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Injury

IQela leKliniki eliNzalisa iNerve. Imithambo-luvo ibuthathaka kwaye inokonakala ngenxa yoxinzelelo, ukolula, okanye ukusika. Ukwenzakala kwimithambo-luvo kunokumisa imiqondiso eya nokusuka ebuchotsheni, nto leyo ebangela ukuba izihlunu zingasebenzi kakuhle kwaye ziphulukane nemvakalelo kwindawo eyonzakeleyo. Inkqubo yemithambo-luvo ilawula uninzi lwemisebenzi yomzimba, ukusuka ekulawuleni ukuphefumla komntu ukuya ekulawuleni izihlunu zabo kunye nokuva ubushushu nokubanda. Kodwa, xa ukuxhwaleka kokwenzakala okanye imeko ephantsi ibangela ukulimala kwemithambo-luvo, umgangatho wobomi bomntu unokuchaphazeleka kakhulu. UDkt Alex Jimenez uchaza iingcamango ezahlukahlukeneyo ngokusebenzisa iqoqo lakhe lee-archives ezijikelezayo malunga neentlobo zokulimala kunye nemeko enokubangela iingxaki ze-nerve kunye nokuxoxa ngeendlela ezahlukeneyo zonyango kunye nezisombululo zokunciphisa intlungu ye-nerve kunye nokubuyisela umgangatho wobomi bomntu.

I-Disclaimer Gabalala *

Ulwazi olulapha ayenzelwanga ukuba luthathe indawo yobudlelwane bomntu nomntu kunye nengcali yezempilo eqeqeshiweyo okanye ugqirha onelayisensi kwaye ayiyongcebiso yezonyango. Siyakukhuthaza ukuba wenze izigqibo zakho zokhathalelo lwempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye neengcali zempilo eziqeqeshiweyo. Umda wethu wolwazi ukhawulelwe kwi-chiropractic, musculoskeletal, amayeza omzimba, impilo, imiba yezempilo ebuthathaka, amanqaku amayeza asebenzayo, izihloko kunye neengxoxo. Sinikezela kwaye sibonise intsebenziswano yeklinikhi kunye neengcali ezivela kuluhlu olubanzi lwezifundo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo kumonzakalo okanye ukuphazamiseka kwenkqubo ye-musculoskeletal. Iividiyo zethu, izithuba, izihloko, imixholo, kunye nokuqonda kugubungela imiba yezonyango, imiba, kunye nezihloko ezinxulumene nenkxaso, ngokuthe ngqo okanye ngokungathanga ngqo, umda wokuziqhelanisa wekliniki.* I-ofisi yethu yenze umzamo ofanelekileyo wokunika ucaphulo oluxhasayo kwaye ichonge. isifundo sophando esifanelekileyo okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zokuxhasa izifundo zophando ezifumanekayo kwiibhodi ezilawulayo kunye noluntu xa ziceliwe.

Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez okanye qha ga mshelana nathi 915-850-0900.

UDkt Alex Jimenez D.C., I-MSACP, I-CCST, IFMCP*, I-CIFM*, I-ATN*

email: qeqeshi@elpasofunctionalmedicine.com

Ilayisenisi kwi: Texas & New Mexico*

 


I-Neuropathic Gait: Uhlalutyo lokuhamba ngokungaqhelekanga

I-Neuropathic Gait: Uhlalutyo lokuhamba ngokungaqhelekanga

Ngaba unyango lomzimba lunokunceda ukunyanga i-steppage gait ephezulu kukwenzakala okanye iimeko zonyango kunye nokubuyisela iipatheni eziqhelekileyo zokuhamba kwabantu abanayo okanye abaphuhlisayo?

I-Neuropathic Gait: Uhlalutyo lokuhamba ngokungaqhelekanga

Ukuhamba okanye ukuhamba uhlalutyo lwe-anthropometric kwi-treadmill

I-Neuropathic Gait

I-neuropathic gait, i-aka equine okanye i-high steppage gait, luhlobo lokuhamba okungaqhelekanga okubangela ukuba abantu baphakamise izinqe zabo ukuze baphakamise imilenze yabo phezulu kunesiqhelo. Kwenzeka xa abantu behla unyawo okanye i-ankle equinus ngenxa yokulahlekelwa yi-dorsiflexion. Ngenxa yoko, unyawo lujinga ngeenzwane ezijonge phantsi, nto leyo eyenza ukuba iinzwane zirhuqe xa uhamba. Unyawo lusenokubonakala luthambile xa luwa. Ukuhla kweenyawo kubangelwa ubuthathaka okanye ukukhubazeka kwe-tibialis muscle yangaphambili phambi kwethambo le-shin. I-anterior tibialis muscle contracts ukuze uncede ukuguqula unyawo kunye ne-ankle ngelixa uhamba, uqinisekisa ukuba unyawo luhlambulula umgangatho kwaye aluyi kudonsa. Abantu abanobuthakathaka be-tibialis yangaphambili okanye ukukhubazeka banokuba ne-neuropathic gait kwaye bagobe ngokugqithiseleyo i-hip kunye nedolo ngelixa beqhubela phambili, bephakamisa umlenze wabo phezulu phantsi ukuze basuse unyawo ukuze bagweme ukukhubeka. Iqela lonyango lomzimba linokunceda ngepatheni ephezulu ye-steppage gait emva kokugula okanye ukulimala.

Izizathu

Iimeko ezinokubangela ubuthathaka be-tibialis yangaphambili okanye ukukhubazeka kunye nephethini ephezulu ye-steppage gait ibandakanya:

Sciatica

  • Intlungu ebangelwa ukunyanzeliswa okanye ukucaphuka kwe-nerve ye-sciatic iqala kumqolo ophantsi kwaye ihambe phantsi komlenze. (McCabe, FJ, McCabe, JP 2016)

Injury Peroneal Nerve

  • Umonakalo kumasebe e-peroneal nerve avela kwi-nerve ye-sciatic enceda ukuhambisa umlenze ophantsi kunye nonyawo. (Johns Hopkins Medicine. 2024)

Isifo sokugubhuka

Stroke

Umboneleli wezempilo osisiseko unokuthumela iqela lonyango lomzimba ukunceda ukulungisa ipateni ye-neuropathic gait.

impatho

Unyango lunokubandakanya iindlela ezahlukeneyo zonyango ezijolise kwi-anterior tibialis muscle.

  • Ukuzivocavoca kwe-ankle ekujoliswe kuyo kunokunceda ukuqinisa izihlunu.
  • Ukuzolula ithole kunokunceda ukugcina uluhlu lokushukuma kweqatha.
  • Uqeqesho lwe-Gait ukuzilolonga.
  • Ukuzivocavoca ngokulinganisela kuya kunceda ekuphuculeni iproprioception iyonke, okanye ingqiqo yesikhundla somzimba kunye nokuhamba.
  • I-Neuromuscular electrical stimulation, okanye i-NMES, inokunceda ukuphucula umsebenzi we-muscle. (Hollis, S., McClure, P. 2017)
  • Ukukhuthazwa kombane kudibanisa ngokufanelekileyo i-muscle ukubuyisela umsebenzi ofanelekileyo.
  • Ngenxa yobuthathaka be-tibialis yangaphambili ebangelwa yi-sciatica, i-back decompression exercises ingamiselwa ukukhulula uxinzelelo kwi-nerve ye-sciatic.
  • Ukuzivocavoca kukhulula i-nerve ukubuyisela ukuhanjiswa kwesignali eqhelekileyo phezulu nasezantsi kwi-nerve kumqolo ongezantsi.
  • Ukukhuthazwa kombane we-Neuromuscular kungasetyenziselwa ukunceda ukuphucula ukusebenza kwemisipha.

