Inhlekelele Yokulimala
Ithimba Lokulimala Kwezinzwa Emuva. Imizwa ibuthakathaka futhi ingalinyazwa ukucindezela, ukwelula, noma ukusika. Ukulimala emthanjeni kungamisa izimpawu eziya noma ezibuya ebuchosheni, kubangele ukuthi imisipha ingasebenzi kahle futhi ilahlekelwe umuzwa endaweni elimele. Isimiso sezinzwa silawula iningi lemisebenzi yomzimba, kusukela ekulawuleni ukuphefumula komuntu kuya ekulawuleni imisipha yakhe kanye nokuzwa ukushisa nokubanda. Kodwa, lapho ukuhlukumezeka kokulimala noma isimo esingaphansi kubangela ukulimala kwezinzwa, izinga lokuphila lomuntu lingase lithinteke kakhulu. UDkt. Alex Jimenez uchaza imiqondo ehlukahlukene ngeqoqo lakhe lemibhalo egciniwe ezungeza izinhlobo zokulimala kanye nesimo esingabangela izinkinga zezinzwa kanye nokuxoxa ngezindlela ezahlukene zokwelapha nezixazululo zokunciphisa ubuhlungu bezinzwa nokubuyisela izinga lokuphila lomuntu.
Umshwana Wokuzikhipha Emthwalweni Okuvamile *
Ulwazi olulapha alwenzelwe ukumiselela ubudlelwano bomuntu oyedwa nochwepheshe bezempilo abaqeqeshiwe noma udokotela onelayisensi futhi akusona iseluleko sezokwelapha. Sikukhuthaza ukuthi uzenzele izinqumo zokunakekelwa kwezempilo ngokusekelwe ocwaningweni lwakho kanye nobambiswano nochwepheshe bezempilo abaqeqeshiwe. Ububanzi bethu bolwazi bukhawulelwe ku-chiropractic, musculoskeletal, imithi yenyama, impilo enhle, izindaba zezempilo ezibucayi, izihloko zemithi esebenzayo, izihloko, nezingxoxo. Sihlinzeka futhi sethula ukusebenzisana komtholampilo nochwepheshe abavela emikhakheni eminingi eminingi. Uchwepheshe ngamunye ulawulwa ububanzi bomsebenzi wabo kanye negunya labo lelayisense. Sisebenzisa amaphrothokholi asebenzayo ezempilo nempilo ukuze selaphe futhi sisekele ukunakekelwa kokulimala noma ukuphazamiseka kwesistimu ye-musculoskeletal. Amavidiyo ethu, okuthunyelwe, izihloko, izihloko, kanye nemininingwane ihlanganisa izindaba zomtholampilo, izingqinamba, nezihloko ezihlobene futhi zisekela, ngokuqondile noma ngokungaqondile, ububanzi bokusebenza bethu basemtholampilo.* Ihhovisi lethu lenze umzamo ozwakalayo wokuhlinzeka ngezingcaphuno ezisekelayo futhi likhombe ucwaningo olufanele noma izifundo ezisekela okuthunyelwe kwethu. Sihlinzeka ngamakhophi ocwaningo olusekelayo olutholakala kumabhodi alawulayo kanye nomphakathi uma uwacela.
Siyaqonda ukuthi sihlanganisa izindaba ezidinga incazelo eyengeziwe yokuthi ingasiza kanjani kuhlelo oluthile lokunakekelwa noma inqubo yokwelashwa; ngakho-ke, ukuqhubeka nokuxoxa ngendaba engenhla, sicela ukhululeke ukubuza UDkt. Alex Jimenez noma xhumana nathi 915-850-0900 .
UDkt. Alex Jimenez A.D, I-MSACP , I-CCST , I-IFMCP *, I-CIFM *, I-ATN *
imeyili: qeqeshi@elpasofunctionalmedicine.com
Ilayisensi ku: Texas & New Mexico *
by UDkt Alex Jimenez Inhlekelele Yokulimala , Sciatica
Lapho i-sciatica noma obunye ubuhlungu bezinzwa obukhazimulayo buveza, ingabe ukufunda ukuhlukanisa phakathi kobuhlungu bezinzwa nezinhlobo ezahlukene zobuhlungu kusiza abantu ukuba babone lapho izimpande zemizwa yomgogodla zicasuka noma zicindezelwe noma izinkinga ezinkulu kakhulu ezidinga ukunakekelwa kwezokwelapha?
Izimpande ze-Spinal Neerve and Dermatomes
Izimo zomgogodla ezifana nama-disc herniated kanye ne-stenosis zingaholela ebuhlungu obukhiphayo obuhamba phansi kwengalo eyodwa noma umlenze. Ezinye izimpawu zihlanganisa ubuthakathaka, ukuba ndikindiki, kanye/noma ukudubula noma ukushiswa kwemizwa kagesi. Igama lezokwelapha lezimpawu ze-pinched nerve i-radiculopathy (Izikhungo Zezempilo Zikazwelonke: Isikhungo Sikazwelonke Sezinkinga Zezinzwa Nesifo Sohlangothi. 2020 ). Ama-dermatomes angaba nomthelela ekucasukeni komgogodla, lapho izimpande zezinzwa zibangela izimpawu emhlane nasezithweni.
Anatomy
Umgogodla unezingxenye ezingu-31.
Ingxenye ngayinye inezimpande zezinzwa kwesokudla nakwesokunxele ezinikezela ngemisebenzi ye-motor nezinzwa ezithweni.
Amagatsha okuxhumana angaphambili nangemuva ahlangana ukuze enze izinzwa zomgogodla eziphuma emgodini we-vertebral.
Izingxenye ezingu-31 zomgogodla ziphumela emithanjeni engu-31 yomgogodla.
Ngayinye idlulisa okokufaka kwemizwa yezinzwa kusuka endaweni ethile yesikhumba kulelo hlangothi nendawo yomzimba.
Lezi zifunda zibizwa ngokuthi ama-dermatome.
Ngaphandle kwe-nerve yokuqala yomgogodla womlomo wesibeletho, ama-dermatome akhona ku-nerve ngayinye yomgogodla.
Izinzwa zomgogodla kanye nama-dermatome ahlobene nawo enza inethiwekhi kuwo wonke umzimba.
Dermatomes Inhloso
Ama-dermatome yizindawo zomzimba/isikhumba ezinokufakwa kwezinzwa ezinikezwe imizwa yomgogodla ngayinye. Impande ngayinye yezinzwa ine-dermatome ehlobene, futhi amagatsha ahlukahlukene ahlinzeka nge-dermatome ngayinye kuleyompande yenzwa eyodwa. Ama-dermatome ayindlela lapho ulwazi oluvusa amadlingozi esikhumbeni ludlulisela khona amasignali luye noma lusuka ohlelweni lwezinzwa olumaphakathi. Imizwa ezwakalayo ngokomzimba, njengokucindezela nezinga lokushisa, idluliselwa ohlelweni lwezinzwa olumaphakathi. Uma impande yenzwa yomgogodla icindezela noma icasukile, ngokuvamile ngenxa yokuthi ihlangana nesinye isakhiwo, iphumela ku-radiculopathy. (Izikhungo Zezempilo Zikazwelonke: Isikhungo Sikazwelonke Sezinkinga Zezinzwa Nesifo Sohlangothi. 2020 ).
I-Radiculopathy
I-Radiculopathy ichaza izimpawu ezibangelwa inzwa epinkiwe eduze komgogodla. Izimpawu nezinzwa zincike lapho i-nerve iphiniwe kanye nezinga lokucindezelwa.
Umlomo wesibeletho
Lena i-syndrome yobuhlungu kanye/noma ukwehluleka kwezinzwa lapho izimpande zezinzwa entanyeni zicindezelwa.
Imvamisa iveza ubuhlungu obuhla ngengalo eyodwa.
Abantu ngabanye bangase futhi bezwe ukuzwa kukagesi njengezikhonkwane nezinaliti, ukushaqeka, nezinzwa ezishisayo, kanye nezimpawu zemoto ezinjengobuthakathaka nokuba ndikindiki.
I-Lumbar
Le radiculopathy ibangelwa ukucindezelwa, ukuvuvukala, noma ukulimala ku-nerve yomgogodla emhlane ophansi.
Ukuzwa izinhlungu, ukuba ndikindiki, ukuntweza, ukuzwa kukagesi noma ukuvutha, kanye nezimpawu zezimoto ezinjengobuthakathaka obuhamba phansi emlenzeni owodwa zivamile.
Sifo
Ingxenye yokuhlolwa komzimba kwe-radiculopathy ukuhlola ama-dermatomes ukuze azwele. Udokotela uzosebenzisa izivivinyo ezithile zezandla ukuze anqume izinga lomgogodla lapho izimpawu zivela khona. Ukuhlolwa okwenziwa mathupha kuvame ukuhambisana nokuhlolwa kwezithombe zokuxilonga njenge-MRI, engabonisa ukungahambi kahle empandeni yemizwa yomgogodla. Ukuhlolwa okuphelele komzimba kuzonquma ukuthi impande yenzwa yomgogodla ingumthombo wezimpawu.
