Uqhaqho lwe-Spinal Decompression Surgery: iLaminotomy kunye neLaminectomy

Utyando lokuqhaqha komqolo kunokuba yingxoxo yonyango kunye nogqirha ukunciphisa iintlungu zentliziyo eziswe ngu a imeko yomqolo okanye ukuphazamiseka. Yonke into yokwazi malunga neenkqubo ngokuthe ngqo ziingcali.  

Iindidi zoqhaqho lwe-Spinal Decompression Surgery: I-Laminectomy okanye iLaminotomy

Zombini ezi nkqubo zibandakanya i-lamina ye-vertebrae, Esi sisithambo samathambo esikhusela umjelo womqolo.

• Kwi laminectomy, le lamina yile isuswe phantse yonke.
• Kwi-laminotomy, yi ukususwa okungaphelelanga.

Ngaphandle kokususwa, i izihlunu ezinkulu zomqolo zibonelela ngokhuseleko oluzinzileyo yemithambo-luvo engezantsi. Ke ngoko, imithambo-luvo yomqolo isakhuselekile kwaye ikhuselekile ngokulandela iinkqubo. Nguwuphi olungileyo oxhomekeke kwimeko.  

• I-laminectomy yile iqhele ukwenziwa ukunyanga imeko ye-arthritic yomjelo womqolo Njenge-spinal stenosis.
• I-Laminotomy isetyenziselwa phantse kuphela ukususa i-disc ye-herniated.
• I-laminectomy isusa amathambo amaninzi kwaye ngamanye amaxesha umda ongaphakathi weqela elidibeneyo.
• Ekugqibeleni, a Ugqirha uya kugqiba ukuba yeyiphi kwezi nkqubo zimbini ilungele iimfuno zomntu kunye nemeko yakhe.

Ugqirha loxinzelelo

I-Spinal stenosis okanye ukunciphisa umjelo womqolo kuhlala kubangelwa sisifo samathambo kunye nokugqitha kweediski kunye namalungu. Imicimbi efanayo yokucinezelwa iphendula kakuhle kunyango olungelonyango. Kodwa ngamanye amaxesha utyando luyimfuneko ekuphatheni iimeko ezingaqhelekanga kodwa ezinokubakho. Oku kubandakanya abaguli abane:

• Iingxaki zamathumbu okanye zesinyi ezibangelwa luxinzelelo kwimithambo-luvo yomqolo
• Ubuthathaka bomlenze buya buba mandundu
• Ukungakwazi ukuhamba okanye ukuhamba ixesha elide kunye nomgama

The Injongo yoqhaqho lokuqhaqha komqolo kukudala indawo ejikeleze intambo yomqolo kunye neentsholongwane ezijikelezileyo ngokususa i-compress structure/s. Xa intambo kunye/okanye imithambo-luvo/imithambo-luvo icinezelekile, iimpawu zomzimba nezemithambo-luvo zifunyanwa ezantsi kwindlela yemithambo-luvo. Oku kuquka:

• Ukulinganisa
• Ubungqina
• Ukutshatyalaliswa kombane
• Ukusasaza / ukusasaza iintlungu
• Ubuthathaka

Nje ukuba iimithambo ezixineneyo zibe nendawo yokuphumla kwaye zijikeleze iimpawu ziyancipha.  