Izixhobo zokuhamba ezincedisayo

Ugqirha usenokucebisa ukuba kusetyenziswe isixhobo sokuncedisa isigulana ukuze sihambe kakuhle. Oku kunokubandakanya umhambi onamavili okanye i-quad cane. Isisombululo sesikhashana sobuthakathaka be-tibialis yangaphambili kukuphakamisa unyawo ngelixa uhamba nge-band elastic. Bopha ibhanti emlenzeni ngaphantsi kwedolo kwaye uyikhusele kwibhola yonyawo. Xa uguqula umlenze phambili, ibhanti idonsa unyawo phezulu. Ukuyisebenzisa njengesisombululo sexeshana kunokunceda ukugcina ukuhamba okukhuselekileyo. Ngamanye amaxesha, ukukhubazeka kwe-anterior tibialis muscle kunokuba sisigxina. Kule meko, abantu ngabanye banokuzuza kwizibophelelo ezikhethekileyo ezibizwa ngokuba yi- i-anthosis ye-ankle-foot. Izihlangu zezilima ezidityaniswe ngentsinjana/ngeplangana zinceda ukuphakamisa unyawo neenzwane emhlabeni.

Kubantu abachaphazelekayo malunga nokulahlekelwa ukulinganisela kunye nokuwa, kukho iindlela zokuphucula iipatheni zokuhamba ukuze bahlale bekhuselekile. Umboneleli wezempilo unokuncoma unyango lomzimba ukulungisa ukuhamba, ukuqinisa i-anterior tibialis muscle, ukuphucula ukulinganisela, nokufundisa ngokuthintela ukulimala. Abantu ngabanye kufuneka baxoxe ngeempawu kunye neemeko kunye nogqirha oyintloko, umboneleli wezempilo, okanye ingcali ukuba ibakhokele kwicala elifanelekileyo kwaye inqume unyango olungcono.

I-Chiropractic yezoNyango zeChiropractic kunye ne-Functional Medicine Clinic isebenzisa indlela edibeneyo eyenzelwe umntu ngamnye egxile kwizinto ezisebenzelayo kunye nokuphatha ukulimala kunye ne-syndromes yentlungu engapheliyo ngezicwangciso zokunyamekela zomntu eziphucula amandla ngokusebenzisa ukuguquguquka, ukuhamba, kunye neenkqubo zokunciphisa intlungu. Ukuba olunye unyango luyadingeka, uDkt Jimenez uye wadibanisa kunye noogqirha abaphezulu, iingcali zeklinikhi, abaphandi bezonyango, kunye nababoneleli bokubuyisela ukubonelela ngonyango olusebenzayo.


Lawula ukunyakaza kweenyawo kunye nokuma


Ucaphulo

McCabe, FJ, & McCabe, JP (2016). Inkcazo engaqhelekanga ye-Sciatica ye-Right-Sided nge-Foot Drop. Iingxelo zeemeko kwi-orthopedics, i-2016, i-9024368. doi.org/10.1155/2016/9024368

Johns Hopkins Medicine. (2024). Ukulimala kwe-nerve peroneal. www.hopkinsmedicine.org/health/conditions-and-diseases/peroneal-nerve-injury

Kaykisiz, EK, & Unluer, EE (2017). Isizathu esingalindelekanga sokulahla unyawo olulodwa: I-Acute Stroke. Ijenali yasePakistan yezenzululwazi zonyango, 33 (5), 1288-1290. doi.org/10.12669/pjms.335.13593

Taylor, PN, Wilkinson Hart, IA, Khan, MS, & Slade-Sharman, DE (2016). Ukulungiswa kweFootdrop ngenxa ye-Multiple Sclerosis Ngokusebenzisa i-STIMuSTEP eFakelwe isivuseleli seenyawo eziwisiweyo. Ijenali yamazwe ngamazwe ye-MS care, i-18 (5), i-239-247. doi.org/10.7224/1537-2073.2015-038

Hollis, S., & McClure, P. (2017). I-Intramuscular Electrical Stimulation for Muscle Activation of the Tibialis Anterior Emva kokulungiswa koCwangciso: Ingxelo yeNgxelo. Ijenali yonyango lwamathambo kunye nezemidlalo, 47 (12), 965-969. doi.org/10.2519/jospt.2017.7368

I-Demystifying Spinal Nerve Roots kunye nempembelelo yazo kwiMpilo

I-Demystifying Spinal Nerve Roots kunye nempembelelo yazo kwiMpilo

Xa i-sciatica okanye ezinye iintlungu zemithambo-luvo ziveza, ngaba ukufunda ukwahlula phakathi kweentlungu zemithambo-luvo kunye neentlobo ezahlukeneyo zeentlungu kunokunceda abantu babone xa iingcambu zemithambo-luvo zicaphukile okanye zicinezelekile okanye iingxaki ezingakumbi ezifuna unyango?

I-Demystifying Spinal Nerve Roots kunye nempembelelo yazo kwiMpilo

Iingcambu zeNerve yoMnqongo kunye neDermatomes

Iimeko zomgogodla ezifana neediski ze-herniated kunye ne-stenosis zingakhokelela kwiintlungu ezikhuphayo ezihamba phantsi kwengalo enye okanye umlenze. Ezinye iimpawu ziquka ubuthathaka, ukuba ndindisholo, kunye/okanye ukudubula okanye ukuvutha kombane. Igama lezonyango kwiimpawu ze-nerve pinched yi-radiculopathy (AmaZiko eSizwe ezeMpilo: Iziko leSizwe leZiphazamiso zeNeurological kunye ne-Stroke. 2020). I-Dermatomes inokubangela ukucaphuka kwintambo yomgogodla, apho iingcambu zemithambo-luvo zibangela iimpawu kumqolo kunye nemilenze.

Anatomy

Umnqonqo unamacandelo angama-31.

  • Icandelo ngalinye lineengcambu zemithambo-luvo ngasekunene nangasekhohlo ezibonelela ngemoto kunye nemisebenzi yeemvakalelo kumalungu.
  • Amasebe angaphambili kunye nasemva anxibelelana adibanisa ukwenza i-nerve spinal ephuma kwi-vertebral canal.
  • Amacandelo angama-31 omqolo abangela i-31 ye-spinal nerves.
  • Ngamnye uhambisa igalelo le-nerve ye-sensory evela kwindawo ethile yesikhumba kweli cala kunye nommandla womzimba.
  • Le mimandla ibizwa ngokuba ziidermatomes.
  • Ngaphandle kwe-nerve yokuqala yomlomo wesibeleko, i-dermatomes ikhona kwi-nerve nganye yomgogodla.
  • Imithambo yomqolo kunye needermatomes ezinxulumene nazo zenza inethiwekhi kuwo wonke umzimba.

Dermatomes Injongo

I-Dermatomes yimimandla yomzimba / yesikhumba kunye negalelo leemvakalelo ezinikezelwe kwimithambo-luvo yomqolo ngamnye. Ingcambu yemithambo-luvo nganye ine-dermatome ehambelana nayo, kwaye amasebe ahlukeneyo abonelela ngedermatome nganye kwingcambu yomthambo omnye. I-Dermatomes ziindlela apho ulwazi oluchukumisayo eluswini luthumela imiqondiso ukuya nokusuka kwinkqubo yemithambo-luvo. Iimvakalelo eziviwa ngokwasemzimbeni, njengoxinzelelo kunye nobushushu, zigqithiselwa kwinkqubo yemithambo-luvo. Xa ingcambu ye-nerve ye-spinal igxininiswe okanye inomsindo, ngokuqhelekileyo ngenxa yokuba idibana nesinye isakhiwo, ibangela i-radiculopathy. (AmaZiko eSizwe ezeMpilo: Iziko leSizwe leZiphazamiso zeNeurological kunye ne-Stroke. 2020).

