Kuze kube ngu-74.6% wamaphesenti ahlinzeka ngokuhlinzwa okuphuthumayo ahlukumeze ngokuphelele ubuhlungu, ngokusho kokubuyekezwa kuka-2016 okushicilelwe encwadini ye- Journal of Pain Research.
Yikholelwa noma cha, kukhona igama lezokwelapha le-syndrome ye-back-back failed. I-FBSS njengoba ivame ukubizwa ngokuthi ifushane, ibhekisela ebuhlungu obuphikisayo obulandela ukuhlinzwa kwangemuva. Ubuhlungu bungaba emuva kwakho, emlenzeni wakho, noma kokubili.
I-FBSS inezincazelo ezingenakuqhathaniswa, futhi njengoba uzobona, kungaba ngokushesha isimo esiyinkimbinkimbi.
Amanye amagama we-syndrome ehluleka ukuhlinzwa emuva ahlanganisa: Isifo se-post-lumbar syndrome, i-post-laminectomy syndrome, i-back syndrome ehlulekile, nokuthunyelwa kwesifo se-operative eqhubekayo. (I-syndrome iqoqo lezibonakaliso nezimpawu).
Yikuphi Ukuhlinzwa Okungemva Kokuthi Kungakunika Ukuhluleka Ukubuyela Kwesifo?
Ngenkathi ukuhluleka kokuhlinzwa emuva emuva kungase kubangelwe kunoma yiluphi uhlobo lokuhlinzwa emuva, okuvame kakhulu kuhlanganisa i-laminectomy ne-discectomy. I-Laminectomy, eyaziwa nangokuthi i-decompression, yinkqubo lapho ingxenye ye-bony ring ngemuva kwe-vertebra isuswe ukuze yenze indawo yezinzwa ukuba idlule ngaphandle kokugcizelela. I-Laminectomy ivame ukusetshenziselwa ukulawula izimpawu zesisu somgogodla.
Ku-discectomy, izingcezu ze-disc ye-herniated zisusiwe emgodleni wakho. Ukususa i-disc izingcezu kungasiza ukuthatha ingcindezi emisipha yomgogodla. Lokhu kungenxa yokuthi izingcezu zivame ukuba "umhlaba" ezimpandeni zesisu zomgogodla , zibacasule futhi zivame ukubangela ubuhlungu kanye nezinye izimpawu.
Esinye sezizathu zokuthi i-laminectomy ne-discectomy inenani eliphakeme lokuhluleka lingase lihlangane kanjani nokuthi lezi zindlela zokuhlinza izigulane ziphakathi kwezinto ezivame ukunikezwa iziguli.
Kwenzekani Ngemva Kokuhlinzwa Okuhlulekile Kamuva?
Ngokuqondile kwenzekani kubantu abahlinzwa ukuhlinzwa emuva "? Ngeshwa, isithombe singase siphephe; lokhu kungenxa yokuthi ayikho ikhambi langempela le-FBSS.
Udokotela wakho angase asiphakamise ukuhlinzwa okubili, okubizwa ngokuthi ukuhlinzwa okubukezwayo , kodwa, lokhu, kuxhomeke ezintweni eziningi kuhlanganise nohlobo lokuhlinzekwa owawunalo ekuqaleni, uhlobo lobuhlungu obhekana nakho ngemuva kwalokho nokuningi. Futhi uma ukuhlinzwa okubukezwayo kungakhulumi izimpawu zakho, udokotela wakho angakukhuthaza nokuba uqhubeke nenye inqubo evumayo.
Ngandlela-thile, phakathi kwamaphesenti angu-13 no-35% wabantu abathola ukuhlinzwa emuva futhi bathola ukuhlinzwa okubukezwayo, ngokusho kokubuyekezwa kuka-2016 okukhulunywe ngenhla.
Ukubuyekezwa kubonisa ukuthi ukuhlinzwa okuphindaphindiwe akugcini nje ukuholela ezindlekweni eziphezulu zokwelashwa kodwa njengoba inqubo ngayinye elandelanayo isenziwa, izinkinga zomphumela owanelisayo ziyancipha.