Inkqubo yeLaminectomy

• I-Lumbar laminectomy yinkqubo eqhelekileyo yokunyanga i-spinal stenosis kumqolo osezantsi.
• It ikwanceda ukunyanga ii-disc ze-herniated ngokuvumela ugqirha ukuba afikelele kwiidiski ngokulula ukulungisa nawuphi na umonakalo.
• Ugqirha ususa i-lamina kunye ne-ligaments eziye zaqina kwaye zibangela iingxaki ukudala indawo engaphezulu kumjelo.
• Utyando lwandisa umjelo womqolo ukuze uxinzelelo lukhululwe.
• Ngokususa umthombo woxinzelelo, iintlungu ezibangelwa yimithambo exinzelelweyo ziyancipha.
• An I-laminectomy evulekileyo idala ukusikwa kwee-intshi ezimbalwa kwaye uveza umqolo.
• Izihlunu zomqolo kunye nomqolo ziyanqunyulwa ukuveza ithambo.
• Enye indlela yokuba Oogqirha basebenzisa ngokusebenzisa ityhubhu.
• Baye zilungelelanise obu buchule ukuze zikwazi ukudibanisa zombini amacala asekhohlo nasekunene nangona zisebenza kwicala elinye kuphela.
• Zombini iinkqubo, Okuncinci kunye nesiko kufezekisa iinjongo ezifanayo.
• Umahluko ngu Inkqubo yokungenelela encinci ibandakanya into enye okanye ezingaphezulu ezincinci ezaziwa ngokuba kukugqobhoza kolusu kunye nezixhobo ezincinci ezenzelwe ukwahlula izihlunu kunye nezicubu ezithambileyo endaweni yokuzisika.
• The Indlela yesiko ifuna ukusikwa okukhulu kunye nezixhobo ezirhoxisa, zahlule kwaye zisike izicubu.

Utyando lweLaminectomy

• IiLaminectomies zezi kwenziwa phantsi kwe-anesthesia ngokubanzi kusetyenziswa indlela yangasemva / ukulala ubuso phantsi ngexesha lenkqubo.
• Inokuvulwa okanye Ukungenelela kancinci ngamanye amaxesha kubizwa ngokuba yi-microlaminectomy.
• Kwi-laminectomy evulekileyo, ugqirha wotyando wenza ukusikwa kufutshane nendawo echaphazelekileyo yomqolo.
• Nje ukuba ukusikwa kwenziwe, a I-retractor izakuhambisa ulusu, amanqatha, kunye nezihlunu ecaleni ke ugqirha unokufikelela kumqolo.
• Emva koko, bayayisusa okanye bayinciphise i-lamina kunye ne-ligaments ezixineneyo ukuze bandise indawo ejikeleze imithambo-luvo exinzelelweyo.
• Xa usenzile, i-retractor isuswe kwaye i-incision ivaliwe nge-sutures.
• Utyando olungenayo oluncinci okanye iMIS lwenziwa kusetyenziswa izixhobo ezizodwa ezinje ngee-endoscopes kunye neetubular retractors.
• Ezi zixhobo zivumela ukusikwa okuncinci kunye nokusika okuncinci.
• Baya kusebenzisa izambatho zamehlo ezizodwa ukuze babe nembono eneenkcukacha ngecandelo lotyando.
• Ngamanye amaxesha, ugqirha osebenzisa ugqirha usebenzisa i-endoscope okanye imicroscope ejolise ezantsi kumbhobho ukwenza utyando.
• The isahlulo se-lamina sisuswe, kunye nolunye ukwanda kwamathambo / ii-osteophytes kunye nezihlunu ze-ligament.
• Ababuyisi beetyhubhu bayathathwa bakhutshwe ukuze izicwili ezithambileyo zibuyele endaweni yazo, kwaye ukusikwa kuvaliwe ngokunyibilika kwemisonto.

Ezinye iinkqubo zomqolo ezenziwa ecaleni

IiLaminectomies kunye neelaminotomies ngokwesiqhelo azenziwa kunye. Nangona kunjalo, ugqirha wotyando unokwenza zombini ukuba utyando luchaphazela amanqanaba amaninzi omqolo. Banokudityaniswa kunye nezinye iindlela zotyando lomqolo, ezibandakanya:

Foraminotomy

• I-foraminotomy nayo yinkqubo yokunciphisa. Kodwa endaweni yokususa inxalenye okanye yonke i-lamina, ugqirha wotyando ufikelela kwimithambo-luvo ngokusebenzisa i-foramen yomnqonqo okanye indlela edlula imithambo macala omabini.

Ukuqonda

• Olu tyando lokunyanzeliswa kubandakanya ukususwa kwayo yonke into okanye inxenye yediski eyonakalisiweyo kwaye isetyenziselwa iidiski ze-herniated.

Umswakama

• I-Fusion ihlala yenziwa emva kotyando lokuqaqanjelwa ngumqolo, njengoko isithuba esenziwe ngokususa isakhiwo somqolo sinokubangela ukungazinzi emqolo.