Radiculopathy

I-Radiculopathy ichaza iimpawu ezibangelwa yi-nerve pinched kunye nomqolo. Iimpawu kunye neemvakalelo zixhomekeke apho i-nerve igxininiswe khona kunye nobukhulu boxinzelelo.

Umlomo wesibeleko

  • Le yi-syndrome yentlungu kunye / okanye ukusilela kwe-sensorimotor xa iingcambu ze-nerve entanyeni zixinzelelwe.
  • Idla ngokuba neentlungu ezehla ngengalo enye.
  • Abantu ngabanye banokufumana imvakalelo yombane efana nezikhonkwane kunye neenaliti, ukothuka, kunye nokutshisa, kunye neempawu zemoto ezifana nokuba buthathaka kunye nokuba ndindisholo.

Lumbar

  • Le radiculopathy ibangelwa ukunyanzeliswa, ukuvuvukala, okanye ukulimala kwi-nerve yomgogodla kwi-back back.
  • Uvakalelo lwentlungu, ukuphazamiseka, ukubetha, ukuvakala kombane okanye ukutshisa, kunye neempawu zeemoto ezifana nobuthathaka obuhamba phantsi komlenze omnye ziqhelekileyo.

Ukuqondwa

Inxalenye yovavanyo lomzimba we-radiculopathy kukuvavanya i-dermatomes ukuva. Ugqirha uya kusebenzisa iimvavanyo ezithile zezandla ukufumanisa inqanaba lomgogodla apho iimpawu zivela khona. Iimviwo ezenziwa ngesandla zihlala zikhatshwa luvavanyo lokuxilonga olufana ne-MRI, enokubonisa izinto ezingaqhelekanga kwingcambu yemithambo-luvo. Uvavanyo olupheleleyo lomzimba luya kugqiba ukuba ingcambu ye-spinal nerve imvelaphi yeempawu.

Ukunyanga oonobangela

Uninzi lweengxaki zomqolo zinganyangwa ngonyango olulondolozayo ukubonelela ngokukhululeka kweentlungu. Kwidiski ye-herniated, umzekelo, abantu banokucetyiswa ukuba baphumle kwaye bathathe iyeza elichasene ne-nonsteroidal anti-inflammatory. I-acupuncture, unyango lomzimba, i-chiropractic, i-traction engeyiyo yokuhlinzwa, okanye unyango lokuthomalalisa inokumiselwa kwakhona. Kwiintlungu ezibuhlungu, abantu banokunikwa inaliti ye-epidural steroid enokubonelela ngesiqabu seentlungu ngokunciphisa ukudumba. (I-Akhademi yaseMelika yeeGqirha ze-Orthopedic: i-OrthoInfo. 2022) Kwi-spinal stenosis, umboneleli unokuqala ugxininise kunyango lomzimba ukuze kuphuculwe ukufaneleka okupheleleyo, ukuqinisa izibilini kunye nemisipha yangasemva, kunye nokugcina ukunyakaza kumqolo. Amayeza okuphelisa iintlungu, kuquka ii-NSAID kunye neenaliti ze-corticosteroid, anokunciphisa ukuvuvukala kunye nokunciphisa intlungu. (IKholeji yaseMelika yeRheumatology. 2023) Iingcali zonyango zibonelela ngeendlela ezahlukeneyo zonyango ukunciphisa iimpawu, kubandakanywa ukuchithwa kwe-manual kunye ne-mechanical kunye ne-traction. Utyando lunokucetyiswa kwiimeko ze-radiculopathy ezingaphenduliyo kunyango olulondolozayo.

Izicwangciso zokhathalelo lwezonyango lweChiropractic kunye neFunctional Medicine Clinic kunye neenkonzo zeklinikhi zikhethekileyo kwaye zijolise kukulimala kunye nenkqubo yokubuyisela ngokupheleleyo. Imimandla yethu yokuziqhelanisa ibandakanya i-Wellness & Nutrition, Intlungu engapheliyo, ukwenzakala komntu, ukuKhathalelwa kweNgozi ye-Auto, ukwenzakala komsebenzi, ukwenzakala ngasemva, iintlungu ezisezantsi, iintlungu zentamo, iMigraine Headaches, i-Sciatica enzima, i-Scoliosis, i-Complex Herniated Discs, i-Fibromyalgia, i-Chronic Iintlungu, Ukwenzakala Okuntsonkothileyo, Ulawulo Loxinzelelo, Unyango Lwezonyango oluSebenzayo, kunye neeprothokholi zokhathalelo olukwi-scope. Sigxininise ekubuyiseleni imisebenzi eqhelekileyo yomzimba emva kokulimala kunye nokulimala kwezicubu ezithambileyo usebenzisa iiProtocol eziKhethekileyo zeChiropractic, iiNkqubo zoBulungisa, iZondlo eziSebenzayo kunye nokudibanisa, i-Agility, kunye nokuhamba koQeqesho lweFitness, kunye neeNkqubo zoBuyiselo kuyo yonke iminyaka. Ukuba umntu ufuna olunye unyango, uya kuthunyelwa kwiklinikhi okanye kugqirha oyilungeleyo imeko yakhe. UDkt Jimenez uye wabambisana noogqirha abaphezulu, iingcali zeklinikhi, abaphandi bezonyango, abaqeqeshi, abaqeqeshi, kunye nababoneleli bokuvuselela i-premiere ukuzisa u-El Paso, unyango oluphezulu lweklinikhi, kuluntu lwethu.


Buyisela ukuHamba kwakho: Ukhathalelo lweChiropractic yokuBuyisa iSciatica


Ucaphulo

AmaZiko eSizwe ezeMpilo: Iziko leSizwe leZiphazamiso zeNeurological kunye ne-Stroke. (2020). Iphepha lenyaniso leentlungu ezisezantsi. Ifunyenwe kwi www.ninds.nih.gov/sites/default/files/migrate-documents/low_back_pain_20-ns-5161_march_2020_508c.pdf

I-Akhademi yaseMelika yeeGqirha ze-Orthopedic: i-OrthoInfo. (2022). Idiski yeHerniated kumqolo osezantsi. orthoinfo.aaos.org/en/diseases-conditions/herniated-disk-in-the-lower-back/

IKholeji yaseMelika yeRheumatology. (2023). I-stenosis yomqolo. rheumatology.org/patients/spinal-stenosis

Uncedo oluvela kwiNeurogenic Claudication: Iinketho zonyango

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?

Uncedo oluvela kwiNeurogenic Claudication: Iinketho zonyango

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)

Iyeza lokuhamba: Ukhathalelo lweChiropractic


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

Ukuqonda iibhloko zeNerve: Ukuxilongwa kunye nokulawula iintlungu zokulimala

Ukuqonda iibhloko zeNerve: Ukuxilongwa kunye nokulawula iintlungu zokulimala

Kubantu abajongene neentlungu ezingapheliyo, ngaba ukuqhuba inkqubo ye-nerve block kunokunceda ukunciphisa nokulawula iimpawu?

Ukuqonda iibhloko zeNerve: Ukuxilongwa kunye nokulawula iintlungu zokulimala

Iibhloko zemithambo

I-nerve block yinkqubo eyenziwa ukuphazamisa / ukuvala iimpawu zentlungu ngenxa yokungasebenzi kakuhle okanye ukulimala. Zingasetyenziselwa iinjongo zokuxilonga okanye unyango, kunye nemiphumo yazo ingaba yifutshane okanye ixesha elide, kuxhomekeke kuhlobo olusetyenziswayo.

