Ukungaboni kakuhle kweDiskhi yeHerniated
Ngethuba le-discectomy, iicandelo ze-disc herniated ezityinayo kwi-nerve okanye kwi-spinal cord zisuswa. Ukungaqondakali kwenziwa xa i-disc ye-herniated ibangela intlungu kunye / okanye ezinye iimpawu ziquka ukungqinwa, ubuthathaka okanye ukuvalelwa kombane phantsi komlenze omnye okanye ingalo.
Xa i-disc ye-herniated yimbangela, ezi zimpawu zibizwa ngokuba yi-radiculopathy, kodwa abaninzi abantu abangenalo unyango babhekisela kubo njenge- sciatica .
Xa une-discectomy, yonke into okanye inxalenye ye- lamina , eyindawo yethambo emva kwe-vertebra, kufuneka isuswe. Oku kukukwenza ukuba ugqirha ufikelele kwi-nerve kunye ne-disc. Ngokuxhomekeke kwindlela elithatyathwa ngayo ithambo, le nxalenye yenkqubo ingaba namagama amabini. I-laminectomy isusa yonke i-lamina, ngelixa i-hemilaminectomy isusa isigxina se-lamina.
Kufuneka nini i-Discectomy?
Inkoliso yexesha, iindlela zokulondoloza ezinjengamachiza, unyango lomzimba, okanye ii-injection ze-steroid ziyazama phambi kokuhlinzwa. Enyanisweni, i-disc ye-herniated ivame ukuphilisa ngaphandle kokuhlinzwa kuyo yonke into-kodwa oku kungathatha unyaka. Ukuba ne-discectomy kunganciphisa ixesha lakho lokuphilisa. Ukuba intlungu yakho inamandla, okanye ubuthakathaka / ubunzima obubonakalayo, i-discectomy ingaba yinto ekhethekileyo, kodwa ukuba iimpawu zakho zincinci okanye zincinci, unyango luya kuba yiyo yonke into oyifunayo.
Ngandlela-thile, xubusha iimpawu zakho kunye nokukhetha ngogqirha wakho.
Microdiscectomy
I-Microdiscectomy yinkqubo encinci ye-invasive eyenziwa kwisilungiselelo sokugula. Isincinci esincinci senziwe kwikhanyiso kunye nezixhobo ezincinci zethubhu zifakwe kuyo yonke indlela, ide ifike kwi-disc. Uphando lonke lwenzeka ngokusetyenziswa kwezixhobo.
Ngexesha le-microdiscectomy, imisipha ayinqunywanga njengoko ikhona ngexesha le-discectomy evulekile; endaweni yoko basuswa ngaphandle kwendlela.
Ngenxa yoko, ixesha lokuphilisa lisoloko likhawuleza kwaye lincinci kunokuba livule inkqubo.
Vula Discectomy
I-discectomy evulekile yindlela yokuhlinzwa yangasemva . Yenziwe kwisibhedlele esibhedlele phantsi kwe-anesthesia jikelele. (Mhlawumbi kuya kufuneka uhlale esibhedlele olunye usuku.)
I-discectomy evulekileyo ibandakanya ukwenza i-incision eyi-1 "ende; iimisipha kufuneka zinqunywe ukunika ugqirha ukufikelela kwi-disc. emva kokuba iinkqubo ezivulekileyo zinokuba buhlungu kakhulu, ngokunjalo.
Ngaphandle kweentlukwano kunye nobunzima kwixesha lokuphulukisa emva kokupasa, le nkqubo ilandelelaniswa.
Uphando olutsha lwe-2011 olupapashwe kwiNcwadi ye-Orthopedic Surgery (ephuma eHong Kong) yafumanisa ukuba i-discectomy evulekileyo kunye ne-discectomy encinci ye-invasive yayinokusebenza ngokufanelekileyo ekunciphiseni iimpawu. Kodwa, abalobi bathi, ukuhlinzwa okungaphantsi kwe-minimally kudinga ukuhlala kancinci kwebhedlele, ngaphambili kubuyela emsebenzini kunye nokuphindaphinda kwengxaki yokuqala.
Oko kwathiwa, abalobi bayalumkisa ukuba ubuchule obuncinci bokungaxilwanga kwezinto ezixhasayo bufuna kakhulu ugqirha, kwaye kufuneka uqeqesho oluthile.
Ukukhetha i-Surgeon kwi-Discectomy
Bobabini beemathambo kunye nama-neurosurgeon benza iintlobo ezininzi zokuhlinzwa, emva kokubandakanya ukungaqali.
Naluphi na uhlobo logqirha luya kulungiselelwa kakuhle umsebenzi. Ukukhethwa kwabagqirha kwi-discectomy kuya kwenene kuya kuhlalutyo lwakho lwezinga lobuchule lomntu. Unganqikazi ukubuza imibuzo emininzi ngaphambi kokugqiba ukuba ngubani oya kwenza le nqubo.
Ukusebenza kweziNkokeli
I-Discectomy isebenza malunga ne-80 ukuya kwi-90% yexesha kwaye ngokuqhelekileyo iphumela ekuphumuleni ngokukhawuleza kwentlungu yomlenze kunye nezinye iimpawu. Izinzuzo ze-discectomy zibambe ngokukhawuleza ngexesha elide-uphando olushicilelwe kwiphepha le- Spine lathola ukuba ezininzi izigulane zonyango zafumana intlungu epheleleyo emva kweminyaka eyi-10.