Abagqatswa kotyando lokuqaqanjelwa ngumqolo

Zombini ziinkqubo eziqhelekileyo ezenziwa zii-neurosurgeons kunye ne-orthopedic spine surgeons. I-Laminectomies ithathwa njengenye yezona ndlela zonyango ezisebenzayo kwi-spinal stenosis kunye nemiba yomgogodla efana nale:

• Izidumbu
• Ezinye iintlobo zosulelo kunye namathumba
• Imiba yomqolo ebandakanya ukungasebenzi kwamathumbu / isinyi
• Esona sizathu siphambili se-laminectomy yi-spinal stenosis, exhaphake kubantu abangaphezulu kweminyaka engama-60.

Ezinye izinto eziqwalaselwayo kunye neemeko zibandakanya:

• Unyango olungaphazamisiyo olungaphuculi imeko ebandakanya amayeza, i-massage, kunye nonyango lomzimba
• Ukusilela kotyando lwe-Fusion
• Ukusilela kunyango lwenaliti
• Ubukho bamathumba ngaphakathi okanye ngeenxa zonke emqolo
• Usulelo olunjenge ithumba elibonakalayo
• Imiba ye-Neurologic
• Ukungasebenzi kakuhle kwesisu okanye kwesinyi
• Isifo seCauda equina syndrome

Buza imibuzo malunga nenkqubo yokuqinisekisa ukuba ukhululekile ekusebenzeni. Nayi eminye imibuzo:

• Ziziphi iingozi ezinxulumene nazo?
• Ngaba utyando luya kuzisusa zonke iimpawu?
• Ngaba awunayo ingozi yotyando?
• Kunjani ukuchacha?

ukuchacha

• Vula okanye encinci, ukubuyisela kwakhona kuthatha ixesha. Ukulandela imiyalelo kagqirha ngononophelo kubalulekile ukwenza ukuchacha okupheleleyo, okusempilweni.
• Abantu kufuneka balumke kangangenyanga emva kotyando. Kodwa oko akuthethi ukubeka phantsi okanye ukuhlala phantsi. Ukuhamba kubalulekile ekubuyiseni.
• Isigulana akufuneki sihlale ebhedini okanye silale esofeni.
• Lindela iveki okanye ezimbini ngaphambi kokuba uqale unyango lomzimba ukuba kukho imfuneko.
• Uninzi luya kuba nefayile ye- Isiseko esibuthathaka, ukungahambi kakuhle, kunye noomatshini bokusebenza abampofu, Injongo kukunceda ukuphuhlisa nokomeleza le mimandla.

Izinto zokunceda ekubuyiseni zibandakanya:

• Imiqulu yomkhenkce / ebandayo izakunceda ukunciphisa ukudumba neentlungu.
• Zama ukuhlala ixesha elide, njengokuhlala esona sikhundla sincinci emva kotyando lwasemva.
• Ukwazisa ngomatshini kuthetha ukunqanda ukugoba okanye ukuphakamisa kakhulu kunye nokusebenzisa ubuchwephesha bomzimba obuchanekileyo xa ugoba okanye uphakamisa.
• Ukuhamba komzimba emva kokusebenza emva kotyando kubalulekile kwaye kunceda ukuthintela imiba yasemva kotyando.

Izinto zokwenza ngaphambi kotyando:

Ukuyeka ukutshaya

• Ngokukodwa ngaphambi kokuhlinzwa. Ukuyeka ngokupheleleyo okanye ubuncinci iiveki ezintandathu ubuncinci ngaphambi kotyando kuya kwenza ukuba ukubuyela kwimeko yesiqhelo kube lula kwaye kube sempilweni.

Ukulahlekelwa isisindo

• Thetha nogqirha malunga nobunzima. Iiponti nje ezi-5 zinokwenza umahluko omkhulu ngexesha lokuchacha.

Igazi leswekile

• Kubantu abanesifo seswekile, ukuba ne-A1C phantsi kwesibhozo ngaphambi kotyando kufanelekile.

