2nd Back Surgery
Za'a iya ganin aikin likita (ko ku) idan kuna da alamun bayyanar cututtuka bayan an fara aiki, ko kuma idan kuna da sababbin alamu. Amma ta yaya ka san idan kana bukatar wannan hutu na biyu? Duba wannan jerin don fara bincikenku.
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Hanyoyin Hoto KullunIdan, bayan da ba shi da wata nakasa, za a sake samun sciatica, ciwo da hannunka, ko sauran alamar cututtuka, za ka iya samun magungunan sakewa. Wani labarun labaran labaran mahimmanci shine maimaita matsalar da ta haifar da tiyata a farkon.
Abubuwan da ke ciki: Hanyoyin cututtukan cututtuka na ƙwayar cuta
Rashin rarraba yawanci yana cire kawai waɗannan nau'ikan diski (wanda ake kira gutsutsure) wanda ya zama wani ɓangare ko kuma cikakken rarraba daga babban diski. Har yanzu kana da diski ɗinka, kuma har yanzu yana da damar haɓakar ɓangaren da ke hagu.
Sakamakon : Menene Fragment Disc?
Dokta Joshua D. Auerbach, Babban Jami'in Harkokin Cikin Gida a Bronx-Lebanon Hospital Center a Birnin New York, ya kwatanta rashin cin abinci don cin nama, musamman ga masu sha'awar wannan abincin.
Yayin da kake jin dadin mayar da hankali kan kwarewar gustatory, ya ce, chances ne rassan cakulan zai raba daga babban yanki. Wasu za su sauko a kan farantin, wasu zasu iya sauka a kan iyakar farantin, kuma wasu na iya fada gaba ɗaya. A wannan yanayin, mafi yawan mutane zasu watsar da waɗannan rushewar da suka fadi daga farantin, amma ci gaba da ci babban yanki.
Halin ƙaddamarwa yana aiki kamar haka: Wadanda ba'a amfani dasu ba suna tsagewa daga babban tsari, suna barin sauran bayanan ka, ko sashi na cake, cikakke.
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PseudoarthrosisPseudoarthrosis wani lokaci ne wanda ya bayyana rashin raunin kashi a baya bayan shekara guda bayan aikin tiyata.
Pseudoarthrosis yana da mahimmanci, yana faruwa a cikin kashi 68 cikin 100 na lumbar fusions, a cewar Auerbach. Daga cikin waɗannan, tsakanin 6 zuwa 36% na buƙatar sakewa, in ji shi.
Wasu abubuwa da zasu iya taka muhimmiyar rawa a ci gaba da pseudoarthrosis bayan aikin tiyata na farko shine:
- Yanayin asalin asalinku
- Nau'in hardware (ko rashin shi) an shigar
- Nau'in kashi na kashi , idan akwai, amfani
- Kayan lafiyarku da yanayin ku. Alal misali, idan ka shan taba ko kuma kai corticosteroids , haɗarinka ga pseudoarthrosis zai iya ƙara.
- Idan kuna da fuska na kashin baya wanda ba a sanya faranti ba, kullun ko sauran kayan aiki.
A cikin babinsa akan aikin tiyata na lumbar na rubutun na rubutun maganin likita mai suna The Textbook of Spinal Surgery, na 3rd Edition , Auerbach ya rubuta binciken da ke nuna fuskokin da aka yi ba tare da shigar da kayan aiki ba na iya kara yawan haɗarin pseudoarthrosis da kashi 70%. Wannan adadi ya fi ƙasa - 10% - don ƙananan fuska wanda aka sanya hardware, ya yi rahoton.
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Adjacent Segment cutaASD, ko ɓangaren ɓangaren gefe, wani yanayin ne wanda canjin yanayi zai faru a cibiyoyin kashin baya a sama da / ko a kasa wurin da ake aiki da baya.
Auerbach ya ce idan ASD ta auku, yakan yi haka bayan kimanin shekaru biyu ko fiye da shekaru marasa jinƙai.
Shafata: Mene ne Tsakanin Gangaren Ƙasa?
