Idiski Ephukile

Thola ulwazi oluthe xaxa kuMohamad Bydon, M.D.

Ezikhathini eziningi, i-disk ephukile yenzeka ngenxa yokugqwala nokukhahlela, okuyinto eyaziwa ngokuthi ukubola kwe-disk njengoba ugoduka. Ama-disk akho aba mancane ukuguquguquka futhi abekwe engcupheni yokuklebhuleka nokuphazamiseka. Abantu abaningi abakwazi ukubona imbangela ye-disk yabo ephukile. Kungenzeka ukusuka ekusebenziseni imisipha yakho yomhlane esikhundleni semisipha yakho yomlenze nezinyawo ukuze uthwale into enzima. Noma kusuka ekugoqweni nasekujikelezweni okungafanele. Lokho kusho ukuthi, kunezinye izinto ngaphandle kokuguga kwakho ezingandisa ingozi yakho yokuphazamisa i-disk. Ukukhuluphala kukhuphula ukucindezela kuma-disk emhlane wakho ophansi. Abanye abantu bangase babe nezinto ezihlukanisayo eziholela ekuphazamisekeni kwe-disk. Ukusebenza umsebenzi onzima ngokomzimba, nokubhema kunganciphisa ukunikezwa komoya kwi-disk yakho, okubangela ukuba ibole ngokushesha.

Udokotela wakho ngokuvamile uzobe ekwazi ukutshela uma une-disk ephukile ngokwenza ukuhlolwa komzimba, ebuza ngomlando wakho wezokwelapha. Bangase bakucela ukuba ulethe phansi, uhambise imilenze yakho ezindaweni ezahlukene. Bangase futhi bahlole imiphumela yakho, amandla emisipha, ikhono lokuphila, babone ukuthi ungaba nomuzwa othambile, ukudlidliza. Uma udokotela wakho ecabanga ukuthi enye isimo sibangela ubuhlungu noma kudingeka ukubona ukuthi yiziphi izicubu ezihlaselekayo yi-disk ephukile, bangase bayalele okukodwa noma ngaphezulu kwalokhu okulandelayo; i-X-ray, i-CT scan, i-MRI, ngokungavamile i-myelogram. Iqembu lakho lezokwelapha lingase lenze ukuhlolwa kwezinzwa njenge-nerve conduction study noma i-EMG ukusiza ukubona indawo yomonakalo wezinzwa.

Ngokuvamile, ukubuka ukuhamba kwakho, nokusebenzisa imithi yokuhlanza ubuhlungu kuqeda izimpawu kubantu abaningi. Imithi yokunciphisa ubuhlungu ethengekayo njenge-acetaminophen, i-ibuprofen, i-naproxen kuyizindlela ezinhle zokuhlanza ubuhlungu obukhulu. Uma ubuhlungu bakho bukhulu, udokotela wakho angase akukhuthaze ukudubula kwe-cortisone noma imithi yokunciphisa imisipha. Ezimweni ezingavamile, i-opioids ingase ilotshwe isikhathi esifushane lapho ezinye izindlela zokwelapha zingasebenzi. Ukwelashwa komzimba kungasiza futhi ekulawuleni ubuhlungu ngezikhundla, ukwelula, kanye nokuzivocavoca okuqanjwe ukunciphisa ukungakhululeki okubangelwa yi-disk ephukile. Abantu abambalwa abane-disk ephukile abadinga ukucutshungulwa, kodwa uma kudingeka, ochwepheshe bezokucutshungulwa bangase benze lokho okuthiwa yi-diskectomy. Lokhu kungenziwa ngendlela evulekile noma ngendlela encane. Ingxenye ephumayo ye-disk isuswa. Ngezinye izikhathi ezimweni zokungazinzi komgogodla, kudingeka ukufakwa kwamathambo lapho ama-vertebrae ahlanganiswe ndawonye nge-hardware yensimbi. Ezimeni ezingavamile, udokotela angase afake i-disk yokwenziwa ukuze athathe indawo yaleyo ephukile.

I-disk ephukile ibhekisela enkingeni kwenye yezikhukhula ezithambile, ezibizwa ngama-disk, azihlala phakathi kwamathanga ahlanganiswe ndawonye ukwenza umgogodla. La mathanga abizwa ngama-vertebrae.

