Ukungaboni kahle kwe-Disc Herniated
Ngesikhathi se-discectomy, izingcezu ze-disc herniated ezicindezelayo emndenini noma emgodleni womgogodla zisuswa ngokuhlinzwa. Ukungaqondakali kwenziwa ngenkathi i-disc ye-herniated ibangela ubuhlungu kanye / noma ezinye izimpawu ezifaka ukungabi namandla, ubuthakathaka noma izinzwa zombane phansi komlenze owodwa noma ingalo.
Uma i-disc ye-herniated iyimbangela, lezi zimpawu zibizwa ngokuthi i-radiculopathy, kodwa abaningi abangewona ukwelashwa babhekisela kubo njenge- sciatica .
Uma une-discectomy, konke noma ingxenye ye- lamina , eyindawo yethambo ngemuva kwe-vertebra, nayo kufanele isuswe. Lokhu kuzokusiza udokotela ohlinzayo ukuba afinyelele isisindo ne-disc. Kuncike ekutheni isisindo sisuswe kangakanani, lesi sici senqubo singaba namagama amabili. I-laminectomy isusa yonke i-lamina, kuyilapho i-hemilaminectomy isusa isigamu se-lamina kuphela.
Kuyadingeka nini i-Discectomy?
Esikhathini esiningi, izindlela zokwelapha ezifana nemithi , ukwelashwa ngokomzimba, noma ukujola ama-steroid kuvivinywa ngaphambi kokuhlinzwa. Empeleni, i-disc ye-herniated ivame ukuphilisa ngaphandle kokuhlinzwa-kodwa lokhu kungathatha unyaka. Ukuba ne-discectomy kunganciphisa isikhathi sakho sokuphulukisa. Uma ubuhlungu bakho bukhulu, noma ubuthakathaka / ubunzima obubonakalayo, i-discectomy ingase ibe yinto enhle, kodwa uma izimpawu zakho zilula noma zilinganisela, ukwelashwa kungase kube yilokho okudingayo.
Kungakhathaliseki ukuthi yiyiphi indlela, xoza izimpawu zakho kanye nokukhetha kwakho nodokotela wakho.
Microdiscectomy
I-Microdiscectomy iyinkqubo encane encane eyenziwa ngesilungiselelo sesipiliyoni. Ukucubungula okuncane kakhulu okwenziwe esikhumbeni kanye nezinsimbi ezincane ezenziwe nge-tube zifakwa yonke indlela kuze kube yilapho zifinyelela ku-disc. Ukuhlinzwa konke kwenzeka ngokusebenzisa lezi zinto.
Phakathi ne-microdiscectomy, imisipha ayinqunywanga njengoba ikhona ngesikhathi se-discectomy evulekile; kunalokho basuswa endleleni.
Ngenxa yalokhu, isikhathi sokuphulukisa ngokuvamile sibuhlungu futhi sinabuhlungu kakhulu kunezinqubo ezivulekile.
Vula i-Discectomy
I-discectomy evulekile yindlela yokuhlinzwa yangokwemvelo . Yenziwa endaweni yokubhedlela ngaphansi kwe-anesthesia jikelele. (Mhlawumbe uzodinga kuphela ukuhlala esibhedlela usuku olulodwa.)
I-discectomy evulekile ihilela ukwenza i-incision engaba ngu-1 "ubude; imisipha kufanele ikhwekwe ukunikeza udokotela ohlinzayo ukufinyelela kwi-disc. Njengoba kuxoxwe ngenhla, lokhu ngokuvamile kusho isikhathi esengeziwe sokuphulukiswa emva kokuhlinzwa kuyodingeka. ngemuva kwezinqubo ezivulekile kungaba buhlungu nakakhulu.
Ngaphandle kokuhlukana kanye nobunzima esikhathini sokuphulukiswa emva kokuhlinzwa, lezi zinqubo ezimbili zifaniswa.
Ucwaningo oluncane lwe-2011 olwanyatheliswa kuyi- Journal of Surgery Orthopedic (oluvela eHong Kong) lathola ukuthi kokubili discectomy evulekile kanye ne-discectomy encane encane yayiphumelele ngokufanayo ekunciphiseni izimpawu. Kodwa, abalobi bathi, ukuhlinzwa okuncane okungavamile kudinga ukuhlala esibhedlela esifushane, ekuqaleni kubuyela emsebenzini futhi kuphinde kubhekane nenkinga yokuqala.
Lokho kusho ukuthi abalobi baqaphele ukuthi amasu amancane angenawo ama-discectomy afuna kakhulu udokotela ohlinzayo, futhi adinga ukuqeqeshwa okuqondile.
Ukukhetha i-Surgeon ye-Discectomy
Bobabili ama-orthopedic and neurosurgeons benza izinhlobo eziningi zokuhlinza emuva, kufaka phakathi izidakamizwa.
Noma yiluphi uhlobo lodokotela oluzolungiswa kahle emsebenzini. Ukuzikhethela udokotela ohlinzayo we-discectomy kwehle ngempela ekuhloleni kwakho izinga lekhono lomuntu. Unganqikazi ukubuza imibuzo eminingi ngaphambi kokunquma ukuthi ubani ozokwenza lenqubo.
Ukuphumelela kwama-Discectomies
I-Discectomy isebenza cishe ngo-80 kuya kwezingu-90% wesikhathi futhi ngokuvamile ibangela ukuphumula okusheshayo kobuhlungu bomlenze nezinye izimpawu. Izinzuzo ze-discectomy zibambe ngokuqhubekayo ngesikhathi esithile - isifundo eshicilelwe encwadini ye- Spine sathola ukuthi iziguli eziningi zokuhlinzwa zajabulela ukuphumula okuphelele ngisho nangemva kweminyaka eyishumi.