Masana basu san cikakken ko wane ne tiyata ba ne ko kuma ci gaba da sauyi na canzawar canjin da ke da alhakin ASD.
Frank Cammisa, Jr., MD, Babban Jami'in Spine Service a asibitin na Musamman a New York, ya ce wasu dalilai banda aikin kwalliya na iya aiki a cikin ci gaba da canje-canjen da ake kira ASD. "Sau da yawa, ana zargin ASD a kan cewa mai haƙuri yana da fuska, duk da cewa idan mai haƙuri bai taba yin fuska ba, za su iya ci gaba da canza canje-canje a wani mataki."
Nazarin da Song ya yi, et. al, mai suna, "Sakamakon cutar cutar degenerative: Shin, saboda ci gaba na cutar ko wani abu mai haɗuwa da haɗin gwiwa?" A kwatanta tsakanin sassan da ke kusa da ƙungiyoyi masu zaman kansu da wadanda ba a haɗa su ba, "an wallafa shi a watan Nuwamba 2011 na Jaridar Spine Journal ta Birtaniya cewa" Sakamakon ɓangaren da ke kusa da shi yafi sakamakon tarihin halitta na spondylosis na mahaifa fiye da fuska. "
Related: Menene Cervical Spondylosis?
Auerbach ya ce binciken nazarin halittu yana nuna karin damuwa a matakan da ke kusa da bayan fuska. Saboda jingina yana tayin inganta ƙwanƙwashin kusurwar tsakanin ƙasusuwan biyu na haɗin haɗin gwiwa , hanyar da za a yi motsi ta hanyar motsa jiki zai iya canzawa. Wannan na iya sanya ƙarin matsa lamba a wasu yankunan haɗin gwiwa.
"Harsuna sun karbi slack," in ji shi.
A cewar Auerbach da sauransu, irin wannan ƙaruwa ne babban dalilin da ya sa mutane da yawa a cikin masana'antu suna turawa don ci gaba da tsare-tsaren fasaha da na'urori . Harkokin fasaha - alal misali, jimlar maye gurbi - ba da damar likitoci su magance matsala ba tare da yin motsi ba a yankin da ya shafa.
Idan kana mamaki, akwai nazarin da ke nuna alamar amfani da maye gurbin faya a kan fusion na kashin baya, ko da yake ba a amsa tambayoyin ba (kamar yadda 2016). Alal misali, a cikin nazarin binciken uku da aka kwatanta sakamakon sakamakon maye gurbin kwakwalwa tare da fuska daga kashin baya bayan shekaru biyu bayan tafiyarwa, masu bincike sun gano cewa mutanen da ke da nakasasshen (maye gurbin) sun kasance 44% na kasa da za su buƙaci na biyu. Irin wannan binciken bai bayar da rahoto kan duk wani amfani mai amfani na arthroplasty don ragewa ko kaucewa ASD ba.
An yi amfani da tiyata mai gyaran gyare-gyare a cikin zurfi a cikin labarin na: Matsayi na Cervical Disc
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Gyara TDRKwancen maye gurbin, wanda ake kira TDR a takaice, wani sabon tiyata ne (a Amurka, akalla) wanda masana masana juyin juya hali ke gani a matsayin wata hanya mai dacewa don aikin tiyata. An yi musayar maye gurbin a cikin Turai har zuwa wani lokaci, amma Amurka tana amfani da wannan fasahar sannu a hankali.
Saboda sabon maye gurbin sabo ne a cikin wannan ƙasa, ina tsammanin cewa masana'antun na'urori da likitoci waɗanda suka fara aikin fasaha suna aiki da cikakkun bayanai. Wannan na iya ƙara haɗari na ɗaya ko fiye da rikice-rikice a sakamakon sakamakon maye gurbin.
Auerbach ya ce kawai kimanin kashi 0-5 cikin 100 na marasa lafiya da ake kira na tiyata ne ya dace da ka'idoji don tsari da maye gurbin rikodin gurbi duka. Idan ba kai dan takarar ba ne, amma kana da wata hanya, sai ya ce, za ka iya fuskanci matsalolin.