Ukwelapha Izimbangela Eziyisisekelo
Iziyaluyalu eziningi zangemuva zingelashwa ngemithi yokwelapha elondolozayo ukuze inikeze ukukhululeka kobuhlungu okuphumelelayo. Ngediski ye-herniated, isibonelo, abantu banganconywa ukuba baphumule futhi baphuze imithi elwa nokuvuvukala okungezona i-steroidal. I-acupuncture, ukwelapha ngokomzimba, i-chiropractic, i-traction engeyona yokuhlinzwa, noma zokwelapha decompression ingase futhi inqunywe. Ngobuhlungu obukhulu, abantu banganikezwa umjovo we-epidural steroid onganikeza ukukhululeka kobuhlungu ngokunciphisa ukuvuvukala. (I-American Academy of Orthopedic Surgeons: OrthoInfo. 2022 ) Nge-stenosis yomgogodla, umhlinzeki angase aqale agxile ekwelapheni ngokomzimba ukuze athuthukise ukuqina komzimba wonke, aqinise izisu zesisu nemisipha yangemuva, futhi alondoloze ukunyakaza emgogodleni. Imithi edambisa izinhlungu, kuhlanganise nama-NSAID nemijovo ye-corticosteroid, inganciphisa ukuvuvukala futhi ikhulule ubuhlungu. (I-American College of Rheumatology. 2023 ) Abelaphi bomzimba banikeza izindlela zokwelapha ezihlukahlukene zokunciphisa izimpawu, okuhlanganisa ukuwohloka okwenziwa ngesandla nokomshini kanye nokudonsa. Ukuhlinzwa kungase kunconywe ezimweni ze-radiculopathy ezingaphenduli ekwelashweni okuvamile.
Izinhlelo zokunakekelwa kwe-Injury Medical Chiropractic kanye ne-Functional Medicine Clinic kanye nezinsizakalo zomtholampilo zikhethekile futhi zigxile ekulimaleni kanye nenqubo yokutakula ephelele. Izindawo zethu zokuzijwayeza zihlanganisa Wellness & Nutrition, Ubuhlungu obungapheli, Ukulimala Komuntu, Ukunakekelwa Kwengozi Yezimoto, Ukulimala Umsebenzi, Ukulimala Emuva, Ubuhlungu Obuphansi, Ubuhlungu Bentamo, Ikhanda Elibuhlungu, Ukulimala Kwezemidlalo, I-Severe Sciatica, I-Scoliosis, I-Complex Herniated Discs, Fibromyalgia, Chronic Ubuhlungu, Ukulimala Okuyinkimbinkimbi, Ukulawulwa Kwengcindezi, Ukwelashwa Kwemithi Esebenzayo, kanye nezinqubo zokunakekelwa kwe-in-scope. Sigxila ekubuyiseleni imisebenzi evamile yomzimba ngemva kokulimala kanye nokulimala kwezicubu ezithambile kusetshenziswa i-Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility, and mobility Fitness Training, and Rehabilitation Systems yayo yonke iminyaka. Uma umuntu edinga okunye ukwelashwa, uzothunyelwa emtholampilo noma kudokotela osifanelekela kangcono isimo sakhe. UDkt. Jimenez uhlanganyele nodokotela abahlinzayo abaphezulu, ochwepheshe bezokwelapha, abacwaningi bezokwelapha, abelaphi, abaqeqeshi, nabahlinzeki bokuvuselela i-premiere ukuletha u-El Paso, ukwelapha okuphezulu kwemitholampilo, emphakathini wethu.
Buyisela Ukuhamba Kwakho: Ukunakekelwa Kwe-Chiropractic For Sciatica Recovery
VIDEO
Okubhekwayo
Izikhungo Zezempilo Zikazwelonke: Isikhungo Sikazwelonke Sezinkinga Zezinzwa Nesifo Sohlangothi. (2020). Iphepha leqiniso lezinhlungu eqolo. Kubuyiswe kusuka www.ninds.nih.gov/sites/default/files/migrate-documents/low_back_pain_20-ns-5161_march_2020_508c.pdf
I-American Academy of Orthopedic Surgeons: OrthoInfo. (2022). I-Herniated disk ngemuva. orthoinfo.aaos.org/zu/diseases-conditions/herniated-disk-in-the-lower-back/
I-American College of Rheumatology. (2023). I-stenosis yomgogodla. rheumatology.org/patients/spinal-stenosis
by UDkt Alex Jimenez I-Chiropractic , Inhlekelele Yokulimala , Sciatica
Abantu ababhekene nokudubula, ubuhlungu obubuhlungu emaphethelweni aphansi, kanye nobuhlungu bemilenze obuphakathi kungenzeka bahlushwa yi-neurogenic claudication. Ingabe ukwazi izimpawu kungabasiza abahlinzeki bezempilo ukuthi bakhe uhlelo lokwelapha olusebenzayo?
I-Neurogenic Claudication
I-Neurogenic claudication yenzeka lapho izinzwa zomgogodla zicindezelwa ku-lumbar noma umgogodla ophansi, okubangela ubuhlungu bemilenze obuphakathi. Izinzwa ezicindezelwe emgogodleni we-lumbar zingabangela ubuhlungu bomlenze kanye namajaqamba. Ubuhlungu buvamise ukuba bubi kakhulu ngokunyakaza okuthile noma imisebenzi efana nokuhlala, ukuma, noma ukugobela emuva. Yaziwa nangokuthi i-pseudo-claudication lapho isikhala esingaphakathi kwe-lumbar spine sincipha. Isimo esaziwa ngokuthi i-lumbar spinal stenosis. Kodwa-ke, i-neurogenic claudication i-syndrome noma iqembu lezimpawu ezibangelwa i-pinched nerve spinal, kuyilapho i-spinal stenosis ichaza ukuncipha kwemigudu yomgogodla.
Izimpawu
Izimpawu ze-Neurogenic claudication zingabandakanya:
Umlenze uminyanisa.
Ukuba ndikindiki, ukuluma, noma ukuzwa ukuvutha.
Ukukhathala komlenze nokuba buthakathaka.
Ukuzwa ubunzima emlenzeni/ emizuzwini.
Ubuhlungu obubukhali, obudubulayo, noma obubuhlungu obudlulela emaphethelweni aphansi, ngokuvamile kuyo yomibili imilenze.
Kungase futhi kube nobuhlungu emhlane ongezansi noma ezinqeni.
I-Neurogenic claudication ihlukile kwezinye izinhlobo zobuhlungu bomlenze, njengoba ubuhlungu bushintshana - buyeka futhi buqala ngokungahleliwe futhi bube bubi kakhulu ngokunyakaza okuthile noma imisebenzi. Ukuma, ukuhamba, ukwehla ngezitebhisi, noma ukujikela emuva kungabangela ubuhlungu, kuyilapho ukuhlala, ukugibela izitebhisi, noma ukuncika phambili kuvame ukukhulula ubuhlungu. Nokho, zonke izimo zihlukile. Ngokuhamba kwesikhathi, i-neurogenic claudication ingathinta ukuhamba njengoba abantu bezama ukugwema imisebenzi ebangela ubuhlungu, kuhlanganise nokuzivocavoca, ukuphakamisa izinto, nokuhamba isikhathi eside. Ezimweni ezimbi kakhulu, i-neurogenic claudication ingenza ukulala kube nzima.
I-Neurogenic claudication kanye ne-sciatica ayifani. I-Neurogenic claudication ihilela ukucindezelwa kwezinzwa emgodini ophakathi we-lumbar spine, okubangela ubuhlungu emilenzeni yomibili. I-Sciatica ihilela ukucindezelwa kwezimpande zezinzwa eziphuma ezinhlangothini zomgogodla we-lumbar, okubangela ubuhlungu emlenzeni owodwa. (UCarlo Ammendolia, 2014 )
Izimbangela
Nge-neurogenic claudication, izinzwa zomgogodla ezicindezelwe ziyimbangela eyinhloko yobuhlungu bomlenze. Ezimweni eziningi, i-lumber spinal stenosis - LSS iyimbangela ye-pinched nerve. Kunezinhlobo ezimbili ze-lumbar spinal stenosis.
I-Central stenosis iyimbangela eyinhloko ye-neurogenic claudication. Ngalolu hlobo, umsele ophakathi we-lumbar spine, ohlala kuyo umgogodla, uyancipha, ubangele ubuhlungu emilenzeni yomibili.
I-Lumbar spinal stenosis ingatholakala futhi ithuthuke kamuva ekuphileni ngenxa yokuwohloka komgogodla.
I-Congenital isho ukuthi umuntu uzalwa enalesi simo.
Kokubili kungaholela ku-claudication ye-neurogenic ngezindlela ezahlukene.
