2nd Surgery Back
Kudzokorora chirwere chepfungwa kunogona kuonekwa kudikanwa nachiremba wako (kana iwe) kana iwe uchiri nezviratidzo mushure mekutanga, kana iwe une zviratidzo zvitsva. Asi iwe unoziva sei kana iwe unonyatsoda chirwere ichocho chepiri zvakare? Tarisa urongwa uhwu kutanga tsvakurudzo yako.
1 -
Recurring Disc HerniationsKana, mushure mekusaziva, iwe zvakare une sciatica, zvinorwadza pasi ruoko rwako, kana zvimwe zviratidzo zvekudzidzira, unogona kuva nemararamiro anoramba achiita. Rudzi rwekodhi rinodzokorora rinonyanya kudzokorora dambudziko rakatungamirira pakuvhiyiwa panzvimbo yekutanga.
Maererano: Zviratidzo zveCervical Radiculopathy
A discectomy inowanzobvisa zvidimbu zviduku zveseti (zvinonzi fragments) izvo zvave zvikamu kana zvakakwana zvisingabvumirwi kubva kubhuku guru. Iwe unenge uine diski yako, uye ichiri kukwanisika kuratidza chikamu chakasara.
Akabatana: Chii chinonzi Disc Fragment?
Dr. D. D. D. Auerbach, Chief of Spine Surgery paBronx-Lebanon Hospital Centre muNew York City, anofananidza kusaziva kudya chikafu cheesecake, kunyanya kune avo vane shungu pamusoro pezvinonaka izvi.
Kunyange iwe uri kufara uchifunga nezvechiitiko chinotyisa, anoti, mikana ibate cheesecake ichaparadzaniswa kubva pachikamu chikuru. Vamwe vanozogara patafura, vamwe vanogona kumira pamucheto weplate, uye vamwewo vanogona kuwira zvachose. Mumamiriro ezvinhu aya, vanhu vakawanda vaizobvisa zvidimbu izvi zvinowira pasi, asi ramba uchidya chimedu chikuru.
Iyo discectomy analogy inoshanda zvakafanana: Zvipfeko zvisina kushandiswa zvinobviswa kubva pakurongeka kukuru, zvichisiya zororo rako rose, kana chikamu chekeke, chisina kumira.
2 -
PseudoarthrosisPseudoarthrosis izwi rinotsanangura kushaikwa kwemapfupa fusion mushure megore rimwe mushure mekuvhiyiwa kwepelinal fusion.
Pseudoarthrosis inowanzoitika, inowanikwa kusvika 68% yemafungiro evanhu, maererano Neerbach. Pakati idzi, pakati pe6 ne36% zvinoda kudzokera zvakare, anodaro.
Zvimwe zvinhu zvinogona kuita basa mukugadzirwa kwepseudoarthrosis mushure mekuvhiya kwako kwekutanga kunosanganisira:
- Chimiro chako chepakutanga kuongororwa
- Rudzi rwe hardware (kana kusarura kwayo) rwakasungirirwa
- Mhando yepafupa , kana iripo, yakashandiswa
- Utano hwako uye mamiriro ako. Somuenzaniso, kana ukasvuta kana kutora corticosteroids , ngozi yako ye pseudoarthrosis inogona kuwedzerwa.
- Kana iwe uine musana wepelinha umo pasina mahwendefa, zvigadzirwa kana imwe hardware yakaiswa.
Muchitsauko chake pamusoro pekushandurwa kwemaitiro ekuvhiya kwepineti yemashoko ekurapa ane musoro unonzi The Textbook of Spinal Surgery, 3rd Edition , Auerbach inotsanangura zvidzidzo zvinoratidza kushungurudzwa kunoitwa kunze kwekugadzirwa kwehurdware kunowedzera ngozi yako ye pseudoarthrosis ne 70%. Nhamba iyoyo inonyanya kuderera - 10% - nokuda kwenyonganyonga yepelinha umo hardware yakaiswa, anorondedzera.
3 -
Chikamu Chinowedzera ChirwereASD, kana kuti pedo chekugadzikana kwechikamu, ndiyo mamiriro ekushanduka kwemaatomical anoitika pamakumbo emusana kumusoro uye / kana pasi apa nzvimbo yekuvhiya kumashure kwaitwa.
Auerbach inoti kana ASD inowanzoitika, inowanzoita saizvozvo mushure memakore anenge maviri kana kupfuura akawanda asina marwadzo.
Related: Chii chinonzi Adjacent Segment Degeneration?
