Ukuhlanganiswa kwe-spinal bekuyi-"standard standard" yokuhlinza ngezinkinga eziningi zezinkinga emuva kwesikhathi eside. Kodwa ngokusho kwabasekelayo, i-dis replacement - inqubo entsha e-United States - kungenzeka ukuthi ngelinye ilanga lithathwe.
Nokho, okwamanje, kunamanye amafesheni amaningi omgogodla ayenziwa kunokwesekwa kwama-disc okuvamile okwejwayelekile emgogodini njengesifo se-disenerative, i-scoliosis nokuningi.
Futhi lokhu kungakhathaliseki ukukhathazeka okuqhubekayo nemibuzo engaphenduliwe mayelana nokuhlanganiswa.
Ukuhlaziywa okuqhathaniswa nokulinganisa kwama-lumbar spinal fusions kuze kube yiminyaka engu-2000 kuya ku-2008 kusetshenziselwa ukushintshwa kwe-disc okwakushiwo u-2% wabo bonke abahlinzekwa ngogesi. Ucwaningo lwanyatheliswa ngo-Okthoba 2011 wephephandaba i- Surgical Neurology International.
Kungani I-Disc Yokufakelwa Kokuhlinzwa?
Ukukhishwa kwe-disc totali kwenzelwe, okungenani ngeyingxenye, ngaphandle kokukhathazeka ngemiphumela umfutho we-spinal ungase ube namagceke we- vertebral ngenhla nangaphansi kwesayithi lokuhlinza. Ngoba amathambo amabili aseduze ahlangene ndawonye emgodini we-spinal - ekuqedeni konke ukunyakaza kuleso sigaba somgogodla - indlela umgogodla uhamba ngayo emva kokusebenza kungashintshwa, nokucindezelwa okungeziwe kubekwe kumajoyini aseduze. Abanye ochwepheshe bakholelwa ukuthi ukucindezelwa okungeziwe kuholele ekuwohlokeni kulezo zindawo.
Abanye abaqiniseki ukuthi lezo zinguquko zokuthungwa komgogodla ezokuthunyelwa komzimba zibangelwa ukuhlinzwa.
Noma ngabe yikuphi, ukucabanga ngemuva kwe-disc total esikhundleni ukuthi kugcina amandla akho omgogodla ukuhambisa ezingeni (s) inqubo yenziwe. Ngale ndlela, ukushintshwa kwe-disk kungasiza ukunciphisa isifo sezithuba zokuguqula ukuguqulwa kwezigulane ezingxenyeni eziseduze.
Ukuguqulwa kwamalungu omgogodla ngenhla nangaphansi kwesayithi lomfutho we-spinal isaziwa ngokuthi ukuguqulwa kwesigaba esiseduze, noma i-ASD .
I-Disc Yokufakelwa Kokuhlinzwa - Yini Esaziyo?
Nakuba ukuhlinzwa kokulondolozwa kokunyakaza, ne-dis replacement esikhundleni sohlobo oluvame kakhulu, kusengumusha e-United States, ubufakazi bubonisa ukusebenza kwayo. Ngokufanayo, abacwaningi baqhubeka beqoqa idatha yesikhathi eside emiphumeleni kanye nezingozi.
Ngokukhomba imiphumela ethize, umnyaka we-10, umbiko womphumela wesikhathi eside oshicilelwe emaphephandabeni ( Scientific Reports) ngo-2017 womeleza ulwazi oluvamile (phakathi kwabahlinzayo nabachwepheshe, okungenani) ukuthi imiphumela yokuguqula i-disc kanye nokuhlinzwa kwe-fusion cishe ilingana. Abacwaningi bathola ukuthi ukuthuthukiswa kwe-ASD ngemuva kwenqubo, isivinini sokuphumula kanye nemiphumela ebuhlungu konke kwakungalingana phakathi kwezinqubo ezimbili.