  • A i-nerve block yethutyana Isenokubandakanya usetyenziso okanye inaliti enqanda imiqondiso yeentlungu ekudluliseleni ixesha elifutshane.
  • Umzekelo, ekukhulelweni, inaliti ye-epidural ingasetyenziswa ngexesha lokubeleka kunye nokunikezelwa.
  • Iibhloko zemithambo-luvo esisigxina kubandakanya ukusika / ukuqhawula okanye ukususa iindawo ezithile ze-nerve ukumisa iimpawu zentlungu.
  • Ezi zisetyenziselwa kwiimeko ezinokulimala kakhulu okanye ezinye iimeko ezibuhlungu ezingapheliyo ezingakhange ziphuculwe kunye nezinye iindlela zonyango.

Ukusetyenziswa koNyango

Xa ababoneleli bezempilo befumanisa imeko yentlungu engapheliyo ebangelwa kukwenzakala kwe-nerve okanye ukungasebenzi, banokusebenzisa i-nerve block ukuze bafumane indawo eyenza iimpawu zentlungu. Banokwenza i-electromyography kunye / okanye a i-nerve conduction velocity/uvavanyo lwe-NCV ukukhomba unobangela weentlungu ezingapheliyo zemithambo-luvo. Iibhloko ze-nerve zinokunyanga iintlungu ezingapheliyo ze-neuropathic, ezifana neentlungu ezibangelwa ngumonakalo we-nerve okanye ukunyanzeliswa. Iibhloko ze-nerve zihlala zisetyenziselwa ukunyanga iintlungu zemva kunye nentamo ezibangelwa yi-discs ye-herniated okanye i-spinal stenosis. (Johns Hopkins Medicine. 2024)

iintlobo

Iindidi ezintathu ziquka:

  • weNgingqi
  • Neurolytic
  • Utyando

Zonke ezintathu zingasetyenziselwa iimeko ezibangela intlungu engapheliyo. Nangona kunjalo, iibhloko ze-neurolytic kunye noqhaqho zisisigxina kwaye zisetyenziselwa kuphela iintlungu ezibuhlungu eziye zaqatsela kunye nolunye unyango olungakwaziyo ukunika isiqabu.

Iibhloko zeThutyana

  • Ibhloko yendawo yenziwa ngokutofa okanye ukusebenzisa i-anesthetics yendawo, njenge-lidocaine, kwindawo ethile.
  • I-epidural yi-nerve block yendawo ethi ifake i-steroids okanye i-analgesics kwindawo ejikeleze intambo yomgogodla.
  • Ezi zixhaphakile ngexesha lokukhulelwa, lokubeleka, kunye nokuzala.
  • I-Epidurals ingasetyenziselwa ukunyanga intamo engapheliyo okanye iintlungu zangasemva ngenxa ye-nerve yomgogodla.
  • Iibhloko zendawo zihlala zesikhashana, kodwa kwisicwangciso sonyango, zinokuphinda ziphindwe emva kwexesha ukulawula intlungu engapheliyo kwiimeko ezifana ne-arthritis, i-sciatica, kunye ne-migraines. (Impilo ye-NYU Langone. 2023)

Iibhloko ezisisigxina

  • Ibhloko ye-neurolytic isebenzisa utywala, i-phenol, okanye i-thermal agents ukunyanga intlungu engapheliyo ye-nerve. (Iziko leSizwe leZiphazamiso zeNeurological kunye neStroke. 2023) Ezi nkqubo zonakalisa iindawo ezithile ze-nerve pathway ngenjongo ukuze iimpawu zentlungu zingakwazi ukudluliselwa. Ibhloko ye-neurolytic isetyenziselwa ikakhulu kwiimeko ezibuhlungu ezingapheliyo, njengentlungu evela kumhlaza okanye i-syndrome yengingqi enzima / i-CRPS. Ngamanye amaxesha zisetyenziselwa ukunyanga intlungu eqhubekayo evela kwi-pancreatitis engapheliyo kunye nentlungu eludongeni lwesifuba emva kokuhlinzwa. (Johns Hopkins Medicine. 2024) (Alberto M. Cappellari et al., 2018)
  • I-neurosurgeon yenza ibhloko ye-nerve yotyando ebandakanya ukususa okanye ukonakalisa iindawo ezithile ze-nerve. (Iziko leSizwe leZiphazamiso zeNeurological kunye neStroke. 2023) Ibhloko ye-nerve yotyando isetyenziselwa kuphela iimeko ezibuhlungu ezibuhlungu, ezifana neentlungu zomhlaza okanye i-neuralgia ye-trigeminal.
  • Nangona i-neurolytic kunye neebhloko zemithambo-luvo ziziinkqubo ezisisigxina, iimpawu zentlungu, kunye neemvakalelo zinokubuya ukuba imithambo-luvo iyakwazi ukuphinda ikhule kwaye izilungise. (U-Eun Ji Choi et al., ngo-2016) Nangona kunjalo, iimpawu kunye neemvakalelo zingenakubuya emva kweenyanga okanye iminyaka emva kwenkqubo.

IiNdawo zoMzimba ezahlukeneyo

Zinokulawulwa kwiindawo ezininzi zomzimba, kuquka: (Isibhedlele soTyando oluKhethekileyo. 2023) (Amayeza eStanford. 2024)

  • Scalp
  • ubuso
  • Neck
  • Ikholabone
  • Amagxa
  • Izixhobo
  • umva
  • Ibhokisi le
  • Ikhayiji yembambo
  • Isisu
  • Pelvis
  • Iintonga
  • Amagxa
  • iqatha
  • iinyawo

Imiphumela

Ezi nkqubo zinokuba nobungozi obunokwenzeka bomonakalo osisigxina we-nerve. (Umhobe weBlueCross. 2023) Imithambo-luvo ibuthathaka kwaye iphinda ikhule kancinane, ngoko ke impazamo encinci inokubangela iziphumo ebezingalindelekanga. (D O'Flaherty et al., 2018) Iziphumo ebezingalindelekanga eziqhelekileyo ziquka:

  • Ukukhubazeka kwemisipha
  • Ubuthathaka
  • Ukuba ndindisholo rhoqo
  • Kwiimeko ezinqabileyo, ibhloko inokucaphukisa i-nerve kwaye ibangele intlungu eyongezelelweyo.
  • Abasebenzi bezempilo abanezakhono nabanelayisensi abafana noogqirha botyando, oogqirha bolawulo lweentlungu, ii-anesthesiologists, kunye noogqirha bamazinyo baqeqeshelwe ukwenza ezi nkqubo ngononophelo.
  • Kuhlala kukho umngcipheko wokulimala kwe-nerve okanye ukulimala, kodwa uninzi lweebhloko ze-nerve ngokukhuselekileyo kwaye zinciphisa ngempumelelo kwaye zincede ukulawula intlungu engapheliyo. (Umhobe weBlueCross. 2023)

Yintoni ongayilindela

  • Abantu banokuziva ndindisholo okanye ukuba buhlungu kunye/okanye baqaphele ububomvu okanye ukucaphuka kufutshane okanye kufutshane nendawo okwethutyana.
  • Kwakhona kunokubakho ukuvuvukala, okunyanzelisa i-nerve kwaye kufuna ixesha lokuphucula. (Amayeza eStanford. 2024)
  • Abantu ngabanye banokucelwa ukuba baphumle ixesha elithile emva kwenkqubo.
  • Kuxhomekeka kuhlobo lwenkqubo, umntu ngamnye kusenokufuneka achithe iintsuku ezimbalwa esibhedlele.
  • Ezinye iintlungu zisenokuba zisekhona, kodwa oko akuthethi ukuba inkqubo khange isebenze.

Umntu ngamnye kufuneka adibane nomboneleli wezempilo malunga nemingcipheko kunye neenzuzo ukuqinisekisa ukuba ilungile impatho.