I-Foramen stenosis ingenye uhlobo lwe-lumbar spinal stenosis ebangela ukuncishiswa kwezikhala nhlangothi zombili zomgogodla lapho izimpande zezinzwa ziphuma khona emgogodleni. Ubuhlungu obuhambisanayo buhlukile ngoba bukhona emlenzeni wesokudla noma wesobunxele.
Ubuhlungu buhambisana nohlangothi lomgogodla lapho kuncinzwa khona imizwa.
Kutholwe i-Lumbar Spinal Stenosis
I-Lumbar spinal stenosis ivame ukutholwa ngenxa yokuwohloka komgogodla we-lumbar futhi ivame ukuthinta abantu abadala asebekhulile. Izinkinga zokunciphisa zingabandakanya:
Ukuhlukumezeka komgogodla, okufana nokushayisana kwemoto, umsebenzi, noma ukulimala kwezemidlalo.
I-Disc herniation.
I-osteoporosis yomgogodla - i-arthritis egugayo.
I-Ankylosing spondylitis - uhlobo lwe-arthritis oluvuthayo oluthinta umgogodla.
Ama-osteophyte - amathambo e-bone spurs.
Izimila zomgogodla - izimila ezingenawo umdlavuza futhi ezinomdlavuza.
I-Congenital Lumbar Spinal Stenosis
I-Congenital lumbar spinal stenosis isho ukuthi umuntu uzalwa enezinto ezingavamile zomgogodla okungenzeka zingabonakali lapho ezalwa. Ngenxa yokuthi isikhala esingaphakathi komgogodla sesivele sincane, umgogodla usengozini kunoma yiziphi izinguquko njengoba iminyaka ngayinye. Ngisho nabantu abane-arthritis ethambile bangathola izimpawu ze-neurogenic claudication kusenesikhathi futhi babe nezimpawu eminyakeni yabo yama-30s nama-40s esikhundleni seminyaka yabo yama-60s kanye nengama-70s.
Sifo
Ukuxilongwa kwe-neurogenic claudication ngokuyinhloko kusekelwe emlandweni wezokwelapha womuntu, ukuhlolwa ngokomzimba, nokucabanga. Ukuhlolwa ngokomzimba nokubuyekezwa kukhomba ukuthi ubuhlungu buvela kuphi futhi nini. Umhlinzeki wezempilo angabuza:
Ingabe ukhona umlando wezinhlungu ezingezansi?
Ingabe ubuhlungu emlenzeni owodwa noma kokubili?
Ingabe ubuhlungu buhlala njalo?
Ingabe ubuhlungu bufika budlule?
Ingabe ubuhlungu buya ngcono noma bubi nakakhulu lapho umile noma uhlezi?
Ingabe ukunyakaza noma imisebenzi idala izimpawu zobuhlungu kanye nemizwa?
Ingabe ikhona imizwa evamile lapho uhamba?
Ukwelashwa
Ukwelashwa kungabandakanya ukwelashwa ngokomzimba, imijovo ye-spinal steroid, kanye nemithi yobuhlungu. Ukuhlinzwa kuyindlela yokugcina lapho zonke ezinye izindlela zokwelapha zingakwazi ukunikeza usizo oluphumelelayo.
Ukwelashwa Kwemvelo
A uhlelo lokwelashwa izobandakanya ukwelashwa ngokomzimba okuhlanganisa:
Ukwelula nsuku zonke
Ukuqinisa
Ukuvivinya umzimba nge-aerobic
Lokhu kuzosiza ukuthuthukisa futhi kuzinzise imisipha ephansi emuva futhi kulungise izinkinga zokuma.
Ukwelashwa komsebenzi kuzoncoma ukuguqulwa komsebenzi okubangela izimpawu zobuhlungu.
Lokhu kuhlanganisa ukukhanda umzimba okufanele, ukonga amandla, nokubona izimpawu zobuhlungu.
Izinsimbi zasemuva noma amabhande nawo angase anconywe.
Imijovo yeSteroid yomgogodla
Abahlinzeki bezempilo bangancoma imijovo ye-epidural steroid.
Lokhu kuletha i-cortisone steroid engxenyeni engaphandle yekholomu yomgogodla noma isikhala se-epidural.
Imijovo inganikeza ukukhululeka kobuhlungu izinyanga ezintathu kuya eminyakeni emithathu. (Sunil Munakomi et al., 2024 )
Imithi Yobuhlungu
Imithi yobuhlungu isetshenziselwa ukwelapha i-intermittent neurogenic claudication. Lokhu kubandakanya:
Ama-analgesics angaphezu kwe-counter afana ne-acetaminophen.
Izidakamizwa ezingezona ukuvuvukala noma ama-NSAID njenge-ibuprofen noma i-naproxen.
Ama-NSAID kadokotela angase anqunywe uma kudingeka.
Ama-NSAID asetshenziswa ngobuhlungu obungapheli be-neurogenic futhi kufanele asetshenziswe kuphela uma kudingeka.
Ukusetshenziswa isikhathi eside kwama-NSAID kungandisa ingozi yezilonda zesisu, futhi ukusetshenziswa ngokweqile kwe-acetaminophen kungaholela ebusheni besibindi nokuhluleka kwesibindi.
Ukuhlinzwa
Uma izindlela zokwelapha ezilondolozayo zingakwazi ukuhlinzeka ngokukhululeka okuphumelelayo nokuhamba kanye/noma izinga lokuphila liyathinteka, ukuhlinzwa okwaziwa ngokuthi i-laminectomy kungase kunconywe ukuze kuncishiswe umgogodla we-lumbar. Inqubo ingenziwa:
I-Laparoscopically - enezimbobo ezincane, ububanzi, nezinsimbi zokuhlinza.
Ukuhlinzwa okuvulekile - nge-scalpel kanye ne-sutures.
Ngesikhathi senqubo, izingxenye ze-vertebra zisuswa kancane noma ngokuphelele.
Ukuze anikeze ukuzinza, amathambo ngezinye izikhathi ahlanganiswa nezikulufu, amapuleti, noma izinduku.
Amazinga empumelelo akho kokubili acishe afane.
Phakathi kuka-85% no-90% wabantu abahlinzwa bathola ukukhululeka okuhlala isikhathi eside kanye/noma okungapheli kobuhlungu. (U-Xin-Long Ma et al., 2017 )
Umuthi Wokunyakaza: Ukunakekelwa Kwe-Chiropractic
VIDEO
Okubhekwayo
U-Ammendolia C. (2014). I-Degenerative lumbar spinal stenosis kanye nabakhohlisi bayo: izifundo ezintathu zecala. I-Journal ye-Canadian Chiropractic Association, i-58 (3), i-312-319.
Munakomi S, Foris LA, Varacallo M. (2024). I-Spinal Stenosis kanye ne-Neurogenic Claudication. [Kubuyekezwe 2023 Aug 13]. Ku: StatPearls [I-inthanethi]. I-Treasure Island (FL): I-StatPearls Publishing; 2024 Jan-. Itholakala ku: www.ncbi.nlm.nih.gov/books/NBK430872/
Ma, XL, Zhao, XW, Ma, JX, Li, F., Wang, Y., & Lu, B. (2017). Ukuphumelela kokuhlinzwa ngokumelene nokwelashwa okulondolozayo kwe-lumbar spinal stenosis: Ukubuyekezwa kwesistimu kanye nokuhlaziywa kwe-meta yezilingo ezilawulwa ngokungahleliwe. Ijenali yamazwe ngamazwe yokuhlinzwa (London, England), 44, 329-338. doi.org/10.1016/j.ijsu.2017.07.032
by UDkt Alex Jimenez Inhlekelele Yokulimala , I-neuropathy
Kubantu ababhekene nobuhlungu obungapheli, ingabe ukwenza inqubo ye-nerve block kungasiza ekunciphiseni nasekulawuleni izimpawu?
Izivimba Zemizwa
I-nerve block inqubo eyenziwa ukuphazamisa/ukuvimba izimpawu zobuhlungu ngenxa yokungasebenzi kahle kwezinzwa noma ukulimala. Zingasetshenziselwa izinjongo zokuxilonga noma zokwelashwa, futhi imiphumela yazo ingaba mfushane noma yesikhathi eside, kuye ngohlobo olusetshenziswayo.
A i-nerve block yesikhashana kungase kubandakanye ukufakwa noma umjovo ovimba izimpawu zobuhlungu ukuthi zingadlulisi isikhathi esifushane.
Isibonelo, ekukhulelweni, umjovo we-epidural ungasetshenziswa ngesikhathi sokubeletha nokubeletha.
Izinzwa ezihlala njalo kubandakanya ukusika/ukusika noma ukususa izingxenye ezithile zemizwa ukuze kumiswe izimpawu zobuhlungu.Lezi zisetshenziswa ezimweni ezinokulimala kanzima noma ezinye izimo ezibuhlungu ezingapheli ezingathuthukanga nezinye izindlela zokwelapha.
