Ingabe Usengozini Yokuqalwa Kwezingxenye Eziseduze?
Uma ucabangela ukuhlinzekwa kwe-spinal fusion ye-dis degenerative noma enye inkinga, ungase ube engozini ye-ASD. I-ASD ifinyelele ukuguqulwa kwesigaba esiseduze, noma ukugqoka okunye nokugqabhuka kwamalungu omgogodla ngenhla nangaphansi kwe-fusion. Nazi ezinye izinto eziyisihlanu ezivame ukubhekana nezingozi ze-ASD.
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Isizathu Sokuhlinzwa Kwakho KamuvaNgokuya kokuxilongwa okuholela ekuhlinzekeni kwakho emuva , ungase ube engozini yokwandisa i- ASD .
UDkt. John Toerge, udokotela we-osteopathic, uprofesa wezokwelapha eGeorgetown University, noMqondisi Wezokwelapha we-National Rehabilitation Hospital we-Musculoskeletal Institute, uthi abantu abaphila ngendlala yomgogodla ngenxa yezifo eziphuthumayo zegazi basengozini enkulu ye-ASD. I-Toerge ithi lokhu kungenxa yokuthi ukuguqulwa sekuvele kuqalile kumazinga angenhla nangaphansi kwendawo yenkinga, nakuba ungase ungaboni izimpawu. Ngokuvamile, udokotela ohlinzayo akafaki amafomu kulabo abaseduze, uyanezela.
I-Toerge ithi iziguli ezine-arthritis enamandla zingase zibe yingozi enkulu ye-ASD. Uyachaza: "Laba bantu banezinto ezimbalwa ezingakunciphisa ingozi," kuchaza. "Ngomthamo wokuncipha owehlisiwe, iziguli ezine-arthritis ezithuthukisiwe azikho iphutha elincane, futhi ngaleyo ndlela, zijwayele ukuqhutshelwa phansi kwesimo somgogodla."
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Iminyaka yakhoKuyamukelwa kabanzi ukuthi iminyaka idlala indima ebalulekile engozini ye-ASD.
Njengoba sikhula, izihluthulelo zethu zivame ukuhlambalaza, okuyinkimbinkimbi yokuthi ukuhlinzwa emuva kubangela i- ASD. Eqinisweni, ukutadisha kuka-1999 ngezimo ezingozini ze-ASD entanyeni, eyenziwa ngu-Hilibrand futhi enyatheliswa kuyi -Journal of Bone and Joint Surgery , yathola ukuthi ukuguqulwa kwamaphilisi okubonakalayo njengamabhayisikobho (njengama- MRIs kanye no-CT scans) kwakungenye enkulu izingozi ze-ASD.
"Umlando wemvelo wezinguquko eziguquguqukayo emgogodleni uyinguquko ehlanganiswayo lapho kunquma imbangela ye-ASD," kusho uDkt. Frank P. Cammisa, oyiNhloko Yezinsizakalo Zokuhlinzeka Nge-Spinal Surgical Service eSibhedlela Sokuhlinzwa Okukhethekile eNew York. "Uma lezi zinguquko sezivele sezikhona emgodleni wakho, zingase zibe khona (noma zingahle zikhule) ezingeni elilodwa, noma ngaphandle kokuhlinzwa."
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Indawo Yendawo Yokuhlinzwa KwakhoUmgogodla wakho unezinhlangothi eziphikisanayo, ezikusiza ukulinganisela njengoba uhamba. Lezi zindwangu zihlukaniswe ezindaweni: Umgogodla ( umlomo wesibeletho ), phezulu nangaphakathi emuva ( thoracic ), emuva okuphansi ( lumbar ), nasendaweni ye- sacral . Uma ukuhlinzeka kwakho kwenzeka lapho ukushintshwa kwejika elilodwa kuya okulandelayo - isibonelo, lapho i-thoracic iba yileli lugar (T12-L1) - ingozi yakho ye-ASD ingase ibe ngaphezulu.
I-Toerge ibiza lezi zindawo zokuguquka "izingxenye zokuhamba ezisebenzayo." Uthi ukuxolisa emagcekeni okuhamba okusebenzayo kuvame ukuletha izinkinga kamuva. Lokhu kungenxa yokuthi, uthi, ukuhlanganiswa okunjalo kungaholela ekutheni umthwalo okhuphuke emakhaneni angama-intervertebral angomakhelwane, okwakwenyusa ingozi ye-ASD, kanye nesifo esithile esiseduze.
Ucwaningo lwe-Hilibrand okukhulunywe ngaye ngenhla lithole ukuthi ubungozi be-ASD buhluka ngokuvumelana nendawo ye-fusion. Abacwaningi baqaphela amazinga e-C5-C6 ne-C6-7 (lawa angama- joint intervertebral aphansi kakhulu entanyeni yakho) njengoba ebeka ingozi enkulu kunoma iyiphi indawo entanyeni yokulahla okungabonakali ngaphambili kumafilimu. Lezi zingxenye ezimbili zokunyakaza, noma amazinga, asondelene kakhulu noma kulezi zigaba ezihamba phambili ezikhulunywe nguDkt. Toerge.
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Ubude be-FusionNgokuvamile, ingozi yakho ye-ASD iphakeme uma amazinga amaningi ehlangene.
UDkt. Cammisa uthi izinkinga zomgogodla ezidinga ukuhlanganiswa okude (amazinga amaningi ahlangene) zibeka engozini enkulu ye-ASD. Ukuhamba nge-Scoliosis yisibonelo salokhu. UCammisa uchaza uma uhlanganisiwe kusuka ku-T4-L4 (ububanzi bezingxenye zokuhamba, noma amajoyina okuphazamiseka, okuphuma phakathi kwesifuba sakho kuze kube ngaphansi kwenkinobho yakho yesisu) ukulungisa i-scoliosis, kungenzeka ukuthi eminyakeni engaphezu kwakho Izokwakha i-ASD ku-T4-5 no-L5-S1. (T4-5 no-L5-S1 yizingxenye zokunyakaza ezitholakala ngqo ngenhla nangaphansi kwe-T4 no-L4, ngokulandelana.)