Sciatica, Iimbangela, Iimpawu, kunye neengcebiso


Ucaphulo

Johns Hopkins Medicine. (2024). Iibhloko zemithambo-luvo. (Impilo, umba. www.hopkinsmedicine.org/health/conditions-and-diseases/nerve-blocks

Impilo ye-NYU Langone. (2023). Ibhlokhi ye-Nerve ye-migraine (Imfundo kunye noPhando, Umba. nyulangone.org/conditions/migraine/treatments/nerve-block-for-migraine

Iziko leSizwe leZiphazamiso zeNeurological kunye neStroke. (2023). Iintlungu. Ifunyenwe kwi www.ninds.nih.gov/health-information/disorders/pain#3084_9

Johns Hopkins Medicine. (2024). Unyango olungapheliyo lwe-pancreatitis (Impilo, uMba. www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pancreatitis/chronic-pancreatitis-treatment

Cappellari, AM, Tiberio, F., Alicandro, G., Spagnoli, D., & Grimoldi, N. (2018). I-Intercostal Neurolysis yoNyango lwe-Postsurgical Thoracic Pain: i-Case Series. Izihlunu kunye ne-nerve, 58 (5), 671-675. doi.org/10.1002/mus.26298

Choi, EJ, Choi, YM, Jang, EJ, Kim, JY, Kim, TK, & Kim, KH (2016). Ukukhutshwa kwe-Neural kunye nokuhlaziywa kwakhona kwi-Pain Practice. Ijenali yaseKorea yeentlungu, i-29 (1), i-3-11. doi.org/10.3344/kjp.2016.29.1.3

Isibhedlele soTyando oluKhethekileyo. (2023). I-anesthesia yendawo. www.hss.edu/condition-list_regional-anesthesia.asp

Amayeza eStanford. (2024). Iintlobo zeebhloko zemithambo-luvo (Kubaguli, uMba. med.stanford.edu/ra-apm/for-patients/nerve-block-types.html

Umhobe weBlueCross. (2023). Iibhloko ze-nerve ze-peripheral kunyango lweentlungu ze-neuropathic. (Umgaqo-nkqubo wezoNyango, umba. www.anthem.com/dam/medpolicies/abc/active/policies/mp_pw_c181196.html

O'Flaherty, D., McCartney, CJL, & Ng, SC (2018). Ukulimala kwe-nerve emva kwe-peripheral nerve blockade-ukuqonda kwangoku kunye nezikhokelo. Imfundo ye-BJA, i-18 (12), i-384-390. doi.org/10.1016/j.bjae.2018.09.004

Amayeza eStanford. (2024). Imibuzo eqhelekileyo yesigulane malunga neebhloko zemithambo-luvo. (Kwabaguli, umba. med.stanford.edu/ra-apm/for-patients/nerve-block-questions.html

Ukujonga ngokubanzi kwiNerve yeThoracodorsal

Ukujonga ngokubanzi kwiNerve yeThoracodorsal

Abantu abafumana iimpawu zentlungu ezifana nokudubula, ukuhlatywa, okanye ukuva kombane kwi-latissimus dorsi yomqolo ongaphezulu kunokubangelwa kukwenzakala kwentsholongwane kwi-thoracodorsal nerve. Ngaba ukwazi i-anatomy kunye neempawu kunokunceda ababoneleli bezempilo baphuhlise isicwangciso sonyango esisebenzayo?

Ukujonga ngokubanzi kwiNerve yeThoracodorsal

Inzwa yeThoracodorsal

Yaziwa nangokuthi i-nerve ye-subscapular ephakathi okanye i-nerve ye-subscapular ende, ihluma ukusuka kwindawo ye-brachial plexus kwaye ibonelela nge-motor innervation/ukusebenza imisipha ye-latissimus dorsi.

Anatomy

I-brachial plexus yinethiwekhi yemithambo-luvo ephuma kumqolo wentamo. Imithambo-luvo inika uninzi lweemvakalelo kunye nokunyakaza kweengalo nezandla, enye kwicala ngalinye. Iingcambu zayo ezintlanu zivela kwiindawo eziphakathi kwesihlanu ukuya kweyesibhozo i-vertebrae yomlomo wesibeleko kunye ne-thoracic vertebra yokuqala. Ukusuka apho, benza isakhiwo esikhulu, emva koko bahlule, badibanise kwakhona, kwaye bahlukane kwakhona ukuze benze i-nerve encinci kunye nezakhiwo ze-nerve njengoko zihamba phantsi kwe-armpit. Ngentamo kunye nesifuba, imithambo-luvo ekugqibeleni ijoyina kwaye yenze iintambo ezintathu ezibandakanya:

  • Intambo esecaleni
  • Intambo ephakathi
  • Intambo yangasemva

Intambo yangasemva ivelisa amasebe amakhulu kunye amancinci aquka:

  • I-Axillary nerve
  • I-radial nerve

Amacandelo amancinci abandakanya:

  • I-nerve ephezulu ye-subscapular
  • I-nerve ye-subscapular engaphantsi
  • I-thoracodorsal nerve

Ubume kunye neNdawo

  • Amagatsha e-thoracodorsal nerve aphuma kwintambo yangasemva kwi-armpit kwaye ahamba ehla, elandela umthambo ongaphantsi kwe-subscapular, ukuya kwi-latissimus dorsi muscle.
  • Idityaniswe nengalo engaphezulu, yolule ngasemva kwekhwapha, yenze i-axillary arch, ize ke iye yande ibe ngunxantathu omkhulu ojikeleza iimbambo nomqolo.
  • I-thoracodorsal nerve ilele nzulu kwi-latissimus dorsi, kwaye umda ongezantsi ufikelela kufutshane esinqeni.

Umahluko

  • Kukho indawo esemgangathweni kunye nekhosi ye-thoracodorsal nerve, kodwa iimbilini zomntu azifani kumntu wonke.
  • I-nerve ngokuqhelekileyo ihlahlela intambo yangasemva ye-plexus ye-brachial ukusuka kumanqaku amathathu ahlukeneyo.
  •  Nangona kunjalo, ii-subtypes ezahlukeneyo ziye zachongwa.
  • I-nerve thoracodorsal inika i-teres enkulu yemisipha malunga ne-13% yabantu. (UBrianna Chu, uBruno Bordoni. 2023)
  • I-lats ingaba nokwahluka kwe-anatomical enqabileyo eyaziwa ngokuba yi-a Ilitye likaLanger, eyinxalenye eyongezelelweyo edibanisa nezihlunu okanye izicubu ezidibeneyo zengalo ephezulu ngaphantsi kwendawo yokudibanisa eqhelekileyo.
  • Kubantu abanale nto ingaqhelekanga, i-thoracodorsal nerve inikezela umsebenzi / innervation) kwi-arch. (Ahmed M. Al Maksoud et al., 2015)

itheko

I-latissimus dorsi muscle ayikwazi ukusebenza ngaphandle kwe-thoracodorsal nerve. Uncedo lwemisipha kunye nemithambo-luvo:

  • Zinzise umva.
  • Tsala ubunzima bomzimba xa ukhwela, uqubha, okanye utsalwa phezulu.
  • Ncedisa ngokuphefumla ngokwandisa iimbambo ngexesha lokuphefumla kunye nokufinyela xa ukhupha umoya. (Encyclopaedia Britannica. 2023)
  • Jikelezisa ingalo uye ngaphakathi.
  • Tsala ingalo uye embindini womzimba.
  • Ukwandisa amahlombe ngokusebenza kunye ne-teres enkulu, i-teres minor, kunye nemisipha ye-deltoid yangasemva.
  • Yehlisa umbhinqo wamagxa ngokugoba umqolo.
  • Ukugobela ecaleni ngokugoba umqolo.
  • Nyakazisa i-pelvis phambili.

