Ukuhlukumezeka kwentambo yomgogodla

Ukuhlukumezeka kwentambo yomgogodla kulimaza umgogodla. Kungabangelwa ukulimala ngqo entanjeni uqobo noma ngokungaqondile kusuka ezifweni zamathambo aseduze, izicubu, noma imithambo yegazi.

Intambo yomgogodla iqukethe imicu yezinzwa. Le micu yezinzwa ithwala imiyalezo phakathi kobuchopho bakho nomzimba wakho. Umgogodla udlula emgodini womgogodla womgogodla wakho entanyeni yakho bese ubuyela emuva ku-vertebra yokuqala ye-lumbar.

Ukulimala komgogodla (SCI) kungadalwa nganoma yikuphi okulandelayo:

• Ukuhlaselwa
• Ukuwa
• Amanxeba okudutshulwa
• Izingozi zezimboni
• Izingozi zezimoto (ama-MVAs)
• Ukutshuza emanzini
• Ukulimala kwezemidlalo

Ukulimala okuncane kungalimaza umgogodla. Izimo ezinjenge-rheumatoid arthritis noma i-osteoporosis zinganciphisa umgogodla, ovame ukuvikela umgogodla. Ukulimala kungenzeka futhi uma umgudu womgogodla ovikela intambo yomgogodla ube mncane kakhulu (umgogodla wokuqina). Lokhu kwenzeka ngesikhathi sokuguga okujwayelekile.

Ukulimala okuqondile noma ukulimala kwentambo yomgogodla kungenzeka ngenxa:

• Imihuzuko uma amathambo enziwe buthaka, axega, noma aqhekeka
• I-Disc herniation (lapho i-disc iqhubekela emgogodleni)
• Izingcezu zethambo (njengalezo eziphuma kuma-vertebrae aphukile, okungamathambo omgogodla) entanjeni yomgogodla
• Izicucu zensimbi (ezinjengengozi yethrafikhi noma ukuqhuma kwesibhamu)
• Ukudonsa eceleni noma ukucindezela noma ukucindezela kusuka ekusonteni ikhanda, intamo noma emuva ngesikhathi sengozi noma ukukhohlisa okukhulu kwe-chiropractic
• Umsele oqinile womgogodla (i-spinal stenosis) ocindezela umgogodla

Ukopha, ukwakheka koketshezi, nokuvuvukala kungenzeka ngaphakathi noma ngaphandle komgogodla (kepha ngaphakathi komgogodla womgogodla). Lokhu kungacindezela intambo yomgogodla bese kuyilimaza.

Ama-SCI amaningi anomthelela omkhulu, njengezingozi zezimoto noma ukulimala kwezemidlalo, abonakala kubantu abasha, abanempilo. Abesilisa abaneminyaka engu-15 kuya ku-35 bavame ukuthinteka.

Izici zobungozi zifaka:

• Ukubamba iqhaza emisebenzini eyingozi yomzimba
• Ukugibela noma ukuhamba ngezimoto ezinejubane
• Ukuntywila emanzini angajulile

I-SCI yomthelela ophansi ivame ukuvela kubantu abadala kusukela ekuweni ngenkathi bemi noma behleli. Ukulimala kungenxa yomgogodla obuthakathaka kusuka ekugugeni noma ekulahlekelweni kwethambo (i-osteoporosis) noma i-spinal stenosis.

Izimpawu ziyahlukahluka, kuya ngendawo yokulimala. I-SCI ibangela ubuthakathaka nokulahlekelwa umuzwa, nangaphansi kokulimala. Ukuthi izimpawu ziqine kangakanani kuncike ekutheni intambo yonke ilimale kabi (iphelele) noma ilimale kancane (ayiphelele).

Ukulimala ngaphansi nangaphansi kwe-vertebra yokuqala ye-lumbar akubangeli i-SCI. Kepha kungadala i-cauda equina syndrome, okulimaza izimpande zemizwa. Ukulimala okuningi komgogodla kanye ne-cauda equina syndrome yizimo eziphuthumayo zezokwelapha futhi zidinga ukuhlinzwa khona manjalo.