Ukusetshenziswa Kokwelashwa
Lapho abahlinzeki bezempilo behlola isimo sobuhlungu obungapheli obubangelwa ukulimala kwenzwa noma ukungasebenzi kahle, bangasebenzisa i-nerve block ukuze bathole indawo ekhiqiza izimpawu zobuhlungu. Bangase benze i-electromyography kanye/noma a I-nerve conduction velocity/ukuhlolwa kwe-NCV ukukhomba imbangela yobuhlungu bezinzwa obungapheli. Ama-nerve blocks angakwazi futhi ukwelapha ubuhlungu be-neuropathic obungapheli, njengobuhlungu obubangelwa ukulimala kwenzwa noma ukucindezelwa. Ama-nerve blocks asetshenziselwa njalo ukwelapha ubuhlungu beqolo nentamo obubangelwa ama-disc herniated noma i-spinal stenosis. (Johns Hopkins Medicine. 2024 )
izinhlobo
Izinhlobo ezintathu zihlanganisa:
Local
I-Neurolytic
Ukuhlinzwa
Zontathu zingasetshenziselwa izimo ezibangela ubuhlungu obungapheli. Kodwa-ke, amabhulokhi e-neurolytic kanye nokuhlinzwa ahlala unomphela futhi asetshenziselwa kuphela ubuhlungu obunzima obuye baba bubi kakhulu ezinye izindlela zokwelapha ezingakwazi ukunikeza ukukhululeka.
Amabhulokhi Esikhashana
Ibhulokhi yendawo yenziwa ngokujova noma ngokufaka izinzwa zendawo, njenge-lidocaine, endaweni ethile.
I-epidural iyi-nerve block yendawo ejova ama-steroid noma ama-analgesics endaweni ezungeze umgogodla.
Lezi zivamile ngesikhathi sokukhulelwa, ukusikwa, kanye nokubeletha.
Ama-Epidurals angasetshenziswa futhi ukwelapha intamo engapheli noma ubuhlungu beqolo ngenxa yenzwa yomgogodla ecindezelwe.
Amabhulokhi wendawo ngokuvamile angokwesikhashana, kodwa ohlelweni lokwelapha, angaphinda aphindwe ngokuhamba kwesikhathi ukuze alawule ubuhlungu obungapheli obuvela ezimeni ezifana nesifo samathambo, i-sciatica, ne-migraines. (I-NYU Langone Health. 2023 )
Amabhulokhi Angunaphakade
I-neurolytic block isebenzisa utshwala, i-phenol, noma ama-thermal agents ukwelapha ubuhlungu bemizwa obungapheli. (I-National Institute of Neurological Disorders and Stroke. 2023 ) Lezi zinqubo zilimaza izindawo ezithile zomzila wezinzwa ngamabomu ukuze izimpawu zobuhlungu zingakwazi ukudluliselwa. I-neurolytic block isetshenziselwa kakhulu izimo zobuhlungu obungapheli, njengobuhlungu obuvela kumdlavuza noma i-syndrome yobuhlungu besifunda/i-CRPS. Ngezinye izikhathi zisetshenziselwa ukwelapha ubuhlungu obuqhubekayo be-pancreatitis engapheli kanye nobuhlungu odongeni lwesifuba ngemva kokuhlinzwa. (Johns Hopkins Medicine. 2024 ) (U-Alberto M. Cappellari et al., 2018 )
I-neurosurgeon yenza i-nerve block yokuhlinzwa ehilela ukususa ngokuhlinzwa noma ukulimaza izindawo ezithile zenzwa. (I-National Institute of Neurological Disorders and Stroke. 2023 ) I-nerve block block isetshenziswa kuphela ezimweni zobuhlungu obukhulu, njengobuhlungu bomdlavuza noma i-trigeminal neuralgia.
Nakuba i-neurolytic kanye ne-surgery nerve blocks kuyizinqubo ezihlala njalo, izimpawu zobuhlungu, nemizwa ingabuya uma imizwa ikwazi ukukhula futhi izilungise. (U-Eun Ji Choi et al., 2016 ) Nokho, izimpawu nemizwa ingase ingabuyi ezinyangeni noma iminyaka ngemva kwenqubo.
Izindawo Ezihlukene Zomzimba
Zingalawulwa ezindaweni eziningi zomzimba, okuhlanganisa: (Isibhedlela Sokuhlinzwa Okukhethekile. 2023 ) (I-Stanford Medicine. 2024 )
Scalp
Face
Neck
I-collarbone
Amahlombe
Izikhali
Emuva
Chest
Ingxenye engezansi yezimbambo
esiswini
Pelvis
Izintambo
Imilenze
iqakala
Feet
Okuqhamuka uma udla imishanguzo
Lezi zinqubo zingaba nengozi engaba khona yokulimala kwezinzwa unomphela. (Iculo le-BlueCross. 2023 ) Imizwa iyazwela futhi ivuselela kancane, ngakho iphutha elincane lingabangela imiphumela engemihle. (D O'Flaherty et al., 2018 ) Imiphumela emibi evamile ihlanganisa:
Ukukhubazeka kwemisipha
Ukungabi namandla
Ukuba ndikindiki njalo
Ezimweni ezingavamile, i-block ingacasula i-nerve futhi ibangele ubuhlungu obengeziwe.
Odokotela abanekhono nabanelayisensi njengodokotela abahlinzayo, odokotela abalawula izinhlungu, odokotela ababulala izinzwa, nodokotela bamazinyo baqeqeshelwe ukwenza lezi zinqubo ngokucophelela.
Kuhlale kunengozi yokulimala kwenzwa noma ukulimala, kodwa iningi lezinzwa ezivimba ngokuphepha nangempumelelo liyehla futhi lisize ukuphatha ubuhlungu obungapheli. (Iculo le-BlueCross. 2023 )
Ongakulindela
Abantu bangazizwa bendikindiki noma bebuhlungu futhi/noma baqaphele ububomvu noma ukucasuka eduze noma endaweni yesikhashana.
Kungase futhi kube nokuvuvukala, okucindezela inzwa futhi kudinga isikhathi sokuthuthuka. (I-Stanford Medicine. 2024 )
Abantu bangacelwa ukuthi baphumule isikhathi esithile ngemva kwenqubo.
Kuye ngohlobo lwenqubo, abantu kungase kudingeke bachithe izinsuku ezimbalwa esibhedlela.
Obunye ubuhlungu kungenzeka busekhona, kodwa lokho akusho ukuthi inqubo ayizange isebenze.
Abantu kufanele baxhumane nomhlinzeki wezokunakekelwa kwempilo mayelana nezingozi nezinzuzo ukuze baqinisekise ukuthi ilungile ukwelashwa .
I-Sciatica, Izimbangela, Izimpawu, Namathiphu
VIDEO
Okubhekwayo
Johns Hopkins Medicine. (2024). Izinzwa ezivimbayo. (Impilo, Indaba. www.hopkinsmedicine.org/health/conditions-and-diseases/nerve-blocks
I-NYU Langone Health. (2023). I-nerve block ye-migraine (Imfundo Nocwaningo, Indaba. nyulangone.org/conditions/migraine/treatments/nerve-block-for-migraine
I-National Institute of Neurological Disorders and Stroke. (2023). Ubuhlungu. Kubuyiswe kusuka www.ninds.nih.gov/health-information/disorders/pain#3084_9
Johns Hopkins Medicine. (2024). Ukwelashwa kwe-pancreatitis engapheli (Impilo, Indaba. www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pancreatitis/chronic-pancreatitis-treatment
U-Cappellari, AM, Tiberio, F., Alicandro, G., Spagnoli, D., & Grimoldi, N. (2018). Intercostal Neurolysis for The Treatment of Postsurgical Thoracic Pain: a Case Series. Imisipha nezinzwa, 58(5), 671-675. doi.org/10.1002/mus.26298
U-Choi, EJ, Choi, YM, Jang, EJ, Kim, JY, Kim, TK, & Kim, KH (2016). I-Neural Ablation kanye Nokuvuselelwa Kokuzijwayeza Kobuhlungu. Iphephabhuku laseKorea lobuhlungu, i-29 (1), i-3-11. doi.org/10.3344/kjp.2016.29.1.3
Isibhedlela Sokuhlinzwa Okukhethekile. (2023). Izinzwa zesifunda. www.hss.edu/condition-list_regional-anesthesia.asp
I-Stanford Medicine. (2024). Izinhlobo zamabhlogo ezinzwa (Ezigulini, Udaba. med.stanford.edu/ra-apm/for-patients/nerve-block-types.html
Anthem BlueCross. (2023). I-peripheral nerve blocks yokwelashwa kobuhlungu be-neuropathic. (Inqubomgomo Yezokwelapha, Indaba. www.anthem.com/dam/medpolicies/abc/active/policies/mp_pw_c181196.html
O'Flaherty, D., McCartney, CJL, & Ng, SC (2018). Ukulimala kwezinzwa ngemva kokuvinjelwa kwenzwa ye-peripheral-ukuqonda kwamanje nemihlahlandlela. Imfundo ye-BJA, 18(12), 384–390. doi.org/10.1016/j.bjae.2018.09.004
I-Stanford Medicine. (2024). Imibuzo evamile yesiguli mayelana nezinzwa. (Okweziguli, ukukhishwa. med.stanford.edu/ra-apm/for-patients/nerve-block-questions.html
by UDkt Alex Jimenez I-Chiropractic , Inhlekelele Yokulimala
Abantu abazwa izimpawu zobuhlungu njengokudubula, ukugwazwa, noma ukuzwa ngogesi ku-latissimus dorsi engenhla ngemuva kungase kubangelwe ukulimala kwenzwa ku-thoracodorsal nerve. Ingabe ukwazi i-anatomy nezimpawu kungabasiza abahlinzeki bezempilo ukuba bakhe uhlelo lokwelapha olusebenzayo?
