Paunowana kuvhiyiwa shure, kufunga kwangu ndekwokuti kana kwapera, chinhu chokupedzisira chaunotarisira chimwe dambudziko. Zvinosuruvarisa, chero upi noupi upiyona hunouya nehutano hwezvinetso , izvo zvinogona kukupa kurwadziwa kana zvimwe zviratidzo mushure mezvo. Chimwe chikonzero chakadai chekuvhiyiwa kwepamusoro chirwere chepidural fibrosis, kana kupora panzvimbo yekuvhiya.
Overview
Epidural fibrosis ndiro zita rakapiwa kukura rinoitika mushure mekuvhiyiwa shure.
Icho chimwe chezvikonzero zvakakonzerwa zvinokonzerwa nemamiriro ezvinhu anozivikanwa seakakundikana kumashure chirwere chirwere (acronym: FBSS.) Epidural fibrosis ndiyo inonyanya kukonzera ivo vose; inowanikwa kusvika ku 91 kubva muzana yevashandi vekuvhiya mushure mekudzokera.
Asi pane mashoko akanaka: Epidural fibrosis haisi nguva dzose inoguma kurwadziwa kana zvimwe zviratidzo. Zvechokwadi, kune vamwe vanhu, hazvibatsiri hupenyu hwezuva nezuva kana hutano hwehupenyu zvachose. Chidzidzo che2015 chakabudiswa mumagazini inonzi Insights Imaging chakawana kuti mubvunzo wokuti kana zviratidzo zvisizvo zvingaonekwa here zvingave zvakabatana nekupararira kwekupararira kwacho.
Imwe yedzidzo yegore ra2015, ino inobudiswa muAsia Spine Journal, yakawana kuti epidural fibrosis inogona kukonzera marwadzo kusvika kusvika 36 kubva muzana yevanhu vakundikana kumashure ekurapa chirwere. Uye nepo 36 kubva muzana chikamu chakakura chevarwere, inenge iri kure kubva 91 kubva muzana.
Epidural fibrosis yakafanana neyekunyatsosiyana zvakanyanya kune arachnoiditis .
Chokutanga, epidural fibrosis inokanganisa chifukidziro chekunze chemupendero wecinara (iyo yakagadziriswa,) asi arachnoiditis inowedzera kusvika mukati memucherechedzo. Kungofanana nesimbi yakasara pamusoro payo (uye iyo inowedzera pasi) yerchnoid inopoteredza uye inochengetedza mitsipa yakaoma iyo ine mutsara wesimbi.
Mumwe musiyano ndeyekuti epidural fibrosis inokonzerwa nekuvhiyiwa kumashure; asi kuvhiyiwa kumashure ndeye imwe chete yezvikonzero zvinokonzera arachnoiditis. Uye pakupedzisira, kuvhiringidza kunogona kuita izvo zvinokonzera kuti mutsvuku uite, izvo zvino zvinogona kutungamirira kumakumbo emutsipa-zvinorwadza uye zvakaoma kubata chirwere.
Maitiro
Chii chaicho chinoitika kumutsipa wako apo iwe unowana epidural fibrosis? Iyi mhinduro, kazhinji, yakabatana nenzvimbo yemumumvu mako inonzi spinal nerve root.
Zvizhinji zvekuvhiyiwa zvakapiwa kumarwadzo kumashure uye kumakumbo zvinogona kuve iyo laminectomy (inonziwo chirwere chekudzidzira kubviswa) kana kuti discectomy . Nzira mbiri idzi dzakagadzirirwa kusunungura kudzvinyirira pamutsipa wesiperesi midzi sezvo ichibuda mumutsara wepelinha. (Kukuvadza kwakadai sedhayi , uye pamwe nekuchinja kunokonzera mumusana wacho pachayo kunogona kuita kuti zvivako zvakasiyana-siyana zvakadai sezvidimbu zvakasiyana-siyana kana bone spurs zvinongomhanya, uye zvinogumbura, mutsara.)
Zvinorevei izvi ndezvenguva yakawanda, chirwere chepfungwa chinenge chiri kushanda pedyo nenharaunda yako yenzara. Nemhaka yokuti acharamba achitarisa kubvisa zvinhu (zviduku zviduku izvo zvisiri zvepano kana mapfupa emapfupa ari kuswedera pedyo nemutsara), iye anofanira kunge achivagonesa nekushanda kukuru.
Nemhaka yeizvi, maronda achagadzirwa sechikamu chekuvhiya kwako.
Kupararira ndeyekuzvarwa kwechiito kune rumwe rudzi rwevanga rinokanganisa chimiro chemuviri, uye nzvimbo yakapoteredza musana wako wepelinha mukati mekuvhiyiwa hazvisi izvo. Izvo zvakaitwa ndizvo zvakafanana zvinoitika kana iwe ukanyura bvi; mune mamwe mazwi, kukurudzirwa kwepidural fibrosis kwakaenzana neyenga yakaita pamabvi ako mushure mekukuvara kwekutanga. Necheka, uye epidural fibrosis, inongoita zvirongwa zvekuporesa.