Conditions

I-thoracodorsal nerve inokulimala naphi na kwindlela yayo ngokwenzakala okanye izifo. Iimpawu zomonakalo wemithambo-luvo zinokubandakanya: (IThala leeNcwadi leSizwe laseMelika laseMelika: iMedlinePlus. 2022)

  • Iintlungu ezinokuba kukudutyulwa, ukuhlatywa, okanye ukuziva kombane.
  • Ubundisholo, ukubetha.
  • Ubuthathaka kunye nokulahlekelwa ngumsebenzi kwimisipha ehambelanayo kunye namalungu omzimba, kubandakanywa nesandla kunye nokuhla kweminwe.
  • Ngenxa yendlela ye-nerve kwi-armpit, oogqirha kufuneka baqaphele ukuhluka kwe-anatomical ukuze bangonakalisi ngengozi i-nerve ngexesha leenkqubo zomhlaza wesifuba, kuquka i-axillary dissection.
  • Inkqubo yenzelwe ukuvavanya okanye ukususa i-lymph nodes kwaye isetyenziselwa ukubeka umhlaza webele kunye nakunyango.
  • Ngokophononongo, i-11% yabantu abane-axillary lymph node dissection bafumana umonakalo kwi-nerve. (URoser Belmonte et al., 2015)

Ukubuyiswa kwesisu

  • Kutyando lokwakhiwa ngokutsha kwebele, iilathi zingasetyenziswa njengeflap phezu kofakelo.
  • Ngokuxhomekeke kwiimeko, i-thoracodorsal nerve inokushiywa injalo okanye inqunywe.
  • Uluntu lwezonyango aluzange luvumelane malunga nokuba yeyiphi indlela eneziphumo ezilungileyo. (Sung-Tack Kwon et al., 2011)
  • Kukho ubungqina bokuba ukushiya i-nerve intact kunokubangela ukuba i-muscle ivume kwaye ikhuphe i-implant.
  • I-nerve ye-thoracodorsal engaguqukiyo inokubangela i-atrophy ye-muscle, enokuthi ibangele ubuthathaka kunye nengalo.

Ukusetyenziswa kweGrafti

Inxalenye ye-thoracodorsal nerve idla ngokusetyenziswa kwi-nerve graft reconstruction ukubuyisela umsebenzi emva kokulimala, okubandakanya oku kulandelayo:

  • Umthambo we-Musculocutaneous
  • I-accessory nerve
  • I-Axillary nerve
  • I-nerve ingasetyenziselwa ukubuyisela ukusebenza kwe-nerve kwisihlunu se-triceps engalweni.

kwimo

Ukuba i-thoracodorsal nerve yenzakele okanye yonakele, unyango lungabandakanya:

  • Izikrweqe okanye iiplagi.
  • Unyango lomzimba ukuphucula uluhlu lwentshukumo, ukuguquguquka, kunye namandla emisipha.
  • Ukuba kukho uxinzelelo, utyando lunokufuneka ukunciphisa uxinzelelo.

Ukuphonononga i-Integrative Medicine


Ucaphulo

Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Nerves. [Ihlaziywe 2023 Jul 24]. Ku: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Ifumaneka kwi: www.ncbi.nlm.nih.gov/books/NBK539761/

Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). I-Langer's arch: i-anomaly enqabileyo ichaphazela i-axillary lymphadenectomy. Ijenali yeengxelo zetyala lotyando, 2015(12), rjv159. doi.org/10.1093/jscr/rjv159

Britannica, Abahleli be-Encyclopaedia. “latissimus dorsi“. Encyclopedia Britannica, 30 Nov. 2023, www.britannica.com/science/latissimus-dorsi. Ifikeleleke nge-2 kaJanuwari 2024.

IThala leeNcwadi leSizwe leLizwe lase-US: i-MedlinePlus. I-peripheral neuropathy.

Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Ukwenzakala okude kwe-thoracic nerve kwizigulane zomhlaza webele zinyangwa nge-axillary lymph node dissection. Ukunyamekelwa kweNkxaso kumhlaza : iphephancwadi elisemthethweni le-Multinational Association of Supporting Care in Cancer, 23 (1), 169-175. doi.org/10.1007/s00520-014-2338-5

Kwon, S. T., Chang, H., & Oh, M. (2011). Isiseko se-anatomic se-interfascicular nerve splitting ye-latissimus dorsi ye-muscle flap engapheliyo. Ijenali yeplastiki, utyando oluhlaziyiweyo kunye nobuhle : JPRAS, 64(5), e109–e114. doi.org/10.1016/j.bjps.2010.12.008

Izibonelelo zokuthotywa kweNerve ngokuNgekho kotyando

Izibonelelo zokuthotywa kweNerve ngokuNgekho kotyando

Ngaba abantu abanengxaki yokungasebenzi kakuhle kwemithambo-luvo banokubandakanya ukunyibilika ngaphandle kotyando ukuze babuyisele umsebenzi wokushukuma emizimbeni yabo?

intshayelelo

Ikholamu yomgogodla kwi-musculoskeletal system iquka amathambo, amalunga, kunye neentsholongwane ezisebenza kunye nemisipha eyahlukeneyo kunye nezicubu ukuqinisekisa ukuba intambo yomgogodla ikhuselwe. Intambo yomgogodla yinxalenye yenkqubo ye-nervous central apho iingcambu ze-nerve zisasazwa kwiindawo eziphezulu kunye nezisezantsi zomzimba ezibonelela ngemisebenzi ye-sensory-motor. Oku kuvumela umzimba ukuba uhambe kwaye usebenze ngaphandle kweentlungu okanye ukuphazamiseka. Nangona kunjalo, xa umzimba kunye nomnqonqo uguga okanye xa umntu ejongene nokulimala, iingcambu zemithambo-luvo zinokucaphuka kwaye zibangele iimvakalelo ezingaqhelekanga ezifana nokuba ndindisholo okanye ukubetha, okuhlala kuhambelana neentlungu zomzimba. Oku kunokubangela umthwalo wentlalo noqoqosho kubantu abaninzi kwaye, ukuba akunyangwa ngokukhawuleza, kunokukhokelela kwiintlungu ezingapheliyo. Ukuza kuthi ga ngoku, kunokukhokelela kubantu abaninzi abajongana neentlungu zomzimba ezinxulunyaniswa nokungasebenzi kakuhle kwemithambo-luvo. Oku kubangela ukuba abantu abaninzi abajongene nengxaki ye-musculoskeletal baqale ukukhangela unyango. Inqaku lanamhlanje liphonononga indlela ukungasebenzi kakuhle kwemithambo-luvo okuchaphazela ngayo imida kunye nendlela ukudambisa okungekho tyando kunokunceda ngayo ukunciphisa ukungasebenzi kakuhle kwemithambo-luvo ukuvumela ukushukuma ukubuyela kumalungu aphezulu nasezantsi. Sithetha nababoneleli bezonyango abaqinisekisiweyo ababandakanya iinkcukacha zezigulana zethu ukubonelela ngezisombululo ezingezizo utyando ezifana nokuthomalalisa ukunceda abantu abanengxaki yemithambo-luvo. Sikwaxelela izigulane ukuba ukuchithwa kwe-non-surgical decompression kungabuyisela njani i-mobility-sensory ukuya kwiindawo eziphezulu kunye nezisezantsi. Sikhuthaza izigulana zethu ukuba zibuze imibuzo entsonkothileyo kunye nemfundo kubaboneleli bethu bezonyango abanxulumeneyo malunga neempawu ezinjengeentlungu abahlangabezana nazo ezihambelana nokungasebenzi kakuhle kwenzwa. UDkt Alex Jimenez, DC, usebenzisa olu lwazi njengenkonzo yezemfundo. isikhanyeli.