Ukulimala kwentambo yomgogodla kunoma yiliphi izinga kungadala:

• Ukwandisa ithoni yemisipha (ukuqina)
• Ukuphulukana nokulawulwa kwamathumbu okujwayelekile kanye nesinye (kungafaka ukuqunjelwa, ukungakwazi ukuzibamba, ukuqunjelwa kwesinye)
• Ubudikadika
• Izinguquko ezibucayi
• Ubuhlungu
• Ubuthakathaka, ukukhubazeka
• Ukuphefumula kanzima ngenxa yobuthakathaka besisu, isisu, noma imisipha ye-intercostal (ubambo)

UKULIMALA KWESIBOPHELELE (INTAMO)

Lapho ukulimala komgogodla kusendaweni yentamo, izimpawu zingathinta izingalo, imilenze, naphakathi komzimba. Izimpawu:

• Kungenzeka ezinhlangothini noma zombili zomzimba
• Kungabandakanya izinkinga zokuphefumula kusuka ekukhubazekeni kwemisipha yokuphefumula, uma ukulimala kuphezulu entanyeni

UKULIMALA KWETHORACIC (CHEST LEVEL)

Lapho ukulimala komgogodla kusezingeni lesifuba, izimpawu zingathinta imilenze. Ukulimala komgogodla wesibeletho noma umgogodla ophakeme we-thoracic nakho kungaholela ku:

• Izinkinga zomfutho wegazi (ziphezulu kakhulu futhi ziphansi kakhulu)
• Ukujuluka okungavamile
• Inkinga yokugcina ukushisa okuvamile

UKULIMALA KWE-LUMBAR (KUNCANE EMUVA)

Lapho ukulimala komgogodla kusezingeni eliphansi emuva, izimpawu zingathinta umlenze owodwa noma yomibili. Imisipha elawula amathumbu nesinye nayo ingathinteka. Ukulimala komgogodla kungalimaza intambo yomgogodla uma kusengxenyeni engenhla yomgogodla we-lumbar noma izimpande ze-lumbar kanye ne-sacral nerve (cauda equina) uma zisemgogodleni ophansi we-lumbar.

I-SCI yisimo esiphuthumayo sezokwelapha esidinga ukunakekelwa kwezokwelapha khona manjalo.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza isivivinyo somzimba, kufaka phakathi ukuhlolwa kobuchopho nohlelo lwezinzwa (i-neurological). Lokhu kuzosiza ukukhomba ukuthi ikuphi ngempela ukulimala, uma kungaziwa.

Eminye yemiqondo ebucayi ingahle ingajwayelekile noma ilahleke. Lapho ukuvuvukala kwehla, ezinye izingqondo zingalulama kancane kancane.

Izivivinyo ezinga-odwa zifaka:

• I-CT scan noma i-MRI yomgogodla
• I-Myelogram (i-x-ray yomgogodla ngemuva kokujova udayi)
• I-X-ray yomgogodla
• I-Electromyography (EMG)
• Izifundo zokuqhuba izinzwa
• Ukuhlolwa komsebenzi wePulmonary
• Ukuhlolwa komsebenzi wesinye

I-SCI idinga ukwelashwa ngokushesha ezimweni eziningi. Isikhathi esiphakathi kokulimala nokwelashwa singathinta umphumela.

Imithi ebizwa nge-corticosteroids kwesinye isikhathi isetshenziswa emahoreni ambalwa okuqala ngemuva kwe-SCI ukunciphisa ukuvuvukala okungalimaza umgogodla.

Uma ingcindezi yomgogodla ingancipha noma yehliswe ngaphambi kokuba izinzwa zomgogodla zibhujiswe ngokuphelele, ukukhubazeka kungathuthuka.