Nyanzvi hadzizive zvizere kana kuri kuvhiyiwa kumashure kana kuenderera mberi kwepanyama kwekugadzirisa kuchinja mumharapara iyo inotarisira ASD.
Frank Cammisa, Jr., MD, Chief of the Spine Service paChipatara Chekuvhiyiwa Kunokosha muNew York, inotaura zvimwe zvinhu kunze kwekuvhiya kunogona kunge iri kushanda mukukudziridza kwekuchinja kunotyisa kunonzi ASD. "Nguva dzakawanda, ASD inonzi inorwara nokuti murwere ane fusion, zvisinei, kunyange kana murwere asina kumbobvira awana fusion ivo vanogona kunge vachiri kuchinja kusimba kune imwe nzvimbo."
Chidzidzo chakaitwa neRwiyo, et. al, ane chikamu, "Chirwere chekare chinopera simba: ndezvikonzero nekuda kwekuwedzera kwezvirwere kana kuenzaniswa kwehuwandu?" Kuenzanisa pakati pezvikamu zvakatarisana nezvikamu zvisina kufanira uye zvisina kufanira, "yakabudiswa mumagazini yaNovember 2011 yeEuropean Spine Journal yakawana kuti" pedo chikamu chirwere chinowedzera chikonzero chezvakaitika kare zvechirwere chepervylosis kupfuura kuvepo kwekukanganiswa. "
Akabatana: Chii chinonzi Cervical Spondylosis?
Auerbach inotaura kuti zvidzidzo zvebiomechanical zvinoratidza kuwedzera kudzvinyirira pane zvikamu zvakatarisana nekutevedza. Nokuti fusion inowedzera kuwedzera kwemafuro emakona pakati pemapfupa maviri emubatanidzwa we intervertebral , iyo nzira yako yemusana inogona kuchinjwa. Izvi zvingaita kuti vamwe vamanikidzwe pane dzimwe nzvimbo dzekubatana.
"Dhayi yacho inotakura slack," anonditaurira.
Maererano neArebach nevamwewo, rudzi urwu rwekuwedzera kushushikana ndicho chikonzero chikuru nei vazhinji vari mumabhizimusi vachikurudzira kugadzirwa kwemafambiro ekuchengetedza maitiro ekuvhiya uye zvigadzirwa . Kufambira mberi mune teknolojia - somuenzaniso, kushandiswa kwematokari ose - kupa vanachiremba kurapa dambudziko pasina kupa chibayiro chekufamba munzvimbo yakakanganiswa.
Kana iwe uri kushamisika, pane zvidzidzo zvinoratidza kubatsirika kuva nechinzvimbo chekudzidzira pamusoro pemusana wepelinha, kunyange zvazvo kwete mibvunzo yose yakapindurwa (sa2016). Somuenzaniso, pakutsvakurudza kwezvidzidzo zvitatu zvichifananidza nemigumisiro yekodhidhi inoshandiswa nekugadziriswa kwepervinal fusion makore maviri mushure mekugadzirisa, vatsvakurudzi vakawana kuti vanhu vane arthroplasty (disk replacement) vaiva 44% vashoma vangada chirwere chechipiri. Chidzidzo ichocho hachina kuparidzira pane chero ipi zvayo inobatsira yeArthroplasty yekuderedza kana kudzivisa ASD, zvisinei.
Dhip replacement chirurgic inokurukurwa zvakadzama munyaya yangu: Kuchinja kweCervical Disc
4 -
Kudzokorora TDRKwose kubviswa kwekadhi, kazhinji kunonzi TDR kwenguva pfupi, inoshandiswa zvitsva (muUnited States, zvishoma) iyo inoonekwa nevamwe vadzidzisi vemumumhino sechinhu chinogona kushandiswa kune chirwere chepaupus fusion. Kudhindwa kwechirongwa kwakaitwa muEurope kwechinguva, asi US inotora teknolojia iyi zvishoma nezvishoma.
Nemhaka yokuti kugadziriswa kwekadhi mutsva munyika muno, ndezvekufunga kwangu kuti vaiti vezvigadziri uye vanachiremba vanoita mapiyona ekuvhiya maitiro vachiri kushanda kunze kwemashoko. Izvi zvinogona kuwedzera dambudziko reimwe kana zvimwe zvinetso zvinowanzoitika semugumisiro wokudhinda.
Auerbach inotaura kuti inenge 0-5% yevarwere vanonzi chirwere chepaya chinokodzera nzira yekuchengetedza uye yakabudirira total disc replacement nzira. Kana iwe usati uri mumiririri, asi iwe une imwe nzira, anoti, unogona kuva nezvinetso.