 

Indlela iNerve Dysfunction echaphazela ngayo iiNdawo

Ngaba uziva ukuntyiloza okanye ukuziva ndindisholo ezandleni okanye ezinyaweni zakho ezingafuni ukuhamba? Ngaba uziva iintlungu kwiindawo ezahlukeneyo zomqolo ezinokuthi zikhululeke kuphela ngokuzolula okanye ukuphumla? Okanye ngaba kubuhlungu ukuhamba imigama emide ovakalelwa kukuba kufuneka uphumle rhoqo? Iimeko ezininzi ezinjengeentlungu zihambelana nokungasebenzi kakuhle kwe-nerve sensory enokuthi ichaphazele iindawo eziphezulu kunye nezisezantsi. Xa abantu abaninzi befumana ukungasebenzi kakuhle kwemithambo-luvo kwaye bejongana neemvakalelo ezingaqhelekanga kwimida yabo, abaninzi bacinga ukuba kungenxa yeentlungu ze-musculoskeletal entanyeni, emagxeni, okanye ngasemva. Oku kuyingxenye yomcimbi, njengoko izinto ezininzi zokusingqongileyo zinokudibaniswa nentlungu ye-nerve ye-sensory, njengoko iingcambu ze-nerve zinyanzeliswa kwaye ziphazamisekile, ezibangela ukungasebenzi kakuhle kwe-nerve ye-sensory in the end. Ekubeni iingcambu zemithambo-luvo zisasazekile ukusuka kwintambo yomgogodla, ingqondo ithumela ulwazi lwe-neuron kwiingcambu zemithambo-luvo ukuvumela ukusebenza kwe-sensory-mobility in the top and low ends. Oku kuvumela umzimba ukuba uhambe ngaphandle kokungahambi kakuhle okanye intlungu kunye nokusebenza ngemisebenzi yemihla ngemihla. Nangona kunjalo, xa abantu abaninzi beqala ukwenza ukunyakaza okuphindaphindiweyo okubangela ukuba i-spinal disc ixinzelelwe rhoqo, kunokukhokelela kwi-disc ye-disc kunye ne-musculoskeletal disorders. Ekubeni iingcambu ezininzi ze-nerve zisasazeka kwiindawo ezahlukeneyo, xa iingcambu eziphambili ze-nerve zigqithiswa, zinokuthumela iimpawu zentlungu kumgca ngamnye. Ke, abantu abaninzi bajongana ne-nerve entrapment ekhokelela kumqolo osezantsi, i-buttock, kunye neentlungu zomlenze ezinokuchaphazela indlela yabo yemihla ngemihla. (UKarl et al., ngo-2022) Ngexesha elifanayo, abaninzi abantu abane-sciatica bajongene nokungasebenzi kakuhle kwe-nerve sensory echaphazela amandla abo okuhamba. Nge-sciatica, inokudityaniswa ne-spinal disc pathology kwaye ibangela abantu abaninzi ukuba bafune unyango. (Bush et al., 1992)

 


Iimfihlo zeSciatica zityhiliwe-Ividiyo

Xa kuziwa ekujongeni unyango lokunciphisa ukungasebenzi kakuhle kwemithambo-luvo, abantu abaninzi baya kukhetha izisombululo ezingezizo utyando zokunciphisa iimpawu ezinjengeentlungu kunye nokunciphisa imiqondiso yentlungu ebangela ukuba iindawo eziphezulu nezisezantsi zibandezeleke. Izisombululo zonyango ezingaqhawukiyo ezifana nokuthotywa kwemithambo-luvo zinokunceda ukubuyisela ukusebenza kwemithambo-luvo ngokutsaleka ngokuthambileyo ngokubangela ukuba i-spinal disc ibeke ingcambu yemithambo-luvo eyingozi kwaye iqalise inkqubo yokuphilisa yendalo yomzimba. Ngexesha elifanayo, kunceda ukunciphisa ukuphazamiseka kwe-musculoskeletal ukusuka ekubuyeni. Le vidiyo ingasentla ibonisa indlela i-sciatica ehambelana nokungasebenzi kakuhle kwe-nervous sensory inokwehliswa ngonyango olungenalo utyando ukuvumela iziphelo zomzimba ukuba zive ngcono.


Ukunyanzeliswa ngokuNgekho kotyando kuNciphisa ukungasebenzi kakuhle kweNerve

Unyango olungazenzisiyo lunokunceda ekunciphiseni iintlungu ezisezantsi ezinxulunyaniswa ne-sensory nerve dysfunction ukubuyisela ukusebenza kwe-sensory-motor ukuya kwindawo ephezulu nasezantsi. Abantu abaninzi ababandakanya unyango olungazenzisiyo olunjengoxinzelelo lwengqondo njengenxalenye yempilo yabo kunye nendlela yokuphila kakuhle banokubona ukuphucuka emva konyango olulandelelanayo. (I-Chou et al., 2007) Ukusukela oko uninzi lwabasebenzi bezempilo bebandakanya unyango olungaqhayisiyo olufana noxinzelelo kwimisebenzi yabo, kubekho ukuphucuka okukhulu kulawulo lweentlungu. (Bronfort et al., 2008

 

 

Xa abantu abaninzi beqala ukusebenzisa i-decompression engenziwa ngotyando ngenxa yokungasebenzi kakuhle kwemithambo-luvo, abaninzi baya kubona ukuphucuka kwiintlungu zabo, ukuhambahamba, kunye nemisebenzi yabo yemihla ngemihla. (Gose et al., 1998). Yiyiphi i-spinal decompression eyenza iingcambu ze-nerve kukuba inceda i-disc echaphazelekayo eyenza i-root root root, ikhuphe i-disc kwindawo yayo yokuqala, kwaye iyibuyisele kwakhona. (URamos noMartin, ngo-1994) Xa abantu abaninzi beqala ukucinga ngempilo kunye nokuba sempilweni kwabo, unyango olungazenzisiyo lunokuba luncedo kubo ngenxa yeendleko zabo ezifikelelekayo kunye nendlela abanokudityaniswa ngayo nolunye unyango ukuze balawule ngcono iintlungu ezinxulunyaniswa nokungasebenzi kakuhle kwemithambo-luvo okuchaphazela iziphelo zemizimba yabo.

 


Ucaphulo

Bronfort, G., Haas, M., Evans, R., Kawchuk, G., & Dagenais, S. (2008). Ulawulo olunolwazi lobungqina bentlungu engapheliyo ye-back back kunye nokuguqulwa komgogodla kunye nokuhlanganisa. Umqolo J, 8(1), 213-225. doi.org/10.1016/j.spinee.2007.10.023

Bush, K., Cowan, N., Katz, DE, & Gishen, P. (1992). Imbali yendalo ye-sciatica ehambelana ne-disc pathology. Uphononongo olulindelekileyo kunye nolandelelwano lwe-radiologic oluzimeleyo. Isihlwele (Phila Pa 1976), 17(10), 1205-1212. doi.org/10.1097/00007632-199210000-00013

Chou, R., Huffman, LH, American Pain, S., & American College of, P. (2007). Unyango lwe-Nonpharmacologic kwiintlungu ezibuhlungu kunye nezingapheliyo ezibuhlungu: ukuphononongwa kobungqina be-American Pain Society / American College of Physicians clinical practice guideline. Ann Intern Med, 147(7), 492-504. doi.org/10.7326/0003-4819-147-7-200710020-00007

