Uncedo oluvela kwiNeurogenic Claudication: Iinketho zonyango

Abantu abafumana ukudutyulwa, iintlungu ezibuhlungu kwiindawo ezisezantsi, kunye neentlungu ezingapheliyo zomlenze zinokuba nokuxhatshazwa kwe-neurogenic claudication. Ngaba ukwazi iimpawu kunokunceda ababoneleli bezempilo baphuhlise isicwangciso sonyango esisebenzayo?

Neurogenic Claudication

I-Neurogenic claudication iyenzeka xa i-spinal nerves ixinzeleleka kwi-lumbar okanye ezantsi kumqolo, okubangela intlungu yomlenze. Imithambo-luvo ecinezelekileyo kwi-lumbar spine inokubangela intlungu yomlenze kunye ne-cramps. Intlungu idla ngokuba mandundu ngeentshukumo ezithile okanye imisebenzi efana nokuhlala, ukuma, okanye ukugoba ngasemva. Ikwabizwa ngokuba ipseudo-claudication xa isithuba phakathi kwe-lumbar spine sincinci. Imeko eyaziwa ngokuba yi-lumbar spinal stenosis. Nangona kunjalo, i-neurogenic claudication yi-syndrome okanye iqela leempawu ezibangelwa yi-pinched nerve spinal, ngelixa i-spinal stenosis ichaza ukucutha kweendlela zomgogodla.

iimpawu

Iimpawu ze-Neurogenic claudication zinokubandakanya:

• Umlenze ukukrala.
• Ukuba ndindisholo, ukuntlitheka okanye ukutshisa.
• Ukukhathala komlenze kunye nobuthathaka.
• Ukuva ubunzima emlenzeni/imizu.
• Iintlungu ezibukhali, ezidubulayo, okanye ezibuhlungu ezifikelela kumazantsi, rhoqo kwimilenze yomibini.
• Kusenokubakho iintlungu kumqolo ongezantsi okanye ezimpundu.

I-Neurogenic claudication ihluke kwezinye iintlobo zentlungu yomlenze, njengoko intlungu itshintshana - ukuyeka kwaye iqale ngokungaqhelekanga kwaye ibe nzima ngakumbi ngeentshukumo ezithile okanye imisebenzi. Ukuma, ukuhamba, ukuhla ngezinyuko, okanye ukujikela ngasemva kunokubangela intlungu, ngelixa uhleli, ukunyuka izitebhisi, okanye ukuxhomekeka phambili kudla ukukhulula intlungu. Nangona kunjalo, zonke iimeko zahlukile. Ngokuhamba kwexesha, i-neurogenic claudication inokuchaphazela ukuhamba njengoko abantu bezama ukuphepha imisebenzi ebangela intlungu, kuquka ukuzivocavoca, ukuphakamisa izinto, kunye nokuhamba ixesha elide. Kwiimeko ezinzima, i-neurogenic claudication inokwenza ukulala kube nzima.

I-Neurogenic claudication kunye ne-sciatica ayifani. I-Neurogenic claudication ibandakanya ukunyanzeliswa kwe-nerve kwi-canal ephakathi kwe-lumbar spine, ebangela intlungu kwimilenze yomibini. I-Sciatica ibandakanya ukunyanzeliswa kweengcambu ze-nerve eziphuma emacaleni e-lumbar spine, kubangela intlungu emlenzeni omnye. (UCarlo Ammendolia, ngo-2014)

Izizathu

Nge-neurogenic claudication, i-spinal nerves egxininisiweyo yiyona nto ibangela intlungu yomlenze. Kwiimeko ezininzi, i-spinal stenosis yamaplanga - i-LSS yimbangela ye-nerve pinched. Kukho iintlobo ezimbini ze-lumbar spinal stenosis.

