Ukwelashwa kwe-hernia ye-intervertebral (umgogodla we-lumbosacral). Ukuhlinzwa ukukhipha umlando wakhe we-intervertebral

Izinkinga ngomgogodla zihlupha abantu abaningi. Abanye abantu, ngenxa yomsebenzi onzima, bathuthukisa isimo esinjengomlando wakhe we-intervertebral we-lumbosacral umgogodla.

Kuyini?

I-hernia ye-intervertebral ivame ukubizwa ngokuthi yisimo esibi, lapho i-disc intervertebral isuka khona indiza yomgogodla. Ngokuvamile, lesi simo siqala ngenxa yomthwalo okhudlwana emgqeni wamagogasi.

Ukuhlushwa kulesi sifo ikakhulukazi amadoda aphakathi kweminyaka engama-20 kuya ku-50.

Isifo salesi sifo singamacala angu-100 kubantu abayi-100 000 ngonyaka.

Iningi lala ma-hernias avela ngenxa yokweqa ngokweqile komgogodla ngenxa yomsebenzi. Ukubonakaliswa okubonakalayo kwe-hernia ebulalayo ngemva kokuhlinzwa emgqeni wamagogasi noma ngenxa yesilonda. Ngokuvamile, kodwa kunomlando wakhe wokuzalwa otholile.

Kubantu asebekhulile kunezimo zokuthuthukiswa kwe-hernias ngemuva kokubuthakathaka ngokomzimba kwemigqa yomgogodla.

Okuvame kakhulu ukuthi i- hernia intervertebral yomgogodla we-lumbosacral, ngoba emuva okuphansi kuyindawo engozini kakhulu ekuthuthukiseni lesi sifo.

I-Pathogenesis yokuthuthukiswa kwe-hernia

Ngaphansi kwethonya lomthwalo ophezulu emgqeni wamagogasi, i- disc intervertebral igxilile kancane kancane. Ngenxa yalokhu, umgqomo wendandatho yangaphandle (i-outer fibrous ring) ivame ukuphuka, emva kwalokho okuqukethwe kwe-disk intervertebral kuphuma ngaphandle.

I-nucleus ekhishweyo ekhishwe ingasuswa endaweni yombili emgodini womgogodla, nasezinhlangothini zayo. Esikhathini sokuqala, ukwephulwa kwentambo yomgogodla kuvela, okungabangela imiphumela engaphenduki. Esikhathini sesibili, i-radicular syndrome ingathuthuka ngenxa yokucindezelwa kwemizwa ephuma emthonjeni womgogodla. Endaweni yokucindezela, ukuvuvukala kwe-aseptic kuyaqala, kukhona ukuvuvukala kwezicubu ezizungezile, okuqhubeka kube nzima nakakhulu.

Ngenxa yalokho, i-hernia ye-intervertebral ibonakala ngezibonakaliso ze-radicular syndrome (ubuhlungu, ukukhathazeka kobuzwe nokusebenza komzimba). Ngokuhamba kwesikhathi, ukuhamba kwikholomu yomgogodla kuphelelwe amandla.

Ngokusobala, indawo lapho imithwalo ye-intervertebral evame ukuvela khona iminyango ye-lumbosacral. Ukwelashwa kufanele kubelwe ngokushesha nje uma i-disk offset itholakala.

Ukwelapha

Kungakhathaliseki ukuthi yikuphi, ngokushesha uqale ukwelashwa kwe-hernia ye-intervertebral. Umgogodla we-lumbosacral wenza umsebenzi oqakathekile kakhulu wokulinganisa umzimba nokulondoloza izitho endaweni eqondile. Ngokuthuthukiswa kwe-hernia esifundeni se-lumbar, lo msebenzi uba nzima ngokwengeziwe ngenxa yesifo esibuhlungu esibuhlungu lapho kuqhutshwa izinzwa. Lesi simo sikhuliswa ukwelashwa okungahambi kahle kwabanye odokotela.

Uma izimpawu zokuqala zivela, masinyane uqale ukwelashwa kwe-hernia ye-intervertebral. Umgogodla we-lumbosacral uphendula kahle ezindleleni ezinjalo ezingezona zokwelapha njengokusetshenziswa kwamagumbi omzimba we-orthopedic, ukusikhipha, ukusetshenziselwa ukucindezeleka okubandayo. Lezi zindlela zinezimpawu ezibonakalayo (ukulungisa isimo sesiguli) futhi zingasetshenziswa isikhathi esithile ukugwema izinkinga ze-hernia. Ngokwehlukumeza isimo, kuyisifiso sokwenza ngokushesha i-aphoyintimenti ne-neurologist.

