Umswakama we-spinal ube ngumsebenzi "wokulinganisa ngegolide" kwiintlobo ezininzi zeengxaki zangemva kwexesha elide. Kodwa ngokuhambelana nabaxhasi, i-dis replacement-inkqubo entsha kwi-United States - unokuthatha olunye usuku.
Okwangoku, nangona kunjalo, amaninzi amaninzi omdaka ayenziwa ngaphezu kokutshintshwa kwetayitile yeemeko eziqhelekileyo zomgudu ezifana nesifo se-discenerative, i-scoliosis kunye nokunye.
Kwaye oku kubakho ukukhathazeka okuqhubekayo kunye nemibuzo engaphenduliyo malunga nokuxuba.
Uhlalutyo oluthathaniswa nomlinganiselo we-lumbar spinal fusions ukuya kwi-lumbar yenqwelwana yokubuyisela i-disc eyenziwa phakathi kweminyaka engama-2000 no-2008 ibone ukuba ukutshintshwa kwe-disc kumele u-2% wabo bonke oogqirha obangelwa umlomo. Uphando lwapapashwa ngo-Oktobha 2011 umxholo we- Daily Neurology International.
Kutheni Ukhumbuza Ukuguqulwa Kwendlela?
Ukutshintshwa kwe-disc totali kwenzelwe, ubuncinane inxalenye, ngaphandle kwenkxalabo yemiphumo yomfudu wesipelingi inokuthi ibe namacandelo angama- vertebral angentla naphantsi kwesiza sokuhlinzwa. Ngenxa yokuba amathambo amabini ahlangeneyo ahlangene kunye nomswakama-spinal - ukuphelisa yonke intshukumo kuloo mgangatho womgudu wakho - indlela ohamba ngayo umlenze emva kokuba umsebenzi ungatshintshwa, kunye noxinzelelo olongezelelweyo lubekwe kwiindawo ezidibeneyo. Ezinye iingcali zikholelwa ukuba ukunyaniseka okongeziweyo kukhokelela ekuhlaleni kule mimandla.
Abanye abaqinisekanga ukuba olo tshintsho lwe-post-fusion lotshintsho lubangelwa utyando.
Ngandlela-thile, ukucinga emva kwenguqu ye-disk ishicilelo kukuba kukugcina umbane wakho wokuhamba emanqanaba (inkqubo) eyenziwa. Ngale ndlela, ukuba ne-disk substitution kunokuncedisa ukunciphisa iziganeko zenguqu yokuguqulwa komzimba kwiindawo ezinomgca.
Ukuguqulwa kwamalungu emagxeni angentla kunye naphantsi kwesiza sokuhluma komgogodla ngokuqhelekileyo kuyaziwa ngokuba yintlupheko yesigxina, okanye i-ASD .
Ukuguqulwa Kwengxubusho Yengxoxo - Yintoni Esiyaziyo?
Nangona utyando lokulondolozwa kwesikhuphelo, kunye nokutshintsha i-disc njengoluhlobo oluqhelekileyo, lusemtsha kwiUnited States, ubungqina bubonisa ukuphumelela kwayo. Ngokufanayo, abaphandi baqhubeka beqokelela ulwazi lwexesha elide kwiziphumo kunye nobungozi.
Ngokuchonga iziphumo ezithile, umnyaka we-10, ingxelo yempembelelo yexesha elide eshicilelwe kwiphepha leencwadi (i- Scientific Reports) ngo-2017 lomeleza ulwazi oluqhelekileyo (phakathi kwabagqirha kunye neengcali, ubuncinane) ukuba iziphumo zokuguqulwa kwidiski kunye nokutyunjwa kwe-fusion zilingana ngokulinganayo. Abaphandi bafumanisa ukuba uphuhliso lwe-ASD emva kwenkqubo, ukukhawuleza kweziphumo zokubuyiselwa kunye neentlungu zilingana ngokulinganayo phakathi kwezi nkqubo ezimbini.
