Ukushintshwa kwediski - umgogodla we-lumbar

I-Lumbar spine disk replacement ukuhlinzwa kwendawo engezansi emuva (lumbar). Kwenziwa ukwelapha izinkinga zomgogodla noma izinkinga zediski futhi kuvunyelwe ukunyakaza okujwayelekile komgogodla.

I-spinal stenosis ikhona lapho:

• Isikhala sekholomu yomgogodla sinciphile.
• Ukuvuleka kwezimpande zezinzwa okushiya ikholomu yomgogodla kuba mncane, kubeka ingcindezi kule nerve.

Ngesikhathi sokufakwa ngokuphelele kwediski (i-TDR), ingxenye yangaphakathi yediski yomgogodla eyonakele ithathelwa indawo yidiski yokufakelwa ukubuyisa ukunyakaza okujwayelekile komgogodla.

Imvamisa, ukuhlinzeka kwenziwa nge-disk eyodwa kuphela, kepha kwesinye isikhathi, amazinga amabili asondelene angahle athathelwe indawo.

Ukuhlinzwa kwenziwa ngaphansi kwe-anesthesia ejwayelekile. Uzobe ulele ungezwa buhlungu.

Ngesikhathi sokuhlinzwa:

• Uzolala ngomhlane etafuleni lokusebenza.
• Izingalo zakho zigxiliwe endololwaneni futhi zisongwe phambi kwesifuba sakho.
• Udokotela wakho ohlinzayo usika (usike) esiswini sakho. Ukwenza ukuhlinzeka ngesisu kuvumela udokotela ohlinzayo ukuthi afinyelele umgogodla ngaphandle kokuphazamisa izinzwa zomgogodla.
• Izitho zamathumbu nemithambo yegazi kuyiswa ohlangothini ukuthola ukufinyelela kumgogodla.
• Udokotela wakho ohlinzayo ususa ingxenye eyonakele yediski bese ebeka idiski yokufakelwa entsha endaweni yayo.
• Zonke izitho zibuyiselwa endaweni yazo.
• Imbobo ivaliwe ngemithungo.

Ukuhlinzwa kuthatha amahora amabili ukuqeda.

Ama-disk afana ne-Cushion asiza umgogodla ukuthi uhlale umakhalekhukhwini. Imithambo endaweni yomgogodla ephansi iyacindezelwa ngenxa:

• Ukuncipha kwediski ngenxa yokulimala okudala
• Ukuqhuma kwediski (protrusion)
• I-arthritis evela emgogodleni wakho

Ukuhlinzwa kwe-spinal stenosis kungacatshangelwa uma unezimpawu ezinzima eziphazamisa impilo yakho yansuku zonke futhi ungathuthuki nolunye ukwelashwa. Izimpawu zivame ukufaka:

• Ubuhlungu obungase buzwakale ethangeni lakho, inkonyane, iqolo elingezansi, ihlombe, izingalo noma izandla. Ubuhlungu buvame ukujula futhi buhlale buqinile.
• Ubuhlungu lapho wenza imisebenzi ethile noma uhambisa umzimba wakho ngendlela ethile.
• Ubundikindiki, ukuncinza, nobuthakathaka bemisipha.
• Ubunzima ngokulinganisela nokuhamba.
• Ukulahlekelwa yisinye noma ukulawulwa kwamathumbu.

Khuluma nomhlinzeki wakho wezokunakekelwa kwempilo mayelana nokuthi ukuhlinzwa kukulungele yini. Akuwona wonke umuntu onezinhlungu ezisezingeni eliphansi odinga ukuhlinzwa. Iningi labantu liphathwa kuqala ngemithi, ukwelashwa ngokomzimba, nokuzivocavoca umzimba ukukhulula izinhlungu zasemhlane.