Inzwa yeThoracodorsal
Uyaziwa nangokuthi inzwa ye-subscapular ephakathi noma inzwa ende ye-subscapular , iphuma engxenyeni ye-brachial plexus futhi inikeza ukugcinwa kwemoto ngaphakathi/ukusebenza i-latissimus dorsi muscle .
Anatomy
I-brachial plexus iyinethiwekhi yezinzwa ezivela emgogodleni wentamo. Izinzwa zihlinzeka ngokuzwa okuningi nokunyakaza kwezingalo nezandla, eyodwa ohlangothini ngalunye. Izimpande zayo ezinhlanu zivela ezikhaleni eziphakathi kwe-vertebrae yomlomo wesibeletho yesihlanu kuya kweyesishiyagalombili kanye ne-thoracic vertebra yokuqala. Ukusuka lapho, zakha isakhiwo esikhulu, bese zihlukanisa, zihlanganise kabusha, futhi zihlukanise futhi ukuze zakhe imizwa emincane nezakhiwo zemizwa njengoba zehla ngekhwapha. Ngentamo nesifuba, imizwa ekugcineni ijoyina futhi yakhe izintambo ezintathu ezihlanganisa:
Intambo yangemuva
Intambo ephakathi
Intambo yangemuva
Intambo yangemuva ikhiqiza amagatsha amakhulu namancane ahlanganisa:
I-Axillary nerve
I-radial nerve
Amagatsha amancane afaka:
I-Superior subscapular nerve
I-subscapular nerve ephansi
I-thoracodorsal nerve
Isakhiwo Nesikhundla
I-thoracodorsal nerve igatsha isuka entanjeni yangemuva ku-armpit futhi ihamba phansi, ilandela umthambo we-subscapular, ukuya ku-latissimus dorsi muscle.
Ixhumeka engalweni engenhla, yelule ngemuva kwekhwapha, yenze i-axillary arch, bese inwebeka ibe unxantathu omkhulu ogoqa izimbambo nomhlane.
I-thoracodorsal nerve ilele ekujuleni kwe-latissimus dorsi, futhi unqenqema olungezansi ngokuvamile lufika eduze nokhalo.
Ukuhluka
Kukhona indawo ejwayelekile kanye nenkambo ye-thoracodorsal nerve, kodwa izinzwa zomuntu ngamunye azifani kuwo wonke umuntu.
Inzwa ngokuvamile isuka entanjeni yangemuva ye-brachial plexus isuka emaphuzwini amathathu ahlukene.
Kodwa-ke, ama-subtypes ahlukene akhonjwe.
I-thoracodorsal nerve inikeza imisipha emikhulu ye-teres cishe ku-13% wabantu ngabanye. (UBrianna Chu, uBruno Bordoni. 2023 )
Ama-lats angaba nokuhlukahluka okungavamile kwe-anatomical okwaziwa ngokuthi a I-arch ye-Langer , okuyingxenye eyengeziwe exhuma emisipha noma izicubu ezixhumeneyo zengalo engenhla ngaphansi kwendawo yokuxhuma evamile.
Kubantu abanalokhu okungavamile, inzwa ye-thoracodorsal inikeza umsebenzi / innervation) ku-arch. (U-Ahmed M. Al Maksoud et al., 2015 )
Umsebenzi
I-latissimus dorsi muscle ayikwazi ukusebenza ngaphandle kwe-thoracodorsal nerve. Usizo lwemisipha nezinzwa:
Zinzise umhlane.
Khuphula isisindo somzimba lapho ukhuphuka, ubhukuda, noma udonsa phezulu.
Siza ngokuphefumula ngokwandisa izimbambo ngesikhathi sokuhogela kanye nokufinyela lapho ukhipha umoya. (I-Encyclopaedia Britannica. 2023 )
Zungezisa ingalo uyifake phakathi.
Donsela ingalo maphakathi nomzimba.
Nweba amahlombe ngokusebenzisa i-teres enkulu, i-teres minor, ne-posterior deltoid muscle.
Yehlisa ibhande lehlombe ngokugoba umgogodla.
Ukugobela ohlangothini ngokugoba umgogodla.
Tshekisa i-pelvis phambili.
Izimo
I-thoracodorsal nerve ingalimala noma yikuphi endleleni yayo ngokuhlukumezeka noma izifo. Izimpawu zokulimala kwezinzwa zingabandakanya: (I-US National Library of Medicine: MedlinePlus. 2022 )
Ubuhlungu obungaba ukudubula, ukugwazwa, noma ukuzwa ugesi.
Ukuba ndikindiki, ukuluma.
Ubuthakathaka nokulahlekelwa ukusebenza kwemisipha ehambisanayo nezitho zomzimba, okuhlanganisa nokuwa kwesandla nomunwe.
Ngenxa yendlela yemizwa enqamula ekhwapheni, odokotela kufanele baqaphele ukuhlukahluka kwe-anatomical ukuze bangalimazi ngokungazi ngesikhathi sezinqubo zomdlavuza webele, kuhlanganise ne-axillary dissection.
Inqubo yenziwa ukuhlola noma ukususa ama-lymph nodes futhi isetshenziswa ekuhloleni umdlavuza webele kanye nasekwelashweni.
Ngokocwaningo, u-11% wabantu abane-axillary lymph node dissection balimale emithanjeni. (U-Roser Belmonte et al., 2015 )
I-Breast Reconstruction
Ekuhlinzweni kokwakhiwa kabusha kwebele, ama-lats angasetshenziswa njenge-flap phezu kokufakelwa.
Kuye ngezimo, i-thoracodorsal nerve ingashiywa iphelele noma inqunywe.
Umphakathi wezokwelapha awukavumelananga ngokuthi iyiphi indlela enemiphumela engcono kakhulu. (Sung-Tack Kwon et al., 2011 )
Kunobufakazi obuthile bokuthi ukushiya i-nerve ingashintshile kungabangela ukuthi imisipha inkontileka futhi ihlukanise ukufakelwa.
I-thoracodorsal nerve eqinile ingase ibangele i-atrophy ye-muscle, engaholela ehlombe nengalo ebuthaka.
Ukusetshenziswa kwe-Graft
Ingxenye ye-thoracodorsal nerve ivame ukusetshenziswa ekwakhiweni kabusha kwe-nerve graft ukubuyisela ukusebenza ngemuva kokulimala, okubandakanya okulandelayo:
I-musculocutaneous nerve
I-accessory nerve
I-Axillary nerve
I-nerve ingasetshenziswa futhi ukubuyisela ukusebenza kwezinzwa kumsipha we-triceps engalweni.
Ukuvuselelwa
Uma i-thoracodorsal nerve ilimele noma ilimele, ukwelashwa kungabandakanya:
Ama-braces noma ama-splints.
Ukwelapha ngokomzimba ukuthuthukisa uhla lokunyakaza, ukuguquguquka, namandla emisipha.
Uma kukhona ukucindezela, kungase kudingeke ukuhlinzwa ukuze kuncishiswe ukucindezela.
Ukuhlola Imithi Edidiyelwe
VIDEO
Okubhekwayo
Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Izinzwa. [Kubuyekezwe 2023 Jul 24]. Ku: StatPearls [I-inthanethi]. I-Treasure Island (FL): I-StatPearls Publishing; 2023 Jan-. Itholakala ku: www.ncbi.nlm.nih.gov/books/NBK539761/
Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). I-Langer's arch: i-anomaly engavamile ithinta i-axillary lymphadenectomy. Ijenali yemibiko yecala lokuhlinzwa, 2015(12), rjv159. doi.org/10.1093/jscr/rjv159
Britannica, Abahleli Be-Encyclopaedia. “latissimus dorsi “. I-Encyclopedia Britannica, 30 Nov. 2023, www.britannica.com/science/latissimus-dorsi . Ifinyelelwe ngomhla ka-2 Januwari 2024.
I-US National Library of Medicine: MedlinePlus. I-neipathy neuropathy .
Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Ukulimala kwe-thoracic nerve ende ezigulini ezinomdlavuza webele ezilashwa nge-axillary lymph node dissection. Ukunakekelwa okusekelayo kumdlavuza : iphephabhuku elisemthethweni le-Multinational Association of Supportive Care in Cancer, 23 (1), 169-175. doi.org/10.1007/s00520-014-2338-5
Kwon, S. T., Chang, H., & Oh, M. (2011). Isisekelo se-anatomic sokuhlukaniswa kwenzwa ye-interfascicular ye-flap yemisipha ye-latissimus dorsi engavaliwe. Ijenali yepulasitiki, ukuhlinzwa okwakha kabusha nobuhle : JPRAS, 64(5), e109–e114. doi.org/10.1016/j.bjps.2010.12.008
by UDkt Alex Jimenez Ukuhlungu obusemhlane , I-Chiropractic , Ubuhlungu obungapheliyo , Inhlekelele Yokulimala , Ukwelashwa Kokucindezeleka Komgogodla , Ukwelashwa , I-Viscerosomatic Reflex
Ingabe abantu abanenkinga yokungasebenzi kahle kwezinzwa bangahlanganisa ukuwohloka ngaphandle kokuhlinzwa ukuze babuyisele ukusebenza kwezinzwa emizimbeni yabo?
Isingeniso
Ikholomu yomgogodla ohlelweni lwe-musculoskeletal iqukethe amathambo, amalunga, nezinzwa ezisebenza ndawonye nemisipha nezicubu ezihlukahlukene ukuze kuqinisekiswe ukuthi umgogodla uvikelekile. Umgogodla uyingxenye yesimiso sezinzwa esimaphakathi lapho izimpande zezinzwa zisakazwa ezingxenyeni ezingaphezulu nezingaphansi zomzimba ezihlinzeka ngemisebenzi ye-sensory-motor. Lokhu kuvumela umzimba ukuthi unyakaze futhi usebenze ngaphandle kobuhlungu noma ukungakhululeki. Kodwa-ke, lapho umzimba nomgogodla uguga noma lapho umuntu ebhekene nokulimala, izimpande zemizwa zingacasuka futhi zibangele imizwa eyinqaba efana nokuba ndikindiki noma ukuluma, okuvame ukuhlobana nobuhlungu bomzimba. Lokhu kungabangela umthwalo wenhlalakahle yezomnotho kubantu abaningi futhi, uma kungelashwa ngokushesha, kungaholela ebuhlungu obungapheli. Kulelo phuzu, kungaholela kubantu abaningi ababhekana nobuhlungu bomzimba obuhambisana nokungasebenzi kahle kwezinzwa. Lokhu kudala ukuthi abantu abaningi abanenkinga ye-musculoskeletal baqale ukufuna ukwelashwa. Isihloko sanamuhla sihlola ukuthi ukungasebenzi kahle kwezinzwa kuyithinta kanjani imikhawulo nokuthi ukuwohloka okungahlinzeki kungasiza kanjani ekunciphiseni ukungasebenzi kahle kwezinzwa ukuze kuvunyelwe ukuhamba kubuyele ezithweni ezingenhla nezingaphansi. Sikhuluma nabahlinzeki bezokwelapha abanezitifiketi abahlanganisa ulwazi lweziguli zethu ukuze sinikeze izixazululo ezingahlinzeki ezifana nokuwohloka ukuze sisize abantu abanokukhubazeka kwemizwa. Siphinde sazise iziguli ukuthi ukuwohloka okungahlinzeki kungabuyisela kanjani inzwa yokuhamba ezindaweni ezingaphezulu neziphansi. Sikhuthaza iziguli zethu ukuthi zibuze imibuzo eyinkimbinkimbi nefundisayo kubahlinzeki bethu bezokwelapha abahlobene mayelana nezimpawu ezifana nobuhlungu ezibhekana nazo ezihlobene nokungasebenzi kahle kwezinzwa. UDkt. Alex Jimenez, DC, usebenzisa lolu lwazi njengenkonzo yezemfundo. Disclaimer .
Ukuthi Ukungasebenzi Kwezinzwa Kuyithinta Kanjani Imikhawulo
Ingabe uzwa ukuzwa ukuntweza noma ukuba ndikindiki ezandleni noma ezinyaweni zakho ezingafuni ukusuka? Ingabe uzwa ubuhlungu ezingxenyeni ezihlukene zeqolo ezingadalulwa kuphela ngokuzelula noma ukuphumula? Noma ingabe kubuhlungu ukuhamba amabanga amade ozwa sengathi udinga ukuphumula njalo? Izimo eziningi ezifana nobuhlungu zihlotshaniswa nokungasebenzi kahle kwezinzwa ezingathinta imikhawulo ephezulu naphansi. Lapho abantu abaningi bezwa ukungasebenzi kahle kwezinzwa futhi bebhekana nemizwa eyinqaba emaphethelweni abo, abaningi bacabanga ukuthi kungenxa yobuhlungu be-musculoskeletal entanyeni, emahlombe, noma emuva. Lokhu kuyingxenye yenkinga, njengoba izici eziningi zemvelo zingahlotshaniswa nobuhlungu bezinzwa zezinzwa, njengoba izimpande zemizwa zicindezelwa futhi ziyanyakaza, okubangela ukungasebenzi kahle kwezinzwa emikhawulweni. Njengoba izimpande zezinzwa zisabalele kusukela entanjeni yomgogodla, ubuchopho buthumela ulwazi lwe-neuron ezimpandeni zemizwa ukuze kuvunyelwe ukusebenza kwezinzwa ezindaweni ezingaphezulu nezingaphansi. Lokhu kuvumela umzimba ukuba uhambe ngaphandle kokuphatheka kabi noma ubuhlungu futhi usebenze ngemisebenzi yansuku zonke. Kodwa-ke, lapho abantu abaningi beqala ukwenza ukunyakaza okuphindaphindiwe okubangela ukuthi i-spinal disc icindezeleke njalo, ingaholela ekutheni i-disc herniation engaba khona kanye nokuphazamiseka kwe-musculoskeletal. Njengoba izimpande zezinzwa eziningi zisakazekela emaphethelweni ahlukene, lapho izimpande eziyinhloko zemizwa ziba zimbi, zingathumela izimpawu zobuhlungu emkhawulweni ngamunye. Ngakho-ke, abantu abaningi babhekene ne-nerve entrapment eholela emhlane ophansi, ezinqeni nasemilenzeni ezingathinta isimiso sabo sansuku zonke. ( U-Karl et al., 2022 ) Ngesikhathi esifanayo, abantu abaningi abane-sciatica babhekene nokungasebenzi kahle kwezinzwa ezithinta ikhono labo lokuhamba. Nge-sciatica, ingahlotshaniswa ne-spinal disc pathology futhi ibangele abantu abaningi ukuba bafune ukwelashwa. ( Bush et al., 1992 )
Izimfihlo ze-Sciatica Kwembulwa-Ividiyo
VIDEO
Uma kuziwa ekufuneni ukwelashwa ukuze kuncishiswe ukungasebenzi kahle kwezinzwa, abantu abaningi bazokhetha izixazululo ezingahlinzeki ukuze banciphise izimpawu ezinjengobuhlungu futhi banciphise izimpawu zobuhlungu ezibangela ubuhlungu obuphezulu nephansi. Izixazululo zokwelapha ezingahlinzeki ezifana ne-decompression zingasiza ukubuyisela ukusebenza kwenzwa yezinzwa ngokudonsa okuthambile ngokubangela i-spinal disc ukuthi isuse impande yenzwa ethuthukisiwe futhi iqale inqubo yokuphulukisa yemvelo yomzimba. Ngesikhathi esifanayo, kusiza ukunciphisa ukuphazamiseka kwe-musculoskeletal ekubuyeni. Ividiyo engenhla ibonisa ukuthi i-sciatica ehlotshaniswa nokungasebenzi kahle kwezinzwa zenzwa ingancishiswa kanjani ngokwelashwa okungahlinzeki ukuze kuvunyelwe imikhawulo yomzimba ukuthi izizwe ingcono.
Ukucindezeleka Okungahlinzeki Kwehlisa Ukungasebenzi Kwezinzwa
Ukwelashwa okungahlinzeki kungasiza ekunciphiseni ubuhlungu obuphansi emuva obuhambisana nokungasebenzi kahle kwezinzwa ukuze kubuyiselwe ukusebenza kwe-sensory-motor emaphethelweni aphezulu naphansi. Abantu abaningi abahlanganisa ukwelashwa okungahlinzeki okufana nokuwohloka kwemisipha njengengxenye yendlela yokuphila nokuphila kahle bangabona ukuthuthuka ngemva kokwelashwa okulandelanayo. ( I-Chou et al., I-2007 ) Njengoba odokotela abaningi bezokwelashwa behlanganisa izindlela zokwelapha ezingahlinzeki njengokuwohloka emisebenzini yabo, kube nokuthuthuka okukhulu ekulawuleni ubuhlungu. ( UBronfort et al., 2008 )
Lapho abantu abaningi beqala ukusebenzisa i-decompression engahlinzeki ngenxa yokungasebenzi kahle kwezinzwa, abaningi bazobona ubungcono ezinhlungwini zabo, ekuhambeni, kanye nemisebenzi yabo yansuku zonke. ( Gose et al., 1998 ). Lokho okwenziwa yi-spinal decompression ezimpandeni zezinzwa ukuthi kusiza i-disc ethintekile eyenza i-nerve root root, idonsele i-disc endaweni yayo yasekuqaleni, futhi iyibuyisele emanzini. ( URamos noMartin, ngo-1994 ) Lapho abantu abaningi beqala ukucabanga ngempilo nokuphila kahle kwabo, izindlela zokwelapha ezingahlinzeki zingasebenza kubo ngenxa yezindleko zabo ezingabizi nokuthi zingahlanganiswa kanjani nezinye izindlela zokwelapha ukuze zilawule kangcono izinhlungu ezihambisana nokungasebenzi kahle kwezinzwa ezithinta amaphethelo emizimba yabo.
