Iqhekeza lamahhala, eyaziwa nangokuthi i-disquestered disc, luhlobo olulodwa lwe-diski e-herniated apho isiqhekeza siphume kwisakhiwo esiphezulu. Emva kokuhlukana, i-fragment edibeneyo inokuthi iqhube phezulu okanye iphantsi, ibangele impawu okanye izimpembelelo kwinqanaba elifanelekileyo lomqolo.
Iimpawu, ezibizwa ngokuba yi- radiculopathy , ngokubanzi zibangelwa kukuqhagamshelana phakathi kweqhekeza lamahhala kunye neengcambu zesisu zomgogodla , ingaba oku kwenzekayo apho kulandelwa kuqala ukukhwabanisa (ukuphuka kwi-diski eyintloko), okanye kwinqanaba eliya kuhamba ngalo.
I-disc ye-herniated ibangelwa yi-fray or break of fibers externally of a spinal disc, ngokuqhelekileyo iqulethe i-disk absorption absorption into the disc. Le nkunkuma ibizwa ngokuba yi-nucleus pulposus. Xa iimbumba ziqhawula, i-nucleus pulposus ingaqhuma, okanye iphume.
Kukho iintlobo ezininzi zeedisiti ze-herniated , kwaye zihambelana nokuqhubela phambili kwe-nucleus pulposus njengoko kwenza indlela yokuphuma kwiphakathi kwidiski. Ezi ntlobo, okanye iindidi, ziyakhankanywa, eyaziwa nangokuthi i-bulging, iqhubekile, ikhutshwe kwaye ilandelwe. I-Sequestered ikwabizwa ngokuba yi-fragment yamahhala.
Njengalo naluphi na i-disni ye-herniated, izibonakaliso ze-radiculopathy ezibangelwa i-fragment yamahhala zingabonakalisa kwelinye icala. Indawo yeqhekeza yamahhala inquma ukuba yiziphi iimpawu eziphelileyo. Ukuba i-fragment yamahhala isentanyeni yakho, uya kuba neempawu kwisandla esinye. Ukuba kukusezantsi kwakho, uya kuba nempawu emlenzeni omnye.
Iimpawu zingabandakanya intlungu kunye neentlungu ezinxulumene neentliziyo ezifana nezikhonkwane kunye neenaliti, ukutshisa kunye / okanye ukutshitshiswa kombane. Ezinye iimpawu ezinokuthi zibandakanya ubuthathaka bomlenze kunye / okanye ukuphazamiseka.
Unyango
Ukuba ingcamango yodiski elandelelweyo yenza ukuba ufuna ukukhawuleza kwaye ufumane ukuhlinzwa kwangaphambili, kunokuqala ukuba ube nolwazi lokuba ulondolozo olugcinayo, oluqhelekileyo luqulethwe ngamachiza kunye nonyango lwangonyango, lunokukunceda ukuba uphinde ufumane.
Uphando oluthile lwe-2002 lubonise ukuba unyango olungapheliyo lwama-disniedicated disks, ngakumbi abo badibeneyo, lunokuphumelela ngokumangalisayo.
Amaphesenti angaphezu kwe-75 yabathathi-nxaxheba abangamashumi amabini anesibini ekufundeni, kungakhathaliseki ukuba bahlobo luni lwe-herniation ababenalo, babike iziphumo ezintle ngaphandle kokuhlinzwa. Kwiininzi zezigulane ezilishumi elinesibini kunye nesilwanyana esisetyenzisiweyo, iziqhekeza ezifudukayo zanyamalala ngokupheleleyo. Kwaye kubandakanyekayo abathathi-nxaxheba kwiidiski ezilandelelweyo, ii-MRIs zityhila ngokunyanisekileyo kwi-fraction fragment size.
Uhlalutyo lwe-meta-2017 olushicilelwe kwiphephancwadi I- Pain Physician ayigcinanga kuphela ukuqinisekisile iziphumo zophando kodwa iphinda ixubushe oko bakubhekisela njengento eyaziwayo-ukuba i-66.66% yee-disc ikhethiweyo i-resorb. Ukulungiswa kwempahla kwenzeka xa izicubu zomzimba ezidibanisa neziqhekeza zamahhala zidibanisa izinto ezichithwa ngokwemichiza. Impahla ephulwe phantsi i-disk, ngokugqithiseleyo kwexesha, iphinde ibanjwe ngumzimba.
