Rimwe remisodzi riri mukati mezvipembenene nderekubatana kwekuchera kwepemusoro umo iyo yakaputika yakavhara mutsara (inonzi dura mater) inotorwa nechiremba chechiremba.
Dural sac misodzi haisi chinhu chokushambadza nacho. Mukudzidza kwavo muna 2017, vatsvakurudzi vechiChinese vanotaura kuti dural sac misodzi inogona kutungamirira kune cerebrospinal fluid kuvuza, meningitis, nerve problems uye mamiriro ezvinhu akaoma, pamwe chete.
Ndeipi Mhando yeUpine Surgery Inokonzera Dural Sac Tear?
Mhinduro ndeyekuti, zvinodaro. Vanyori vechiChinese vakacherechedza nzira dzakasiyana-siyana dzezvinokonzera zvinokonzera.
Muzvizhinji, kunyange zvakadaro, mumisodzi yemisodzi inowanzowanzoitika kakawanda nekugadziriswa kwepfungwa. Multi-level spine chirurgical is next on that list, followed by spinal fusion, uye pakupedzisira kudarika kwemazinga akawanda (nokuda kwepinal stenosis).
Kuvhiyiwa kwechirwere uye kusaroora unyanzvi hwokuvhiya kwepabonde kunowanzokonzera nhamba duku kudarika yemisodzi, kutaura.
Chimwe chezvinyorwa zvevarwere zvakabudiswa mumagazini yaMarch 2016 Clinical Neurology neNeurosurgery yakawana kuti mhedziso dzemisasa yakazviratidza ivo kakawanda kune vanhu vakawana zvisizvo zvisingabatsiri kubva pakucherecherwa kwepachiedza umo synovial cyst yakabviswa. Muzviitiko zvizhinji zvakadai saizvi, maererano nevanyori vekudzidza, zvakaita sokunge kuti mhemberero dzepakati pemvura yaifananidzira kuwanikwa kwevarombo kushanda.
The Clinical Neurology uye Neurosurgery vanyori vanotaurawo kuti kumadzinza emisodzi inowanzoitika nguva dzose paanenge ari L5 / S1.
Vanotiwo vanoti kana chikamu chimwe chete chekstasi chabviswa, murwere haasi pangozi yekuchema kwepakati.
Kudzivisa Duru Dzedu - Dhigiriyari Dambudziko uye Zviitiko Zvengozi Yako
Kunyange kune chiremba anovhiya ane maoko, zvakaoma kusaita nick sac iyo ine mutsara wesimbi. Mutsara inofukidza muromo wepelinha hauna simba semapfupa, ganda kana musuru, Dr.
Auerbach, Chief of Spine Surgery paBronx-Lebanon Hospital Centre muNew York City, anondiudza. "Hazvina kunaka uye zvinononoka kubvaruka."
Kunyange zvazvo chiremba wehutano hwako neecalpel (kana chimwe chiridzwa) chingangove ndicho chinogadzirisa kusvimha misodzi, mamiriro ezvinhu akambovapo uye / kana kuparara kunogona kuwedzera ngozi yako. Semuenzaniso, kushandisa steroids, kuva nechirwere cheshuga, kana kuva kusvuta zvose kuwedzera ngozi yako. Izvozvowo ndezvechokwadi kana une zvimwe zvinetso zvepungu, izvo: spondylolisthesis, stenosis , scoliosis, kana kyphosis .
Zvipatara Usingadi Kuzivisa Dzimba Dzomukati Kuwedzera Kwemari
Dural macho ndeimwe yezvinetso zvakajairika zvekuvhiyiwa shure. Asi zvipatara zvakawanda zvinoratidzika zvisinganono kureva misodzi inowanikwa mumasangano avo. Nokuda kweizvi uye zvichida zvimwe zvikonzero, chiitiko chemukati wemisodzi chingave chisingatauri.
Sezvazviri, kuwedzera kwehuwandu hwehuwandu hunobudiswa mune zvidzidzo zvekutsvakurudza kunowanzosiyana. Zvimwe zvinhu zvinogona kureva kusiyana kwezvikonzero: chikonzero chekuvhiyiwa (stenosis, herniated disc, scoliosis, synovial cysts nezvimwe), zvisinei kuti kuvhiyiwa kwaiva mutevedzeri wekutanga, wechipiri, wechitatu, nezvimwewo, nezvimwe zvinhu.
Pasi parutivi rwakadzika, chidzidzo chaJanuary 2011 chakabudiswa muNeurosurgery ichiongorora vanokwana 108 000 varoyi vepachiona vakawana 1,6% vavo vakawana ruvara rwemasango.
