Ukuqhutshwa komgwaqo kubhekisela enkambeni lapho izikhala zomgogodla, njenge- foramina noma umgogodla womgogodla , zihlala zihlaselwe yizicubu ezingezona. Ukuxoshwa kwezimpande ze-Nerve, ngokuqondile, kuthinta indawo ku-foramina.
Kokubili umgogodla womgogodla kanye ne-intervertebral foramina aqukethe izicubu zesisindo - umgogodla emgodini womgogodla, kanye nezimpande zomgogodla ezimpandeni.
Uma izicubu ezingavamile, kungakhathaliseki ukuthi i-bone spur, i-ligament ene-thickened, ihambele izinto ezikudayi noma ngisho ne-cyst synovial, ithatha ingxenye ethile noma yonke isikhala, ihamba ngezinzwa ezitholakala lapho.
Ukuxhumana phakathi kwezicubu ezixubhayo nezinzwa lapho lezi zicubu zibeka khona kungabangela ubuhlungu kanye / noma ezinye izimpawu.
Uma unezimpande zomshukela wezinzwa, izicubu ezicindezelayo zicindezela noma zicasula izimpande zomgogodla. Izimpande zamasipha omgogodla iqoqo lezinzwa eziye zaxhuma emthonjeni oyinhloko yomgogodla futhi zisendleleni yokuphuma ukuze zisebenze wonke umzimba. Umsebenzi wabo ukubuyisela ukuzwela nokunyakaza emithonjeni yonke nasesiswini nakusuka ebuchosheni. Izimpande zamasipha omgogodla zikhona ku-foramina.
Izimpawu ezihambisana nokucindezeleka kwezimpande, ngakho-ke ezimweni eziningi zokungenelela, kufaka ubuhlungu bomhlane kanye / noma ubuthakathaka, ukuphazamiseka noma ukuzwa kwamandla kagesi okuwela phansi umlenze owodwa.
Yini Ebangela Ukunciphisa I-Nerve Root?
Ukuxoshwa kwezimpande ze-Nerve kuvame ukubangelwa izinguquko eziguqukayo ezakhiweni zomgogodla, kufaka phakathi i-dis, ama-facet kanye nezinye izindawo.
Izinguquko eziguquguqukayo ngokuvamile zihlotshaniswa ne-canal stenosis, okuyinto isisu somgogodla esithinta umgogodla womgogodla.
Iphinde ihlotshaniswe ne-neuroforaminal stenosis, uhlobo lwe-stenosis yomgogodla oluthinta i-intervertebral foramina.
Ingabe Kufanele Ube Nokuhlinza Okuvimbela Ukunciphisa?
Ukubuyekezwa kwezifundo ezingu-2017 ezishicilelwe encwadini ethi Medicine kutholwe ukuthi ukuhlinzwa okucindezelayo kokungenelela (ngenxa yokuqina komgogodla wakho womgogodla, ikakhulukazi i-longitudinal posterior) kuvame ukwenziwa ekuqaleni kokwelashwa. Kodwa uma uhamba kuze kube manje ukuthi ube nokuhlinzwa kokunciphisa ukuvimbela, okungukuthi ngaphambi kokuba izimpawu zenze baziwayo?
Abanye ochwepheshe be-spine bakhuthaza lokhu.
Ukwelashwa kokuhlukunyezwa yinkqubo evame ukubuyiselwa emuva esusa ingxenye ye-vertebra ukuze yenze indawo yezinzwa zemithi ukuba idlule ngaphandle kokumiswa endaweni yayo.)
Lokho abahlinzayo abazama ukukutshela - futhi abaningi bakholelwa ngempela lokhu - kungukuthi ngisho nangokuhlukumezeka okuncane, ingozi yakho yokulimala komgogodla iphakeme ngenxa yezingqinamba.
Ukulimala komgogodla kungumonakalo omkhulu ongabangela ukufa noma ukukhubazeka. Ngokuvamile kubangelwa ukuhlukunyezwa noma umthelela.
