Ukulawula i-Spinal Stenosis: Iinketho zonyango

I-Spinal stenosis ligama elisetyenziselwa ukuchaza umqolo onqabileyo. Unyango luyahluka kuba imeko yomntu wonke yahlukile. Abanye abantu baba neempawu ezibuthathaka, ngelixa abanye bafumana iimpawu ezinzima. Ngaba ukwazi iindlela zonyango kunokunceda isigulana kunye neqela lokhathalelo lwempilo ukuba benze ngokwezifiso isicwangciso sonyango kwimeko yomntu ngamnye?

Unyango Stenosis Umqolo

Izithuba ngaphakathi komqolo zinokuba mfutshane kunokuba zifanele ukuba, ezinokubangela uxinzelelo kwiingcambu zemithambo-luvo kunye nentambo yomgogodla. Naphi na ecaleni komqolo unokuchaphazeleka. Ukunciphisa kunokubangela intlungu, ukutshisa, kunye / okanye ukuqaqanjelwa ngasemva kunye nobuthathaka emilenzeni nasezinyaweni. I-Spinal stenosis inamayeza amaninzi aphambili. Xa usebenza ngonyango lwe-spinal stenosis, umboneleli wezempilo uya kuvavanya iimpawu kwaye aqalise unyango ngonyango lokuqala, olufana namayeza eentlungu kunye/okanye unyango lomzimba. Aba badla ngokuba ngabokuqala phakathi kwabantu abanesifo.

Amachiza

Intlungu engapheliyo yenye yeempawu eziphambili. Unyango lodidi lokuqala luhlala lubandakanya ukusetyenziswa kweyeza/amayeza okudambisa iintlungu. Amayeza amiselweyo aqhelekileyo achasene ne-nonsteroidal anti-inflammatories okanye ii-NSAID. La mayeza anciphisa intlungu kunye nokuvuvukala. Nangona kunjalo, ii-NSAID azikhuthazwa ukuba zisetyenziswe ixesha elide, kwaye amanye amayeza angadinga ukusetyenziswa ukukhulula intlungu equka: (Sudhir Diwan et al., 2019)

• Tylenol - acetaminophen
• UGabapentin
• Pregabalin
• Ii-opioids kwiimeko ezinzima

Lolonga

Ukuzivocavoca kunokunciphisa iimpawu ze-spinal stenosis ngokuthatha uxinzelelo kwiimbilini, ezinokunciphisa intlungu kunye nokuphucula ukuhamba. (U-Andrée-Anne Marchand et al., 2021) Ababoneleli ngezempilo baya kucebisa eyona mithambo isebenzayo kumntu ngamnye. Imizekelo ibandakanya:

• Ukuzivocavoca kweAerobic, njenge ukuhamba
• Ehleli i-lumbar flexion
• I-Lumbar flexion ekuxokeni
• Ukwandiswa kwe-lumbar eqhubekayo
• Ukuqiniswa kwe-Hip kunye nengundoqo
• Ukuma kwe-lumbar flexion

Ulungiso lwenyama

Olunye unyango oluphambili lwe-spinal stenosis lunyango lomzimba, oluhlala lusetyenziswa kunye namayeza eentlungu. Ngokuqhelekileyo, abantu bafumana iiveki ezintandathu ukuya kwezisibhozo zonyango lomzimba, kunye neeseshini ezimbini ukuya kathathu ngeveki. Ukusebenzisa unyango lomzimba kubonisiwe ukuba (Sudhir Diwan et al., 2019)

• Ukunciphisa intlungu
• Yandisa ukuhamba
• Nciphisa amayeza eentlungu.
• Ukunciphisa iimpawu zempilo yengqondo ezifana nomsindo, ukudakumba, kunye nokutshintsha kwemo.
• Kwiimeko ezinzima, unyango lomzimba emva kotyando lunokunciphisa amaxesha okubuyisela.

Iibrayisi zangasemva

I-back braces inokunceda ukunciphisa ukunyakaza kunye noxinzelelo kumqolo. Oku kuluncedo kuba neentshukumo ezincinci zomnqonqo zinokukhokelela ekucaphukeni kwemithambo-luvo, iintlungu, kunye neempawu eziya zisiba mbi. Ngokuhamba kwexesha, i-bracing ingakhokelela ekunyuseni okulungileyo kokuhamba. (UCarlo Ammendolia et al., 2019)

