Iingozi ze-Spinal Fusion kwi-Disgenerative Disc Disease

Ngaba usemngciphekweni weCandelo elongezelelweyo lokuqulunqa?

Ukuba uqwalasela ukuhlinzwa kwe-spinal fusion kwidiski echaphazelekayo okanye enye ingxaki, unokuba usengozini ye-ASD. I-ASD ifutshane nendawo yokutshatyalaliswa kwecandelo, okanye ukunxiba okungaphezulu kunye neengqumbo kumagxa omgco ngasentla nangaphantsi kwendawo yokudibanisa. Nazi ezi ziintlobo ezi-5 ezichaphazela umngcipheko we-ASD.

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Isizathu Sokuvuvukala Kwakho

Ngokuxhomekeke ekuxilongweni okukhokelela ekusebenzisweni kwakho kwangaphambili , unokuba usengozini yokwandisa i- ASD .

UDkt. John Toerge, ugqirha we-osteopathic, uprofesa weyeza kwiYunivesithi yaseGeorgetown, kunye noMlawuli weZonyango kwiSizwe soBuhlengikazi be-Musculoskeletal Institute, uthi abantu abafumana isifo sokugaya amagulane ngenxa yesifo se-disenerative dis-risk are at risk risk for ASD. I-Toerge ithi oku kungenxa yokuba ukutshabalalisa sele kuqalile ukuqala kumanqanaba angentla naphantsi kweengxaki, nangona ungenayo impawu. Ngokuqhelekileyo, ugqirha awunamatheli amazinga afanelekileyo, ungeze.

I-Toerge ithi izigulane ezine-arthritis enamandla zingakho kwingozi yokunyuka kwe-ASD. Uyachaza: "La bantu banamacandelo amancinci anganciphisa umngcipheko," uyachaza. "Ngomthamo wokunciphisa umonakalo, izigulane ezine-arthritis eziphambili zinendawo encinane yokuphambuka, kwaye ngokunjalo, zilungele ukuhlaselwa komgudu."

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Iminyaka yakho

Kuyamkelwa ngokubanzi ukuba iminyaka ibonisa indima ebalulekileyo kwengozi ye-ASD.

Njengoko sikhula, izihluma zethu zivakala ukuba zihlalise, eziyinkimbinkimbi yokuba ukuhlinzwa kwangasemva kubangela i- ASD. Enyanisweni, uphando lwe-1999 malunga nemingcipheko ye-ASD entanyeni, eyenziwa ngu-Hilibrand kwaye yanyatheliswa kwi -Journal of Bone and Joint Surgery , yafumanisa ukuba ukuguqulwa kwesantya kwimeko yefilimu (njenge- MRIs kunye ne-CT scans) yinto enkulu ingozi ye-ASD.

Imbali yendalo yokuguqulwa komonakalo kwintlambo yintlukwano ehlanganisayo xa ichonga imbangela ye-ASD, "kutsho uDkt. Frank P. Cammisa, oyiNtloko yeNkonzo yokuPhepha kweNtsholongwane kwiSibhedlele soPhando oluthile eNew York. "Ukuba olu tshintsho lusele lusempempe, banokuba khona (okanye bahlakulele) kwizinga elingaphezu kweyodwa, kunye okanye ngaphandle kokuhlinzwa."

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Indawo Yendawo Yokuhlinzwa Kwakho

Umgudu wakho unemizila ephikisanayo, ekunceda ukulinganisela njengoko uhamba. Ezi zengqungquthela zihlukaniswe kwiindawo: I-neck ( umlomo wesibeleko ), phezulu kunye nasemva kwe-back ( thoracic ), i-back back ( lumbar ), kunye ne- sacral . Ukuba utyando lwakho lwenzeka apho ujikelezo oluthile luya kutsho-umzekelo, apho i-thoracic iba yinto e-lumbar (T12-L1) - ingozi yakho ye-ASD ingaba phezulu.

