I-Pseudoarthrosis iyigama elisetshenziselwa ukuchaza okwenzekayo lapho umfutho we-spinal uphumelelanga. Ukuhlanganiswa komgogodla uhlobo lokuhlinzwa emuva olunikezwa izinkinga ezihlukahlukene kodwa kufakalelwe kuphela ekulungiseni i-Scoliosis curve, izinkinga ze-diski kanye / noma ubuthakathaka noma ukungazinzi emgodleni (okungaba nesifo noma isisu). Umgomo oyinhloko we-fusion fusion ukunciphisa ubuhlungu nokuthuthukisa umsebenzi.
Ukuze uphethwe isisu noma / noma i-radiculopathy, umgomo wokukhipha i-decompress, noma ukwenza indawo, izinzwa kanye / noma intambo yomgogodla njengoba idlula izikhala emkholini womgogodla.
Ngokusho kwe-American Academy of Orthopedic Surgeons (AAOS), imfucumfucu yomgogodla iyinqubo yokwesekwa. Umqondo uwukuba ujoyine ama-vertebrae angomakhelwane, abuhlungu kanye, futhi ngokuhamba kwesikhathi, ubavumela ukuba bafake ngaphakathi kwelinye elilodwa, elithambo eliqinile.
I-AAOS ithi (ngokuvamile ngokuhambisana "nokusebenza" njengezinduku, izikuluvu, kanye / noma izintambo) zonke izintambo zomgogodla zibandakanya ukubeka uhlobo oluthile lwamathambo esikhaleni phakathi kwe-vertebrae ekugcineni eyokhula ndawonye njengeyunithi eqinile. Lezi zinto zibizwa ngokuthi i-bone graft. I-AAOS ithi i-graft ikwandisa ukukhiqizwa kwethambo futhi ikhuthaza ukuphulukiswa nokuxuba.
Izimbangela
Kodwa kwenzekani uma ukuhlanganiswa komgogodla kungathathi? Odokotela bakhuluma kulokhu ngokuthi "okungewona inyunyana" noma i-pseudoarthrosis. Ezimweni zama-non-unions, okwanele okwenziwe amathambo kwenzeka ngesikhathi sokulanda ngokushesha ngemva kwenqubo.
Ngokuvamile, ukuphulukiswa kwethambo eliphansi kuholela ekutheni i-pseudoarthrosis. Ngezinye izikhathi lokhu kubangelwa ukuhlela kanye / noma okuqhubekayo phakathi nokuhlinzwa; ngezinye izikhathi kungenxa yezinto oziletha etafuleni njengokubhema noma ukuthatha i-steroids.
Pseudoarthrosis nokubhema
Ishadi elingezansi linikeza uhlobo oluthi "wena vs them" lokuqhathaniswa kwezinto ezibangelwa ingozi ye-pseudoarthrosis.
Phawula ukuthi ukubhema kuphakamisa uhlu lwezinto zezempilo . Ngiyazi ukuthi kunzima kakhulu ukuyeka ukubhema, kodwa kufanele wazi ukuthi abanye odokotela bamazinyo ngeke basebenze ngisho nalabo ababhemayo (ngaphandle uma kwenzeka impilo yakho ingengozini ngaphandle kwayo.)
Kungani? Ngenxa yokuthi ukubhema kungaholela ekunciphiseni kwama-33% ngesilinganiso se-fusion, ngokusho kwezilwane ezihlinza uSteven Ondra noShaden Marzouk kusihloko sabo esithi "Amasu Okubuyekeza I-Lumbar Pseudarthrosis" eshicilelwe kwiwebhusayithi yeMedscape. Bathi isizathu sokuthi ukubhema kuthinta imithwalo yakho yegazi futhi kunciphisa inani lokukhula kwezikhumba zegazi kwisayithi ye-fusion. Ukuze uphumelele, i-fusions idinga igazi ukuthi imishaya emisha nekhona ekhona (nge diameter evamile) ingaletha.