Ukuhlinzwa kungadingeka ukuze:

• Hlela kabusha amathambo omgogodla (i-vertebrae)
• Susa uketshezi, igazi, noma izicubu ezicindezela emthonjeni womgogodla (decompression laminectomy)
• Susa izingcezu zamathambo, izingcezu zediski, noma izinto zangaphandle
• Fuse amathambo omgogodla aphukile noma ubeke izinsimbi zomgogodla

Ukuphumula kombhede kungadingeka ukuvumela amathambo omgogodla ukuthi aphole.

Ukudonswa komgogodla kungaphakanyiswa. Lokhu kungasiza ukugcina umgogodla unganyakazi. Ugebhezi lungabanjelwa endaweni ngezidladla. Lezi izinsimbi zensimbi ezibekwe kugebhezi bese zinamathiselwa ezinsimbini noma kwihhanisi emzimbeni (i-halo vest). Ungadinga ukugqoka izinsimbi zomgogodla noma ukhololo wesibeletho izinyanga eziningi.

Ithimba lezokunakekelwa kwempilo lizophinde likutshele ukuthi wenzeni lapho kunqamuka izicubu zomzimba nokukhubazeka kwamathumbu nesinye. Zizokufundisa nokuthi ungasinakekela kanjani isikhumba sakho futhi usivikele ezilondeni zengcindezi.

Cishe uzodinga ukwelashwa ngokomzimba, ukwelashwa emsebenzini, kanye nolunye uhlelo lokuvuselela ngemuva kokulimala seluphilile. Ukuvuselelwa kuzokusiza ukubhekana nokukhubazeka okuvela kwi-SCI yakho.

Ungadinga izinciphisi zegazi ukuvikela amahlule egazini emilenzeni yakho noma emithini ukuvikela izifo ezifana nokutheleleka ngomgudu womchamo.

Funa izinhlangano ngolwazi olungeziwe nge-SCI. Bangakunikeza ukwesekwa njengoba ululama.

Ukuthi umuntu wenza kahle kangakanani kuya ngezinga lokulimala. Ukulimala emgogodleni ophezulu (wesibeletho) kuholela ekukhubazekeni okuningi kunokulimala emgogodleni ophansi (we-thoracic noma we-lumbar).

Ukukhubazeka nokulahlekelwa ukuzwa kwengxenye yomzimba kuvamile. Lokhu kufaka ukukhubazeka okuphelele noma ukuba ndikindiki, nokulahleka kokunyakaza nokuzizwa. Ukufa kungenzeka, ikakhulukazi uma kunokukhubazeka kwemisipha yokuphefumula.

Umuntu olulama ukunyakaza okuthile noma ukuzizwa kungakapheli isonto eli-1 uvame ukuba sethubeni elihle lokuthola umsebenzi owengeziwe, noma lokhu kungathatha izinyanga eziyisithupha noma ngaphezulu. Ukulahleka okusele ngemuva kwezinyanga eziyi-6 kunamathuba amaningi okuba ngunaphakade.

Ukunakekelwa kwamathumbu okuvamile kuvame ukuthatha ihora elilodwa noma ngaphezulu usuku ngalunye. Iningi labantu abane-SCI kumele lenze i-catheterization yesinye njalo.

Ikhaya lomuntu ngokuvamile lizodinga ukuguqulwa.

Iningi labantu abane-SCI bahamba ngesihlalo sabakhubazekile noma badinga amadivayisi okusiza ukuzulazula.

Ucwaningo emkhakheni wokulimala komgogodla luyaqhubeka, futhi kubikwa okutholakele okuthembisayo.