Panzvimbo yakakwirira, Medscape inoshuma kuti kuongorora kwakabudiswa muna 1989 muna Spine kwakaratidza huwandu hunokwana 17.4% huwandu huwandu hwemadzinza emvura munzvimbo dzakawanda dzinosvika 481 vanhu vakazovhiyiwa zvakare.
Dare reCID -CM Coordination uye Maintenance (komiti inotora basa rinokosha pakutsvaga kuongororwa kwezvirwere) yakawana kuti 57% yezvipatara zvavakaongorora yakataurira zviitiko zvemavara emvura. Dare racho rinotaura kuti 46% yezvipatara zvinokwana 2 446 yakashuma pasina dutu remisasa zvachose! Iyo inotaurawo kuti zvipatara zvinoshuma kubata kurapa kwemahara, asi hazvirevi kuti mhedziso dzinogara dziripo dzakamboitika.
Go figure.
Uye apo vanachiremba vachiita chirwere chepfungwa mune dzakawanda zvezvipatara zvakabatanidzwa mune zvidzidzo zvekutsvakurudza zvepirini (izvo zvinochengetwa zvakasiyana nehutungamiri hwehupfumi huri kuitwa nezvipatara), chiitiko chemukati wemisodzi chaive, mune dzimwe nguva, chinopfuura 10%.
ICI-CM Committee inofungidzira kuti zvipatara izvi zvinongotaura hafu yezvinyorwa zvemasango zvakanyatsoitika.
Dural Wear and Cerebrospinal Fluid Leaks - Symptoms and Treatment
Sezvandataura pamavambo echinyorwa chino, zviratidzo zvekumusoro kwemisodzi zvinosanganisira zvipembenene zvinokonzera mvura (inonzi CSF inononoka). Izvozvo zvinoratidzika sei? Iwe ungati sei kana iwe (ungave) une dutu remukati?
Dr. Auerbach anotaura kana iwe une CSF inokonzerwa, unogona kuona kujeka kwemvura kusununguka kubva pane ronda rako rokuvhiya. Iwe unogonawo kuva nemafungiro ane chokuita nemamiriro ezvinhu anowedzera kuipa kana iwe ukasimuka uye unozorodzwa paunorara pasi. Zvimwe zviratidzo zvinosanganisira kuchinja kuonekwa, kushungurudza, kusuruvara kana dutu, Auerbach inoti.
Kana ikasaitirwe nekukurumidza uye zvakakodzera, chirwere chinokonzera mvura chinokonzera chinogona kukukanganisa hutano hwako. Saka zviratidzo zvakadai sezvakakurukurwa pamusoro apa zvinoda kurapwa nokukurumidza.
Zvose izvi zvakati, misodzi yakasununguka inowanzobatwa nachiremba wako panguva yekuvhiyiwa uye inorapwa panguva iyoyo.
Asi zviratidzo zvekupedzisira zvinogoneka, uye munyaya iyi, zvichava kwauri kuti uzvione uye uite chimwe chinhu. Kana ukawana chero chipi zvacho kana zviratidzo zvose zvakanyorwa pamusoro apa, iva nechokwadi chekukurukurirana navo nechiremba wenyu pakarepo paunokwanisa.
Mishonga yemvura yakadzika inosanganisira kurara kwemubhedha, kudira, uye kana kuerera kuchiri mberi, kuvhiyiwa. Kuvhiyiwa kwemajeri emharaunda kwakafanana nekuchera gomba muvhare. Kubva munaMarch 2012, maitiro akawanda ekurapa kwemaziso anosanganisira sutures (stitches), asi nzira dzisina kukwana dzirikudziridzwa zvakare.
Kunobva:
> Fang, Z., Kurapa kweperesipinal fluid mutungamiri mushure mekuvhiyiwa kwepfungwa. Chin J Traumatol. April 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392710/
> Guerin P, et. al., Incidental durotomy panguva yekuvhiyiwa kwepfungwa: Kuitika, kutarisira, uye zvinetso. A retrospective review. Kukuvadza. 2011 Jan 18. [Epub mberi kwekudhinda]. http://www.ncbi.nlm.nih.gov/pubmed/21251652
> Klessinger, S. Nharaunda yemadzinza misodzi mushure mekugadzirisa kushandiswa kwemakondomu e-lumbar synovial and the relationship to the outcome. Clin Neurol Neurosurg. March 2016 Mar http://www.ncbi.nlm.nih.gov/pubmed/26945877
> Shaw, J. Nhengo Durotomy / Dural Tear. ICD-9-CM Komiti Yokugadzirisa uye Kugadzirisa. March 19-20, 2008. Powerpoint Presentation.
> Williams, BJ, et et. al. Chiitiko chebumbiro risina tsananguro mukuvhiya kwepfungwa kunoenderana nematambudziko 108 478. Neurosurgery. Jan 2011. http://www.ncbi.nlm.nih.gov/pubmed/21150757 "