Injections

Iinaliti ze-epidural steroid zinokucetyiswa ukukhulula iimpawu ezinzima. Iisteroids zisebenza njenge-anti-inflammatories ukunciphisa intlungu kunye nokudumba okubangelwa kukudumba kunye nokucaphuka kwemithambo yomqolo. Zigqalwa njengeenkqubo zonyango ezingaqhaqho. Ngokutsho kophando, i-injection inokulawula ngokufanelekileyo intlungu kwiiveki ezimbini ukuya kwiinyanga ezintandathu, kwaye uphando oluthile lufumene ukuba emva kwesitofu somgogodla, ukukhululeka kunokuhlala iinyanga ze-24. (Sudhir Diwan et al., 2019)

Inkqubo yokuTyibilika kweeLigaments ezityebileyo

Abanye abantu banokucetyiswa ukuba benze inkqubo yoxinzelelo. Le nkqubo ibandakanya ukusebenzisa isixhobo senaliti esincinci esifakwe ngasemva. Izicubu ze-ligament ezixubileyo zisuswa ukunciphisa uxinzelelo kumqolo kunye nemithambo-luvo. Uphando lufumene ukuba inkqubo inokunciphisa iimpawu kunye nesidingo sotyando olungakumbi. (Nagy Mekhail et al., 2021)

Unyango olulolunye

Ukongeza kunyango lokuqala, abantu banokuthunyelwa kwezinye iindlela zonyango zolawulo lweempawu, kubandakanya:

Ukwenza i-Acupuncture

• Oku kubandakanya ukufakwa kweenaliti ezinencam encinci kwii-acupoints ezahlukeneyo ukuthomalalisa iimpawu.
• Olunye uphando lufumene ukuba i-acupuncture inokusebenza ngakumbi ekunciphiseni iimpawu kunonyango lomzimba kuphela. Zombini iinketho ziyasebenza kwaye zinokuphucula ukuhamba kunye neentlungu. (Hiroyuki Oka et al., 2018)

Chiropractic

• Olu nyango lunciphisa uxinzelelo kwiimbilini, lugcina ukulungelelaniswa komgogodla, kwaye lunceda ukuphucula ukuhamba.

ukuphulula umzimba womntu ngobunono

• Ukuphulula kunceda ukwandisa ukujikeleza, ukukhulula izihlunu, kunye nokunciphisa intlungu kunye nokuqina.

UKhetho olutsha loNyango

Njengoko uphando lwe-spinal stenosis luqhubeka, unyango olutsha luya kuvela ukunceda ukukhulula kunye nokulawula iimpawu kubantu abangaphenduliyo kumayeza esintu okanye abangakwaziyo ukuthatha inxaxheba kunyango oluqhelekileyo ngenxa yezizathu ezahlukeneyo. Nangona kunjalo, ubungqina obuthile obunikiweyo buyathembisa; ii-inshorensi zonyango zingazithatha njengezovavanyo kwaye zingaboneleli nge-inshorensi de ukhuseleko lwazo lungqinwe. Olunye unyango olutsha lubandakanya:

Acupotomy

I-Acupotomy luhlobo lwe-acupuncture olusebenzisa iinaliti ezibhityileyo ezinencanyana encinci, ecaba, i-scalpel-type-tip ukukhulula uxinzelelo kwiindawo ezibuhlungu. Uphando ngeziphumo zalo lusanqongophele, kodwa idatha yokuqala ibonisa ukuba inokuba lunyango oluncedisayo olusebenzayo. (UJi Hoon Han et al., 2021)

Ulwaphulo lweStem Cell

Iiseli ze-Stem ziiseli eziphuma kuzo zonke ezinye iiseli. Zisebenza njengezinto eziluhlaza ukuze umzimba wenze iiseli ezikhethekileyo ezinemisebenzi ethile. (Amaziko eSizwe ezeMpilo. 2016)

• Abantu abane-spinal stenosis banokuhlakulela umonakalo wezicubu ezithambileyo.
• Unyango lwe-stem cell lusebenzisa iiseli ze-stem ukunceda ukulungisa izicubu ezonzakeleyo okanye ezigulayo.
• Unyango lwe-stem cell lunokunceda ukulungisa okanye ukuphucula iindawo ezonakalisiweyo kunye nokubonelela ngokukhululeka kweempawu.
• Izifundo zeklinikhi zespinal stenosis zixela ukuba inokuba lukhetho olusebenzayo lonyango kwabanye.
• Nangona kunjalo, uphando oluninzi luyafuneka ukuqinisekisa ukuba ngaba unyango lusebenza ngokwaneleyo ukuba lusetyenziswe ngokubanzi. (Hideki Sudo et al., 2023)

