Xa ufumana utyando lomva, ukuqiqa kwam kukuba ukuba sele iphelile, into yokugqibela ulindele enye ingxaki. Ngelishwa, phantse nawuphi na utyando luza nomngcipheko weengxaki , okuza kukunika intlungu okanye ezinye iimpawu emva koko. Enye inkathazo yokuhlinzwa ngethambo ngumgudu we-epidural fibrosis, okanye utywala kwindawo yokuhlinzwa.
Sibanzi
I-epidural fibrosis ligama elinikezwa ukukhwabanzeka okwenzeka emva kokuhlinzwa kwangasemva.
Ngenye yezizathu ezinokubangela imeko eyaziwa ngokuba yi-syndrome ye-back-up syndrome (i-acronym: FBSS.) I-epidural fibrosis mhlawumbi iyona nto ibangele kakhulu kubo bonke; kwenzeka ngo-91 kwipesenti zezigulane zokuhlinzwa emva kokubuya.
Kodwa kukho iindaba ezilungileyo: I-epidural fibrosis ayisoloko idala intlungu okanye ezinye iimpawu. Enyanisweni, kwabanye abantu, ayichaphazeli ubomi babo bemihla ngemihla okanye amanqanaba entlungu. Uphononongo luka-2015 olupapashwe kwiphepha le- Insights Imaging lifumene ukuba umbuzo malunga nokuba imbonakalo okanye imbonakalo ingabonakali ingahambelana nendlela yokusabalalisa ngayo.
Olunye uvavanyo luka-2015, ngeli xesha lipapashwe kwi- Asian Spine Journal, lafumanisa ukuba i-epidural fibrosis ingabangela intlungu kuma-36 ekhulwini abantu abane-syndrome ye-back-back failure. Yaye ngelixa iipesenti ezingama-36 ziyingxaki eninzi yezigulane, kude ku-91%.
I-epidural fibrosis iyafana nokuxilongwa ngokuthe ngqo kune- arachnoiditis .
Okokuqala, i-epidural fibrosis iyichaphazela isambatho esingaphandle kwintambo yomgogodla (umlenze osisigxina,) kanti i-arachnoiditis iya kwi-membrane e-arachnoid. Njengomlenze ohlala phambili ngaphezu kwayo (kunye ne-down mater phantsi) i-arachnoid ejikelezileyo kwaye ikhusela iintsholongwane ezibuhlungu ezibandakanya intambo yomthambo.
Olunye umehluko kukuba i-epidural fibrosis ibangelwa ukuhlinzwa kwangaphambili; kodwa ukuhlinzwa ngokutsha kuphela enye yezinto ezinokubangela i-arachnoiditis. Kwaye ekugqibeleni, ukuvuvukala kungabangela ukuba i-tissu ebomvu ibe yinto, leyo leyo inokukhokelela ekugqibeleni kwemigudu yomgudu-into ebuhlungu kakhulu kwaye kunzima ukunyanga.
Uqeqesho
Yintoni eyenzekayo kumqolo wakho xa ufumana i-epidural fibrosis? Le mpendulo, ngokuqhelekileyo, ihambelana nommandla womlenze wakho obizwa ngokuba yingcambu yomgca.
Uninzi lweentlobo zonyango ezinikwe ngenxa yentlungu emlenzeni nasemlenzeni ziba yi- laminectomy (ekwabizwa ngokuba ngu-surcompression surgery) okanye i- discectomy . Zombini iinkqubo zenzelwe ukunciphisa uxinzelelo kumngcambu womgcini wesipelingi njengoko uphuma intambo yomgogodla. (Ukulimala okunjengodiski we- herniated , kunye neenguqu ezinokuguquka kwintsimi ngokwayo kungabangela izakhiwo ezahlukahlukeneyo-ezifana nezicucu zeediski okanye i-spruce spurs ezixinezelayo, kwaye zicasula, ingcambu yomgca.)
Oko kuthetha ukuthini ixesha elininzi, ugqirha wezantlambo uya kusebenza kufuphi nommandla wengcambu yakho. Ngenxa yokuba uya kugxininisa ekususeni izinto (iidiski ze-diski ezingekhoyo okanye i-spurs bone ezondele kakhulu kwi-nerve), kuya kufuneka ukuba zibaxhomekeke ngokuphumelelayo.
Ngenxa yoko, inxeba iya kudalwa njengenxalenye yokuhlinzwa kwakho.
Ukutshatyalaliswa kuyindlela yokuphendula kwendalo nayiphi na inxeba ephazamisa isakhiwo somzimba, kunye nommandla osondelene nomngcambu wakho wamagxa ngexesha lotyando alukho. Inkqubo ifana nento eyenzekayo xa uhlamba idolo; ngamanye amagama, ukuphuhliswa kwe-epidural fibrosis kufana nokulingana okufomayo emadolweni emva kokulimala kokuqala. I-scab, kunye ne-epidural fibrosis, yinkqubo yokuphilisa yendalo.
Ukwehla kwe-Epidural kubangelwa ngokubanzi phakathi kweeyure ezingama-6 no-12 emva kokuhlinzwa.
