Kazhinji Spinal Chronic Pain Condition Is Difficult To Treat
Arachnoiditis ndiyo inogara isiri nguva inorwadza iyo inogona kuitika kana chimwe chinhu-chirwere chinodzoka shure, somuenzaniso-chakaitwa kumutsipa wako. Nezvo zvakati, chinokonzera arachnoiditis hachirevi kuvhiyiwa shure.
Semuenzaniso, fungal meningitis inopera muna 2012 nemhaka yezvakaipa zvakasvibiswa steroid yakaguma muna 720 mhaka uye kufa kwema 48. ICDC yakataura kuti arachnoiditis, pamwe nehutachiona hwepamunharaunda, zvakaitika panzvimbo yejojo mune vamwe varwere.
Chii Chinonzi Arachinoiditis?
Arachnoiditis isumukira kana kutsamwa kwebhanchnoid membrane ye meninges. Kuti ikubatsire kuti unzwisise kuti zvinorevei izvi, chidzidzo chemukati chemaatomy chinogadzirisa:
Iyo meninges zvikamu zvitatu zvezviputi zvinoputira rwonzi rwepelinha uye uropi. Pamwe chete, uropi uye rwonzi rwomupfupa runoumba nheyo yepamusoro yenheyo. Mhangura ye arachnoid ndiyo nheyo yepakati pechifukidzo ichi. Iyo yakakwirira yepamusoro, iyo inonzi dura mater - iyo inoreva kuti "wakasimba amai" -iyo, sezvinoreva zita, tsvina yakagadzirirwa yakagadzirirwa kuchengetedza kubva kune masimba anobata tsambo kubva kunze. Izvo zvakasimudza, iyo iyo yakadzika yakanyanyisa yeiyo meninges, inhengo yakashata ine mishonga yakawanda yeropa yakaiswa mukati mayo. Irochnoid membrane inewo mitsipa yeropa, uye zvose uyewo uye arachnoid ine cerebrospinal fluid , imwe nzira yekuchengetedza yepakati yenheyo. Izvo zvakasimudza zvinowanikwa pasi pearchnoid membrane, iyo iri pasi pekugara mater.
Mune mamwe mazwi, iyowo yakamera ndiyo yakatsetseka iri pedyo zvikuru nemutsipa wepelinha pachayo.
Sezvo nehuwandu hwemamiriro ekuvhiringidza, apo ruvara rwehachnoid ruchigumburwa, runogona kukonzera marwadzo. Izvi zvinogona kuvhiringidzika kana rwonzi rwepelinha rwunomanikidzwa, zvichida kubva mukukuvadzwa kana muitiro wepempa.
Mu arachnoiditis, kupisa kunotungamirira kuhutu hwemavara. Zvisikwa zvishoma, zvakare, zvinogona kukonzera mutsara wemapapiro kubatana pamwe zvisina kunaka. Imwe nzira yekufungidzira arachnoiditis ibasa remitsetse iyo iri mukati memugero wepelinha.
"Kana iwe uchigona kufungidzira nharo sezvipembenene zvepaghetti zvinoungana pamwe chete, ndizvo zvinonzi arachnoiditis yakafanana," anodaro Dr. Anand Gandhi, anodzivirira muviri . Gandhi chiremba anonyanya kugadzirisa zvirongwa zvishoma. Anoramba achiita tsika pa Laser Spine Institute muTampa, Florida.
Iko kunokanganisa kunowanzoitika kune imwe nzvimbo munharaunda yepasina . Izvi zvinofananidzwa nenharaunda iri mukati-kati (inyanzvi inonzi "medial to") mutsara wemagunha midzi , Gandhi anoti. Iwe unogona kunzwisisa nzvimbo yekugadzirisa sechigaro mudambudziko pamberi pekuti inotanga kubuda uye kuwedzera kuva nhengo dzomukati (s). Nzira dzomukati mutezo ndewemitsipa inopinda kubva kune tambo kusvika kune imwe yose yemuviri wako; idzi mitsipa dzinokubatsira kuti unzwe, kupindura uye kufamba.
Zvinokonzera Arachnoiditis
Arachnoiditis kazhinji inokonzerwa neimwe rudzi rwekukuvadzwa kana kuvhiringidzika kumusana. Inowanzoitika semugumisiro wechinhu chakaitwa kumusana.
Maererano naDr. Gandhi, zvinokonzera zvitatu zve arachnoiditis, mukuronga, ndezvi: Kuvhiyiwa kwepamusoro, kunyanya kusinganzwisisiki kwomuviri, zvirwere zvepasipfu (izvi zvinogona kuva mabhakitiriya, hutachiona, kana zvose) uye kushungurudzika. Zvimwe zvinokonzera, anoti, zviremara uye CT myelograms , iyo dzimwe nguva inopiwa kuti iongorore zvipembenene mune nzvimbo inonzi sub-arachnoid. Nzvimbo yepasi inonziwo nzvimbo inonzi intrathecal .