Ucwaningo olwenziwa ngo-2017 olupapashwe kwi- Global Spine Journal luchaza iziphumo phakathi kwendawo yokuguqula i-disc kunye neentsholongwane zokutyunjwa kwezilwanyana kwizigulana ezisezantsi. Abaphandi bafumanisa ukuba izigulana zokutshintsha ii-disc zibonise ukuphucula ngaphezulu kwintlungu yokuphulukana nokukhubazeka kunokuba izigulane zogqirha zeplasini zifunyenwe (iiveki ezintandathu, inyanga ezintathu, iinyanga ezintandathu kunye nonyaka.)
Kwakhona kulesi sifundo, izigulane ze-disc zibuyele emsebenzini kumashumi amathandathu anesihlanu iintsuku kungekudala kunezigulane zokuxuba.
Ngaba Uyakulungeleka I-Intanethi Yokubuyisela Ukuguqulwa Kwengxowa?
Kodwa oku kwaba yiphononongo enye yokuhlaziywa kwamaxabiso. Uphononongo luka-2015 olupapashwe kwi- Asian Spine Journal lubone ukuba ngoku, ubuncinane, ukuqhutyelwa kwakhona kunye nokuhlaziywa kwezinto zenzeke malunga nezinga elifanayo kungakhathaliseki ukuba uvavanyo lokuqala (olubizwa ngokuba yi "index") lusetshenziselwa ukutshintsha i-disk okanye ngokuqhelekileyo unikezwa ngengxaki yomlomo wesibeleko kunye nomswakama-spinal.
Okokutsho, ngokutsho kukaDkt. Joshua D. Auerbach, intloko yokuhlinzwa ngethambo kwiziko leZibhedlele laseBronx-Lebanon, kwisiXeko saseNew York, kuphela ukuya kwi-5% yezigulane ezifuna utyando lomgudu ukuba zenze abaviwa abafanelekileyo kwi-diski ye-disc.
Imiba yokukhawulela, uthi, ingaquka ukukhetha isigulane. Ngamanye amagama, yiziphi iingxaki oza kuba nazo iziphumo ezikhuselekileyo neziphumelelayo?
Ukuchaswa okunokwenzeka kwi-intanethi yokutshintshwa kwe-disc ingabandakanya:
- i - stenosis i- recess stenosis
- isifo samathambo
- spondylolysis kunye ne- spondylolisthesis
- i-disniated disc kunye ne- radiculopathy
- osteoporosis
- pseudarthrosis
- uphezulu lwangaphambili lomgudu
- befuna i-disk-multi-level substitution esikhundleni, nangona uphando olwenziwa ngo-2018 olupapashwe kwiphepha leNewurgery lafumana ubungqina kwi-disk yokutshintsha i-disc kwisigidi somlomo omnye kumgangatho omnye.
> Imithombo:
> Auerbach, J., MD. I-Chief of Spine Surgery, iZiko leZibhedlele saseBronx-Lebanon, uNjingalwazi oPhezulu woPhepha, u-Albert Einstein College of Medicine. Ifowuni Ingxoxo. Matshi 2012.
> Awe-OO. et. al. Impembelelo ye-disc disc arthroplasty ekulawuleni ulawulo lwe-disk disadative disad disease: Uhlalutyo lweSizwe soPhulo lwe-Inpatient Sample ukususela ngo-2000 ukuya ku-2008. I-Neurol Int. 2011.
> Hellum, C., kunye. al. Ugqirha nge-disc prosthesis kunye nokuvuselelwa kwizigulane ezineentlungu eziphantsi kunye ne-diserative disc: ukulandelelwa kwe-year ukufundwa ngokungaqhelekanga. BMJ. Meyi 2011.
> Mattei, T., MD, kunye. al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544164/ I-Global Spine J. Aug Aug 2017.
> Nunley, P., et. al. I-disc ye-Cervical Disc Arthroplasty: Ubungqina Bokukhoyo kunye nesicelo se-Real-world. Neurosurgery. Jan 2018.
> Skovrlj, B., et. al. Ukubuyiselwa emva kokutshintshwa kweDiskhi yeCervical. I-Asian Spine J. Jun 2015
> Yang, S., kunye. al. Inkunkuma engaphantsi komlomo wesibeleko kunye nokuhlinzwa kwe-fusion ngokubhekiselele ekutshintsheni i-diski yenkunkuma: Uvavanyo olulinganisayo noluncinane lwama-10-minyaka lulandelayo. Iingxelo zeScientific Reports 7, Inombolo yeSihloko: 16443. 2017.