I-Toerge iyabiza le mimandla yenguqu "amaqela okuhamba asebenzayo." Uthi ukuxhamla kwiindawo ezihambayo ezihamba phambili kubakho iingxaki kamva. Oku kungenxa yokuba, uthi, ukuxuba okunjalo kunokubangela umthwalo okwandisiweyo kumanyathelo angama-intervertebral angamakhelwane, okwakunokunyusa umngcipheko we-ASD, kunye nesifo sesigxina esiseduze.

Ucwaningo lweHilibrand olukhankanywe ngentla lubone ukuba umngcipheko we-ASD uhluka ngohlobo lwendawo yokuxuba. Abaphandi bafumanisa amanqanaba e-C5-C6 kunye neeC6-7 (ezi zimbini ezincinci ze- intervertebral entanyeni entanyeni yakho) njengokuba ubangela umngcipheko omkhulu kunoma yimuphi ummandla entanyeni ukwenzela ukuguqulwa okungabonakali ngaphambili kwiifilimu. Amacandelo amabini ahambayo, okanye amanqanaba, asondele kakhulu okanye kumacandelo ashukumisayo ashukunywe nguDkt. Toerge.

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Ubude beFusion

Ngokuqhelekileyo, umngcipheko we-ASD uphezulu xa amanqanaba amaninzi ehlaselwa.

UDkt. Cammisa uthi iingxaki zomgudu ezithintela ukuhlanganiswa kwexesha elide (amanqanaba amaninzi afakwa) zibeka ingozi enkulu kwi-ASD. I-Scoliosis ngumzekelo wale nto. UCammisa uchaza ukuba udibaniswe kwi-T4-L4 (uluhlu lwamagqabha ahambayo, okanye amajoyina e-intervertebral, aphuma phakathi kwesifuba sakho ngaphantsi kweqhosha lakho lesisu) ukulungisa i-scoliosis, mhlawumbi ngaphezu kweminyaka Ndiza kuphuhlisa i-ASD kwi-T4-5 kunye ne-L5-S1. (T4-5 kunye ne-L5-S1 ziziqendu ezihambayo zilapha ngentla nangaphantsi kwe-T4 kunye ne-L4, ngokulandelanayo.)

Ukuhlaziywa kwe-2016 kunye nokuhlaziywa kweemeta epapashwe kwiphepha le- Clinical Spine Surgery fusion ubude yinto ebalulekileyo ehambelana nokuguqulwa kwesigaba kunye nesifo. Ababhali bacetyisa ukuba ukunciphisa inani lamanqanaba afakelwe ukuba libe sisicwangciso esingcono kunokuba utshintshe indlela ukuhlanganiswa kwenziwe ngayo.

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Isikhundla Ngaphambi Kwezihlandlo Zakho Zokuhlinzwa

Ubume bakho, kunye nokulungelelanisa amathambo akho ngexesha lotyando, lunokuchaphazela umngcipheko we-ASD. Ukuba une-kyphosis ngexesha lokuxuba, unokwenza emva koko ufumane uxinzelelo kumalungu akho. Oku kunokukhokelela kwiintlungu kunye neenguqu zokutshintsha kwe-ASD. Kwakhona kunokukhokelela kumathambo omgogodla kwiindawo ezinxulumene nazo.

Ukutshatyalaliswa kwezimbini zangasemva kwendawo ehambelana nokuphuhliswa kweenguqu zokuguqula umgudu kunye ne-ASD zihlobene nomnye. Ukuba i-posture yakho injalo ukuba i-pelvis yakho iguqulwe emuva (ebizwa ngokuba yi-pelvic retroduction) ngexesha lotyando, imisipha enoxanduva lokubamba iqonde ingakwazi ukhathala ngokulula emva koko. Ngokuhamba kwexesha, oku kungakhokelela ekubuhlungu kunye nokuguqulwa kwesimo esiphezulu kuloo ndawo yomgudu wakho.