Okubhekwayo
Bronfort, G., Haas, M., Evans, R., Kawchuk, G., & Dagenais, S. (2008). Ukuphathwa kobufakazi obunobufakazi bobuhlungu obungapheli obuphansi emuva ngokuphathwa komgogodla kanye nokugqugquzela. Umgogodla J , 8 (1), i-213-225. doi.org/10.1016/j.spinee.2007.10.023
Bush, K., Cowan, N., Katz, DE, & Gishen, P. (1992). Umlando wemvelo we-sciatica ohlotshaniswa ne-disc pathology. Ucwaningo olulindelekile olunokulandelwa kwe-radiologic yomtholampilo nozimele. I-Spine (Phila Pa 1976) , 17 (10), i-1205-1212. doi.org/10.1097/00007632-199210000-00013
Chou, R., Huffman, LH, American Pain, S., & American College of, P. (2007). Imithi ye-Nonpharmacologic yobuhlungu obuphansi obuphansi futhi obungapheli: ukubuyekezwa kobufakazi be-American Pain Society / American College of Physicians clinical practice guideline. U-Ann Intern Med , 147 (7), i-492-504. doi.org/10.7326/0003-4819-147-7-200710020-00007
IGose, EE, Naguszewski, WK, & Naguszewski, RK (1998). I-Vertebral axial decompression therapy yobuhlungu obuhlobene nama-disc herniated noma degenerated noma i-facet syndrome: isifundo somphumela. I-Neurol Res , 20 (3), i-186-190. doi.org/10.1080/01616412.1998.11740504
U-Karl, HW, Helm, S., & Trescot, AM (2022). I-Superior and Middle Cluneal Nerve Entrapment: Imbangela Yobuhlungu Obusemuva Nobuhlungu. Udokotela Wezinhlungu , 25 (4), i-E503-E521. www.ncbi.nlm.nih.gov/pubmed/35793175
Ramos, G., & Martin, W. (1994). Imiphumela ye-vertebral axial decompression ku-intradiscal pressure. J Neurosurgery , 81 (3), i-350-353. doi.org/10.3171/jns.1994.81.3.0350
Disclaimer
by UDkt Alex Jimenez Ubuhlungu obungapheliyo , Inhlekelele Yokulimala
Kubantu ababhekene nezimo ezibuhlungu ezingapheli bangakwazi ukuqonda kangcono ochwepheshe bokulawulwa kwezinhlungu ukusiza ekuthuthukiseni izinhlelo eziphumelelayo zokwelapha ze-multidisciplinary?
Ochwepheshe Bokuphathwa Kwezinhlungu
Ukuphathwa kobuhlungu kuwukukhethekile okukhulayo kwezokwelapha okuthatha indlela ehlukahlukene yokwelapha zonke izinhlobo zobuhlungu. Kuyigatsha lezokwelapha elisebenzisa amasu nezindlela ezifakazelwe ngokwesayensi zokukhulula, ukunciphisa, nokulawula izimpawu zobuhlungu kanye nemizwa. Ochwepheshe bokuphatha ubuhlungu bahlola, bavuselele, futhi baphathe izimo eziningi, kuhlanganise nobuhlungu be-neuropathic, i-sciatica, ubuhlungu be-postoperative, izimo ezibuhlungu ezingapheli, nokuningi. Abahlinzeki abaningi bezempilo abayinhloko badlulisela iziguli zabo kochwepheshe bokulawula ubuhlungu uma izimpawu zobuhlungu ziqhubeka noma zibalulekile ekubonakalisweni kwazo.
ongoti
Abahlinzeki bezempilo abagxile ekulawulweni kwezinhlungu bayaqaphela uhlobo oluyinkimbinkimbi yobuhlungu futhi babhekane nenkinga kuzo zonke izinkomba. Ukwelashwa emtholampilo wezinhlungu kugxile esigulini kodwa kuya ngezinsiza ezitholakalayo zomtholampilo. Njengamanje, awekho amazinga amisiwe ezinhlobo zezifundo ezidingekayo, esinye isizathu izindlela zokwelashwa ezihluka kuye ngomtholampilo. Ochwepheshe bathi isikhungo kufanele sinikeze iziguli:
Udokotela ongumxhumanisi onguchwepheshe ekulawuleni ubuhlungu kanye nochwepheshe bezokubonisana egameni lesiguli.
Uchwepheshe wokuvuselela umzimba.
Udokotela wengqondo ukusiza umuntu ukuthi abhekane nanoma yikuphi ukucindezeleka okuhambisanayo noma ukukhathazeka, ikakhulukazi lapho ebhekene nobuhlungu obungapheli. (I-American Society of Regional Anesthesia kanye Nemithi Yobuhlungu. 2023 )
Okunye Okukhethekile Kwezokwelapha
Okunye okukhethekile okumelelwe ekulawulweni kobuhlungu yi-anesthesiology, neurosurgery, kanye nemithi yangaphakathi. Umhlinzeki wokunakekelwa kwezempilo oxhumanisa angase adlulisele umuntu ngamunye ngezinsizakalo ezivela:
Umhlinzeki wezokunakekelwa kwezempilo kufanele ukuthi aqede ukuqeqeshwa okwengeziwe kanye nokuqinisekiswa kwemithi yobuhlungu futhi abe yi-MD enesitifiketi sebhodi okungenani kokukodwa kwalokhu okulandelayo (I-American Board of Medical Specialties. 2023 )
Anesthesiology
Ukuvuselelwa ngokomzimba
I-Psychiatry
Neurology
Udokotela olawula izinhlungu kufanele futhi enze umkhuba wabo ukhawulelwe kulokho okukhethekile aphethe isitifiketi.
Imigomo Yokuphatha
Umkhakha wokulawula ubuhlungu uphatha zonke izinhlobo zobuhlungu njengesifo. Okungapheli, njengekhanda elibuhlungu; acute, kusukela ekuhlinzweni, nokunye. Lokhu kuvumela ukusebenzisa isayensi kanye nentuthuko yakamuva yezokwelapha ekudambiseni izinhlungu. Manje kukhona izindlela eziningi, kuhlanganise:
Imithi
Izindlela zokungenelela zokulawula ubuhlungu - izithiyo zezinzwa, izikhuthazi zomgogodla, kanye nokwelashwa okufanayo.
Ukwelapha ngokomzimba
Imithi yokwelapha
Inhloso ukunciphisa nokwenza izimpawu zilawuleke.
Thuthukisa umsebenzi.
Khulisa izinga lempilo. (Srinivas Nalamachu. 2013 )
Umtholampilo wokulawula izinhlungu uzobhekana nalokhu okulandelayo:
Ukuhlola.
Ukuhlolwa kokuxilonga, uma kunesidingo.
Ukwelashwa ngokomzimba - kwandisa ububanzi bokunyakaza, kuqinisa umzimba, futhi kulungiselela abantu ngabanye ukuthi babuyele emsebenzini kanye nemisebenzi yansuku zonke.
Ukwelashwa kokungenelela - imijovo noma ukugqugquzela umgogodla.
Ukudluliselwa kudokotela ohlinzayo uma kuboniswa ukuhlolwa nokuhlola.
I-Psychiatry yokubhekana nokucindezeleka, ukukhathazeka, kanye/noma ezinye izinkinga ezihambisana nezimpawu zobuhlungu obungapheli.
Umuthi ohlukile wokusekela nokuthuthukisa ezinye izindlela zokwelapha.
Abantu abenza kahle ngohlelo lokulawula ubuhlungu
Abantu abanalokhu:
Ukuhlungu obusemhlane ubuhlungu Neck
Uhlinzwe iqolo izikhathi eziningi
Ukuhlinzwa okuhlulekile
I-neuropathy
Abantu ngabanye banqume ukuthi ukuhlinzwa akusizuzisi isimo sabo.
Ukuqonda kangcono ama-syndromes obuhlungu yimiphakathi kanye nezinkampani zomshuwalense kanye nokwanda kwezifundo zobuhlungu kuzosiza ukwandisa ukumbozwa komshuwalense wezokwelapha kanye nobuchwepheshe ukuze kuthuthukiswe imiphumela yokungenelela.