I-disk yomgogodla inenhliziyo ebushelelezi, efana nejeli ebizwa ngokuthi i-nucleus. I-nucleus ibekwe ngaphandle okuqinile, okubomvu, okuthiwa i-annulus. I-disk ephukile yenzeka lapho ingxenye ye-nucleus isunduza ngaphandle ngokuqhekeka kwi-annulus. I-disk ephukile ngezinye izikhathi ibizwa ngokuthi i-disk ephukile noma i-disk ephukile.

I-disk ephukile, engase ienzeke kunoma iyiphi ingxenye yomgogodla, ngokuvamile ienzeka emhlane ophansi. Kuye ngokuthi i-disk ephukile ikuphi, ingase iholele ebuhlungwini, ukungabi nomuzwa noma ubuthakathaka engalweni noma emilenzeni.

Abantu abaningi abanazo izimpawu ze-disk ephukile. Kubantu abanezibonakaliso, izimpawu zivame ukuthuthuka ngokuhamba kwesikhathi. Ukwelashwa ngokuvamile akudingeki ukuze kuqede inkinga.

• Ubuhlungu ezingalweni noma emilenzeni. Uma i-disk yakho ephukile ikulesihlombe sakho esisezansi, ngokuvamile uzoba nobuhlungu ehlombe lakho elingaphansi, emizimba, emadolweni nasemahlombe. Ungaba nobuhlungu engxenyeni yenyathelo lakho futhi.

Nge-disk ephukile entanyeni yakho, ngokuvamile uzoba nobuhlungu obuningi ehlombe lakho nengalweni. Lobu buhlungu bungase buqale ukungena engalweni yakho noma emilenzeni uma ukhwehlela, uthimula noma uthuthukela ezindaweni ezithile. Ubuhlungu ngokuvamile buchazwa njengobunye obukhulu noma obushisayo.

• Ukungezwa noma ukukhahlela. Abantu abanedi-disk ephukile ngokuvamile baba nokungezwa noma ukukhahlela okusakazwayo engxenyeni yomzimba ekhonjiswe yimithambo yezinzwa ethintekile.
• Ubuthakathaka. Imisipha ekhonjiswe yimithambo yezinzwa ethintekile ivame ukubuyekeza. Lokhu kungakwenza ukhubeke noma kuthonye ikhono lakho lokuphakamisa noma ukubamba izinto.

Ubuhlungu ezingalweni noma emilenzeni. Uma i-disk yakho ephukile ikulesihlombe sakho esisezansi, ngokuvamile uzoba nobuhlungu ehlombe lakho elingaphansi, emizimba, emadolweni nasemahlombe. Ungaba nobuhlungu engxenyeni yenyathelo lakho futhi.

Nge-disk ephukile entanyeni yakho, ngokuvamile uzoba nobuhlungu obuningi ehlombe lakho nengalweni. Lobu buhlungu bungase buqale ukungena engalweni yakho noma emilenzeni uma ukhwehlela, uthimula noma uthuthukela ezindaweni ezithile. Ubuhlungu ngokuvamile buchazwa njengobunye obukhulu noma obushisayo.

Ungaba ne-disk ephukile ngaphandle kwezimpawu. Ungase ungazi ukuthi unayo ngaphandle kokuthi ibonakale esithombeni se-spinal.

Funani usizo lokuwelapha uma ubuhlungu bomhlane noma entanyeni buhlela phansi engalweni yakho noma emilenzeni, noma uma futhi uneqili, ukukhahlela noma ubuthakathaka.

Ukukhishwa kwediski kuvame kakhulu ukuba yimphumela yokuguga okuqhubekayo, okuhlobene nokweluka nokukhahlela okubizwa ngokuthi ukubola kwediski. Njengoba abantu bekhula, amadiski aba mancane kakhulu futhi abe lula ukuqhekeka noma ukuqhekeka ngisho nangomzamo omncane noma ukugoqa. Abantu abaningi abakwazi ukubona imbangela yediski yabo ephukile. Ngezinye izikhathi, ukusebenzisa imisipha yomhlane esikhundleni semisipha yemilenze nezinyawo ukuthwala izinto ezisindayo kungabangela ukukhishwa kwediski. Ukugoqa nokujikeleza ngesikhathi sokuphakamisa nakho kungabangela ukukhishwa kwediski. Ngokuvamile, izehlakalo ezibuhlungu njengokuwa noma ukushaywa emhlane yimbangela.

