Ukuqhaqhazela kwi-Spinal Stenosis
Ukugqithiswa kwe-neurogenic engapheliyo yenye yezona zibini eziphambili zomlenze onyawo oluhambelana nesenzo sokuhamba. "I-Neurogenic" ibhekisela ekubeni iimpawu zivela xa izibilini ezithintekayo kwiimeko ze-lumbar spinal stenosis. Olunye uhlobo lwesigxina esisisigxina se-vascular claudication ngokuqhelekileyo ngenxa yesifo se-vascular disease (PVD).
Kungenzeka ukuba, zombini iintlobo zokuqhawula ngokukhawuleza ziya kuba ngumzila ongasecaleni, ubuncinci ukuya kwinqanaba elithile, izicwangciso zakho zokusebenza, kodwa indlela ekufezekiseni ngayo le nto iyahluke.
Ngeentambo ze-vascular, imithwalo yegazi emancinci ukuya kwindawo apho inani legazi eligqithiselayo lingonelanga ukuhlangabezana neemfuno zesigxina sakho esiphantsi. Kwiimeko ze-neurogenic claudication, i- lumbar spine (i-back back) ihlala kwindawo edelelwe ixesha elide. Oku kukunciphisa umgca wakho womgudu okanye i-neuroforamen ukuya kwindawo apho iishubhu ezinomdla eziqhelekileyo zigqithise ngokungenakunqunyanyiswa ziyancatshiswa ngethambo elisondeleyo.
Iimpawu
I-neurogenic claudication ngokwenene isifo okanye iqoqo leempawu. Inxulumene nokumisa kwaye ingabonakalisa nje ngeentlungu ezisezantsi kwaye / okanye umlenze njengengqungquthela ye-muscle. Ukudibaniswa kwe-spinal stenosis kunye nokubuya emva kwezinto ezinjenge-arching kubeka uxinzelelo kwiimbombo ze-lumbosacral kunye ne-cauda equina.
(I-cauda equina-oku kuthetha umsila wehashe -yinto evulekileyo yentsholongwane efana nomsila. I-cauda equina iya ngaphantsi kweyona nxalenye ephambili yomgca wesipelingi.
Izibonakaliso zokuhluthwa kwe-neurogenic eziqhelekileyo zivame ukuziswa ngokuhamba kunye / okanye ukwandisa umlenze wabuyela emuva (kwakhona, ukuguqula umqolo wakho,) kwaye ukhululeke ngokugubha, ukuhlala, kunye / okanye ukugoba phambili okhalweni.
Ezinye iimpawu ze-neurogenic claudication ziquka izikhonkwane kunye neenaliti ezihla emlenzeni wakho, kunye nobuthathaka. Iingxaki zesisu okanye i-vessie zenzeke ukuba ukugqithiswa kwe-neurogenic kunzima.
Ngenxa yokuba i-lumbar spinal stenosis iqhubeka ngokuhamba kwesikhathi kwaye ayikho ngenxa yesiganeko esisodwa, iimpawu zithatha ukuthatha ixesha ngaphambi kokuba zibonwe, ngokunjalo.
Unyango
Unyango lwe-neurogenic claudication uqala ngokufanelekileyo. Ugqirha wakho unokumisela iyeza zentlungu kunye / okanye unyango lomzimba . Ukuba ubona umgqirha womzimba we-neurogenic claudication, mhlawumbi uya kunikwa izivivinyo ezigxininisa ukuchukumisa umqolo wakho.
Olunye unyango olulondolozayo lwe-lumbar spinal stenosis luquka ukuguqula umsebenzi wakho, ukugqoka umqolo okanye umlenze, kunye / okanye unomjovo wokugulisa umlenze ukuze uzinze intlungu. Umbutho weNorth American spine Society uthi uluhlu lwezilonda zomgulane (epilurals injection) (kunye neyeza le-steroid) lunokunceda ekunciphiseni ubuhlungu obuvela kwi-neurogenic claudication (kunye ne-radiculopathy) phakathi kwexesha eliphakathi. Bachaza ixesha eliphakathi njengeenyanga ezi-3 ukuya kwezi-36.
Ukuba ubuhlungu obuqhubekayo obuvela kwi-neurogenic claudication ephazamisayo buphazamisa kakhulu indlela yakho yokuphila, kungaba luphawu lokuba ufuna ukuhlinzwa.
Ngokuqhelekileyo, i-laminectomy (eyaziwa nangokuthi utyando lwe-decompression) yinkqubo enikezelwayo yesifo somgogodla. Xoxa ngeenketho zakho kunye nogqirha wakho ukuqinisekisa.
Kwintetho yeJanuwari 6, 2010, umxholo weNcwadana ye-American Medical Association , uDkt. Alexander Haig kunye noogxa bakhe baxela ukuba imilinganiselo ethembekileyo, kwi-board-to-board for diagnostic and diagnostic stumosis. Oku kunokuthetha ukuba abanye oogqirha baya kusebenzisa i-MRI, CT kunye nee-EMG iimvavanyo ukuxilonga imeko yakho, ngelixa abanye bengenako. Kwakhona kuthetha ukuba abanye oogqirha banokuthi "bakuchukumise" ukuba usebenze emva kokuhlinzwa ngaphandle kokunika unyango olulondolozayo.
Yenza uphando lwakho kwaye uthethe ugqirha wakho malunga nazo zonke iinketho zakho ngaphambi kokugqiba ukuba wenze ntoni.
Umthombo:
> Brunicardi, F. et.al. Ukunyangwa kukaSchwartz. Isahluko 41. Neurosurgery. Icandelo II. Ukuqwalaselwa ngokuthe ngqo. McGraw-Hill. Ukufumaneka kwi-Intanethi: Ukufikelela kwiMithi. Meyi 2010.
> Comer, C., kunye. al. Uvavanyo kunye nokulawulwa kwe-neurogenic claudication ehambelana ne-lumbar spinal stenosis kwinkonzo yase-UK yokunakekelwa ngokusisisigxina: inzululwazi yenkqubo yangoku phakathi kwe-physiotherapists.BMC i-Musculoskeletal Disorders 2009.
> Andrew J. Haig, MD; Christy C. Tomkins, Ph.D. Ukuxilongwa kunye noLawulo lwe-Lumbar Spinal Stenosis. JAMA. 2010; 303 (1): 71-72.
> Nadeau, M., MD Ukuthembeka kokwahlula i-neurogenic claudication ukusuka kwisigxina se-vascular esekelwe kwintetho ebonakalisa impawu. Ngaba J Surgery. NgoDisemba 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3859778/
> Umbutho we-North American Spine Society (NASS). Ukuxilongwa kunye nokunyangwa kwe-lumbar spinal stenosis. IBurr Ridge (IL): UmNyango waseNorth American Spine Society (NASS); 2011.