Ɗaya daga cikin matsalolin da yafi dacewa da ke haifar da TDR mai jujjuya (a matsayin wani aikin gyaran gyare-gyare na biyu na wasu lokuta ana kira shi) shi ne rashin nasarar na'urar. Misalai na rashin nasarar na'ura sun haɗa da rashin aiki na kwakwalwar kwakwalwa da aka sanya a cikin kashin baya, ko kuma lokacin da na'urar ta canza matsayi (extrudes).
Kamfanin Cammisa ya kara da cewa saboda maye gurbin rikodin yana kare motsi, canjin canjin al'ada na al'ada zai iya faruwa a fannin facet. Idan wannan ciwo ya zama mai zafi sosai, in ji shi, likitanku na iya bada shawara cewa fuska ta kashin baya ne a matsayin aikin tiyata.
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Matsaloli tare da Hardware da aka ginaMafi mahimmanci, zaka iya shiga cikin matsaloli tare da kayan aikin da aka dasa a cikin kashin ka. Wannan ya haɗa da fayilolin kwantar da hankula, kamar yadda aka ambata a sama, da kuma kayan da aka yi amfani da su don fuska na kashin baya da sauran magunguna na baya. Kayan aiki, kamar yadda aka kira shi a wasu lokuta, zai iya karya, ko likita mai iya sanya shi a wuri mara kyau a yayin aikin.
Wani irin matsala na matsala wanda ya haifar da tiyata ne wani ciwon da aka sani da "kayan aiki mai zafi." A wannan yanayin, abubuwan da aka tsara sun zama mawuyacin hali, in ji Auerbach.
Camissa ya ce zafi saboda matsalar ciwo mai raɗaɗi yana samuwa ne daga nama mai laushi (watau tsokoki, haɗi, tendons da fascia).
Yin magana da ciwo mai ƙananan ciwo yana bukatar tiyata don cire abubuwa masu laifi. Kamfanin Cammisa ya sanar da ni cewa aikin tiyata don mai ciwo mai matukar damuwa yana yawanci saboda sanya kayan hardware, ba na'urar kanta ba. "Yana da mahimmanci cewa dole ne mu cire kayan kayan aiki saboda ciwo da ke cikin na'urar," in ji Cammisa.
Ana yin aikin tiyata don kayan aiki mai raɗaɗi a nan da nan.
Sources:
Auerbach, J., MD. Babban Cibiyar Harkokin Spine, Bronx-Lebanon Hospital Cibiyar, Mataimakin Farfesa na Tiyata, Albert Einstein College of Medicine. Tambayar waya. Maris 2012.
Auerbach JD, Kuklo TR. Labaran Lumbar Spine Tiyata. A cikin: Bridwell KH, DeWald R, eds. Littafin rubutun ƙwayoyin cututtuka, 3rd Edition. Philadelphi., Lippincott 2011.
Benglis, D., et al. Binciken cikakken bayani game da lafiyar lafiyar sinadarin morphogenetic kashi a cikin tiyata. Neurosurgery 62. 5 (Karin 2) (2008).
Cammisa, F., MD, Babban Jami'in Harkokin Spine a Asibiti na Musamman Hoto. New York. Interview Email. Maris 2012.
Etminan M, Girardi FP, Khan SN, Cammisa FP Jr. Rukunin bincike na lumbar pseudarthrosis.Orthop Clin North Am 2002; 33: 381-392.
Patel AA, Spiker WR. Ɗaukaka a kan ganewar asali da kuma kula da marasa lafiya na lumbar. Semin Spine Surg 2008; 20: 20-26.
Song, K., et. al. Kashi na ɓangare na cutar degenerative: shin saboda cutar ci gaba ko fuska-hade sabon abu? Daidaita tsakanin sassan da ke kusa da sassan da ba a haɗa ba. Eur Spine J. Nov 2011. Samun shiga Jan 2016.
Upadhyaya, et al. Sakamakon haɓaka na 3 US IDE Tsarin ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta ta jiki tare da shekaru 2 na biyewa: 923. Neurosurgery: Agusta 2010 - Volume 67 - Issue 2. Dubu: 10.1227 / 01.NEU.0000386995.74131.4B