Ukwelashwa kwezidakamizwa

Uma ngabe kunjalo, i-intervertebral hernia iye yahlakulela, indlela yokuphatha ngayo ukuze ingalimazi umzimba wayo? Ukuze wenze lokhu, sebenzisa izidakamizwa ezilwa nokuvuvukala kusukela eqenjini lama-non-steroid agents. Okuvamile kakhulu kwakuyi-ointments, ama-gel kanye nama-creams. Ngokuvamile ziqukethe i- "Diclofenac" ("Rumakar", "Diclobert"), "Indomethacin" ("Metindol", "Rumacid"). Ukugxila kwezidakamizwa kulezi zidakamizwa kukuvumela ukukhipha ubuhlungu obukhulu be-syndrome nokuvuvukala (noma kunjalo, ukuthatha umthamo ofanayo wezidakamizwa ngaphakathi kungase kungabi nomphumela omuhle, futhi kubangele ekuthuthukiseni isilonda esiswini noma isilonda se-duodenal 12).

Kungenzeka ukuhlanganisa izidakamizwa ezingekho-steroidal anti-inflammatory nge glucocorticoids.

I-glucocorticoids ilawulwa ngokuqondile noma nge-intravenously ngomphumela osheshayo. Izidakamizwa ezisetshenziswa njengePrednisolone noDexamethasone. Ukwelapha nge-glucocorticoids kufanele kubekwe kuphela uma i-NSAID ingasebenzi, njengoba ukwemukelwa kwe-long-term corticosteroids kwenza umzimba ube nengozi kakhulu kunokuhle.

I-Physiotherapy ekwelapheni ikholomu ye-vertebral yakhe

Esikhathini sesibili ngokwemvamisa yokusetshenziswa ukuphathwa kwe-physiotherapeutic we-hernia ye-intervertebral. Umgogodla we-lumbosacral ungenye yeminyango efinyeleleka kakhulu yesistimu ye-musculoskeletal yokusetshenziswa kwezixhobo ezahlukene.

Ngokombiko abaningi, i-physiotherapy ingabangela ukutholakala ngokushesha, kunokusebenzisa imithi.

Njengamanje, indlela ephumelela kakhulu yokwelapha i-intervertebral hernias ukusetshenziswa kwama-multi-functional electrodes. Okuyinhloko yale nqubo ukuphazanyiswa kwemizwa engenayo ebuhlungu ngokusebenzisa amagagasi omsakazo.

Kwezindlela ezidume kakhulu, i-electrophoresis ene-analgesics, ibheji yokwelashwa, kanye nokwelashwa kwama-laser ngokuvamile kuvame ukusetshenziswa. I-Electrophoresis ne-phonophoresis bavumela ukulethwa kwezidakamizwa ngqo emgodini. Umphumela uvame ukubonakala emva kwezinqubo ezimbalwa.

Ukuphumula okugeza okushisayo kwamanye amacala kungasiza ekwenzeni ukugcinwa kwe-hernia ngokuzenzekelayo endaweni.

Uma kukhona isimo esibucayi, naphezu kwezinyathelo ezithathwe, isifo se-herver intervertebral sesicindezeleke kakhulu. Indlela yokuphatha ngayo lesi simo?

Ukwelapha okuhlinzekwa kwe-hernia ye-intervertebral

Uma ukwelashwa okulindelekile okusetshenzisiwe kungasebenzi noma uma izimpawu ezinkulu ze-neurologic (ukukhubazeka kwesilungu, ukugcoba nokuhlukunyezwa, i-paresis, i-paresthesia, ubuhlungu obukhulu be-syndrome, ubuhlungu endaweni ephezulu ngemuva kwezingxenye eziphansi) kubonakala, ukwelashwa okudingekayo kufanele kuqalwe ngokushesha.

Izinkomba zokwelapha okuphuthumayo ziphulwa komgogodla, ukucindezelwa kwezitsha ezidlula noma ezenzeka eduze.

Ukwelashwa kwenziwa ikakhulukazi eminyangweni ekhethekile yokuhlinzeka (okuvame ukwenziwa nge-neurosurgery).

Phakathi kwezinqubo zokwelashwa ezisetshenziselwa amaqembu amabili amakhulu - ukuhlinzwa okuphelele nokukhishwa kwemithi yendabuko.

Kuncike ekutheni lesi sifo siqhubeka kanjani, thola amaqhinga okufinyelela kokusebenza.

Ukwelashwa kuyadingeka ngaphansi kwe-anesthesia jikelele kanye nokusekelwa kwemisebenzi ebalulekile eyisisekelo.

Ukususwa kwe-Microsurgical

Ngaphambi kokwethulwa kwezinto ezincane ekusebenzeni kwezokwelapha, uma ukwelashwa okuhlinzekwa kwe-hernia intervertebral kuboniswa, isigaba se-lumbosacral somgudu sasivame ukubhekene nezinkinga ezihlukahlukene esikhathini sokulandela (ukuxhaswa, ukuphindaphinda). Ukuguquka kwangempela kwakuwukusetshenziswa kwamathuluzi optical ekwelapheni i-hernias. Lokhu kwavumela ukunciphisa ubukhulu bokutholakala kokusebenza, okuye kwanciphisa kakhulu izigameko zokuthuthukisa izinkinga.