Gose, EE, Naguszewski, WK, & Naguszewski, RK (1998). Unyango lwe-axial decompression ye-Vertebral yentlungu ehambelana ne-disc ye-herniated okanye i-degenerated okanye i-facet syndrome: isifundo sesiphumo. Neurol Res, 20(3), 186-190. doi.org/10.1080/01616412.1998.11740504

UKarl, HW, Helm, S., & Trescot, AM (2022). I-Superior and Middle Cluneal Nerve Entrapment: Isizathu seNzululwazi esezantsi kunye neRadicular. Ugqirha wezinhlungu, 25(4), E503-E521. www.ncbi.nlm.nih.gov/pubmed/35793175

Ramos, G., & Martin, W. (1994). Iziphumo ze-vertebral axial decompression kuxinzelelo lwe-intradiscal. J Neurosurg, 81(3), 350-353. doi.org/10.3171/jns.1994.81.3.0350

isikhanyeli

Ukukhetha iNgcali yoLawulo lweeNtlungu eziLungileyo

Ukukhetha iNgcali yoLawulo lweeNtlungu eziLungileyo

Kubantu abajongene neemeko zentlungu engapheliyo ingaba nokuqonda okungcono kweengcali zokulawula iintlungu kunceda ekuphuhliseni izicwangciso zonyango olusebenzayo lwe-multidisciplinary?

Ukukhetha iNgcali yoLawulo lweeNtlungu eziLungileyo

Iingcali zoLawulo lweeNtlungu

Ukulawulwa kweentlungu kukukhula okukhethekileyo kwezonyango ezithatha iindlela ezininzi zokunyanga zonke iintlobo zentlungu. Lisebe leyeza elisebenzisa ubuchule obungqiniweyo ngokwesayensi kunye neendlela zokunciphisa, ukunciphisa, nokulawula iimpawu zentlungu kunye nokuziva. Iingcali zokulawula iintlungu zivavanya, zihlaziye, kwaye zinyange uluhlu lweemeko, kuquka intlungu ye-neuropathic, i-sciatica, intlungu emva kokuhlinzwa, iimeko ezibuhlungu ezingapheliyo, kunye nokunye. Uninzi lwababoneleli bezempilo abasisiseko bathumela izigulane zabo kwiingcali zokulawula iintlungu ukuba iimpawu zentlungu ziqhubeka okanye zibalulekile ekubonakalisweni kwazo.

Iingcali

Ababoneleli bezempilo abakhethekileyo ekulawuleni intlungu bayaqaphela uhlobo olunzima lwentlungu kwaye bajonge ingxaki kuzo zonke iindlela. Unyango kwikliniki yeentlungu lugxile kwisigulane kodwa luxhomekeke kwizibonelelo ezikhoyo zekliniki. Okwangoku, akukho migangatho ibekiweyo kwiindidi zezifundo ezifunekayo, esinye isizathu ukhetho lonyango lwahluka ukusuka kwiklinikhi ukuya kwiklinikhi. Iingcali zithi indawo kufuneka ibonelele izigulana:

  • Ugqirha oququzelelayo ojongene nolawulo lweentlungu kunye neengcali zokubonisana egameni lesigulane.
  • Ingcali yokubuyisela kwimeko yesiqhelo.
  • Ugqirha wengqondo ukunceda umntu ukuba ajongane nayo nayiphi na into ehamba kunye nokudakumba okanye ukuxhalaba, ngakumbi xa ujongene neentlungu ezingapheliyo. (Umbutho waseMelika weNgingqi ye-Anesthesia kunye neNyango yeentlungu. 2023)

Ezinye iiNzululwazi kwezoNyango

Ezinye iingcali ezimele ekulawuleni iintlungu ziyi-anesthesiology, neurosurgery, kunye neyeza zangaphakathi. Umnxibelelanisi womboneleli wezempilo unokuthumela umntu ngeenkonzo ukusuka:

Umboneleli wezempilo kufuneka agqibe uqeqesho olongezelelweyo kunye nokuqinisekiswa kweyeza lentlungu kwaye abe yi-MD enesatifikethi sebhodi ubuncinane kwenye yezi zilandelayo (Ibhodi yaseMelika yeeNgcali zezoNyango. 2023)

  • Anesthesiology
  • Ukulungiswa komzimba
  • Psychiatry
  • Neurology

Ugqirha wolawulo lweentlungu kufuneka kwakhona abe nesenzo sabo esilinganiselweyo kwi-specialty abambe isatifikethi.

IiNjongo zoLawulo

Intsimi yolawulo lweentlungu iphatha zonke iintlobo zentlungu njengesifo. Ezingapheliyo, njengentloko ebuhlungu; ebukhali, ukusuka kuqhaqho, kunye nokunye. Oku kuvumela ukusetyenziswa kwenzululwazi kunye nenkqubela phambili yezonyango yamva nje yokuthomalalisa iintlungu. Ngoku kukho iindlela ezininzi, kuquka:

  • Amachiza
  • Iindlela zokungenelela zokulawula iintlungu - iibhloko ze-nerve, i-spinal cord stimulators, kunye nonyango olufanayo.
  • Ulungiso lwenyama
  • Elinye iyeza
  1. Injongo kukunciphisa kwaye wenze iimpawu zilawuleke.
  2. Phucula umsebenzi.
  3. Yandisa umgangatho wobomi. (Srinivas Nalamachu. 2013)

Iklinikhi yolawulo lweentlungu iyakuhamba ngolu hlobo lulandelayo:

  • Uvavanyo.
  • Iimvavanyo zokuxilonga, ukuba kuyimfuneko.
  • Unyango lomzimba - kwandisa uluhlu lwentshukumo, lomeleza umzimba, kwaye lulungiselela abantu ukuba babuyele emsebenzini nakwimisebenzi yemihla ngemihla.
  • Unyango lokungenelela - iinaliti okanye ukuvuselela intambo yomgogodla.
  • Ukuthunyelwa kugqirha wotyando ukuba kubonisiwe ziimvavanyo novavanyo.
  • I-Psychiatry yokujongana nokudakumba, ukuxhalaba, kunye / okanye eminye imiba ehamba kunye neempawu zentlungu engapheliyo.
  • Amayeza alolunye ukuxhasa kunye nokomeleza olunye unyango.

Abantu abenza kakuhle ngenkqubo yokulawula iintlungu

Abantu abane:

  • Umqolo obuhlungu
  • intlungu entanyeni
  • Uye watyandwa umqolo izihlandlo ezininzi
  • Utyando olungaphumelelanga
  • Neuropathy
  • Abantu ngabanye baye bafumanisa ukuba utyando aluyizuzisi imeko yabo.

Ukuqonda okungcono kwe-syndromes yeentlungu ngabahlali kunye neenkampani ze-inshurensi kunye nokwanda kwezifundo zentlungu kuya kunceda ukwandisa ukhuseleko lwe-inshurensi yonyango kunye neteknoloji yokuphucula iziphumo zongenelelo.


Ukhathalelo lweChiropractic lokungazinzi komlenze


Ucaphulo

Umbutho waseMelika weNgingqi ye-Anesthesia kunye neNyango yeentlungu. (2023). Ubungcali bolawulo lweentlungu ezingapheliyo.

I-American Academy ye-Pain Medicine (2023). Malunga ne-American Academy of Pain Medicine.

Ibhodi yaseMelika yeeNgcali zezoNyango. (2023). Owona Mbutho uThenjiweyo weSiqinisekiso soNyango oluKhethekileyo.

Nalamachu S. (2013). Isishwankathelo solawulo lweentlungu: ukusebenza kweklinikhi kunye nexabiso lonyango. Ijenali yaseMelika yokhathalelo olulawulwayo, 19(14 Suppl), s261–s266.

Umbutho waseMerika weeGqirha zeentlungu eziNgenelelayo. (2023). Ugqirha wezinhlungu.