Ukuchacha kwesigulana ngasinye kwahlukile. Ixesha lokubuyisela lixhomekeke kwi:

• Ubunzima botyando
• Imbali yonyango lomntu
• Imiba yezeMpilo

Ukubuyisela kwimeko yesiqhelo kuthatha malunga neeveki ezimbini ukuya kwezine emva kotyando. Nangona kunjalo, kuxhomekeke kwisizathu / s sotyando.

imibuzo

Isifo se-post-laminectomy

• I-Post-laminectomy syndrome PLS ekwabizwa ngokuba sisifo sokungaphumeleli sotyando yimeko apho umntu eqhubeka nokuba neentlungu emva kotyando. Abantu abasenempawu emva koko kufuneka bathethe nogqirha wabo ukumisela isigaba esilandelayo sonyango.

Kuthatha ixesha elingakanani ngaphambi kokuzilolonga?

• Ukubuyela kwindawo yokuzivocavoca okanye ukungena kwindawo yokuzivocavoca kuya kuthatha ixesha. Kubalulekile ukulandela iingcebiso zikagqirha kwaye ugqibezele ikhosi epheleleyo yonyango lomzimba phambi kokuba umthambo rhoqo uqalise. Xoxa ngezicwangciso zokuzilolonga nogqirha ukumisela elona xesha lifanelekileyo lomqolo.

Ngaba uchache ngokupheleleyo?

• Ukubuyela kumsebenzi othile kunokwenzeka malunga neeveki ezine emva kotyando. Ukuchacha ngokupheleleyo kuthatha ixesha elide njengoko ukuchacha kwesigulana ngasinye kukodwa. Kuxhomekeke kubunzima botyando, uninzi lubuyela kuyo yonke imisebenzi ngaphakathi kweenyanga ezi-6 ukuya kwezi-9.

---

Ubume boMzimba oBonakalayo

---

 

UGqr Alex Jimenez's Iposti yeBlog

Ubungakanani bolwazi lwethu lukhawulelwe kwi-chiropractic, musculoskeletal, amayeza omzimba, impilo, kunye nemicimbi yezempilo ebuthathaka kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo. Sisebenzisa iinkqubo zempilo kunye nezempilo ukunyanga kunye nenkxaso yokhathalelo lokonzakala okanye ukuphazamiseka kwenkqubo yemisipha. Izithuba zethu, izihloko, izifundo, kunye nokuqonda kugubungela imicimbi yeklinikhi, imiba kunye nezihloko ezinxulumene nokuxhasa ngokuthe ngqo okanye ngokungathanga ngqo kwinqanaba lethu lonyango. * Iofisi yethu yenze iinzame ezifanelekileyo zokubonelela ngeziqendu ezixhasayo kwaye ichonge uphando olufanelekileyo okanye izifundo ezixhasa izithuba zethu. Senza ikopi yezifundo zophando ezixhasayo ukuba zifumaneke ebhodini nakuluntu xa kuceliwe. Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo malunga nendlela enokunceda ngayo kwisicwangciso esithile sokhathalelo okanye kwinkqubo yonyango; Ke, ukuqhubeka nokuxoxa ngalo mbandela ungentla, nceda ukhululeke ukubuza uGqirha Alex Jimenez okanye unxibelelane nathi apha 915-850-0900. Umboneleli (s) unelayisensi eTexas naseNew Mexico *

Ucaphulo

Umbutho waseMelika wooGqirha beNeurological. �Utyando loMnqonqo oluNgamandla.� (nd)�www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Minimally-Invasive-Spine-Surgery Foraminotomy. I-MedlinePlus. medlineplus.gov/ency/article/007390.htm. Ukuhlaziywa ngoNovemba 27, 2016. Iphepha lokugqibela ukuhlaziywa ngoDisemba 21, 2017. Ifikeleleke ngoJanuwari 18, 2018. I-Laminectomy. medlineplus.gov/ency/article/007389.htm. I-MedlinePlus. Ukuhlaziywa ngoNovemba 27, 2016. Iphepha lokugqibela ukuhlaziywa ngoDisemba 21, 2017. Ifikeleleke ngoJanuwari 18, 2018. Iklinikhi yaseMayo. �Laminectomy.� (nd)�www.mayoclinic.org/tests-procedures/laminectomy/about/pac-20394533 Iklinikhi yaseMayo. �Laminotomy.� (nd)�www.mayoclinic.org/diseases-conditions/spinal-stenosis/multimedia/img-20149227