Futhi isifundo se-2017 eshicilelwe encwadini kaNovemba 2017 ye- Clinical Orthopedics kanye noCwaningo oluhlobene nalo lathola ukuthi ngaphezu kwamaphesenti angamashumi ayisishiyagalolunye nesithathu kweziguli ze-discectomy zazihamba kahle eminyakeni eyisikhombisa ngemva kwenqubo.
Kodwa isifundo se- Spine sathola ngemva konyaka owodwa, 25% kokubili iziguli zokuhlinzwa kanye neziguli zokunakekelwa kokuzimela zazidinga ukuhlinzwa okungeziwe (ngaphezulu). Ngemuva kweminyaka eyi-10, iningi lamaqembu womabili labika ukuxazululwa kwesikhathi esibuhlungu kobuhlungu babo, kodwa lokhu kwakuyiqiniso kubantu abaningi eqenjini lokuhlinza (69%) kunalesi sigungu sokunakekelwa kokuzimela (6%.)
Ukuhleleka kokuphindaphindiwe kwe-herniation kungokoqobo. Ukubuyekezwa okuhlelekile kwezinguquko zika-2015, bathole ukuthi ngemva kweminyaka emibili, ubuhlungu bungase buphinde bufike kuma-25% weziguli ezahlukana nezinga elilodwa. Abalobi bathi kulokhu, cishe u-6% udinga ukusebenza kabusha.
Izindaba ezinhle ukuthi ukuhlinzekwa kwe-disc yokuvuselela i-recurrent akudingeki ngaso sonke isikhathi. Okunye futhi, ucwaningo lubonisa ukuthi ukuhlinzeka nokunakekelwa ngokucophelela kwe-herniation elandelayo ngemuva kokuthi i-discectomy ithole imiphumela elinganayo ngokukhululeka kobuhlungu.
Izinkinga zezinkinga
Kanye nekhono lokubamba kabusha (okukhulunywe ngaye ngenhla) izingozi ze-discectomy zifaka ukutheleleka, ukuphuma, ukulimala kumlenze wokugcina, okuyinto ehambisana nomgogodla , noma ukulimala emithonjeni eseduze, emithanjeni noma emithanjeni.
Uma ubona ukubomvu noma ukukhipha ukukhishwa kwakho, ubuhlungu noma ubuthakathaka phansi kwengalo yakho noma umlenze, uba ngumkhuhlane, unenkinga yokugwedla noma ukuphuma, shayela udokotela wakho ngokushesha.
Ngemuva kwe-Discectomy yakho
Ungaba nobuhlungu bokuthutha ngemuva kokuhlinzwa. Ubuhlungu obuvela ku-disc yakho ye-herniated bungase buhlale isikhashana, futhi.
Kungumqondo omuhle ukuqala ukuhamba ngokushesha ngemuva kwenqubo yakho njengoba ukwazi. Lokhu kuzokusiza ukuphumula okusheshayo, ukuvimbela izicubu ezincane futhi uhlanganise umgogodla wakho. Kungakapheli amasonto ambalwa, kufanele ukwazi ukugibela ibhayisikili noma ukubhukuda. Iningi labantu libuyela emuva ukusebenza emasontweni angu-2-8, kuye ngokuthi umsebenzi wabo unjani. Ukwelapha ngokomzimba kungakusiza ekuphindeleni okusheshayo emsebenzini naseminye imisebenzi. Uma udokotela wakho engakunikeli ku-PT, ungase ucabange ukumbuza ngakho.
Iziguli eziningi, ikakhulukazi nge-discectomy yokuqala, zithola ngokugcwele.
Imithombo:
I-Garg, B., Nagraja, U., Jayaswal, A. I-discectomy e-microendoscopic evulekile yokuhlukaniswa kwe-lumbar: ukutadisha okungahle kwenzeke ngokungahleliwe. UJ Orthop Surg (Hong Kong). Ngo-Ephreli 2011. Kufinyelelwe ngo-Feb 2016. http://www.ncbi.nlm.nih.gov/pubmed/21519072
Dewing et al. Imiphumela ye-microdiscectomy lumbar endaweni encane, esebenzayo: ukulungiswa ngohlobo lwe-herniation nezinga. Isiphambano (Phila Pa 1976). Jan 2008.
Atlas et al. Imiphumela emide yesikhathi eside yokuphathwa nokuhlinzwa okungenasidingo kwe-sciatica eseceleni kwe-lumbar disc herniation: imiphumela engu-10 kusukela ekutadisheni kwe-maine lumbar spine. Isiphambano (Phila Pa 1976). Apr 2005. http://www.ncbi.nlm.nih.gov/pubmed/15834338
I-NASS. Vula i-Discectomy. I-NASS. Burr Ridge, IL. Kufinyelelwe: Feb 11 10.
Legrand et al. Isiqephu Sengxenye YeFrance Society yeRheumatology. I-Sciatica kusuka ku-disk herniation: Ukwelashwa noma ukwelashwa? I-Joint Bone Spine. Dec 2007.
Parker S., Mendenhall S., Godil S., Sivasubramanian P., Cahill K., Ziewacz J., McGirt M. Ukukhubazeka Kwesihlungu Esiphansi Emuva Emva kweLumbar Discectomy ye-Disc Herniated kanye Nemiphumela Yayo Emiphumeleni Ebikwe Iziguli. I-Clin Orthop Relat Res. Juni 2015. Kufinyelelwe ngo-Feb 2016. http://www.ncbi.nlm.nih.gov/pubmed/25694267
> Virk, S., et. al. Iyini izinga lokulahlekelwa okubukeziwe ngemuva kwe-Primary Discectomy ku-National Scale? I-Clin Orthop Relat Res. Nov 2017.