Kurwiswa kwepadural kunowanzoitika pakati pemasvondo matanhatu ne12 mushure mekuvhiyiwa.
Nzira
Ngatitangei zvakadzika kuti tinzwisise kuporesa uku sezvo inoshandiswa kune yako disectomy kana laminectomy.
Pashure pokuvhiyiwa kumashure, zvinhu zvakawanda zvinogona kuitika pasi pehood, saka kutaura.
Chokutanga, chimwe chezvinhu zvitatu zvakavharwa mumutsara wako (chipfeko chekunze chairo chinonzi "gara rakasimba") chinogona kuomeswa. Chechipiri, imwe kana imwe yeropa rako remidzi inogona kuve "yakasvibiswa" (kureva, yakasungirirwa.) Uye chechitatu, nekuda kweimwe kana zvose zvezvinhu izvi zvose, ropa rinopa mutsara miviri uye / kana cerebral spinal fluid inodzimwa. Irosebrospinal fluid, inozivikanwawo seCSF, inenge yakajeka, mvura inonaya inopararira pakati peuropi nemumutsipa wepelinha paanenge iri pakati pearchnoid mater uye iyo yakafanana. Basa rayo nderekusimudzira uye kuchengetedza zvivako zvepakati yenheyo system (iyo inogadzirwa nehupfungwa chete nemutsara wemutsara) kubva pamigumisiro.
Kubva muna 2016, vatsvakurudzi vachiri kukakavadzana kuti sei, uye kunyange kana, kuvhara kana pedo nemutsara wemagunha miviri kunofanana nekurwadziwa nezvimwe zviratidzo unogona kuudza chiremba wako pamusoro pekuvhiya kwako kumashure. Nyaya iri muAsia Spine Journal inotaurwa pamusoro apa yakawana kuti vamwe vanyori vekunyora vanoti kwete-avo vaviri havatsananguri zvose. Asi vamwe, Asian Spine Journal inoshuma, vakagumisa kuti kupararira kwakapararira mukati uye kwakapoteredza nerve midzi (kusiyana nemasikirwo akaiswa munharaunda imwechete) vane ukama kune zviratidzo uye kurwadziwa.
Ether nzira, kana mavara akaumbwa, hapana mushonga unonyatsobudirira. Chiremba wako angave achida kudzokera zvakare uye kuputsa zvikanda ne endoscope, asi izvi zvinogona kukonzera kuora kwekare uye epidural fibrosis.
Nokuda kwechikonzero ichi, nzira yakanakisisa yokurapa epidural fibrosis ndeyokudzivirira, kana kuti kuderedza kuumbwa kwechivara.
Nzira iyo iyo inogona kuitwa nayo ikozvino, sa 2016, iri kushandiswa mune zvidzidzo zvitsvakurudzo, kunyanya pamhuka panzvimbo pevanhu. Izvi zvidzidzo zvinongedza mishonga kana zvinhu zvakanyanya pamakonzo, uye oenzanidza maviri neaya eboka rinodzora (rats dzisingatori mishonga kana zvinhu zvinoshandiswa kwavari.)
Degree
Chimwe chinhu icho sayenzi yakabatana nemararamiro uye marwadzo ndeyero ye fibrosis. Epidural fibrosis inogona kubatanidzwa kubva ku 0, iyo inomiririra mhuka dzisina kukwana zvachose kusvika kuGari 3. Gwaro 3 nderimwe dambudziko guru re fibrosis, rine ruvara rwechivara runotora kupfuura 2/3 yenharaunda yakashandiswa pa ( munyaya ye laminectomy.) A grade 3 ruvara inogonawo kuwedzera kumutsipa wevhu, asi maBanga 1 ne2 haaiti. Chikoro chezvikamu zvitatu zvinokonzera zviratidzo uye kurwadziwa kudarika maBanga 1 ne2.
Girasi 1 zvipembenene zvinowanzove zvinyoro, uye zvinoumbwa nemakumbo masimbi ane fiber akaiswa pasi pamusoro pegadziriro yakasara, iyo iri kunze kwembambo dzomukati yakavharidzirwa inorondedzerwa pamusoro apa. Chikoro chechikoro chechipiri chinongodzokorora, chinopfuurira, uye zvinotora zvishoma kudarika 2/3 zve laminectomy nzvimbo. Kana imwe tsanga yakave yakasvika kuBanga 2, inoramba iripo, zvinoreva zvishomanana kana zvidimbu zvevanhu zvikaonekwa.
Kuziva
Chiremba wako anogona kuraira MRI kuti iongorore chero chirwere chepidural fibrosis chaungave nacho. Dambudziko nderokuti, kazhinji, kupora hakugone kuonekwa nemhando iyi yekuongororwa kwekufungidzira imaging. Saka kana iwe uine zviratidzo, uye MRI inodzoka yakashata, iwe unogonawo kuwana epiduroscopy.
