Ukuqonda i-Spinal Synovial Cysts: Isishwankathelo

Abantu abaye bahamba ngokulimala kwangemva banokuhlakulela i-synovial spinal cyst njengendlela yokukhusela umqolo onokubangela iimpawu zentlungu kunye nokuziva. Ngaba ukwazi imiqondiso kunokunceda ababoneleli bezempilo baphuhlise isicwangciso sonyango esicokisekileyo ukuthomalalisa iintlungu, ukuthintela ukuwohloka kwemeko kunye nezinye iimeko zomqolo?

Umqolo Synovial Cysts

I-Spinal synovial cysts yi-benign fluid-ezaliswe ziingxowa ezikhula kumalungu omqolo. Benza ngenxa yokuguqulwa komgogodla okanye ukulimala. I-cysts inokwenza naphi na kumqolo, kodwa ininzi iyenzeka kwingingqi ye-lumbar / ezantsi. Ngokuqhelekileyo baphuhliswa kumalungu e-facet okanye i-junctions egcina i-vertebrae / amathambo omqolo adibeneyo.

iimpawu

Kwiimeko ezininzi, i-synovial cysts ayibangeli iimpawu. Nangona kunjalo, ugqirha okanye ingcali iya kufuna ukubeka iliso kwiimpawu ze-disc degenerative, i-spinal stenosis, okanye i-cauda equina syndrome. Xa iimpawu zikhona, ngokuqhelekileyo zibangela i-radiculopathy okanye i-nerve compression, enokubangela intlungu emva, ubuthathaka, ukuphazamiseka, kunye neentlungu ezikhuphayo ezibangelwa kukucaphuka. Ubunzima beempawu buxhomekeke kubukhulu kunye nendawo ye-cyst. I-Synovial cysts inokuchaphazela elinye icala lomgudu okanye zombini kwaye inokwenza kwinqanaba elinye lomgogodla okanye kumanqanaba amaninzi.

Iziphumo zingabandakanya

• Iimpawu zeRadiculopathy zinokukhula ukuba i-cyst okanye ukudumba okubangelwa yi-cyst kudibana nengcambu yemithambo yomqolo. Oku kunokubangela i-sciatica, ubuthathaka, ukuphazamiseka, okanye ubunzima bokulawula imisipha ethile.
• I-Neurogenic claudication / impingement kunye nokuvuvukala kwemithambo-luvo yomgogodla kunokubangela ukuphazamiseka, intlungu, kunye / okanye ukubetha kumqolo ongaphantsi, imilenze, isinqe, kunye neempundu. (UMartin J. Wilby et al., 2009)
• Ukuba intambo yomgogodla ibandakanyeka, inokubangela myelopathy/ukunyanzeliswa komqolo okunzima okunokubangela ukuphazamiseka, ubuthathaka, kunye neengxaki zokulinganisela. (UDong Shin Kim et al., ngo-2014)
• Iimpawu ezinxulumene ne-cauda equina, kubandakanywa iingxaki zesisu kunye / okanye i-bladder, ubuthathaka bomlenze, kunye ne-saddle anesthesia / ukulahlekelwa kwemvakalelo emathangeni, ezinqeni, kunye ne-perineum, zinokubonisa kodwa zinqabile, njenge-synovial cysts kumqolo ophakathi kunye nentamo. Ukuba i-cysts ye-thoracic kunye ne-cervical synovial cysts ikhula, inokubangela iimpawu ezinjenge-numbness, i-tingling, intlungu, okanye ubuthathaka kwindawo echaphazelekayo.

Izizathu

I-Spinal synovial cysts ibangelwa ngokubanzi utshintsho oluguquguqukayo njenge-osteoarthritis ephuhliswa ngokudibeneyo ngokuhamba kwexesha. Ngokunxitywa rhoqo kunye nokukrazula, i-facet joint cartilage / into edibeneyo enika ukhuseleko, indawo egudileyo, ukunciphisa ukungqubuzana, kunye nokufunxa ukothuka kuqala ukonakala. Njengoko inkqubo iqhubeka, i-synovium inokwenza i-cyst.

• I-Traumas, enkulu kunye encinci, inefuthe elivuthayo kunye nelokunciphisa kumalungu angabangela ukubunjwa kwe-cyst.
• Malunga nesithathu sabantu abane-spinal synovial cyst nabo bane-spondylolisthesis.
• Le meko xa i-vertebrae iphuma kwindawo okanye ngaphandle kokulungelelaniswa kwi-vertebra engaphantsi.
• Luphawu lokungazinzi komqolo.
• Ukungazinzi kunokwenzeka kuyo nayiphi na indawo yomqolo, kodwa i-L4-5 yizona nqanaba eziqhelekileyo.
• Eli candelo lomqolo lithatha uninzi lobunzima bomzimba obungaphezulu.
• Ukuba ukungazinzi kwenzeka, i-cyst inokukhula.
• Nangona kunjalo, ama-cysts angenza ngaphandle kokungazinzi.