Inkqubo
Masibambe encinci ukuqonda le nkqubo yokuphulukisa njengoko isebenza kwi-disectomy yakho okanye i-laminectomy.
Emva kokuhlinzwa kwangasemva, inani lezinto linokuthi lenzeke phantsi kwe-hood, oko kuthetha.
Okokuqala, enye yezinto ezintathu zokugubungela ngentambo yomgudu wakho (isambatho esingaphandle esibizwa ngokuthi "umlenze ohlala phambili") unokunyanzeliswa. Okwesibini, enye okanye ngaphezulu kweengcambu zakho zengxube "zingabanjwa" (oko kukuthi ziboshwe.) Okwesithathu, ngenxa yezo zinto okanye zombini kwezi zinto, ukunikezelwa kwegazi kwingcambu yomgca kunye / okanye ubomi be-spinal fluid. I-cerebrospinal fluid, eyaziwa nangokuthi yi-CSF, isicwecwe esicacileyo, esinamanzi ajikeleza phakathi kwengqondo kunye nomthambo womgca kwinqanaba eliphakathi kwe-arachnoid mater kunye ne-mater. Umsebenzi wayo kukunyusa nokukhusela izakhiwo zesiseko senzwa (eyenziwa kuphela ngengqondo kunye nomgudu womgudu) ukusuka kumphumo.
Ukususela ngo-2016, abaphandi baqhubeka bexubusha ukuba njani, kwaye nangona, ukusila okanye ngasekupheleni kwengcambu yomgulane kuhambelana nentlungu kunye nezinye iimpawu onokuzixelela ugqirha wakho emva kokuhlinzwa kwakho kwangemva. Le nqaku e- Asian Spine Journal ekhankanywe ngasentla ifumanise ukuba abanye abalobi beengxelo bathi akukho-aba babini bayalumkisa konke. Kodwa abanye, ingxelo ye- Asian Spine Journal , baye bagqiba ukuba ukusasazeka kwimizila yengqungquthela yeminwe (ngokuchasene neefayili ezichazwe kwindawo enye kuphela) zinxulumene neempawu kunye nentlungu.
Ether indlela, xa iifom zifom, akukho unyango oluchanekileyo lokwenene. Ugqirha wakho angaphinda afune ukubuyela ngaphakathi aze aphule izikram nge-endoscope, kodwa oku okunokwenzeka kungabangela ukutyhafa kunye ne-epidural fibrosis.
Ngenxa yeso sizathu, indlela engcono kakhulu yokuphatha i-epidural fibrosis kukukhusela, okanye ubuncinci ukunciphisa ukubunjwa kwesibalo.
Indlela eya kwenziwa ngayo okwangoku, ngo-2016, iqhutywe kuphando kuphando, ikakhulukazi kwizilwanyana kunabantu. Ezi ziphumo zovavanyo lweziyobisi okanye izinto eziphathekayo ikakhulukazi kwiirath, uze uthelekise amathishu kunye neqela lokulawula (amagundane angafumani iziyobisi okanye izinto ezisetyenziselwa zona.)
Degree
Into enye inzululwazi ehambelana ngayo neempawu kunye nentlungu yizinga le-fibrosis. I-epidural fibrosis inokuthi ifakwe kwi-0, emele izicubu eziqhelekileyo ezingenanto ebhalelekayo kwiBanga lesi-3. Ibanga lesi-3 yimeko ye-fibrosis eqinile, kunye neethambo ezibomvu ezithatha ngaphezu kwe-2/3 yendawo eqhutywe kuyo ( kwimeko ye-laminectomy.) Ukunqanda kweBanga 3 kunokwandisa kwiingcambu zentsholongwane, kanti amaBakala 1 no-2 ayenzi. Iibakala zeBakala 3 zihambelana neempawu kunye nentlungu engaphezu kwamaBakala 1 no-2.
Iibanga zeBakala 1 zivame ukuba zincinci, zenziwe ngamagqabi amancinci afakwe kwi-mater ehlalayo, engumtya ongaphantsi wokugquma ochazwe ngasentla. Amacwecwe eBakala 2 aphakathi, aqhubekekayo, kwaye athabatha ngaphantsi kwe-2/3 yendawo ye-laminectomy. Xa isiqalo sele sifinyelele kwiBanga lesi-2, liqhubeka, lithetha okumbalwa ukuba nayiphi imicu yomntu iyabonakala.
Ukuxilongwa
Ugqirha wakho unokuyalela i-MRI ukuxilonga nayiphi na i-epidural fibrosis. Ingxaki kukuba, amaxesha amaninzi, ukusila kungabonakali nolu hlobo lovavanyo lwe-imaging test. Ngoko ukuba unempawu, kwaye i-MRI ibuyele ingalunganga, unokufuna kwakhona ukufumana i-epiduroscopy.
I-epiduroscopy yinto yokuhlola apho iprobebhu, okanye ububanzi, ifakwe kwindawo ephazamisayo ukuvumela ugqirha wakho ukuba abone oko kwenzekayo kwingcambu yakho. Kubalulekile ukuthatha inkqubo yokuxilonga ngoku kude ukuba intlungu yakho inokuba yintoni ngenxa yesinye isitifiketi, kunokuba i-epidural fibrosis. Kule meko mhlawumbi ufuna enye intando ; kodwa ukuba iziphumo ze-epiduroscopy zibonakalisa ukonakala, kwaye ukukhwabanisa kukubangela iimpawu zakho, amathuba awunakuyidinga ukuhlinzwa oku-2.
