Izimpawu zobuhlungu noma ukungahambi kahle emilenzeni noma emuva ephansi zingase zibe uphawu lwezinkinga ngomgogodla we-lumbar, nesizathu sokuhlola leyo ngxenye yomzimba wakho. Uma uhlaziya izimo zemigodi ye-lumbar, udokotela wakho uzohlola uchungechunge lwemisebenzi ukunquma indawo nomthombo wenkinga yakho.
Iningi odokotela bathatha indlela ehlelekile kakhulu ekuhloleni izinkinga zomgogodla.
Nakuba kungenakuphika ukuthi ukuhluka okuvela kudokotela kuya kudokotela, izinyathelo eziyisisekelo zokuhlolwa kwe-lumbar spine zivame kakhulu. Kuye ngezibonakaliso zakho kanye nokuthola okutholakala emtholampilo, ukugxila nokujula kokuhlolwa kungahlukahluka.
Amaphuzu ambalwa abalulekile ngaphambi kokungena emininingwaneni yokuhlola umgogodla we-lumbar:
- Okokuqala, ukuhlolwa okuphelele nokuzimisela komthombo wobuhlungu kungathatha ukuvakashelwa okungaphezu kodwa kumtholampilo wakho. Ngokuvamile, umgomo wokuhlola okuqala ukuqinisekisa ukuthi ayikho izimpawu zenkinga ye-lumbar encane engabangela isimo esiphuthumayo. Uma isimo sibonakala singabonakali, umgomo uvame ukuba ukulawula izimpawu kunokuba uhlole ukuhlolwa okubanzi.
- Okwesibili, ukuhlola i-lumbar spine kudinga ukuhlola okungezona ingxenye engezansi yomzimba, kodwa futhi nezinzwa ezibalulekile ezivela kule ndawo kuze kube semkhawulweni ophansi . Yingaleso sizathu ukuthi kungani ungudokotela ungase uchithe isikhathi esithile ukuhlola amandla, ukuzwa, nokuziphendulela emaphethelweni aphansi.
Amafulegi abomvu wezinkinga ezinkulu kakhulu
Njengoba kukhonjisiwe, lapho kuqala ukuhlola inkinga ye-lumbar spine kunezimo ezimbalwa ezingaba zibi kakhulu, futhi lezi zimo zokuphuthumayo eziphuthumayo kanye nezidingo ezidingekayo ngokushesha. Lezi zihlanganisa izimo ezifana nokutheleleka, izicubu, nokucindezeleka okukhulu kwesibindi.
Nakuba lezi zimo zingavamile, udokotela wakho uzokubuza imibuzo futhi akuhlole ukuqinisekisa ukuthi azikho izimpawu zale mibandela. Lezi okuthiwa "amafulege abomvu" ezimweni zomgogodla zihlanganisa:
- Amafiva wakamuva, ushintsho lwesisindo, noma ukujula ebusuku
- Umlando womdlavuza ongadlulisela emathanjeni
- Ubuhlungu obungenakuphumula ekuphumuleni noma ukuvusa ebuthongweni
- Ukugcinwa kwe-incontinence noma ukuvuthwa kwe-urinary
- Ukuhlukunyezwa kwamuva
Lezi zibonakaliso 'ezibomvu zezimpawu' zizohola umtholampilo wakho ukuba agxile ekuhloleni kwabo futhi mhlawumbe uthole ukuhlolwa okwengeziwe ukuze ahlole lezi zimo ezibucayi ezingaba khona. Kubalulekile ukuqaphela ukuthi ngenxa yokuthi unesifo somkhuhlane, akusho ukuthi ubuhlungu bakho emuva buyingozi. Noma kunjalo, lezi zimpawu zingase zihlotshaniswe nezimo ezithile ezibi kakhulu, futhi ziyizibonakaliso okufanele zenze ukuhlolwa okujulile.
Ukuhlola Umgogodla
Ukuba nendlela ehlelekile yokuhlolwa kusiza ukuqinisekisa ukuthi umhloli wakho ngeke alahlekelwe imininingwane ebalulekile. Izinyathelo ezijwayelekile zokuhlola umgogodla we-lumbar kufaka phakathi: ukuhlola, i-palpation, ukuhamba, umsebenzi wezinzwa, nokuhlolwa okukhethekile. Izinyathelo ngayinye zingabuyekezwa ngezinyathelo ezimbalwa ezilula, futhi uma kungabonakali okungajwayelekile, uphenyo oluningiliziwe lungenzeka.
- Ukuhlolwa : Ukuhlola kuhlanganisa ukuhlola ukubonakala komgogodla we-lumbar. Lokhu kungabandakanya ukuhlola ukulungiswa kokubili kokubili nohlangothi lwesiguli. Ukuhlola kufanele kwenzeke esikhunjeni esingenalutho ukuhlola nganoma yisiphi isimo esingavamile noma ubufakazi bokulimala.
- Ukulinganisa : Ukuhlukaniswa kusho ukuthinta umzimba. Umhloli wakho angazizwa nganoma yisiphi isixuku noma ezinye izimo ezingavamile ezungeze isikhala somzimba kanye nesifunda esingaphansi kwesisu. Ngaphezu kwalokho, i-palpation kufanele ihlolwe kunoma yisiphi isifunda esithintekayo sokuthinta.
