwa cha kusungidwa kwa hardware, osati chipangizo chomwecho. "Sizodabwitsa kwambiri kuchotsa zida chifukwa cha ululu umene umayambitsa chipangizocho," Cammisa akutsimikizira.

Kuchita opaleshoni yowonongeka kwa hardware yopweteka imachitidwa nthawi yomweyo.

_Zotsatira:

_{Auerbach, J., MD. Chief of Spine Surgery, Bronx-Lebanon Hospital Center, Wothandizira Pulofesa Wopaleshoni, Albert Einstein College of Medicine. Kuyankhulana kwa foni. March 2012.}

_{Auerbach JD, Kuklo TR. Yongolani opaleshoni ya Lumbar. Mu: Bridwell KH, DeWald R, eds. The Bookbook of Surgery Spinal, Edition 3. Philadelphi., Lippincott 2011.}

_{Benglis, D., et al. Kupenda kwakukulu kwachitetezo cha puloteni yamtundu wa morphogenetic mu opaleshoni ya msana. Neurosurgery 62. 5 (Supp 2) (2008).}

_{Cammisa, F., MD, Chief of the Spine Service ku chipatala cha opaleshoni yapadera. New York. Imelo Kucheza. March 2012.}

_{Etminan M, Girardi FP, Khan SN, Cammisa FP Jr. Njira zowonetsera za lumbar pseudarthrosis.Orthop Clin North Am 2002; 33: 381-392.}

_{Patel AA, Spiker WR. Onetsetsani kuti mukupeza mankhwala ndi mankhwala omwe simukugwirizana nawo. Semin Spine Surg 2008; 20: 20-26.}

_{Nyimbo, K., et. al. Gawo lachilendo lachilendo lachimake: kodi ndi chifukwa cha kupitirira kwa matenda kapena zochitika zokhudzana ndi kusakaniza? Yerekezerani pakati pa zigawo pafupi ndi zigawo zosakanikirana ndi zosagwirizana. Eur Spine J. Nov 2011. Kufikira Jan 2016.}

_{Upadhyaya, et al. Zotsatira Zowonjezera za 3 US IDE Randomised Cervical Arthroplasty Mayesero Ndi Zaka 2 Zotsatira: 923. Maphunziro a Edzi: August 2010 - Vesi 67 - Nkhani 2. doi: 10.1227 / 01.NEU.0000386995.74131.4B}