| Izinto Zempilo | Izinto Zokuhlinza |
|---|---|
| Ukubhema | Inombolo yamazinga ahlanganisiwe |
| Ukukhuluphala | Uhlobo lwe-fusion lwenziwa |
| Ukusetshenziswa kwe-Steroid engapheliyo | Ukukhethwa kokufakelwa kwe-graft (nge- autograft ekhethiwe.) |
| I-osteoporosis | Isimo nokulungiswa kwendawo ehlanganisiwe |
| Isifo sikashukela | Ukubekwa kwe-graft |
| Ukungondleki | Ukusetshenziswa kwe-instrumentation yokuhlinza ukugcina umgogodla uhambelanisiwe futhi ungaguquki ngemva kokuhlinzwa (okubizwa ngokuthi ukulungiswa kwangaphakathi.) |
| I-arthritis yokuvuvukala | Ingabe lokhu kuhlinzekwa ukubuyekezwa? |
| Okunye ukugula okungapheli | |
| Pseudoarthrosis yangaphambilini |
Ehlangothini lokuhlinza, i-Scoliosis Research Society ithi ngisho nasezandleni zokugqoka, ingozi ye-pseudoarthrosis ingenani elingu-5% - 15%. Odokotela abahlinzayo kumele bacabangele ngokucacile nangokwenyama yonke i-biomechanics, isimo se "imvelo" ehlanganisiwe nezinye izinto.
I-Pseudoarthrosis ne-Bone Graft Material
Ngokuqondene nokuthi yini ongayisebenzisa ekufakweni kwamathambo, lapho kukhona amathuba amaningi, kufaka phakathi ukufakelwa kwamathambo, ochwepheshe bayavuma ukuthi ukusebenzisa amathambo isiguli (okubizwa nge-autograft) kungcono kakhulu.
Kodwa lokhu akunakwenzeka ngaso sonke isikhathi. Kuxhomeke ezintweni ezinjengempilo yakho engaphansi, ukuthi isayithi lakho lokufakelwa (okuyisiqhwa sakho, umgogodla noma enye indawo lapho ithambo lithathwa khona) lifana, uma ukusetshenziswa kwe-instrumentation (isib., Izinduku, izikuluvu kanye / noma izintambo) kuhlelwe futhi uma i-fusion izokwenziwa ngaphambili noma ngemuva.
Ngokujwayelekile, i-anterior ikholomu fusion (i-anterior isho phambili nekholomu ibhekisela emzimbeni we-vertebral ehlanganisiwe ukuze yenze ikholomu yakho yomgogodla) iphumelele kakhulu. Ngisho nazo zonke lezi ziguquko, uma usuphethe i-pseudoarthrosis ngaphambili futhi uhamba ngokuhlinzwa okubukezwayo, ukusebenzisa i-autograft impahla kufanele.
Ukuthola i-Pseudoarthrosis
Odokotela ngokuvamile banenkinga enzima yokuthola i-pseudoarthrosis. Esinye isizathu salokhu ukuthi ungabona noma ungaboni izimpawu. Esinye isizathu ukuthi akukho muntu ongasho ngokuqinisekile ukuthi ukuhlinzwa kwakho kokufiphaza komgogodla isikhathi eside kangakanani noma ubuhlungu obuhlobene noma ezinye izimpawu zingase zenzeke. Ungase uzizwe ubuhlungu kusukela ezinyangeni ze-pseudoarthrosis noma ngisho nangemva kokuhlinzwa kwakho kokugaya umgogodla.
Futhi ekugcineni, ngezinye izikhathi i-pseudoarthrosis ingumcibisholo omncane kakhulu emthanjeni, okwenza kube nzima ukuthola ifilimu, uma kungenakwenzeka, ukuba i-radiologist yokufunda.
Ukwelashwa kwe-Pseudoarthrosis
Ukwelashwa kwe-pseudoarthrosis cishe kuyoqala ngokuqhubekayo ngemithi, ukwelashwa ngokomzimba noma ukuphathwa kobuhlungu. Uma lokho kuhluleka ngokunethezeka ukukhulula izimpawu zakho, udokotela wakho angase akhombise ukuhlinzwa okubukeziwe .
Imithombo:
I-AAOS. I-Fusion Fusion. Iwebhusayithi ye-OrthoInfo. http://orthoinfo.aaos.org/topic.cfm?topic=a00348
I-Scoliosis Research Society. Pseudoarthrosis. I-Aging Spine. Iwebhusayithi ye-SRS. https://web.archive.org/web/20150214215129/http://www.srs.org/patient_and_family/the_aging_spine/pseudarthrosis.htm
Ondra, S., MD, uMarzouk, S., MD Ukubuyekeza Amasu okuLumbar Pseudarthrosis. Iwebhusayithi yeMedscape. http://www.medscape.com/viewarticle/462180_2