Izimbangela ezingandisa ingozi yediski ephukile zihlanganisa: Ukuqina. Ukukhuluphala kubangela ukucindezela okwengeziwe kumadiski emuva ophansi. Umsebenzi. Abantu abenza imisebenzi enzima ngokomzimba banengozi enkulu yengxaki yomhlane. Ukuphakamisa okuphindaphindayo, ukudonsa, ukusunduza, ukuguqa eceleni nokugoqa kungandisa ingozi yediski ephukile. Igenetics. Abanye abantu bazama ukufumana idiski ephukile. Ukubhema. Kucatshangelwa ukuthi ukubhema kunciphisa ukunikezwa komoya kumadiski, kubangela ukuba aphule ngokushesha. Ukuqhuba njalo. Ukuba uhleli isikhathi eside kanye nokuthungatha okuvela injini yemoto kungacindezela umgogodla. Ukuba uhlala phansi. Ukuzivocavoca njalo kungasiza ukuvimbela idiski ephukile.

Ncane nje ngaphezulu kwesinqandayo sakho, i-spinal cord yakho iphela. Okulandelanayo ngaphakathi komthamboka-mazinyo yiqembu lezimpande zezinzwa ezibude ezifana nomsila wehashe, ebizwa ngokuthi yi-cauda equina. Ngokungavamile, ukuqhuma kwe-disk kungacindezela umthamboka-mazinyo wonke, kuhlanganise nezinzwa zonke ze-cauda equina. Kwezinye izikhathi ezingavamile, ukucutshungulwa okuphuthumayo kungase kudingeke ukuze kugwenywe ubuthakathaka obungapheli noma ukungakwazi ukuhamba. Funani ukunakekelwa kwezokwelapha okuphaphuthumayo uma una: Izimpawu ezibi. Ubuhlungu, ukungabi namqondo noma ubuthakathaka kunganda kwaze kwaba yingqondo yokuthi kuvimba imisebenzi yakho yansuku zonke. Ukusebenza okungalungile kwesisu noma esibindini. I-Cauda equina syndrome ingabangela ukungakwazi ukuzilawula noma ukuhlupheka ekushiseni ngisho noma isisu sigcwele. Ukungabi namqondo kwe-saddle. Lo kulahleka okukhulu komuzwa kuchaphazela izindawo ezingathinta i-saddle - ama-thighs angaphakathi, emuva kwemilenze nendawo ezungezile i-rectum.

Ukuvimbela isikhwama esiqhekekile, yenza okulandelayo:

• Ukuzivocavoca. Ukuqina kwemisipha yomzimba kuyenza i-spine iqinile futhi isekwe.
• Yeka ukubhema. Gwema ukusetshenziswa kwemikhiqizo yotshani. UEduard Markle wayephelelwe yithemba. Naphezu kokuthola ama-nerve blocks odokotela bakhe, u-Edward uthi ubuhlungu obuvela ezinhlamvini ezimbili eziqhekekile bebukhulu kakhulu futhi abupheli. Wayengeke ahlale noma ahamba ngaphandle kobuhlungu. Wayelele phansi, amahora amabili ngobusuku. Wayekhathazeka ngokwanda ngekusasa. "Kwenze impilo yami ibe yize, " esho. "Ngingahamba. Ngingaphuma. Angitholanga indlela yok…

Udokotela wezinzwa uMohamad Bydon, uM.D., uyaphendula imibuzo ebuzwa kakhulu mayelana ne-disk ephukile.

Ukulala noxinzelelo kokubili kungase kube nomthelela ebuhlungwini. Ukulala yisikhathi lapho umzimba uzivuselela khona. Isikhathi esanele sokulala, ngekhwalithi enhle yokulala, kubaluleke kakhulu ekulawuleni ubuhlungu ngempumelelo. Uxinzelelo lungase futhi kube yinto ebiyisela ubuhlungu. Ukuphatha uxinzelelo ngendlela efanele nokubhekana nakho ngezindlela ezifanele futhi kuyinto ebaluleke kakhulu ekulawuleni ubuhlungu.