Ukunakekelwa Kwe-Chiropractic Yokungaqini Kwemilenze
VIDEO
Okubhekwayo
I-American Society of Regional Anesthesia kanye Nemithi Yobuhlungu. (2023). Okukhethekile kokuphathwa kobuhlungu obungapheli .
I-American Academy of Pain Medicine (2023). Mayelana ne-American Academy of Pain Medicine .
I-American Board of Medical Specialties. (2023). Inhlangano Ethenjwa Kakhulu Yezitifiketi Zezempilo Ezikhethekile .
Nalamachu S. (2013). Uhlolojikelele lokuphathwa kobuhlungu: ukusebenza kahle komtholampilo kanye nenani lokwelashwa. Ijenali yaseMelika yokunakekelwa okuphethwe, 19(14 Suppl), s261–s266.
I-American Society of Interventional Pain Physicians. (2023). Udokotela Wezinhlungu .
by UDkt Alex Jimenez Inhlekelele Yokulimala , Sciatica
Abantu abazwa ukuntweza noma izikhonkwane nemizwelo yezinaliti edlula izingalo noma imilenze kungenzeka ukuthi bahlangabezana ne-paresthesia, eyenzeka lapho inzwa icindezelwe noma ilimele. Ingabe ukwazi izimpawu nezimbangela kungasiza ekuxilongeni nasekwelapheni?
I-Paresthesia Izinzwa Zomzimba
Ukuba ndikindiki noma ukugedla komzwelo lapho ingalo, umlenze, noma unyawo zilele akukona kangako mayelana nokujikeleza kwegazi kodwa ukusebenza kwezinzwa.
I-Paresthesia umuzwa ongavamile ozwakalayo emzimbeni ngenxa yokucindezelwa noma ukucasuka kwemizwa.
Kungaba yimbangela yemishini njengenzwa ecindezelwe/ecijile.
Noma kungase kube ngenxa yesimo sezempilo, ukulimala, noma ukugula.
Izimpawu
I-Paresthesia ingabangela izimpawu ezihlukahlukene. Lezi zimpawu zingasukela kokumnene kuye kokuqina futhi zingaba zifushane noma zihlale isikhathi eside. Izimpawu zingabandakanya: (I-National Institute of Neurological Disorders and Stroke. 2023 )
Ukulinganisa
Izikhonkwane nezinaliti ukuzwa
Ukuzwa sengathi ingalo noma umlenze ulele.
Ubumbulu
Ukulunywa.
Imizwa evuthayo.
Ubunzima bokudonsa imisipha.
Ubunzima bokusebenzisa ingalo noma umlenze othintekile.
Izimpawu ngokuvamile zihlala imizuzu engama-30 noma ngaphansi.
Ukunyakazisa isitho esithintekile kuvame ukukhulula imizwa.
I-Paresthesia ngokuvamile ithinta ingalo eyodwa noma umlenze ngesikhathi.
Nokho, zombili izingalo nemilenze kungathinteka, kuye ngembangela.
Xhumana nomhlinzeki wezempilo uma izimpawu zihlala isikhathi esingaphezu kwemizuzu engama-30. Ukwelashwa kungase kudingeke uma izinzwa zomzimba ze-paresthesia zilethwa yimbangela ejulile eyisisekelo.
Izimbangela
Ukuhlala ngokuma okungalungile nokungalungile kungacindezela inzwa futhi kudale izimpawu. Kodwa-ke, ezinye izimbangela zithinta kakhulu futhi zingabandakanya:
Ukufuna Usizo Lwezempilo
Uma izimpawu zingapheli ngemva kwemizuzu engu-30 noma zilokhu zibuya ngenxa yezizathu ezingaziwa, shayela umhlinzeki wezempilo ukuze uthole ukuthi yini ebangela ukungezwani okungavamile. Icala elibhedayo kufanele liqashwe umhlinzeki wezempilo.
I-peripheral neuropathy ebangelwa isifo sikashukela ngokuvamile iqala ngomuzwa we-paresthesia ezinyaweni/ezinyaweni futhi ingaba yimbi kakhulu futhi iholele kwezinye izinkinga.
Lokhu kuwuphawu lokuthi isifo sikashukela asilawulwa ngendlela efanele futhi sidinga ukulawulwa ngendlela efanele. (National Institute of Diabetes and Digestive and Kidney Diseases. 2018 )
Sifo
Umhlinzeki wokunakekelwa kwezempilo uzosebenza nomuntu ukuze aqonde izimpawu futhi enze izivivinyo ezifanele zokuxilonga ukuze athole imbangela. Umhlinzeki wezempilo uzokhetha ukuhlolwa okusekelwe ekuhlolweni komzimba. Izinqubo zokuxilonga ezijwayelekile zihlanganisa: (Inguqulo ye-Merck Manual Professional. 2022 )
I-Magnetic resonance imaging - i-MRI yomgogodla, ubuchopho, noma imikhawulo.
I-X-ray ukuze ikhiphe ukungahambi kahle kwamathambo, njengokuphuka.
Ukuhlolwa kwegazi.
I-Electromyography - izifundo ze-EMG.
Isivinini se-nerve conduction - ukuhlolwa kwe-NCV.
Uma i-paresthesia ihambisana nobuhlungu beqolo noma bentamo, umhlinzeki wezempilo angase asole inzwa yomgogodla ecindezelwe/ecijile.
Uma umuntu enomlando wesifo sikashukela ongalawuleki kahle, angase asole i-peripheral neuropathy.
Ukwelashwa
Ukwelashwa kwe-paresthesia kuncike ekuxilongweni. Umhlinzeki wokunakekelwa kwezempilo angasiza ekunqumeni inkambo engcono kakhulu yokwenza isimo esithile.
System Ngethukile
Uma izimpawu zibangelwa isimo sezinzwa esimaphakathi njenge-MS, abantu bazosebenzisana eduze nomhlinzeki wabo wezempilo ukuze bathole ukwelashwa okufanele.
Ukwelapha ngokomzimba kungase kunconywe ukusiza ukuthuthukisa ukuhamba komsebenzi kukonke. (Nazanin Razazian, et al., 2016 )
Inzwa Yomgogodla
Uma i-paresthesia ibangelwa ukucindezelwa kwenzwa yomgogodla, njenge-sciatica, abantu bangathunyelwa i-chiropractor kanye nethimba lokwelapha ngokomzimba ukukhulula inzwa nokucindezela. (U-Julie M. Fritz, et al., 2021 )
Umhlinzeki womzimba angase anikeze ukuvivinya umzimba komgogodla ukuze akhulule ukucindezelwa kwenzwa futhi abuyisele ukuzwa nokunyakaza okuvamile.
Ukuzivocavoca ukuqinisa ukubuyisela ukuguquguquka nokuhamba kungase kunqunywe uma ubuthakathaka buvela kanye nokuzwa komzimba we-paresthesia.
I-Disc Herniated
Uma i-disc ye-herniated ibangela izinzwa ezingavamile, futhi akuzange kube khona ukuthuthukiswa ngezinyathelo zokulondoloza, umhlinzeki wezempilo angase asikisele ukuhlinzwa ukuze kuncishiswe ingcindezi ku-nerve / s. (I-American Association of Neurological Surgeons. 2023 )
Ezinkambisweni zokuhlinzwa ezifana ne-laminectomy noma i-discectomy, inhloso ukubuyisela ukusebenza kwezinzwa.
Ngemuva kokuhlinzwa, abantu banganconywa kudokotela womzimba ukuze basize ukubuyisela ukuhamba.
neuropathy peripheral
Iyini i-Plantar Fasciitis?
VIDEO
Okubhekwayo
I-National Institute of Neurological Disorders and Stroke. (2023) I-Paresthesia .
I-American Association of Neurological Surgeons. (2023) I-disc ye-Herniated .
National Institute of Diabetes and Digestive and Kidney Diseases. (2018) I-neipathy neuropathy .
Inguqulo ye-Merck Manual Professional. (2022) Ubumbulu .
Razazian, N., Yavari, Z., Farnia, V., Azizi, A., Kordavani, L., Bahmani, DS, Holsboer-Trachsler, E., & Brand, S. (2016). Ukusebenzisa Imithelela Ekukhathaleni, Ekucindezelekeni, naseParesthesia Ezigulini Zabesifazane ezine-Multiple Sclerosis. Imithi nesayensi kwezemidlalo nokuzivocavoca, 48(5), 796–803. doi.org/10.1249/MSS.0000000000000834
UFritz, JM, Lane, E., McFadden, M., Brennan, G., Magel, JS, Thackeray, A., Minick, K., Meier, W., & Greene, T. (2021). Ukudluliselwa Kokwelashwa Komzimba Kusuka Ekunakekelweni Okuyisisekelo Kwezinhlungu Ezibuhlungu Emuva Nge-Sciatica: Isivivinyo Esilawulwa Ngokungahleliwe. Izibalo zemithi yangaphakathi, 174(1), 8-17. doi.org/10.7326/M20-4187