Arachnoiditis Zviratidzo
Kuoma kwemarwadzo ekudzokera shure kunobatanidza ne arachnoiditis kunogona kubva kubva kune zvinyoro kusvikira kune zvishoma, Gandhi anoti. Anotaura kuti zviratidzo zvinogona kusanganisira kushungurudzika kwehutano zvakadai sokuputira uye kupisa muzasi nepamakumbo.
Anotaura kuti arachnoiditis dzimwe nguva inosanganisira paresthesia (kureva, kurira, kunzwa kwepini nemasese, uye / kana kupera pasi pasi kana ruoko). Izvi zvinorwadza uye paresthesia zvinowanzowanzoitika munzvimbo dzisina kukwana dzisina kufananidzwa nekupararira kwemvura , anodaro. Dermatomal kupararira kunongoreva mufananidzo mukati momuviri umo mavheti "moto".
Zviratidzo zvinogonawo kusanganisira kukanganiswa kwemisumbu, kusanganisa, kana kuti zvishoma. Arachnoiditis inogona kukanganisa bladder, maronda, uye zvepabonde, uye mumatambudziko akaoma, zvinogona kukonzera kuparara kwemakumbo ezasi, Gandhi anoti.
Arachnoiditis Treatment
Arachnoiditis isingaperi chirwere chinorwadza icho, nokuda kwechikamu chikuru, hachisi kunyatsopindura mishonga inowanikwa ikozvino. Pamusoro pezvo, kufungidzira kwayo kunowanzoomeswa nekushaiwa kwechiratidzo chezviratidzo.
Gandhi anobvuma kuti arachnoiditis inogona kuva yakaoma kurapa. Izvi ndizvo, anoti nokuti kurapwa uye nemigumisiro kubva pamishonga inowanzofanana. Kuzosvika panzvimbo yeharunoid pasina kuwedzera kukuvadza kwayo kunokonzera kushandiswa kworudzi rwemhando dzisina kukodzera. Kwete izvozvo bedzi, asi kurapa kusingaiti kunogona kukonzera humwe ruvara rwemavara muhupenyu. Ndiyo chinhu chekupedzisira chamunoda mumatambudziko e arachnoiditis (pamwe nezvimwe zvepamuviri). Ngatitarisei pane zvipingamupinyi zviviri izvi panguva imwe kuti tinyatsonzwisisa kuti nei arachnoiditis kurapwa kwete nguva dzose:
- Kuchengetwa Kwakaitwa: Chirevo chinotevera kurapwa kwerachnoiditis ndechokugadzirisa dambudziko (munharaunda ye subarachnoid) inokonzerwa ne "clumped spaghetti," Gandhi anoti. "Asi nzvimbo ye-sub-arachnoid inogona kuva yakaoma kwazvo kusvika kunze kwekuwedzera inotsamwisa nzvimbo iyo yakaoma," anowedzera kudaro. Zvinosuruvarisa, izvi zvinoratidzirwa kune vanachiremba vanobata chirwere chacho.
- Zvisungo Zvisungo Zvinokonzera Zvisungo: Kunyange zvazvo kune nzira dzakawanda dzinoshandiswa navanachiremba kuti dzishandise maronda akaoma , akawanda anokonzera ruvara rwechivara mune nzvimbo ye arachnoid. Shanduro: Mishonga yecheka mutsvuku iyo inowanikwa munzvimbo ye-sub-arachnoid inowedzera kukwidza mungozi yako kuwedzerwa kuwanda kwe "clumped spaghetti" mumutsipa wako wepelinha.
Saka chii chinonyatsoshanda kurapa arachnoiditis? Izvozvo zvinogona kuvimba nezvokuti zvinokanganisa sei, Gandhi anoti. Uyewo, hapana chivimbo chokuti chero kurapa kupi kuchabudirira mukuderedza zviratidzo.
"Arachnoiditis inetso yakaoma ine mishonga shomanana. Hapana kana imwe yegoridhe yemhando yekubata nayo, "anodaro. "Kana uine arachnoiditis, taura nachiremba wako pamusoro pezvaunogona kuita."
Sangano reNational Institutes of Health rinotaura kuti mishonga yakawanda ye arachnoiditis inotarisa mukurwadziwa nekurwadziwa kwezviratidzo -kuita kuti uite zviri nani muupenyu hwako hwezuva nezuva. Vanotaura zvakare kuti kuvhiyiwa kunokakavadzana, zvikurukuru nokuti pane zvakanakisisa, kuponeswa ndekwenguva pfupi.