Chirwere chepiduroscopy chiyero umo chirwere, kana kuti chiyero, chinopindirwa munzvimbo inotambudzika kuti chiregai chiremba wako aone kuti chii chiri kuitika pamutsipa wako. Zvakakosha kutora chirongwa chekuongororwa ikozvino nokuti marwadzo ako angangodaro anokonzerwa nedzimwe sarudzo, panzvimbo yepidural fibrosis. Muchiitiko ichi iwe ungangodaro unoda imwe kuvhiyiwa ; asi kana mitsara epiduroscopy inoratidzika, uye kuvhara ndiko kuri kukonzera zviratidzo zvako, mikana iwe haufaniri kudiwa iyo yechipiri yekuvhiya.
Kurapa
Iwe unogona kunge uchishamisika: Kana kurapwa kunotevera kusingagoni kubvisa marwadzo ako epdiural fibrosis, iwe unoitei?
Sezvandambotaura kare munyaya ino, masayendisiti uye vanachiremba vasati vauya nehutano hwechikonzero ichi chechikonzero chekukundikana kwezvekurapa chirwere chekurapa. Muzhinji, kunyange zvakadaro, mishonga inopiwa pakutanga-kazhinji pamwe chete nekurapa kwepanyama. Mishonga ingangobatsira nemarwadzo pamwe nekuita basa rinoremekedzwa. Mishonga inopiwa inosanganisira Tylenol (acetaminophen,) NSAIDs (mishonga isingaiti steroidal anti-inflammatory pain), gabapentinoids, nezvimwe.
Chirwere chepanyama chakagadzirirwa kukuchengetedza foni uye chinogona kusimbisa kusimbisa, kutambanudza uye kuita zvekudzidzira. Kuramba uine foni muzvibatanidzi zvako kunogona kubatsira kukanganisa kuumbwa kwemavara .
Nezvekuvhiya kunofamba, imwe yekudzidza inorondedzera kuti inowanzova ne30 kubva muzana kusvika kune 35 muzana yekubudirira kwehuwandu. Kwete izvozvo chete, asi chidzidzo ichocho chinotaura kuti zviratidzo zve kusvika 20 muzana yevarwere zvinowedzera kuipa. Izvozvo zvakati, maitiro maviri ekurapwa kwakapiwa epiidural fibrosis ndiwo anonyanya kutsvaga adhesiolysis uye maginini endoscopy.
Kusvika ikozvino, adhesiolysis yakasiyana-siyana ine uchapupu hwakanakisisa huri shure kwayo. Mune nzira iyi, iyo, nenzira, inoshandiswa kune zvimwe zvikonzero zvekukundikana kwezvekurapa chirwere chekare, zvakare, mushonga, kazhinji steroidal mishonga, inoshandiswa munzvimbo yacho kuburikidza nekanyateri yakaiswa. Uyewo neyiyi nzira, kushandiswa kwegadziriro yezviyo hazvidiwi kuregererwa kwezviratidzo.
Percutaneous adhesiolysis inotsigirwa neIndaneti Ini uchapupu (hukuru hwehutano) maererano nekubudirira kwayo kwekukundikana kwezvekurapa zvirwere zvirwere zviratidzo zvachose, zvinosanganisira epidural fibrosis.
Imwe mushonga uyo chiremba wako angaratidza ndeyepinuscopy. Mune nzira iyi, nzvimbo inobvumira chiremba wako kufungidzira kuti nzvimbo yacho inowanikwa. Dzimwe nguva lasers inoshandiswa kugadzirisa zvinopisa asi nzvimbo yacho irimo imomo. Mharapara endoscopy inoratidzirwa seChikamu II uye III uchapupu, uye kumwe kuongorora kwakawanikwa kwakawana kuti kune "uchapupu" hwakanaka hwekudzivirira zviratidzo.
> Kwakabva:
> Coskun E., Süzer T., Topuz O., Zencir M., Pakdemirli E., Tahta K. Relationships pakati pepidural fibrosis, marwadzo, kuremara, uye pfungwa dzepfungwa mushure mekuvhiyiwa kwekambar disc. Eur Spine J. June 2000. https://www.ncbi.nlm.nih.gov/pubmed/10905440
> Helm S., Racs G., Gerdesmeyer L., Justiz R., Hayek S., Kaplan E., Terany M., Knezevic N. Mutsvaga uye Endoscopic Adhesiolysis Mukusarudza Kuderera Kwakaderera uye Kumusoro Kwakanyanya Kunetseka: Ongororo Yakarongeka uye Meta -analysis. Pain Physician. Feb. 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. Spinal endoscopic adhesicopy in post chiremba chirwere chekuvhiya: chiitiko chekuongorora kweuchapupu. Pain Physician. April 2013. https://www.ncbi.nlm.nih.gov/pubmed/23615889
> Masopust V., Häckel M., Netuka D., Bradác O., Rokyta R., Vrabec M. Postoperative epidural fibrosis. Clin J Pain. Sept. 2009. https://www.ncbi.nlm.nih.gov/pubmed/19692802
> Mohi E., Abdel R. Epidural Fibrosisi mushure meLumbar Disc Surgery: Kudzivirira uye Kubudirira Kuongorora. Asian Spine J. Jun 2015. https://www.ncbi.nlm.nih.gov/pubmed/26097652