Ukuvuvukala kwamajozi entanyeni nasemuhlane kuyisimo esivamile. Lokhu kuyaziwa njengokugqwala noma isifo sokuwohloka. Kubangela ubuhlungu emhlane nase ntanyeni. Ubuhlungu emhlane yisizathu esinye esikhulu sokubona udokotela wakho, ubuhlungu entanyeni yisizathu sesithathu sokubona udokotela wakho. Empilweni yethu, i-80% yethu sizobhekana nobuhlungu emhlane obukhulu kangangokuthi kudinga ukunakekelwa kwezokwelapha.

Ukuvuvukala kwamajozi akunakumiswa, ayikho imithi yokwelapha ukuvuvukala kwamajozi, kodwa kungaphathwa futhi kuphathwe. Ukuqina komzimba kubaluleke kakhulu. Ukugcina isisindo somzimba esihle kubaluleke kakhulu. Ukwakha amandla, ukuzivocavoca kungabi lutho, konke lokho kuyizinto ezibaluleke kakhulu ekusizeni ekulawuleni nasekuphatheni ukuvuvukala kwamajozi.

Kubalulekile ukusebenzisana neqembu lakho lezokwelapha ukuze uthole umphumela omuhle kakhulu wesimo sakho sezempilo. Indlela engcono kakhulu yokwenza lokho ukwaziswa ngesimo sakho. Sikunikeze ulwazi oluningi namuhla oluzokuvumela ukuba usebenze nodokotela wakho neqembu labo lezokwelapha. Unganqikazi ukubuza iqembu lakho lezokwelapha imibuzo onayo. Ukuba nolwazi kwenza umehluko. Siyabonga ngesikhathi sakho futhi sikufisela okuhle.

Phakathi kokuhlolwa komzimba, ochwepheshe bakho bezempilo bazohlola umhlane wakho ukuze ubone ukuthi ubuhlungu yini. Ungase ucelwe ukuba ulele phansi bese uhambisa imilenze yakho ezindaweni ezahlukene ukuze usize ukuthola imbangela yobuningi bakho.

Udokotela wakho angase futhi enze ukuhlolwa kwezinzwa ukuze ahlole:

• Izimpendulo.
• Amandla emisipha.
• Ikhono lokuphila.
• Ikhono lokubona uthintana okulula, izipikili noma ukuzamazama.

Ezimweni eziningi ze-disk ephukile, ukuhlolwa komzimba nomlando wezokwelapha konke okudingekayo ekuxilongeni. Uma ochwepheshe bakho bezempilo becabanga ngesinye isimo noma kudingeka babone ukuthi yiziphi izinzwa ezibuthintekile, ungase ube nokuhlolwa okulandelayo.

• Izithombe ze-X-ray. Izithombe ze-X-ray azitholi ama-disk aphukile, kodwa zingakwazi ukukhipha ezinye izimbangela zokubuhlungu emhlane. Izithombe ze-X-ray zingabonisa ukutheleleka, isifo, izinkinga zokulingana komgogodla noma ithambo eliphukile.
• I-CT scan. I-CT scanner ithatha uchungechunge lwezithombe ze-X-ray ezivela ezinhlangothini ezahlukene. Lezo zithombe zihlanganiswe ukuze zenze izithombe zesigaba somgogodla nezinto eziwuqongqozayo.
• I-MRI. Amaza omsakazo nensimu enamandla ye-magnetic asebenza ukuze enze izithombe zezakhiwo zangaphakathi zomzimba. Lolu hlolo lungasetshenziswa ukuqinisekisa indawo ye-disk ephukile nokuthi yiziphi izinzwa ezibuthintekile.

Izifundo zokuphatha kwezinzwa kanye ne-electromyograms (EMGs) zilinganisa ukuthi amandla omsakazo kagesi ahambisa kanjani ezinzwini. Lokhu kungasiza ekutholeni indawo yomonakalo wezinzwa.

• Isifundo sokuphatha kwezinzwa. Lolu hlolo luqapha amandla omsakazo wezinzwa nokusebenza kwemisipha nezinzwa nge-electrodes ezibekwe ebusweni. Isifundo siqapha amandla omsakazo ezinzwini lapho i-current encane idlula enzwini.
• I-Electromyogram (EMG). Phakathi kwe-EMG, udokotela ufake i-needle electrode ngesikhumba kuya emisipha ehlukahlukene. Ukuhlolwa kuhlola umsebenzi womsakazo wemisipha lapho icindezelwe futhi lapho iphumule.