Ukuqondwa

• Iicysts zifunyaniswa ngokubanzi nge-MRI. (Nancy E, Epstein, Jamie Baisden. 2012)
• Ngamanye amaxesha zinokubonwa nge-ultrasound, i-X-reyi, okanye i-CT scans.

impatho

Amanye ama-cysts ahlala emancinci kwaye abangela iimpawu ezimbalwa. I-cysts ifuna unyango kuphela ukuba ibangela iimpawu. (Nancy E, Epstein, Jamie Baisden. 2012)

Uhlengahlengiso kwindlela yokuphila

• Ingcali yezempilo iya kucebisa ukuba iphephe imisebenzi ethile eyenza iimpawu zibe mandundu.
• Abantu ngabanye banokucetyiswa ukuba baqalise ukuzolula kunye nokuzivocavoca okujoliswe kuyo.
• Unyango lomzimba okanye unyango lomsebenzi lunokucetyiswa.
• Ukusetyenziswa okwethutyana kwe-nonsteroidal anti-inflammatories/NSAIDs ezifana ne-ibuprofen kunye ne-naproxen kunokunceda ukuthomalalisa iintlungu ngamaxesha athile.

Iinkqubo zezigulana ezingaphandle

• Kwii-cysts ezibangela intlungu enzulu, ukuphazamiseka, ubuthathaka, kunye neminye imiba, inkqubo yokukhupha ulwelo / i-aspiration kwi-cyst inokucetyiswa.
• Olunye uphononongo lwafumanisa ukuba izinga lempumelelo lisukela kwi-0 ukuya kuma-50 ekhulwini.
• Abantu abatyhubela ulangazelelo badla ngokufuna iinkqubo eziphindaphindiweyo ukuba ulwakhiwo lolwakhiwo luyabuya. (Nancy E, Epstein, Jamie Baisden. 2012)
• Iinaliti ze-epidural corticosteroid zinokunciphisa ukudumba kwaye zinokuba lukhetho lokuthomalalisa iintlungu.
• Izigulane zicetyiswa ukuba zingafumani iinaliti ezingaphezu kwesithathu ngonyaka.

Iinketho zoTyando

Kwiimeko ezinzima okanye eziqhubekayo, ugqirha unokuncoma utyando lwe-decompression ukususa i-cyst kunye nethambo elijikelezileyo ukukhulula uxinzelelo kwingcambu ye-nerve. Iinketho zotyando zisusela kwiinkqubo ze-endoscopic ezincinci ukuya kuqhaqho olukhulu, oluvulekileyo. Olona khetho lulungileyo lotyando luyahluka ngokusekwe kubunzima bemeko nokuba kukho ukuphazamiseka okunxulumene noko. Ukhetho lotyando lubandakanya:

• Laminectomy – Ukususwa kwesakhiwo samathambo esikhusela kwaye sigubungele i-spinal canal / lamina.
• IHemilaminectomy – I-laminectomy elungisiweyo apho inxalenye encinci ye-lamina isusiwe.
• Ukususwa kweFacetectomy – Ukususwa kwenxalenye ye-facet joint echaphazelekayo apho i-cyst synovial ikhona, ngokuqhelekileyo ilandela i-laminectomy okanye i-hemilaminectomy.
• Fusion i-facet joints kunye ne-vertebra – Ukunciphisa ukuhamba kwe-vertebral kwindawo yokulimala.

1. Uninzi lwabantu lufumana isiqabu ngokukhawuleza emva kwe-laminectomy okanye i-hemilaminectomy.
2. Ukudibanisa kunokuthatha iinyanga ezintandathu ukuya kwezilithoba ukuze kuphole ngokupheleleyo.
3. Ukuba utyando lwenziwa ngaphandle kokudityaniswa apho i-cyst yaqala khona, iintlungu zinokubuya, kwaye elinye i-cyst linokwakheka kwiminyaka emibini.
4. Uqhaqho Iingxaki ziquka usulelo, ukopha, kunye nokwenzakala kwintambo yomqolo okanye ingcambu yomthambo.

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Ucaphulo

UWilby, MJ, Fraser, RD, Vernon-Roberts, B., & Moore, RJ (2009). Ukuxhaphaka kunye ne-pathogenesis ye-synovial cysts ngaphakathi kwe-ligamentum flavum kwizigulane ezine-lumbar spinal stenosis kunye ne-radiculopathy. Umqolo, 34(23), 2518-2524. doi.org/10.1097/BRS.0b013e3181b22bd0

UKim, DS, Yang, JS, Cho, YJ, & Kang, SH (2014). I-myelopathy ebukhali ebangelwa yi-cyst ye-synovial yomlomo wesibeleko. Ijenali ye-Korean Neurosurgical Society, i-56 (1), i-55-57. doi.org/10.3340/jkns.2014.56.1.55

Epstein, NE, & Baisden, J. (2012). Ukuxilongwa kunye nokulawulwa kwe-synovial cysts: Ukusebenza kotyando ngokuchasene ne-cyst aspiration. Utyando lwe-neurology ngamazwe, 3 (Suppl 3), S157-S166. doi.org/10.4103/2152-7806.98576