Unyango
Unokuzibuza ukuba: Ukuba ulandelelwano olulandelelweyo alukwazi ukukhulula intlungu yakho ye-epdiural fibrosis, wenza ntoni?
Njengoko ndikhankanyile ngaphambili kule nqaku, izazinzulu kunye noogqirha abanakuze baphathe unyango olusebenzayo kwesi sizathu esithile sokusilela kwe-back syndrome. Ngokuqhelekileyo, nangona kunjalo, amayeza anikwa kuqala-kaninzi ngokubambisana nokunyanga. Amachiza aya kunceda ngeentlungu kunye nokusebenza ngokunyamezelayo. Amayeza anikeziweyo aquka iTylenol (acetaminophen,) ii-NSAID (imithi engeyiyo-stteroidal anti-inflammatory), kunye nabanye.
Iyeza lonyango lenzelwe ukugcina uluncedo kwaye lungaquka ukuqiniswa, ukunweba kunye nokusebenza kwangundoqo. Ukuhlala ehambayo kumalungu akho kunokuncedisa ukunciphisa ukubunjwa kweethambo ezibomvu .
Xa kuqhutywe uvavanyo, olunye uphando lubonisa ukuba lusempesenti engama-30 ukuya kuma-35 epesenti yokuphumelela. Akunjalo kuphela, kodwa isifundo esifanayo sithetha ukuba iimpawu ezifikelela kuma-20 ekhulwini kwezigulane zibuhlungu. Oko kwathiwa, ezi zimbini zonyango eziphambili zinikezwa i-epidural fibrosis zi-adhesiolysis nganye kunye ne-endoscopy yomqolo.
Kuze kube ngoku, i-adhesiolysis nganye yodwa inobungqina obunobulumko obusemva kwayo. Kule nkqubo, leyo, ngendlela, isetyenziselwa ezinye izimbangela ze-syndrome ye-back-back disordery syndrome ngokunjalo, amayeza, amaninzi amayeza e- steroidal , ajojowe kuloo ndawo ngokusebenzisa ikathetha elifakiwe. Kwakhona kunye nale nkqubo, ukuphulwa komatshini wesicacisi akudingekile ukuphucula impawu.
I-adhesiolysis yamathambo ixhaswa yiNqanaba loBungqina (umgangatho ophezulu) ngokubhekiselele ekusebenzeni kwayo kweempawu ze-syndrome ze-back-up, ezibandakanya i-epidural fibrosis.
Olunye unyango apho ugqirha wakho angabonisa ukuba i-endoscopy yomgogodla. Kule nkqubo, indawo evumela ugqirha wakho ukuba acinge ngendawo leyo ifakwe. Ngamanye amaxesha i- lasers isetyenziselwa ukuphatha izikrakra ngelixa ikhona. I-endoscopy yomgulane ibalwa njengobungqina beNqanaba II no-III, kwaye uphando oluthile lufunyenwe lufumene ukuba lunobungqina "obulungileyo" bokunciphisa iimpawu.
> Umthombo:
> Coskun E., Süzer T., Topuz O., uZencir M., Pakdemirli E., Tahta K. Ubudlelwane phakathi kwe-epidural fibrosis, intlungu, ukukhubazeka, kunye neengqondo emva kokuhlinzwa kwe-lumbar disc. J. Eur Spine J. NgoJuni 2000. https://www.ncbi.nlm.nih.gov/pubmed/10905440
> Helm S., Racz G., Gerdesmeyer L., Justiz R., Hayek S., Kaplan E., Terany M., Knezevic N. I-Percutaneous ne-Endoscopic Adhesiolysis ekulawuleni i-Low Back ne-Lower Extremity Pain: UkuHlola okuHlolo kunye neMeta -yilysis. Ugqirha wezinhlungu. NgoFebruwari 2016. https://www.ncbi.nlm.nih.gov/pubmed/26815254
> Helm S., Hayek S., Colson J., Chopra P., Deer T., Justiz R., Hameed M., Falco F. I-endinalcopy endoscopic adhesiolysis kwi-post lumbar syndrome: ukuhlaziywa kovavanyo lobungqina. Ugqirha wezinhlungu. Epreli 2013. https://www.ncbi.nlm.nih.gov/pubmed/23615889
> Masopust V., Häckel M., Netuka D., uBradác O., uRokyta R., Vrabec M. Postoperative epidural fibrosis. Iiklinikhi J Pain. Sept. 2009. https://www.ncbi.nlm.nih.gov/pubmed/19692802
> Mohi E., u-Abdel R. Epidural Fibrosis emva kokukhutshwa kwe-Lumbar Disc: UkuVavanywa nokuVavanywa kweZiphumo. I-Asian Spine J. Jun 2015. https://www.ncbi.nlm.nih.gov/pubmed/26097652