Izixhobo zokuZinzisa eziNgqongileyo

I-LimiFlex sisixhobo sonyango esenza uphando kunye nohlalutyo ngokukwazi kwayo ukubuyisela ukuhamba kunye nokuzinza kumqolo. Ifakwe emqolo ngenkqubo yotyando. Ngokophando, abantu abane-spinal stenosis abafumana i-LimiFlex bahlala befumana ukuncipha okuphezulu kweentlungu kunye neempawu kunezinye iindlela zonyango. (T Jansen et al., 2015)

Lumbar Interspinous Distraction Decompression

I-Lumbar interspinous distraction decompression yenye inkqubo yotyando ye-spinal stenosis. Utyando lwenziwa nge-incision ngaphezu komqolo kwaye lubeka isixhobo phakathi kwama-vertebrae amabini ukudala indawo. Oku kunciphisa ukunyakaza kunye noxinzelelo kwiimbilini. Iziphumo zokuqala zibonisa ukukhululeka kwexesha elifutshane elihle kwiimpawu; idatha yexesha elide ayikabikho njengoko iyindlela entsha yonyango ye-spinal stenosis. (INkonzo yezeMpilo yeSizwe yase-UK, ngo-2022)

Inkqubo yoNyango

Kukho iinkqubo ezininzi zotyando ezikhoyo kwi-spinal stenosis. Ezinye ziquka: (Impilo ye-NYU Langone. 2024) Utyando lwe-spinal stenosis luhlala lugcinelwe abantu abaneempawu ezinzima, ezifana nokuba ndindisholo kwiingalo okanye emilenzeni. Xa ezi zimpawu zikhula, kubonisa ukunyanzeliswa okuphawuleka ngakumbi kwi-spinal nerves kunye nesidingo sonyango olunamandla. (Impilo ye-NYU Langone. 2024)

Laminectomy

• I-laminectomy isusa inxalenye okanye yonke i-lamina, ithambo lomqolo eligqume umjelo womqolo.
• Inkqubo yenzelwe ukunciphisa uxinzelelo kwi-nerve kunye nentambo yomgogodla.

I-Laminotomy kunye ne-Foraminotomy

• Zombini utyando zisetyenziswa ukuba i-spinal stenosis yomntu ichaphazela kakubi ukuvuleka kwi-vertebral foramen.
• I-Ligaments, i-cartilage, okanye ezinye izicubu ezithintela imithambo-luvo ziyasuswa.
• Bobabini banciphisa uxinzelelo kwiimbilini ezihamba nge-foramen.

I-Laminoplasty

• I-laminoplasty ikhulula uxinzelelo kwintambo yomgogodla ngokususa iinxalenye zelamina yomqolo womqolo.
• Oku kwandisa i-spinal canal kunye nokunciphisa uxinzelelo kwimithambo-luvo. (Columbia Neurosurgery, 2024)

Ukuqonda

• Le nkqubo yotyando ibandakanya ukususa iidiski ze-herniated okanye i-bulging ezibeka uxinzelelo kwintambo yomgogodla kunye neentsholongwane.

Umswakama

• Ukudityaniswa komqolo kubandakanya ukudibanisa ama-vertebrae amabini kusetyenziswa iziqwenga zentsimbi ezifana neentonga kunye nezikrufu.
• I-vertebrae izinzile ngakumbi kuba iintonga kunye nezikrufu zisebenza njengebrace.

Loluphi Unyango OluLungileyo?

Ngenxa yokuba zonke izicwangciso zonyango zahlukile, ukumisela eyona nto isebenzayo yeyona ifaneleke kakhulu kumboneleli wezempilo. Indlela nganye iya kujongwa kumntu ngamnye. Ukugqiba ukuba loluphi unyango olulungileyo, ababoneleli bezempilo baya kuvavanya: (Iziko leSizwe le-Arthritis kunye ne-Musculoskeletal and Skin Diseases. 2023)

• Ubunzima beempawu.
•  Inqanaba langoku lempilo yonke.
• Inqanaba lomonakalo owenzeka kumqolo.
• Inqanaba lokukhubazeka kunye nendlela ukuhamba kunye nomgangatho wobomi obuchaphazelekayo.

I-Chiropractic yezoNyango ze-Chiropractic kunye ne-Functional Medicine Clinic iya kusebenza kunye nomboneleli wezempilo oyintloko womntu ngamnye kunye / okanye iingcali zokunceda ukuchonga iindlela ezifanelekileyo zonyango kunye neenkxalabo malunga namayeza okanye ezinye iindlela zonyango.