Ukubuyekezwa kwe-2016 nokuhlaziywa kwe-meta eshicilelwe emaphepheni we- Clinical Spine Surgery fusion ubude yisici esikhulu kunazo zonke ezihlobene nokuguqulwa kwesigaba eseduze nezifo. Abalobi basikisela ukuthi ukunciphisa inani lamazinga ahlanganisiwe kungaba isu elingcono kunokushintsha indlela ukuhlanganiswa kwenziwe ngayo.
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Ukumiswa Ngaphambi Nesikhathi Phakathi Nokuhlinzwa Kwakho EmuvaUkuma kwakho, kanye nokuhlelwa kwamathambo akho ngesikhathi sokuhlinzwa, kungathinta ingozi yakho ye-ASD. Uma une-kyphosis ngesikhathi se-fusion, ungase uhlangabezane nakho kwesikhathi esizayo ukuxhuma ezinhlangothini zakho zezinhlamvu . Lokhu kungabangela ubuhlungu kanye nezinguquko ezishintshashintshayo ezibonisa ukuthi i-ASD. Kungase futhi kuholele emthonjeni we-arthritis emagcekeni ezinhlangothi.
Ukuhlukumeza okubili kokuthunyelwe okuhambisana nokuthuthukiswa kwezinguquko zokugaya komgogodla kanye ne-ASD zihlobene komunye nomunye. Uma ukuhlelwa kwakho kunjengokuthi isifuba sakho siphenduliwe emuva (esibizwa ngokuthi impumuko ye-pelvic) ngesikhathi sokuhlinzwa, imisipha enesibopho sokubamba iqotho ingakhuba kalula ngemva kwalokho. Ngokuhamba kwesikhathi, lokhu kungaholela ekubukeni nasekushintsheni okwenyukayo kule ndawo yomgogodla wakho.
I-angle ye-sacrum yakho ngesikhathi sokuhlinzwa yenza umehluko, futhi. Ngokuvamile, phezulu kwe-sacrum kuhamba phambili (njengoba kwenza i-pelvis, okukhulunywe ngenhla). Uma i-sacrum yakho ihamba ngokuqondile noma eduze nesikhundla esiphakathi ngesikhathi sokuhlinzwa (okungase kube njalo uma i-pelvis yakho iguqulwa emuva), ingozi yakho ye-ASD ingakhuphuka.
Futhi ekugcineni, ingabe unomsebenzi wokuhamba phambili kwekhanda? Uma kunjalo, futhi une-fusion yomgogodla, ingozi yakho ye-ASD ingabuye yanda.
Ngenkathi ezinye zalezi zinkinga zingakwazi ukubhekana nodokotela wakho odokotela ngenkathi yenqubo, khumbula ukuthi uletha ukuhamba kwakho nawe etafuleni lokusebenza.
Kwabaningi bethu, ukuhlelwa kwemvelo ukuqoqwa kwemikhuba ngokuhamba kwesikhathi; kwabanye, liyingxenye yesakhiwo sethu. Uma ikhyphosis yakho, ikhanda eliphambili, i-sacral angle, kanye / noma i-pelvic ne-tilt nezindaba eziphathelene nokuthutha okuhlobene ne-pelvic ayakhiwa emathanjeni akho (futhi kwezinye izimo, noma ngabe zikhona), ebona isazi esingokwenyama sehlelo lokuzivocavoca ekhaya ngaphambi kokuhlinzwa kungakusiza ukunciphisa ezinye zezinkinga zakho ze-ASD.
"Ukuzivocavoca okukhethiwe ngokucophelela ukuze uqinise izindawo eziyingozi kungasiza kakhulu ekunciphiseni izimpawu zakho," kusho uToerge.
Imithombo:
UCammisa, F., MD, uMphathi we-FACS, iSpinal Surgical Service e-Hospital for Surgery Special. I-imeyili Ingxoxo. Jan 2012.
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I-Kyoung-Suok Cho, MD, ne-. al. Izingozi Zengozi Nezokwelapha Ezihlinzekwa Isigaba Sokwemvelo Esimisiwe Ukuvuselelwa emva kwe-Lumbar Spine Fusion. J Korean Neurosurg Soc. 2009 November; 46 (5): 425-430.
I-Hilibrand, A., MD. et. al. I-Radiculopathy kanye ne-Myelopathy ezigabeni eziphambili kwiSayithi se-Anterior Cervical Arthrodesis yangaphambili. I-Surgery ye-Bone ne-Joint Surgery. 1999.
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U-Schlegel JD, et. al. Ingxenye ye-Lumbar motion pathology eduze kwe-thoracolumbar, i-lumbar, ne-lumbosacral fusions. Isiphambano (Phila Pa 1976). 1996 Apr 15; 21 (8): 970-81.
I-Toerge, J. DO, i-Medical Director Musculoskeletal Institute National Rehabilitation Hospital, eWashington, DC. I-imeyili Ingxoxo. Jan 2012.
Zhang, C., et. al. Ukuguqulwa Kwengxenye Eyinkimbinkimbi Kanye Nezifo Emva kwe-Lumbar Spine Fusion ye-Degenerative Pathology: Ukubuyekezwa Okuhlelekile Ngokuhlaziywa Kwezincwadi. I-Clin Spine Surg. Feb 2016 http://www.ncbi.nlm.nih.gov/pubmed/26836484