Ngokuvamile, i-herver intervertebral esifundeni se-sacral isuswe ngokukhipha okuncane (i-laminectomy eyenziwa). Ngaphansi kokwanda okukhulu, kungenzeka ukuba ususe ngobumnene ukukhuphuka ngaphandle kokulimaza izicubu eziningana.

Ukuvuselelwa kwesiguli kakade ngosuku olulandelayo. Isiguli sivunyelwe nsuku zonke ukusebenza ngezinsuku ezingu-10, futhi inyanga ngemuva kwalokho angakwazi ukuhlanganyela emsebenzini womuntu ngaphandle kokufaka ingozi.

Ukusebenza kwe-Endoscopic

Lezi zinsuku zokususa i-hernia ye-intervertebral ziyisiqondiso esisheshayo ekuhlinzekeni kwegazi. Ngokuvame kakhulu ukuthi ziqhutshwa ngokusebenzisa izindlela zokugcina ezihamba phambili. Izinzuzo zalezi zindlela ukuphepha okukhulu nakakhulu ekudaleni isilonda sokusebenza (ngezinye izikhathi ukukhishwa kwesikhumba evamile kwenziwa). Kodwa-ke, nalokhu kuyingozi enkulu - kulokhu, amathuba okuqokwa okuphelele kwe-hernia nokukhishwa kwawo kusuka endaweni yokuqhafaza kunqunyelwe. Ama-hernias, noma ama-hernias asebenzayo okunzima, ahambisana nokucindezelwa komgogodla, ngosizo lwemisebenzi enjalo ayisusiwe.

Isiguli sesivele sisekhona ngosuku lapho kwenziwa umsebenzi, khuphuka, hamba. Umsebenzi uvunyelwe cishe ngesonto ngemuva kokukhishwa esibhedlela.

Izinkinga ze-hernias

Ngokuhamba kwesikhathi, uma i-hernia iqala ukucindezela izicubu eziseduze, kungenzeka ukuthuthukiswa kwezinkinga.

Uma i-hernia evamile (i-intervertebral) ithuthukile, isigaba se-lumbosacral asilahleli ngokuphelele umsebenzi wayo, futhi intambo yomgogodla ayithintekile. Konke kubiza lapho i-hernia ishintshela emgodini ongasemgogodleni.

Into eyingozi kunazo zonke ukuphulwa komgogodla. Kule ndaba, imisebenzi yokugcoba nokuhlukumeza iphulwa, okwenza kube yingozi empilweni (ukuphuza ngokweqile, ukuphuka kwesisu, amathumbu kanye nesifo somzimba). Ngaphezu kwalokho, uma ukuvuvukala kudlulela emthonjeni womgogodla, kungenzeka ukulimaza izindawo ezithintekayo ngokuphulwa kwemisebenzi yezitho zangaphakathi, kuze kube nomphumela obulalayo.

Enye inkinga ejwayelekile ye-hernia yi-radicular syndrome. Ukuphila isikhathi eside kudambisa kakhulu isimo.

Izinkinga ezingcono kakhulu ukunciphisa ukuzwela kanye ne-paresthesia.

Ukuvuselelwa nokuvimbela

Ukuthuthukiswa kwe-hernia kuthatha isikhathi esithile (okungukuthi, ngokomzimba kungabizwa ngokuthi yisifo esingelapheki). Uma izincomo eziyinhloko zibhekwa, ukuthuthukiswa kwayo kungavinjelwa.

Ukuze uvimbele ukuphindaphindiwe, ngemuva kokususwa kwe-hernia ye-intervertebral, umthwalo kufanele uhanjiswe ngokufanele ngesikhathi somzimba. Akufanelekile ukusebenza ngokweqile, ngoba kungagcina kabi.

Futhi ukuvimbela ama-hernias, ukuzivocavoca umzimba nokuzivocavoca kunconywa ukuthi kuqinisekiswe isifuba sembuyiselo ye-muscular (isibonelo, ukubulawa kwezinto ezithintekayo nemithwalo enengqondo).

Ngomsebenzi omude futhi onzima wokuvimbela, kunconywa ukuthatha okugeza okuphumuzayo - kubangele ukuhlukana okuncane kwe-vertebrae, okuvimbela i-disc ukuba iphule.

Ukuvuselelwa emva komlando odlule kuhlanganisa ukugwema ukuzivocavoca, ukwelashwa ngokomzimba, ukusikhipha umzimba kanye nokwelashwa kwamathambo noma ama-acupuncture sessions.