Ukuqothuka Kusuka Ekujuleni Kwesibindi
I-claudication engavumelani ne-neurogenic ingenye yezinhlobo ezimbili eziyinhloko zokweqa umlenze ezihambisana nesenzo sokuhamba. "I-Neurogenic" ibhekisela eqinisweni lokuthi izimpawu ziphakama lapho izinzwa ezithintekayo ezimweni ze-lumbar stenosis. Olunye uhlobo lwe-claudication-intermittent claudication ephakathi kwezikhathi ngokuvamile lubangelwa izifo ze-vascular peripheral (PVD).
Kungenzeka ukuthi, kokubili ukucaciswa okuphakathi komphakathi kuzoba ngesitimela ohlangothini, okungenani ngezinga elithile, izinhlelo zakho zokusebenza, kepha indlela umuntu ngamunye ayenzayo ngayo ahluke ngayo.
Ngama-claudication e-vascular, imithwalo yegazi iminyene kuze kube lapho inani legazi eligeleza kuzo linganele ukuhlangabezana nezidingo zomkhawulo wakho ophansi. Ezimweni ze-neurogenic claudication, i- lumbar spine yakho (ephansi emuva) ihlala endaweni enwetshiwe isikhathi eside. Lokhu futhi, kunciphisa umgogodla wakho womgogodla noma i-neuroforamen yakho kuze kube lapho izicubu ezibuthaka ezivame ukudlulela ngaphandle kokugcizelela zicindezelwa ithambo eliseduze.
Izimpawu
I-neurogenic claudication empeleni i-syndrome noma iqoqo lezimpawu. Ihlobene nokuhlehliswa futhi ingabonisa njengoba ubuhlungu emhlane ophansi futhi / noma umlenze njengama-cramp muscle. Ukuhlanganiswa kwe-stenosis yomgogodla ngezinye izimo ezinjenge-arching ezifana ne-arching kubeka ingcindezi ezimpandeni ze-lumbosacral nezimbangela kanye / noma i-cauda equina.
(I-cauda equina-okusho umsila wehhashi- isisindo esivulekile sezinzwa ezifana nomsila. I-cauda equina ihamba ngaphansi kwengxenye enkulu yomgogodla. Umgogodla we-lumbosacral usezingeni eliphezulu ngaphezu kwe-cauda equina).
Izimpawu ze-claudication ezihambisana neurogen zivame ukulethwa ngokuhamba kanye / noma ukwandisa umgogodla emuva (futhi, ukuguqula emuva,) nokukhululeka ngokugubha, ukuhlala, kanye / noma ukuqhubekela phambili okhalweni.
Ezinye izimpawu ze-claudication eziphakathi kwegazi zihlanganisa izikhonkwane nezinaliti eziwela phansi umlenze wakho, nobuthakathaka. Izinkinga zamathumbu noma isisu zingase zenzeke uma ukucaciswa kwe-neurogenic kunzima.
Ngenxa yokuthi i-stunosis ye-spinal stunosis iqala ngokuhamba kwesikhathi futhi ingekho ngenxa yesigameko sesikhathi esisodwa, izimpawu zithatha isikhathi esithile ngaphambi kokuba zibonakale, futhi.
Ukwelapha
Ukwelashwa kwe-neurogenic claudication kuqala ngokuqhubekayo. Udokotela wakho angase anikeze imithi yobuhlungu kanye / noma ukwelashwa ngokomzimba . Uma ubona ochwepheshe wezinto zokwelapha for claudication neurogenic, kungenzeka ukuthi uzonikezwa ukuvivinya umzimba okugcizelela ukuguquguquka kwesiphambano sakho.
Okunye ukwelashwa okulondolozayo okuphathelene nesimo sokugaya umgogodla kufaka phakathi ukuguqula umsebenzi wakho, ukugqoka i-back brace noma ibhande, kanye / noma ukuba nomjovo we-spinal epidural ukuzolalisa ubuhlungu. I-North American Spine Society ithi uchungechunge lwezilonda zomgogodla we-spinal epidurals (nge imithi ye-steroid) lingasiza ekunciphiseni ubuhlungu obuvela ku-claudication (ne-radiculopathy) phakathi nesikhathi esiphakathi. Bachaza isikhathi esiphezulu njengezinyanga ezingu-3 kuya kwezingu-36.
Uma ubuhlungu obuqhubekayo buvela ekuphazamiseni okukhulu kwe-neurogenic kuphazamisa kakhulu indlela yakho yokuphila, kungase kube isibonakaliso sokuthi udinga ukuhlinzwa emuva.
Ngokuvamile, i-laminectomy (eyaziwa nangokuthi ukuhlinzeka ngokweqile) yinkqubo enikezwe ukuqina kwesiphaphu. Xoxa ngezinketho zakho nodokotela wakho ukuze uqiniseke.
Kuphawula ku-January 6, 2010, umagazini we- Journal of the American Medical Association , uDkt. Alexander Haig kanye nozakwabo basebenzise ukuthi izindinganiso ezithembekile, ezisezingeni eliphezulu ukuze zihlolwe futhi zibheke ngokucophelela ukwelashwa kwesibindi sokuphefumula. Lokhu kungasho ukuthi abanye odokotela bazosebenzisa i-MRI, CT scan kanye / noma izivivinyo ze-EMG ukuxilonga isimo sakho, kanti abanye kungenzeka. Kungasho futhi ukuthi odokotela abathile bangase babe "amathuba okuba" bangene ekuhlinzekeni emuva ngaphandle kokunikeza kuqala ukwelapha okulondolozayo ithuba.
Yenza ucwaningo lwakho bese ukhuluma nodokotela wakho mayelana nakho konke ongakwenza ngaphambi kokunquma ukuthi wenzeni.
Umthombo:
> Brunicardi, F. et.al. Ukuhlinzwa kukaSchwartz. Isahluko 41. I-Neurosurgery. Ingxenye II. Ukucabangela okucacile. McGraw-Hill. Kufinyeleleke ku-intanethi: Finyelela kumuthi. Meyi 2010.
> Comer, C., et. al. Ukuhlola nokuphathwa kwe-neurogenic claudication ehlobene nokuqina kwesibindi emgogodleni we-UK oyinhloko yokunakekelwa kwemisipha: ukuhlola okwenziwa kwamanje phakathi kwe-physiotherapists.BMC Musculoskeletal Disorders 2009.
> Andrew J. Haig, MD; Christy C. Tomkins, Ph.D. Ukuxilongwa Nokuphathwa Kwe-Lumbar Stinal Stenosis. I-JAMA. 2010; 303 (1): 71-72.
> Nadeau, M., MD Ukuthembeka kokuhlukanisa ukunqunywa kwesifo se-neurogenic kusuka ekuhlanjululeni amacilisi okusekelwe ekubonisweni kwesimiso. Ingabe J Surg. Dec. 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3859778/
> Society of North America Spine Society (NASS). Ukuxilongwa nokwelashwa kwesimo sokugulisa umgogodla we-lumbar owohlokayo. I-Burr Ridge (IL): Inhlangano YaseNyakatho Melika YaseNorth America (NASS); 2011.