Ngesikhathi sokuhlinzwa kwendabuko komgogodla we-spinal stenosis, udokotela ohlinzayo uzodinga ukuhlanganisa amanye amathambo asemgogodleni wakho ukuze umgogodla wakho uzinze. Ngenxa yalokhu, ezinye izingxenye zomgogodla wakho ngezansi nangaphezulu kwe-fusion kungenzeka zibe nezinkinga zediski ngokuzayo.

Ngokuhlinzwa okufakwa esikhundleni sediski, akukho fusion edingekayo. Ngenxa yalokhu, umgogodla ngenhla nangaphansi kwesiza sokuhlinzwa usalondolozile ukunyakaza. Lokhu kuhamba kungasiza ekuvikeleni ezinye izinkinga zediski.

Ungase ubhekele ukuhlinzekwa kokufakwa esikhundleni sediski uma okulandelayo kuyiqiniso:

• Awukhuluphele kakhulu.
• Izinga elilodwa noma amabili kuphela omgogodla wakho onale nkinga nezinye izindawo azizange.
• Awunayo i-arthritis eningi emalungeni omgogodla wakho.
• Awukaze uhlinzwe umgogodla esikhathini esedlule.
• Awunayo ingcindezi enkulu emithanjeni yomgogodla wakho.
  

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela okweqile emithini
• Izinkinga zokuphefumula
• Ukopha, amahlule, nokutheleleka

Izingozi ze-TDR yilezi:

• Khulisa ebuhlungu emuva
• Kunzima nokunyakaza
• Ukulimala emathunjini
• Ukuqina kwegazi emilenzeni
• Ukwakheka kwamathambo okungajwayelekile emisipheni nasemathanjeni azungeze umgogodla
• Ukungasebenzi ngokocansi (okuvame kakhulu emadodeni)
• Ukulimala kwe-ureter nesinye
• Ukutheleleka endaweni yokuhlinzwa
• Ukwephuka kwediski lokufakelwa
• Idiski lokufakelwa lingasuka endaweni
• Ukuxega kokufakwa
• Ukukhubazeka

Umhlinzeki wakho uzo-oda ukuhlolwa kwe-imaging njenge-MRI, i-CT scan, noma i-x-ray ukuhlola ukuthi udinga ukuhlinzwa yini.

Umhlinzeki wakho uzofuna ukwazi uma:

• Bakhulelwe
• Uthatha noma yimiphi imithi, izithasiselo, noma amakhambi
• Ingabe unesifo sikashukela, unesifo sikashukela, noma unanoma yisiphi esinye isimo sezokwelapha
• Uyabhema

Tshela umhlinzeki wakho ukuthi iyiphi imithi oyiphuzayo. Lokhu kufaka phakathi imithi, izithasiselo, noma amakhambi owathengile ngaphandle kwemithi kadokotela.

Phakathi nezinsuku ngaphambi kokuhlinzwa:

• Lungisa ikhaya lakho uma uzophuma esibhedlela.
• Uma ubhema, udinga ukuyeka. Abantu abane-TDR futhi abaqhubeka nokubhema kungenzeka bangapholi futhi. Buza udokotela wakho usizo lokuyeka.
• Isonto elilodwa ngaphambi kokuhlinzwa, umhlinzeki wakho angakucela ukuthi uyeke ukuthatha imithi eyenza kube nzima ngegazi lakho ukuminyana. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn).
• Uma unesifo sikashukela, isifo senhliziyo, noma ezinye izinkinga zezokwelapha, udokotela wakho ohlinzayo uzokucela ukuthi ubonane nodokotela wakho ojwayelekile.
• Khuluma nodokotela wakho uma uphuze kakhulu utshwala.
• Buza udokotela wakho ukuthi imiphi imithi okufanele usayiphuza ngosuku lokuhlinzwa.
• Vumela udokotela wakho azi ngokushesha uma uthola umkhuhlane, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma ezinye izifo onazo.
• Ungahle ufune ukuvakashela owelapha ngokomzimba ukuze ufunde izivivinyo okufanele uzenze ngaphambi kokuhlinzwa.