Chimwe chezvinetso zvakajairika zvinotungamirira mukuvandudzwa kweTDR (sechipiri chekudzidzira kushandiswa kunoshandiswa dzimwe nguva kunonzi) kusakatika kwekushandisa. Mienzaniso yekukundikana kwechigadzirwa inosanganisira kushanda kwebasa re prosthetic rinowanikwa mumutsipa wako, kana kuti iyo shanduko inoshandura nzvimbo yayo (extrudes).
Cammisa anowedzera kuti nokuti kugadziriswa kwekadhi kunochengetedza kufamba, kuchinja kwechigarire kunogona kuitika pazvikamu zvehutano. Kana kukanganiswa uku kuchiva kunorwadza, anoti, chiremba wako angaratidza kuti chirwere chepinini chinoshandiswa pakuvhiya.
5 -
Matambudziko neImplanted HardwareKunyanya kazhinji, iwe unogona kupinda mumatambudziko ne hardware yakaiswa mumutsara wako. Izvi zvinosanganisira prosthetic discs, sezvataurwa pamusoro apa, uyewo hardware inoshandiswa kugadzirwa kwepelin fusion nemamwe marudzi ekuvhiya kumashure. Icho chinoshandiswa, sezvinonzi pane dzimwe nguva chinodanwa, chinogona kuputsa, kana chiremba wacho angave akaisa panzvimbo isina kururama panguva inoitwa.
Imwe mhando yezvinetso zvehurumende inokonzerwa nekuvhiyiwa shure ndeye chirwere chinozivikanwa se "hardware inorwadza." Muchiitiko ichi, zvinhu zvakasimwa hazvisi kunyanyisa, Auerbach anoti.
Camisa anotaura kuti kurwadziwa nemhaka yehutachiona hwehutachiona hunowanzobva kune zvinyama zvishoma (kureva masumbu ako, ligaments, tendon uye fascia).
Kutaura nehurombo hutachiona hutano dzimwe nguva kunoda kuvhiyiwa kubvisa zvinhu zvinogumbura. Cammisa anonditaurira kuti kuongororwa kwezvekuvhima kwehutachiona hwema hardware syndrome kazhinji kunokonzerwa nekuiswa kwe hardware, kwete iyo pachake pachake. "Hazviwanzoiti kubvisa chigadziro nekuda kwekutambudzika kunokonzerwa nechigadzirwa," Cammisa anosimbisa.
Kudzokorora kuvhiyiwa kwezvinhu zvinorwadza zvinowanzoitwa pakarepo.
Sources:
Auerbach, J., MD. Chief of Spine Surgery, Bronx-Lebanon Hospital Centre, Mupiro Wepurofesa Wokuvhiya, Albert Einstein College of Medicine. Telefonhare Hurukuro. March 2012.
Auerbach JD, Kuklo TR. Kuvandudza Lumbar Spine Surgery. Mu: Bridwell KH, DeWald R, eds. The Bookbook of Spinal Surgery, 3rd Edition. Philadelphi., Lippincott 2011.
Benglis, D., et al. Kuongororwa kwakajeka kwehutano hwehutano hwepa bone morphogenetic protein mune chirwere chepfungwa. Neurosurgery 62. 5 (Supp Supp 2) (2008).
Cammisa, F., MD, Chief of the Spine Service paChipatara Chekuvhiya Kukosha. New York. Email Hurukuro. March 2012.
Etminan M, Girardi FP, Khan SN, Cammisa FP Jr. Revision strategies for lumbar pseudarthrosis.Orthop Clin North Am 2002; 33: 381-392.
Patel AA, Spiker WR. Chirongwa chekuongorora uye kurapwa kwekwenyununoni. Semin Spine Surg 2008; 20: 20-26.
Rwiyo, K., et. al. Chikamu chinowedzera chechirwere chinokonzera: ndezvikonzero nekuda kwekuwedzera kwechirwere kana kusanganiswa kwechirwere ichi? Kuenzanisa pakati pezvikamu zvakatarisana nezvikamu zvakasanganiswa uye zvisingafadzi. Eur Spine J. Nov 2011. Yakasvika muna Jan 2016.
Upadhyaya, et al. Zvikamu zvakakanganiswa zveZvondo 3 US IDE Randomized Cervical Arthroplasty Mitsva Ne 2-Makore Okutevera: 923. Neurosurgery: August 2010 - Bhuku 67 - Nyaya 2. nei: 10.1227 / 01.NEU.0000386995.74131.4B