Kukhona ezinye izindaba ezinhle kukho konke lokhu, noma kunjalo. Abantu abaningi abathola ukuhlinzekwa kwe-2 no-3 babika ukuthi izinqubo ezilandelayo zisebenza kahle-ubuhlungu babo nezinye izimpawu ziphelile, futhi iminyango yabo izwa injabulo entsha.
Kodwa abantu abane-syndrome ye-back-back ehlulekile abaye babhekana nokuhlinzwa okuphindaphindiwe okuncane noma okungekho ukuthuthukiswa ngokuvamile kuvunyelwe ukuphathwa ubuhlungu. Kulesi simo, imithi yokuhlunguphazwa kanye neuromodulation- okubandakanya noma i-stimulator ye-spinal cord, noma ngokuvamile, njengendlela yokugcina, ubuhlungu obufakiwe (izidakamizwa) ipompo-zivame ukuvivinywa, kanye nokuzivocavoca, izindlela zokwelapha eziphelele kanye nokuziphatha okucatshangelwayo ukwelapha.
Ukufunda indlela yokuphatha ubuhlungu nsuku zonke kuyinkhono eliyinhloko elithuthukile uma ukhona ohlelweni lokuphatha ubuhlungu .
Ukusetshenziswa kwezinhlelo zokuvuselela izintambo zomgogodla ukulawulwa kobuhlungu kuqhuma embonini okwamanje. Ukuqala phakathi nekhulu lama-20, kuphumelela kakhulu njengengxenye yohlelo lokwelapha jikelele lwezinhlungu ezilandela ukuhlinzwa emuva. Lolu hlobo lobuhlungu ngokuvamile luhlanganiswa nobuhlungu benzwa, ikakhulukazi, i-radiculopathy, nobuhlungu obuvela ekulimaleni komzimba (okubizwa ngokuthi i-nocioceptive).
Manje ukuthi wazi kancane mayelana nesifo se-back back failure, ungase uzibuze ukuthi kwenzekani "ngaphansi kwe-hood" ukuze ukhulume; Ngamanye amazwi, kungani ubuhlungu ngemva kokuhlinzwa?
Akufanele yini ukuhlinzwa kukhululeke ubuhlungu bakho?
Ukuhluleka Kokubuyiselwa Kokubuyela Kwama Syndrome
Ngokuvamile, ukuhluleka kokuhlinzwa emuva emuva kwehluleka ukuqondakala njengokuthi kwenzeke ngesikhathi sesinye sezigaba ezintathu: Isigaba sokuhlela, isigaba sokusebenza, nesigaba sokuthutha.
Isigaba sokuHlelwa
Isigaba sokuhlela sihlanganisa izinto ezinjengalezi: Ingabe ungumuntu omele ukhetho lokuhlinzwa kuqala?
Uma umgogodla wakho ungaguquki ngisho nangaphambi kokuba uhlinzekwe kuba yindlela yokukhetha (okungukuthi ngenkathi wenza izinkambo ukukhuluma nochwepheshe, odokotela abahlinzayo kanye namanye amalungu enkampani yokwelapha ngomzamo wokuthola ukuthi kwenzekani,) ukuhlinzwa emuva cishe hhayi kuwe.
Uma ubuhlungu bakho bungabangelwa izinto ezinjenge-disni ye-herniated, futhi, ungase ungabi ngumuntu omele ukhetho lokuhlinzwa. Izimo zezempilo eziwela kulesi sigaba zihlanganisa izinkinga zemethamo ezifana nesifo sikashukela, kanye nezinkinga ze-vascular (blood vessel), amagciwane nama-tumor.
Ukuhlukunyezwa kwangaphambilini kungenye isizathu ongavinjelwa ukuhlinzwa emuva, naphezu kobuhlungu bakho.
Futhi ekugcineni, uma, kanye nomlenze wakho noma ubuhlungu bokubuyela emuva, unesifo sokucindezeleka, ukukhathazeka noma ezinye izinkinga ezingokwengqondo, ungase ube engozini enkulu yokuhluleka ukuhlinzwa kwe-back back. (Into okufanele ucatshangelwe ngaphambi kokunquma ukuqhubeka ngenqubo).