I-angle ye sacrum yakho ngexesha lotyando lenza umehluko, naye. Ngokuqhelekileyo, phezulu kwesikram ehamba phambili phambili (njengoko kwenza i-pelvis, echazwe ngasentla). Ukuba i-sacrum yakho inokuthi ibhekise kwindawo okanye ngokufuphi kwimeko ngexesha lotyando (oko kungenokwenzeka ukuba i-pelvis yakho iguqulwe ngasemva), ingozi yakho ye-ASD inokwandiswa.

Kwaye ekugqibeleni, ngaba uye phambili phambili kweso sihloko? Ukuba kunjalo, kwaye une-fusion fusion, umngcipheko we-ASD unokwanda kwakhona.

Nangona ezinye zezinto ezinokuthi zifanele kwaye zifanele ziqwalaselwe ngugqirha wakho wengcali ngexesha le nkqubo, khumbula ukuba uzisa ukuhamba kwakho kunye nawe kwitheyibhile yokusebenza.

Kwabaninzi bethu, ukunyamezela kukuqokelela kwemikhwa kwexesha; kwabanye, inxalenye yesakhiwo sethu. Ukuba i-kyphosis yakho, ikhanda eliphambili, i-sacral angle, kunye / okanye i-pelvic imiba ye-post-post inclusion are not built in your bones (kwaye kwezinye iimeko, nokuba ngaba zikhona), ukubona i-physicist yeprogram yovavanyo lwendlu ngaphambi kokuhlinzwa kunokukunceda unciphise ezinye zeengozi ze-ASD yakho.

"Ukuzivocavoca ngokukhethekileyo ukuzinzisa indawo eziyingozi kunokunceda kakhulu ekunciphiseni iimpawu zakho," kusho uToerge.

_Imithombo:

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_{I-Ebatbar S, Cahill DW. Izinto ezijongene nobungozi bokungaphumeleli kwesigaba esilandelayo emva kokulungiswa kwembumbulu kunye neengcingo ezinzima zokungazinzi .J Neurosurg. 1999; 90 (2 Suppl): 163-9.}

_{Kyoung-Suok Cho, MD, kunye. al. Izinto ezijongene nobungozi kunye noPhando oluPhezulu lokuPhepha lweSimptomatic Adjacent Segment Degeneration emva kweLumbar Spine Fusion. J Korean Neurosurg Soc. 2009 ngoNovemba; 46 (5): 425-430.}

_{I-Hilibrand, A., MD. et. al. I-Radiculopathy kunye ne-Myelopathy kwiCandelo elingaphambili kwiSayithi ye-Anterior yaseCervical Arthrodesis yangaphambili. I-Orthopedic Bone and Joint Surgery. 1999.}

_{U-Lee, uCK ukuphazamiseka okukhawulezileyo kwecandelo elikufutshane ne-lumbar fusion.Spine (Phila Pa 1976). 1988 Mar; 13 (3): 375-7.}

_{Levin, kunye. al. Icandelo elongezelelweyo Ukuqulunqwa kokulandela ukuFusion Fusion kwi-Disgenerative Disc Disease. I-Bulletin yeSibhedlele sase-NYU seZifo eziManyeneyo 2007; 65 (1): 29-36}

_{Schlegel JD, et. al. Ingxenyana ye-Lumbar yokunyanga kwesifo esondele kufuphi ne-thoracolumbar, lumbar, kunye ne-lumbosacral fusions. Isihlwele (Phila Pa 1976). 1996 Apr 15; 21 (8): 970-81.}

_{I-Toerge, J. DO, uMlawuli wezeMpilo kwiSizwe soBuhlengikazi beSizwe soBuhlengikazi, eWashington, DC. I-Email Interview. Jan 2012.}

_{Zhang, C., kunye. al. Icandelo elongezelelweyo Ukuqulunqa ngokuchasene nezifo Emva kwe-Lumbar Spine Fusion kwi-Pathology ye-Degenerative: UkuHlola ngokuSingqinisiso nge-Meta-Uhlalutyo lweeNcwadi. Clin Clin Spine Surg. Feb 2016 http://www.ncbi.nlm.nih.gov/pubmed/26836484}