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Ukuvula Wellness

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Ucaphulo

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Marchand, AA, Houle, M., O'Shaughnessy, J., Châtillon, C. É., Cantin, V., & Descarreaux, M. (2021). Ukusebenza kwenkqubo esekelwe kwi-prehabilitation yezigulane ezilindele ukuhlinzwa kwi-lumbar spinal stenosis: uvavanyo lweklinikhi olungahleliwe. Iingxelo zenzululwazi, i-11 (1), i-11080. doi.org/10.1038/s41598-021-90537-4

Ammendolia, C., Rampersaud, YR, Southerst, D., Ahmed, A., Schneider, M., Hawker, G., Bombardier, C., & Côté, P. (2019). Umphumo we-prototype ye-lumbar spinal stenosis belt ngokubhekiselele kwinkxaso ye-lumbar ekuhambeni kwamandla kwi-lumbar spinal stenosis: uvavanyo olulawulwa ngokungahleliwe. Ijenali yomqolo : ijenali esemthethweni yeNorth American Spine Society, 19 (3), 386-394. doi.org/10.1016/j.spinee.2018.07.012

Mekhail, N., Costandi, S., Nageeb, G., Ekladios, C., & Saied, O. (2021). Ukuqina kwenkqubo yokunciphisa i-lumbar encinci kwizigulane ezine-symptomatic lumbar spinal stenosis: ukulandelwa kwexesha elide. Iintlungu zokuziqhelanisa : iphephancwadi elisemthethweni le-World Institute of Pain, i-21 (8), i-826-835. doi.org/10.1111/papr.13020

Oka, H., Matsudaira, K., Takano, Y., Kasuya, D., Niiya, M., Tonosu, J., Fukushima, M., Oshima, Y., Fujii, T., Tanaka, S., & Inanami, H. (2018). Uphononongo oluthelekisayo lwezonyango ezintathu ezilondolozayo kwizigulane ezine-lumbar spinal stenosis: i-lumbar spinal stenosis kunye ne-acupuncture kunye ne-physiotherapy study (LAP study). I-BMC encedisayo kunye neyeza elilolunye, i-18(1), i-19. doi.org/10.1186/s12906-018-2087-y

Han, JH, Lee, HJ, Woo, SH, Park, YK, Choi, GY, Heo, ES, Kim, JS, Lee, JH, Park, CA, Lee, WD, Yang, CS, Kim, AR, & Han , CH (2021). Ukusebenza kunye nokhuseleko lwe-acupotomy kwi-lumbar spinal stenosis: i-pragmatic randomized, controlled, pilot trial trial: Iprotocol yokufunda. Amayeza, 100 (51), e28175. doi.org/10.1097/MD.0000000000028175

Sudo, H., Miyakoshi, T., Watanabe, Y., Ito, YM, Kahata, K., Tha, KK, Yokota, N., Kato, H., Terada, T., Iwasaki, N., Arato, T., Sato, N., & Isoe, T. (2023). Iprotocol yokunyanga i-lumbar spinal canal stenosis kunye nendibaniselwano ye-ultrapurified, i-allogen bone marrow-derived mesenchymal stem cells kunye ne-situ-forming gel: i-multicentre, i-prospective, i-double blind blind-controlled controlled trial. BMJ vula, 13(2), e065476. doi.org/10.1136/bmjopen-2022-065476

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Jansen, T., Bornemann, R., Otten, L., Sander, K., Wirtz, D., & Pflugmacher, R. (2015). Vergleich dorsaler Dekompression nicht stabilisiert und dynamisch stabilisiert mit LimiFlex™ [Uthelekiso lweDorsal Decompression kunye neDorsal Decompression Didityaniswe nesixhobo sokuZinzisa esiDynamic iLimiFlex™]. Zeitschrift fur Orthopadie und Unfallchirurgie, 153(4), 415–422. doi.org/10.1055/s-0035-1545990

INkonzo yezeMpilo yeSizwe yase-UK. (2022). Utyando lokuthotywa kweLumbar: lwenziwa njani. www.nhs.uk/conditions/lumbar-decompression-surgery/what-happens/

Impilo ye-NYU Langone. (2024). Utyando lwe-spinal stenosis. nyulangone.org/conditions/spinal-stenosis/treatments/surgery-for-spinal-stenosis

Columbia Neurosurgery. (2024). Inkqubo ye-laminoplasty yomlomo wesibeleko. www.neurosurgery.columbia.edu/patient-care/treatments/cervical-laminoplasty

Iziko leSizwe le-Arthritis kunye ne-Musculoskeletal and Skin Diseases. (2023). I-Spinal stenosis: Ukuxilongwa, unyango kunye namanyathelo okufuneka uwathathe. Ifunyenwe kwi www.niams.nih.gov/health-topics/spinal-stenosis/diagnosis-treatment-and-steps-to-take