Phakathi nokuhlinzwa okubuyiselwa emuva
Isigaba sesibili se-FBSS imbangela-eyenzeka ngenkathi usendafuleni yokusebenza-kufaka izinto ezifana nephutha lokuhlinza futhi uhlobo lokuhlinzwa olutholayo (ikakhulukazi njengoba luhlobene nohlobo noma ubunzima bezimpawu ze-FBSS ezenzeka kamuva).
Yiziphi izinhlobo zamaphutha ongazenza udokotela ohlinzayo ngenkathi "ungaphansi?" Angase asebenze ezingeni elingalungile, noma ohlangothini olungalungile lomzimba wakho. Noma angase asebenze noma asebenze, okusho ukuthi ususa noma kuncane kakhulu isakhiwo somgogodla.
Uma esebenza, lokhu ngezinye izikhathi kubhekwa njengento enobudlova, futhi kungabangela ukungazinzi komgogodla okwakungekho ngaphambi kokuhlinzwa. Uma esebenza, angase ahluleke ukususa ezinye noma zonke izinto eziwumthombo wobuhlungu bakho (okuthiwa "ama-generator ubuhlungu").
Futhi izwi lesixwayiso. Uma ukhethe inqubo encane encane njengendlela i-microdiscectomy-mhlawumbe ngenxa yokuthi utshelwe ukuthi kuyoba lula kuwe kunomusa wendabuko ovulekile-izimpawu zakho ze-FBSS (uma uthola) kungenzeka ukuthi zingabi lula. Nakuba abanye kulo mkhakha bengavumelani, ochwepheshe bezintambo eziningi bakholelwa ukuthi inqubo encane engavamile ayisho ukuthi i-FBSS izoba mnene, futhi. Eqinisweni, ukubuyekezwa kwe-Journal of Pain Research okukhulunywe ngawo ngenhla kwalesi sihloko akukho izindlela zokuhlinzeka ukuthi, lapho zisetshenzisiwe, zizoqinisekisa ukuthi i-FBSS ayenzeki.
Isigaba sesi-3 uma i-FBSS ibangelwa uma kwenzeka inqubo. Ebizwa nge-post-operative, leli qembu lezindaba zezempilo lingaba yinoma yikuphi ukutheleleka, ukugezwa kwamagundane noma ama-hematomas ukuphindaphinda ukuxoshwa kwegazi, ukuhlushwa kwemisipha, nokunye okuningi. Nansi uhlu olufushane lwezinto ezingabangela ubuhlungu ngemuva kokuhlinzwa kokusebenza kwe-lumbar.
- Ukutheleleka. Ucwaningo lwango-2016 oluzama ukuthola ukuthi yini eyenza abantu babuyele esibhedlela esitholakala ukutheleleka kube yinkimbinkimbi evame ukuhlangana nayo.
- I-Pseudoarthrosis, igama elivamile elisetshenziselwa ukuphuka kwethambo elingaphilisi. I-pseudoarthrosis ngemuva kokuhlinzwa kwemigogodla ngokuvamile ihlobene nenqubo yomgogodla we-spinal futhi ibonisa ukwehluleka kwamathambo ukuze kufinyelele indlela okufanele bayenze ngayo.
- I-Epidural fibrosis yigama lezokwelapha eliyinkimbinkimbi yezinyosi ezibomvu ezakhela izimpande zomgogodla. Kuyinto evamile kakhulu emva kokuhlinzwa emuva.
- Izinguquko kumzimba wakho we-anatomy kanye / noma womzimba we-biomechanics zingabangela ukungazinzi komgogodla , ukungasebenzi komzimba kwe-sacroiliac , i- foraminal stenosis (okungukuthi, ukwehlukaniswa "kwemigodi" eceleni komgogodla owadlula kuwo). Izinguquko ezinjalo zesakhiwo zingase zibe nokucindezela okwengeziwe kwezinye izindawo zamathambo omgogodla phezu kwabanye, okuholela ezinkingeni eziningi emgodini kamuva. Eqinisweni, lapho lokhu kwenzeka, ungathola ukuthi ubuhlungu nezinkinga ezakuholela ekutheni ufune ukuhlinzwa.