Kwaye uphando olwandu-2017 olupapashwe kwiphepha likaNovemba ka-2017 le-klinikhi ye- Clinical Orthopedics kunye noPhando olumalunga naloo mfuyo lubonise ukuba ngaphezu kwezingamashumi asibhozo anesithathu kwipesenti zezigulane ezingabonakaliyo zazihamba kakuhle iminyaka eyisixhenxe emva kwenkqubo.
Kodwa isifundo se- Spine sasifumana emva komnyaka owodwa, i-25% yezigulane zonyango kunye nezigulane zokunyamekela ezilondolozayo zifunekayo (ngaphezulu). Emva kweminyaka eyi-10, uninzi lwamaqela omabini lwaluxela isigqibo esisexesha elide lentlungu yabo, kodwa oku kwakuyinyaniso kubantu abaninzi kwiqela lotyando (i-69%) kuneqela elinoxhasayo (6%.).
Ubunokwenzeka bokuphindaphinda kwe-herniation yinyani. Uhlolo lwe-2015 oluhlelekile lwezifundo, lwafumanisa ukuba emva kweminyaka emibini, ubuhlungu buya kuphinda lufike kwi-25% yezigulane ezenza i-discectomy yezinga elilodwa. Ababhali bathi oku, malunga nama-6% ayedinga ukuqhutyelwa kwakhona.
Iindaba ezilungileyo kukuba utyando lwe-disc ye-disc yokuphindaphindiweyo alisoloko luyimfuneko. Kwakhona, uphando lubonisa ukuba utyando kunye nokunyamekela okulondoloziweyo emva kokuhlaselwa emva kokungaxilwanga kukufumana iziphumo ezilinganayo ngokwempazamo yentlungu.
Iingxaki zeentlukwano
Ngokubhekiselele kumandla okubuyisela (okukhankanywe ngasentla) ingozi yokungazibandakanyi kubandakanya ukusuleleka, ukuphuma kwamanzi, ukulimala kwindoda yokuhlala emzimbeni, okuyiyo ejikelezayo kumtya womthambo , okanye ukulimala kwimiva esondeleyo, imirhoxo okanye imivilini.
Ukuba ubona obomvu okanye ukhupha kwi-incision yakho, intlungu okanye ubuthathaka phantsi kwengalo yakho okanye umlenze, uyaba ngumkhuhlane, unenkinga yokuchama okanye ukuphuma, khaza ugqirha wakho ngokukhawuleza.
Emva kweDisctomy yakho
Unokuba nentlungu emva kokuhlinzwa. Ubuhlungu obuvela kwi-disc yakho ye-herniated buhlala ixesha elide, naye.
Ingcinga efanelekileyo ukuqala ukuhamba emva kwenkqubo yakho njengoko unako. Oku kuya kunceda ukukhawuleza ukuphucula, ukuthintela izicubu ezinqabileyo kunye nokuququzelela umlenze wakho. Kwiiveki ezimbalwa, kufuneka ukwazi ukukhwela ibhayisikili okanye ukubhukuda. Uninzi lwabantu lubuyela emsebenzini ukusebenza kwiiveki ezi-2-8, kuxhomekeka kwindlela umzimba wabo umsebenzi ngayo. Ulwaphulo olunokwenyama lunokukunceda ekubuyeni ngokukhawuleza emsebenzini nakweminye imisebenzi. Ukuba ugqirha wakho akakuthumeleli kwi-PT, unokucinga ukuba umbuza ngaye.
Izigulane ezininzi, ngokukodwa nge-discectomy yokuqala, zenze uhlaziywa ngokupheleleyo.
Imithombo:
Garg, B., Nagraja, U., Jayaswal, A. I-Microendoscopic ngokuvisisana ne-discectomy evulekile kwi-disc ye-disc idl UJ Orthop Surg (Hong Kong). Ngo-Apreli 2011. Kufumaneka ngo-Feb 2016. http://www.ncbi.nlm.nih.gov/pubmed/21519072
Dewing et al. Iziphumo ze-lumbar microdiscectomy kwindawo encinci, esebenzayo: ulungelelwano lwelo hlobo kunye nezinga. Isihlwele (Phila Pa 1976). Jan 2008.
Atlas et al. Iziphumo zexesha elide lolawulo lokugqithisa nokungahambisani nolawulo lwe-sciatica ngasese kwi-disc lniar: i-10 yeziphumo ezivela kwi-maine lumbar spine study. Isihlwele (Phila Pa 1976). Matshi 2005. http://www.ncbi.nlm.nih.gov/pubmed/15834338
NASS. Vula Discectomy. NASS. Burr Ridge, IL. Kufumaneka: Feb 11 10.
Legrand et al. Icandelo lesigxina se-French Society yeRheumatology. Sciatica kwi-disk herniation: unyango okanye unyango? I-Bone Joint Bone. Disemba 2007.
Parker S., Mendenhall S., Godil S., Sivasubramanian P., Cahill K., Ziewacz J., McGirt M. Isiganeko se-Down Back Pain Emva kweLumbar Discectomy kwi-Disc Herniated kunye nomphumo wayo kwiziPhumo ezichazwe ngumonde. Clin Orthop Relat Res. Juni 2015. Kufumaneke ngoFebruwari 2016. http://www.ncbi.nlm.nih.gov/pubmed/25694267
> Virk, S., et. al. Iyini Intlawulo yokuLungulwa kweeNkcazo emva kokuba iDiscectomy yasePrayimari kwiSizwe soBanzi? Clin Orthop Relat Res. Novemba 2017.