- Ukuhamba : Ukuhamba komgogodla kungabonwa ngokucela isiguli ukuba siphume phambili, emuva, siphume eceleni, futhi sincike ohlangothini ngalunye. Ngaphezu kwalokho, abahloli abaningi bazofuna ukuhlola nganoma yikuphi ukungafani okungahle kwenzeke okungabonakalisa izinkinga ngomsebenzi wezinzwa.
- Umsebenzi wamanzi : Ngokujwayelekile, umhloli wakho uzohlola imisebenzi emithathu yezinzwa. Okokuqala, amandla emisipha ehlukahlukene yomkhawulo ophansi. Okwesibili, ukuzwa kuyo yonke imikhawulo ephansi. Okwesithathu, umsebenzi wezingqondo zakho, kaningi emadolweni nasemagqumeni, nakuba kunezinye izimo ezinengqondo ezingabuye zihlolwe. Ukwehluleka kwemisipha, ukungavamile kokuzwa, nama-reflexes asymmetric kungabonakalisa ukusebenza komzimba ongajwayelekile.
- Ukuhlolwa okukhethekile : Kunezinombolo zezivivinyo ezikhethekile umhloli wakho angazenza. Lezi zivivinyo zingase zibandakanye ukuhlolwa okukhethekile komsebenzi wesisindo kanye nezibonakaliso zokucasuka kwenzwa. Isivivinyo esivame ukwenziwa ngokujwayelekile sibizwa ngokuthi umlenze oqondile wokuphakamisa ukuhlolwa .
Ukuhlola ukuhlola
Ukuhlelwa kwezifundo zokuzicabangela ngokuvamile akudingekile ekwelapheni kokuqala kobuhlungu obunzima. Uma kunezimpawu zesimiso esibucayi esibucayi, ukuhlolwa kungalawulwa ukuthi kuhlolwe enye yalezi zimo. Noma kunjalo ngenxa yobuhlungu besikhathi esidlule obucatshangelwa ukuthi buvela emthonjeni ojwayelekile kakhulu (umuthi we-muscular, ukungavamile kwe-disc, i-arthritis, njll), ukuhlolwa kokuqala ngokuvamile akusizi, futhi ezimweni eziningi kungadala ukwelashwa okungenasiphambano kunokuba kungadingeka.
Uma uvivinyo luyalwe, udokotela wakho angase alandise enye yezivivinyo ezihlukahlukene. Omunye akusilo kangcono kunomunye, kodwa ezimweni ezithile umuntu angaba usizo kakhulu. Abantu abaningi engibabona ngezinhlungu zangemuva bafuna i-MRIs. I-MRIs ivame ukuhlolwa okuwusizo, kodwa hhayi kuzo zonke izimo. Ngaphezu kwalokho, i-MRIs idinga ukuhunyushwa ngokucophelela, ngoba ivame ukukhombisa okunye okutholakele okungawusizo, kanti abanye abangenakukwenza okuncane ngomthombo wokungahambi kahle. Ukukhohliswa ngokulandela imiphumela yokuhlolwa ngaphandle kokufaka lokho kumongo wokuhlolwa kanye nokuthola okubalulwe ngenhla kungaholela ekunakekelweni okungalungile noma okungadingekile.
Izwi elivela
Kubalulekile ukuvuma ukuthi akukho okuchazwe kuze kube manje kungakwenza uzizwe ungcono noma ukhulule izimpawu ezibuhlungu. Nakuba kuqinisekiswa ukuthi akukho zimo ezibucayi okwenzekayo futhi uzama ukuchaza inkinga yizinyathelo ezibalulekile, iqiniso liwukuthi ukwelashwa yilokho abantu abakufunayo. Ngokuvamile, ukwelashwa akuxhomekile ekuxilongweni okuqondile. Ngezimbangela eziningi zokubuhlungu emuva, ukwelashwa kuqala ngezinyathelo ezifanayo kungakhathaliseki ukuthi inkinga yinkinga ye-disc, uhlobo lwe-muscle, noma olunye uhlobo. Kulezi zimo ezingavamile ngokuvamile ezibandakanya izimpawu ze-reg flag, ukwelashwa kuphelile kube enye into.
> Imithombo:
> Ukukhetha ngokuhlakanipha ® kuyisinyathelo se-ABIM Foundation. © 2017
> Chou R, et al. Ikomidi elincane lokuhlola ukuhlolwa kwe-Efficacy ye-American College of Physicians; I-American College of Physicians; I-American Pain Society Panel Guidelines Pain Guidelines Panel. "Ukuxilongwa nokwelashwa kwezinhlungu ezisezingeni eliphansi: isiqondiso somtholampilo esihlangene esivela eMelika College of Physicians kanye ne-American Pain Society." U-Ann Intern Med. 2007 Oct 2; 147 (7): 478-91.
> Forseen S, Corey A. "Ukusekelwa kwezinqumo zokwelashwa kanye nobuhlungu obunzima bokubuyela emuva: i-oda-based order set sets". J Am Coll Radiol. 2012 Oct; 9 (10): 704-12.