- I-muscle spasm ethinta imisipha yama-paraspinal, imisipha ye-diaphragm kanye nabanye.
- Izinguquko emathisini wakho we-myofascial (i-myofascia ibhekisela emathini ehlanganisayo ehlanganisa izicubu ezisiza umzimba ukuba ugcine ifomu kanye nobuqotho bawo) kungabangela ubuhlungu obukhulunywayo obungase budideke kalula ne-radiculopathy. (I-Radiculopathy ibhekisela ebuhlungu nasezintweni zikagesi, kanye nokuziphazamisa nokubuthakathaka okungase kube phansi umlenze lapho izimpande zomgogodla zicasuliwe noma zicindezelwa. Abantu abaningi bayabiza le " sciatica ").
Izinguquko zemvelo zingase zenzeke eduze nesilinganiso se-vertebral esetshenziswayo, ikakhulukazi emisipha ye-paraspinal engena ku-spasm. - Ibhalansi yakho yangaphambili nangemuva ingaphazanyiswa ngemuva kokuhlinzwa kwangemuva, futhi futhi, ukuzinza nokusebenza kwakho njengoba uhamba ngemisebenzi yakho yansuku zonke kungashintshwa.
Ikusasa le-FBSS
Kuze kube muva nje (2016), ukusetshenziswa kwegama elithi, "ukuhluleka ukuhlinzwa emuva emuva" kusho ukuthi ubuhlungu, izimpawu kanye / noma izinkinga zempilo ezintsha noma eziqhubekayo ngemuva kokuhlinzekwa komgogodla kwakuyisiphambeko sochwepheshe. Njengoba ungabona kusuka ngenhla, lokho ngezinye izikhathi kuyiqiniso, kodwa ngokuvamile kunezinye izizathu ze-FBSS.
Imbonini okwamanje iyashintsha njengoba ifuna ukuvumelana mayelana nencazelo entsha ye-FBSS. Lokhu kuhilela, phakathi kwezinye izinto, ukukwazi ukuqamba kabusha isimo kanye nokufika ngolwimi olugxile kakhulu esikhathini esizayo (okufanele ukwenze ngokulandelayo) kanye nodokotela ohlinzayo obangaphansi.
> Umthombo:
> Blond S., Mertens P., David R., Roulaud M., Rigoard P. Kusuka "Mechanical" kuya "Neuropathic" I-Back Pain Concept ku-FBSS Iziguli. Ukubuyekezwa Okuhlelekile Okusekelwe Ezizindleleni Eziholela Ekupheleni Kwengxenye Yezinhlungu C). I-Neurochirurgie. Mashi 2015. https://www.ncbi.nlm.nih.gov/pubmed/25596973
> Blond S., David R., Mertens P. Pathophysiological Characterzation of Generator Pain Generator ku-Emuva Ukuhlinzwa Okusindayo Syndrome (Ingxenye B). I-Neurochirurgie. Mashi 2015. https://www.ncbi.nlm.nih.gov/pubmed/25456443
> Bordoni B., i-Marelli F. Yehlulekile Ukuhlinzwa Ukuhlinzwa Syndrome: Ukubukeza kanye Namaqiniso Amasha. J Pain Res. Jan 2016. https://www.ncbi.nlm.nih.gov/pubmed/26834497
> Durand G., Girodon J., Debiais F. Ukuphathwa Kwezokwelapha Zokuhlinzwa Okuhlulekile Ukubuyela EYurophu: Izindlela Zokuhlola Nokumiswa Kwezimpawu. I-Neurochirurgie. Mashi 2015 https://www.ncbi.nlm.nih.gov/pubmed/25676909.
> Rigoard P., Desai M., Taylor R. Ukuhlukunyezwa Kwamaphutha Okuhlukumezayo: Kuyini Igama? Isiphakamiso Sokufaka "i-FBSS" esikhundleni sika "POPS" I-Neurochirurgie. Mashi 2015. https://www.ncbi.nlm.nih.gov/pubmed/25665773.