Ucwaningo lwango-2017 olwanyatheliswa ku- Global Spine Journal luqhathanisa imiphumela phakathi kwenani lama-disc esikhundleni kanye nezinhlobo zokuhlinzekwa kwe-fusion kumagciwane aphansi. Abacwaningi bathola ukuthi iziguli ezithatha ukushintshwa kwezidakamizwa zibonisa ukuthuthukiswa okungaphezulu kokuphumula ubuhlungu nokukhubazeka kuneziguli ezingama-spinal fusion kuzo zonke izikhathi zokufunda ngemuva kokuhlinzwa (amasonto ayisithupha, izinyanga ezintathu, izinyanga eziyisithupha kanye nonyaka.)
Kulolu cwaningo, iziguli ze-disc zabuyela emsebenzini cishe ezinsukwini ezingamashumi ayisithupha nanhlanu ngokushesha kuneziguli ze-fusion.
Ingabe Uyakuthola Ngokufanele Ukwakhiwa Kwezingxoxo Zama-Total?
Kodwa lokhu kwakuwukucwaninga okulodwa nje kumazinga wokubuyekeza. Ucwaningo lwe-2015 olwanyatheliswa ku- Asian Spine Journal lithole ukuthi okwamanje, okungenani, ukuhlinzwa kabusha nokuvuselelwa kokuhlinzwa kwenzeke cishe ngesilinganiso esifanayo kungakhathaliseki ukuthi ukuhlinzwa kokuqala (okubizwa ngokuthi "index") kwakuyindlela yokuguqula i-cervical noma ngokuvamile unikezwe i-discectomy yomlomo wesibeletho nge-fusion fusion.
Lokho kusho, ngokusho kukaDkt. Joshua D. Auerbach, oyinhloko yokuhlinza umgogodla eBronx-Lebanon Hospital Centre, eNew York City, kuphela iziguli ezingafika ku-5% ezidinga ukuhlinzwa kwemiphongolo zenza abakhethiweyo abafanele ukuba bathathe indawo.
Izizathu ezikhawulayo, uthi, zingafaka ukukhetha isiguli. Ngamanye amazwi, yiziphi izinkinga ozothola umphumela ophephile futhi ophumelelayo?
Ukungaqhathaniswa okungenzeka kunokuhlinzwa okuphelele okuyi-disc kungafaka:
- i-central or lateral recess stenosis
- i-facet arthritis
- i-spondylolysis ne- spondylolisthesis
- i-disc yakheni ne- radiculopathy
- ukuphefumula kwamathambo
- pseudarthrosis
- ukuhlinzwa okwedlulele kwangaphambilini
- badinga indawo yama-multi-level esikhundleni, nakuba isifundo se-2018 eshicilelwe ephepheni I- Neurosurgery itholakala ubufakazi be-disc total esikhundleni somgogodla wesibeletho ngezinga elilodwa noma amabili.
> Imithombo:
> Auerbach, J., MD. Chief of Spine Surgery, Isikhungo Sezibhedlela saseBronx-Lebanon, uMsizi oPhezulu wezokwelapha, u-Albert Einstein College of Medicine. Ifoni Ingxoxo. Mashi 2012.
> Awe-OO. et. al. Impact ye-disc total arthroplasty ekuphathweni kokuhlinzeka kwezifo ze-disk-degenerative dis-disease: Ukuhlaziywa kwesampula sikazwelonke sokugula iziguli kusukela ngo-2000 kuya ku-2008. Surg Neurol Int. 2011.
> Hellum, C., et. al. Ukuhlinzwa nge-disc prosthesis ngokubhekiselele ekuvuselelweni kweziguli ezinezinhlungu ezibuhlungu emuva kanye ne-diserant degenerative: ukulandelwa konyaka wokufunda okungahleliwe. BMJ. Meyi 2011.
> Mattei, T., MD, et. al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544164/ Global Spine J. Aug 2017.
> Nunley, P., et et. al. I-Cervical Disc Arthroplasty: Ukufakaza Kwamanje ne-Real-world Application. I-Neurosurgery. Jan 2018.
> Skovrlj, B., et. al. Ukuphindaphinda Ukulandela Ukuguqula I-Cervical Disc. I-Asian Spine J. Jun 2015
> Yang, S., et. al. I-discectomy yangaphandle yomlomo ne-fusion operation ne-total disc substitution: Ucwaningo lokuqhathaniswa nokulinganisa okungenani kweminyaka engu-10 kulandela. Imibiko yeScientific 7, Inombolo yendikimba: 16443. 2017.