• I-Central stenosis yimbangela ephambili ye-neurogenic claudication. Ngolu hlobo, i-canal ephakathi ye-lumbar spine, ehlala intambo yomgogodla, iyancipha, ibangela intlungu kwimilenze yomibini.
• I-Lumbar spinal stenosis inokufunyanwa kwaye iphuhliswe kamva ebomini ngenxa yokuwohloka komqolo.
• Ukuzalwa kuthetha ukuba umntu uzalwa enaloo meko.
• Zombini zingakhokelela kwi-neurogenic claudication ngeendlela ezahlukeneyo.
• I-Foramen stenosis lolunye uhlobo lwe-lumbar spinal stenosis ebangela ukucuthwa kwezithuba ngapha nangapha kwe-lumbar spine apho iingcambu ze-nerve ziphuma kwintambo yomgogodla. Intlungu ehambelanayo iyahluka kuba ingaba kumlenze wasekunene okanye wasekhohlo.
• Intlungu ihambelana necala lomqolo apho imithambo-luvo icinezelwa.

Ufunyenwe Lumbar Spinal Stenosis

I-Lumbar spinal stenosis idla ngokufunyanwa ngenxa yokuncipha kwe-lumbar spine kwaye ivame ukuchaphazela abantu abadala. Izizathu zokunciphisa zingabandakanya:

• Ukwenzakala komqolo, okufana nokungqubana kwesithuthi, emsebenzini, okanye ukwenzakala kwezemidlalo.
• I-Disc herniation.
• I-Spinal osteoporosis-i-arthrosis yokunxiba kunye nokukrazula.
• I-Ankylosing spondylitis - uhlobo lwe-arthritis evuthayo echaphazela umqolo.
• I-Osteophytes - i-bone spurs.
• Izidumbu zomnqonqo - izicubu ezingenayo umhlaza kunye nomhlaza.

I-Congenital Lumbar Spinal Stenosis

I-Congenital lumbar spinal stenosis ithetha ukuba umntu uzalwa enezinto ezingaqhelekanga zomqolo ezinokuthi zingabonakali ekuzalweni. Ngenxa yokuba indawo engaphakathi kwi-spinal canal sele incinci, intambo yomgogodla isengozini kulo naluphi na utshintsho njengoko ubudala bomntu. Nabantu abane-arthritis ebuthathaka banokufumana iimpawu ze-neurogenic claudication kwangethuba kwaye bavelise iimpawu kwi-30s kunye ne-40 yabo endaweni ye-60s kunye ne-70s yabo.

Ukuqondwa

Ukuxilongwa kwe-neurogenic claudication kusekelwe kakhulu kwimbali yonyango yomntu, ukuhlolwa komzimba kunye nokucinga. Uvavanyo lomzimba kunye nokuphonononga ukuchonga apho intlungu ibonisa khona kwaye nini. Umboneleli wezempilo unokubuza:

• Ngaba kukho imbali yeentlungu ezisezantsi?
• Ngaba iintlungu kumlenze omnye okanye yomibini?
• Ngaba intlungu ihlala ihlala?
• Ngaba iintlungu ziyafika zidlule?
• Ngaba iintlungu ziba ngcono okanye zibe mbi ngakumbi xa umile okanye uhleli?
• Ngaba ukunyakaza okanye imisebenzi ibangela iimpawu zentlungu kunye nokuziva?
• Ngaba kukho ukuva okuqhelekileyo ngelixa uhamba?

impatho

Unyango lunokubandakanya unyango lomzimba, inaliti ye-spinal steroid, kunye neentlungu zentlungu. Utyando linyathelo lokugqibela xa zonke ezinye iindlela zonyango zingakwazi ukunika isiqabu esisebenzayo.

Ulungiso lwenyama

A Isicwangciso sonyango iya kubandakanya unyango lomzimba olubandakanya:

• Ukolula imihla ngemihla
• Ukuqiniswa
• Ukuzivocavoca kweAerobic
• Oku kuya kunceda ukuphucula kunye nokuzinzisa izihlunu ezisezantsi kunye nokulungisa iingxaki zokuma.
• Unyango lomsebenzi luya kuncoma ukuguqulwa komsebenzi obangela iimpawu zentlungu.
• Oku kubandakanya ubugcisa bomzimba obufanelekileyo, ukugcinwa kwamandla, kunye nokuqaphela iimpawu zentlungu.
• Iibrashi zasemva okanye iibhanti nazo zinokucetyiswa.