Okulandelayo kungenzeka kube nezinkinga ze-SCI:

• Izinguquko zengcindezi yegazi ezingaba ngokweqile (i-autonomic hyperreflexia)
• Ingozi eyengeziwe yokulimala ezindaweni eziyindikimba zomzimba
• Ingozi eyengeziwe yokutheleleka ngomgudu womchamo
• Isifo sezinso sesikhathi eside
• Ukulahlekelwa isinye nokulawulwa kwamathumbu
• Ukulahleka komsebenzi wezocansi
• Ukukhubazeka kwemisipha yokuphefumula nezitho (paraplegia, quadriplegia)
• Izinkinga ngenxa yokungakwazi ukuhamba, njenge-vein thrombosis ejulile, ukutheleleka kwamaphaphu, ukuwohloka kwesikhumba (izilonda zengcindezi), nokuqina kwemisipha
• Ukushaqeka
• Ukucindezeleka

Abantu abahlala ekhaya abane-SCI kufanele benze okulandelayo ukuvimbela izinkinga:

• Thola ukunakekelwa kwamaphaphu (amaphaphu) usuku ngalunye (uma bekudinga).
• Landela yonke imiyalo yokunakekelwa kwesinye ukuze ugweme ukutheleleka nokulimala kwezinso.
• Landela yonke imiyalo yokunakekelwa kwesilonda okujwayelekile ukuze ugweme izilonda zengcindezi.
• Gcina imigomo isesikhathini.
• Gcina ukuvakashelwa kwezempilo okujwayelekile nodokotela wabo.

Shayela umhlinzeki wakho uma ulimele emuva noma entanyeni. Shayela ku-911 noma inombolo ephuthumayo yendawo uma ulahlekelwa ukunyakaza noma umuzwa. Lesi yisimo esiphuthumayo sezokwelapha.

Ukuphatha i-SCI kuqala endaweni yengozi. Izimo eziphuthumayo eziqeqeshiwe zikhubaza umgogodla olimele ukuvimbela ukulimala okuqhubekayo kwesistimu yezinzwa.

Umuntu okungenzeka abe ne-SCI akufanele asuswe ngaphandle uma esengozini ngokushesha.

Izinyathelo ezilandelayo zingasiza ekuvikeleni ama-SCIs:

• Izindlela zokuphepha ezifanele ngesikhathi somsebenzi nokudlala zingavimbela ukulimala komgogodla okuningi. Sebenzisa okokuvikela kunoma yimuphi umsebenzi lapho kwenzeka khona ukulimala.
• Ukuntywila emanzini angajulile kuyimbangela enkulu yokuhlukumezeka komgogodla. Hlola ukujula kwamanzi ngaphambi kokuntywila, bese ubheka amatshe noma ezinye izinto ezikhona endleleni.
• Ibhola ne-sledding kungabandakanya ukushaywa okucijile noma ukusonteka okungafani nokugoba emuva noma entanyeni, okungadala i-SCI. Ngaphambi kokudonsa izihlibhi, ukushushuluza noma ukushibilika eqhweni phansi egqumeni, hlola indawo ngezithiyo. Sebenzisa amasu nemishini efanele lapho udlala ibhola noma eminye imidlalo yokuxhumana.
• Ukushayela okuvikelayo nokufaka ibhande lesihlalo kunciphisa ubungozi bokulimala kanzima uma kunengozi yemoto.
• Faka futhi usebenzise imigoqo yokubamba endlini yokugezela, nezinsimbi zokubopha eceleni kwezitebhisi ukuvimbela ukuwa.
• Abantu abanobhalansi obubi bangadinga ukusebenzisa i-walker noma umoba.
• Imikhawulo yejubane lomgwaqo kufanele ibonwe. Ungaphuzi bese ushayela.

Ukulimala komgogodla; Ukuminyanisa kwentambo yomgogodla; I-SCI; Ukucindezelwa kwentambo

• Ukuvimbela izilonda zengcindezi

• Vertebrae
• Cauda equina
• I-Vertebra nezinzwa zomgogodla

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I-National Institute of Neurological Disorders and Stroke iwebhusayithi. Ukulimala komgogodla: ithemba ngocwaningo. www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Spinal-Cord-Injury-Hope-Through-Research#3233. Kubuyekezwe uFebhuwari 8, 2017. Kufinyelelwe kuMeyi 28, 2018.

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