Ngosuku lokuhlinzwa:

• Landela imiyalelo yokuthi ungaphuzi noma ungadli lutho ngaphambi kwenqubo. Lokhu kungaba amahora ayisithupha kuya kwayi-12 ngaphambi kokuhlinzwa.
• Thatha imithi udokotela wakho akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Umhlinzeki wakho uzokutshela ukuthi ufika nini esibhedlela. Qiniseka ukuthi ufika ngesikhathi.

Uzohlala esibhedlela izinsuku ezimbili kuya kwezi-3 ngemuva kokuhlinzwa. Umhlinzeki wakho uzokukhuthaza ukuthi ume futhi uqale ukuhamba ngokushesha lapho i-anesthesia iphela. Kungase kudingeke ukuthi ugqoke i-corset brace yokusekelwa nokuphulukiswa ngokushesha. Ekuqaleni, uzonikezwa iziphuzo ezicacile. Ngokuhamba kwesikhathi uzoqhubekela ekudleni oketshezi nokuqinile.

Umhlinzeki wakho uzokucela ukuthi:

• Yenza noma yimuphi umsebenzi owelula umgogodla wakho ngokweqile
• Bamba iqhaza emisebenzini ebandakanya ukugoqa, ukugoba, nokusonta njengokushayela nokuphakamisa izinto ezisindayo okungenani izinyanga ezintathu ngemuva kokuhlinzwa

Landela imiyalo yokuthi unganakekela kanjani emuva kwakho ekhaya.

Kungenzeka ubuyele emisebenzini ejwayelekile ezinyangeni ezintathu ngemuva kokuhlinzwa.

Ubungozi bezinkinga buphansi ngemuva kokushintshwa kwe-lumbar disk. Ukuhlinzwa kuvame ukuthuthukisa ukunyakaza komgogodla kangcono kunezinye (ukuhlinzwa komgogodla). Kuyindlela ephephile futhi ukukhululeka kobuhlungu kwenzeka ngokushesha ngemuva kokuhlinzwa. Ingozi yokulimala kwemisipha yomgogodla (paravertebral muscle) ingaphansi kunezinye izinhlobo zokuhlinzwa komgogodla.

I-Lumbar disk arthroplasty; I-arthroplasty yediski ye-Thoracic; Ukufaka esikhundleni sediski lokufakelwa; Inani lediski elizongena esikhundleni; TDR; I-disc arthroplasty; Ukufaka esikhundleni sediski; Idiski yokufakelwa

• Ama-vertebrae emilenzeni
• Idiski ye-intervertebral
• I-spinal stenosis

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IGardocki RJ, iPaki AL. Ukuphazamiseka okwehlayo komgogodla we-thoracic ne-lumbar. Ku: Azar FM, Beaty JH, ama-eds. I-Operational Orthopedics yaseCampbell. Umhlaka 14. IPhiladelphia, PA: Elsevier; 2021: isahluko 39.

UJohnson R, uGuyer RD. Ukwehla kwe-Lumbar disc: Ukuhlangana kwangaphambili kwe-lumbar interbody, ukonakala, nokushintshwa kwediski. Ku: Garfin SR, Eismont FJ, Bell GR, Fischgrund JS, Bono CM, abahleli. URothman-Simeone noHerkowitz ethi The Spine. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 49.

UVialle E, uSantos de Moraes OJ. I-Lumbar arthroplasty. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans ne-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 322.

UZigler J, Gornet MF, uFerko N, uCameron C, uSchranck FW, uPatel L. Ukuqhathaniswa kwe-lumbar total disc replacement ne-spinal fusion yokuhlinza yokwelapha isifo se-disc esiwohlokayo esisodwa: ukuhlaziywa kwe-meta kwemiphumela yeminyaka emi-5 evela kokungahleliwe izilingo ezilawulwayo. IGlobal Spine J. 2018; 8 (4): 413-423. I-PMID: 29977727 kushicilelwe.ncbi.nlm.nih.gov/29977727/.