Ucwaningo luka-2015 ngu-Chang, et. al. eyanyatheliswa kuyi-Okthoba umagazini we- Neurosurgery wabheka ngalolu daba ngoba, abalobi bathi, iziguli ezine-stenosis yomlomo wesibeletho kodwa ezithola izibonakaliso ezincane noma akekho ovamile ukuhlinzwa ukucindezelwa okukhulunywe kubo - futhi, okumele kuthiwe ukunciphisa noma ukuqeda ingozi yokukhubazeka ngemva kwesenzakalo esibuhlungu.
Abacwaningi bahlola iziguli ezingama-55 ze-cervical stenosis ezinezivivinyo kanye ne-x-ray. Iziguli nazo zahlolwa ngemibuzo efana nalokhu:
- Ingabe udokotela uncome ukuhlinzwa kwentamo kuwe?
- Ingabe udokotela wake wabonisa ukuthi uzobe ukhubazekile ngemva kwesenzakalo esibuhlungu?
- Phakathi nenkathi yokulandelela yalolu cwaningo, ingabe uhlangene nesenzakalo esibuhlungu?
Abacwaningi bathola ukuthi iziguli ezingu-18% zenzeke isenzakalo esiphazamisayo ngemva kokuhlinzwa, kodwa akekho owalimaza intambo yomgogodla. Abalobi baphetha ngokuthi "ukulimala komgogodla (SCI) kulesi siguli sesiguli ngemuva kokuhlukunyezwa okuncane cishe kuncane kunokuba odokotela abaningi bagxile."
Ngokufanayo, ijaji lisaphuma kulokhu; kuyisihloko esibaluleke kangaka ukuphepha kwezempilo neziguli ukuthi abacwaningi basikisela ukuthi izifundo ezengeziwe zizoqhutshwa.
Enye into ongacabanga ngayo ukuthi kungenzeka ukulimaza izimpande zakho zezinzwa ngesikhathi sokuhlinzwa emuva. Ukubuyekezwa kwezifundo ezingu-2016 kutholakale ukuthi ezinye izinhlobo zokuhlinzwa kwe-lumbar spine zahlanganiswa nengozi ephakeme yokulimala okunjalo kunezinye. Umlobi wathola ukuthi, kuye ngokuthi uhlobo oluqondile lohlinzekwa kanye nesifundo esibucayi, izingozi ezivela ku-0% ngenxa ye- laminectomy evulekile, evame ukusetshenziswa emaphoyiseni omgogodla kuze kufike ku-45.8% lapho i-bone morphogenic protein-2 esetshenziselwa ukuhlinzwa kwe-TFIL. I-TFIL imele i-transformaminal lumbar interbody fusion; kuyinkqubo yokuxuba lapho udokotela ohlinzayo engena emgodleni wakho ngemuva.
Khumbula ukuthi isinqumo sokuhlinzwa kufanele ekugcineni. Cabanga ukuthatha isikhathi esidingekayo ukuze ulinganise izinketho zakho ngaphambi kokuvuma.
Imithombo:
> Chang, V. Ellingson, BM, Salamon, N., Holly, LT Ubungozi be-Acinal Cord Cord Ukulimala Ngemuva Kokuhlukunyezwa Okuncane Kwamalungu Ezigulane Nge-Preexisting Stervical Stenosis. I-Neurosurgery. 2015 Okthoba.
> Epstein, N. Ukulimala okungaphezulu kwezimpande zenzelwa ukuhlinzwa okuncane okungenasidingo, ikakhulukazi okungekho emthethweni kwe-interbody fusion: Ukubuyekeza. Surg Neurol Int. Jan. 2016.
> Wu, D., MD, futhi. al. Ukungenelela okuhlinzekwa kwesipervylosis yomlomo wesibeletho ngenxa yokungena kwesimo se-longitudinal posterior. Aug 2017.