Spinal Steroid Injections

Ababoneleli ngezempilo banokucebisa iinaliti ze-epidural steroid.

• Oku kuzisa i-cortisone steroid kwindawo engaphandle yomqolo womqolo okanye isithuba se-epidural.
• Iinaliti zinokubonelela ngokukhululeka kwintlungu kwiinyanga ezintathu ukuya kwiminyaka emithathu. (Sunil Munakomi et al., 2024)

Iipilisi Zobunzima

Amayeza eentlungu asetyenziselwa ukunyanga i-neurogenic claudication engapheliyo. Ezi ziquka:

• Ii-analgesics ezingaphezulu kwe-counter njenge-acetaminophen.
• Amachiza achasene nokudumba okanye ii-NSAID ezifana ne-ibuprofen okanye i-naproxen.
• Ii-NSAID ezimiselweyo zinokumiselwa ukuba ziyimfuneko.
• Ii-NSAID zisetyenziselwa iintlungu ezingapheliyo ze-neurogenic kwaye kufuneka zisetyenziswe kuphela xa zifunwa.
• Ukusetyenziswa kwexesha elide le-NSAID kunokunyusa umngcipheko wezilonda zesisu, kwaye ukusetyenziswa ngokugqithiseleyo kwe-acetaminophen kunokukhokelela kwityhefu yesibindi kunye nokungaphumeleli kwesibindi.

Ukuhlinzwa

Ukuba unyango olulondolozayo alukwazi ukunika uncedo olusebenzayo kunye nokuhamba kunye / okanye umgangatho wobomi uchaphazelekayo, utyando olwaziwa ngokuba yi-laminectomy lunokucetyiswa ukuba lunciphise i-lumbar spine. Inkqubo inokwenziwa:

• I-Laparoscopically - kunye nezithintelo ezincinci, i-scopes, kunye nezixhobo zotyando.
• Utyando oluvulekileyo - nge-scalpel kunye ne-sutures.
• Ngexesha lenkqubo, iinkalo ze-vertebra zisuswe ngokuyinxenye okanye ngokupheleleyo.
• Ukubonelela uzinzo, ngamanye amaxesha amathambo adityaniswa kunye nezikrufu, iipleyiti, okanye iintonga.
• Amazinga empumelelo kuzo zombini ziyafana okanye ziyafana.
• Phakathi kwe-85% kunye ne-90% yabantu abenza utyando bafumana ixesha elide kunye / okanye ukukhululeka kweentlungu ezingapheliyo. (Xin-Long Ma et al., 2017)

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Iyeza lokuhamba: Ukhathalelo lweChiropractic

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Ucaphulo

U-Ammendolia C. (2014). I-Degenerative lumbar spinal stenosis kunye nabakhohlisi bayo: izifundo ezintathu. I-Journal ye-Canadian Chiropractic Association, i-58 (3), i-312-319.

Munakomi S, Foris LA, Varacallo M. (2024). I-Spinal Stenosis kunye ne-Neurogenic Claudication. [Ihlaziywe ngo-2023 ngo-Agasti 13]. Ku: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Ifumaneka kwi: www.ncbi.nlm.nih.gov/books/NBK430872/

Ma, XL, Zhao, XW, Ma, JX, Li, F., Wang, Y., & Lu, B. (2017). Ukusebenza kotyando ngokubhekiselele kunyango olulondolozayo lwe-lumbar spinal stenosis: ukuphononongwa kwenkqubo kunye nohlalutyo lwemeta yezilingo ezilawulwa ngokungahleliwe. Ijenali yamazwe ngamazwe yotyando (eLondon, eNgilani), 44, 329–338. doi.org/10.1016/j.ijsu.2017.07.032