Xa uhamba ngendlela ekhuselekileyo kunokukunceda ukuba ugweme uxinzelelo kunye nokungaqiniseki kwenkqubo enomngcipheko, gcinani engqondweni ukuba kunokuthatha ixesha elide ukufumana ukukhululeka kwentlungu kunye nokuhluthwa kweempawu.
Ukuba unayo idiski ekhethiweyo, kwaye ucinga ukuhamba kwindlela yokukhathalela, unokufumana inhlanhla.
Oku kungenxa yokuba inkqubela phambili yokunyuka kwayo, kukuthi mhlawumbi i-diski iya kuhamba ngokukhawuleza.
Uphando olupapashwe kwiphepha likaFebruwari 2015 leNkcazo yokuHlulwa kweeNtsholongwane n yafunyanwa ukuba zombini iintlobo zokunqanda kunye nokulandelelana kweendlela zokuhlalisa zikwazi ukuhlaziywa ngokukhawuleza kunokuba zikhuphe iibhola kunye neentambo. Uphando lwafumanisa ukuba xa kuthelekiswa nokugqithisa, ukukhuphaza, ukudlulisa, iidiski ezidlulayo-ngamanye amagama, zonke iindidi ezihamba phambili zokudibanisa ii-disk-free kunye ne-disquestered disc zinakho ukuphakanyiswa okupheleleyo kunye nokusisombulula imeko.
Kwaye ekugqibeleni, ukuhlinzwa okuqhelekileyo kwidiski ye-herniated elula kungeke kusebenze i-disquestered disc yakho. Akunakuphela nje ukufumana isahluko samahhala okanye iziqwenga ezixanduva lweempawu zakho zibe ngumngeni ogqithiseleyo kumgqirha wakho, kodwa ubuncinane iinkqubo ezimbini ezingenayo i-discectomy, kunye ne-chemonucleolysis, ziye zafunyaniswa ngugqirha, ngokubhetele, ezingenakusebenza, kodwa, ngakumbi yingozi.
Inqaku kwiphepha le-Oktobha 2016 le- Asian Spine Journal lisixwayisa oogqirha ukuba ngelixa utyando lwe-laser disc lungile kwiimeko ezingenakunzima zeedisiti ze-herniated, akukhuthazwa kwiidiski ezikhethiweyo. Yaye ukuba unengxaki yangemva yangasemva eyenza umlenze wakho ungaqiniseki, abalobi bathi, ukuhlinzwa kwelasi, mhlawumbi akuyiyo inyulo efanelekileyo yeenkqubo, nangenxa yokuhlawula okulula.
> Imithombo:
> Ahn, S., et. al. Ukuthelekiswa kweziphumo zeklinikhi kunye nezinguquko zemvelo ezikhoyo phakathi kweempawu eziphambili ze-disc. Yonsei Med J. Juni 2002.
> Chiu, C. et. al. Ubungakanani bokuguqulwa ngokuzenzekelayo kwidiski ye-lniar herniated: ukuhlolwa okucwangcisiweyo. KwiKlinikhi yokubuyisela. Feb. 2015.
> Lee, J., kunye. al. Inkqubo yexesha elide kwiiLumbar Disc Resorption Izigulane kunye nezinto eziPhambi kweNkqubo eziHlangeneyo neCop Resorption. U-Evid osekelwe kwi-Alternate Med ngoJulayi 2017.
> Omidi-Kashani, F., kunye. al. Iingcebiso Ezilishumi Ezibalulekileyo Ekuphatheni Umonde ngeLumbar Disc Herniation. Journal of Spine Journal. Oktobha 2016
> Stadnick, M., MD. Isiqendu se Disc Disclaimer. I-MRI Web Clinic. Jan 2004.
> Zhong, M., kunye. al. Isiganeko soKuhlaziywa okuKhe kweLumbar Disc Herniation: I-Meta-Analysis. Ugqirha wezinhlungu. Jan-Feb. 2017