Gandhi anoti kurapwa kunowanzotanga uye kunowedzera kune dzimwe nzira dzekuvhiringidza. Heino rundown (mukuronga):
- Therapy Therapy
- (Muchirevo) mishonga yemarwadzo emutsipa, somuenzaniso: Lyrica kana Neurotonin
- Inrathecal steroid injection mu subarachnoid space, iyo inonyanya kushandiswa-anti-inflammatory medication yairehwa kugadzirisa kusuruvara mukati
- Yakasimwa (inowanzosavhiringidza nzira) yemutsipa rutsva kukurudzira iyo inogona kubatsira kubvisa marwadzo ekurwadziwa kuitira kuti iwe usanzwire sevari nyore
- Thecaloscopy, ichitsva, kunyanya kusingazivikanwi kunopesana nenzira yakasvibiswa yakaitwa pashure pokunge vanachiremba vakatanga kushandisa endoscope kuti vaongorore arachnoiditis. Vanachiremba vakaziva kuti chirongwa chekuongororwa chinogona kuchinjwa kuva chirwere chakasunungura kushungurudzwa kwakakonzerwa ne "clumped spaghetti" nerve. Kusvikira ikozvino, kurapwa uku kwave kuri kuedzwa chete nevarwere 23; mune mamwe mazwi, kwete tsvakurudzo yakawanda pamusoro pechipatoscopy yakaitwa, uye naizvozvo haisi mibvunzo yose pamusoro pokuchengetedzwa kwayo uye kubudirira kwayo yakapindurwa.
Fungisisa iwe, hazvidikanwi kuva nelosloscapy ichiita kuti uwane arachnoiditis kuongorora. Thecaloscopy ndiyo imwe nzira inogona kuitika. Kutaura zvazviri, Gandhi anotaura kuti chiyero chegoridhe chekuwana chirwere cheMRI .
Mushonga wakanakisisa we arachnoiditis ndiko kudzivirira, Gandhi anoti. Izvi zvinotenderera kune chinonyanya kukonzera matambudziko akawanda - ruvara rwemavara mavara pashure pokunge chimwe chinhu chaitwa kumutsipa wako. Pfungwa iyi ndeyokuderedza dambudziko rako rekuvhara mavara. Kune izvi Gandhi anotaura kuti kana uri kuronga kuti uite chirwere chepfungwa, funga nezvekuita zvishoma. Kusarudza kuenda zvishoma nezvishoma (kana zvakakodzera kumamiriro ako) zvinogona kuderedza ngozi yako yehutachiona hwakawanda hwemavara, nekudaro, kuderedza ngozi yako ye arachnoiditis. Sezvo chero ipi zvayo inogona kupera mushonga, taura nachiremba wako paunenge uchitora nzira yakanakisisa yekuita iwe.
Ndezvipi Zvakaitwa Nokutsvakurudza?
Munda we arachnoiditis mishonga inongova nhamba iyo vashomanana vanopa uye vatsvakurudzi vakakwira kuti vazadze. Tsvakurudzo yakakwana uye yakavimbika inogona kuitika paNational Institutes of Health. Saka, arachnoiditis tsvakurudzo yakawanda kwazvo yakabatanidzwa pamwe nekutsvakurudza kune dzimwe zvirwere zvisingaperi zvinorwadza. Kana uchida kuwedzera nzira dzako dzokurapa, zvakare, taura nachiremba wako nezvezvinhu zvakanyorwa pamusoro apa.
Sources:
Cerebral Spinal Fluid (CSF) Collection. Medline Plus. Yakapedzisira kushandurwa: June 2011.
Di leva, A., et al. Lumbar Arachnoiditis uye Thecaloscopy: Ongororo Pfupi. Cent Eur. Neurosurg 2012.
Gandhi, A., Interventional Physiatrist, Laser Spine Institute, Tampa, Fla. May 2013.
Ruzivo rwevarwere: Multistate Outbreak yeFungal Meningitis uye Zvimwe Zvirwere. CDC Website.
Meninges of the Brain. Medline Plus. Kugadziriswa Kwakapedzisira: Gumiguru 2012.
NINDS Arachnoiditis Information Page. National Institute Neurological Disorders uye Stroke web page. Yakapedzisira kushandurwa: Jan. 2011.
Cherechedza kune Vachipatara: Kuenderera mberi Kuchenjerera Kunokurudzirwa Kurwarisa Kwechirwere pakati pevarwere Vakagamuchira Secidal Steroid Injections. CDC Website.
> Tetsuryu Mitsuyama, Shunji Asamoto, Takakazu Kawamata. Novel Surgical Management of Spinal Adhesive Arachnoiditis neArachnoid Microdissection uye Ventriculo-Subarachnoid Shunting. Nyaya yeCliniki Neuroscience 18 (2011).