Kutarisira Spinal Stenosis: Kurapa Sarudzo

Spinal stenosis izwi rinoshandiswa kutsanangura musana wakatetepa. Kurapa kunosiyana nekuti nyaya yemunhu wese yakasiyana. Vamwe vanhu vanonzwa zviratidzo zvakapfava, nepo vamwe vachiona zviratidzo zvakakomba. Kuziva marapirwo angaite here kunobatsira murwere nechikwata chezvehutano kugadzirisa uye kugadzirisa hurongwa hwekurapa kumamiriro emunhu?

Spinal Stenosis Treatments

Nzvimbo dziri mukati memuzongoza dzinogona kuita dzakatetepa kupfuura dzavanofanirwa kunge vari, izvo zvinogona kukonzera kudzvanywa pamidzi yetsinga uye musana. Kwese kwese kumusana kunogona kukanganiswa. Iko kupfupika kunogona kukonzera marwadzo, kupisa, uye / kana kurwadza kumashure uye kushaya simba mumakumbo netsoka. Spinal stenosis ine akati wandei ekutanga kurapwa. Paunenge uchishanda kuburikidza nespinal stenosis kurapwa, mupi wehutano anoongorora zviratidzo uye otanga kurapwa nekutanga-mutsara kurapa, senge mushonga wemarwadzo uye / kana kurapa kwemuviri. Izvi zvinowanzova zvekutanga pakati pevanhu vane chirwere ichi.

Mishonga

Chirwere chisingaperi chimwe chezviratidzo zvikuru. Kurapa kwekutanga kazhinji kunosanganisira kushandisa mishonga/s yekubvisa marwadzo. Mishonga inowanzotaurwa ndeye nonsteroidal anti-inflammatories kana NSAIDs. Iyi mishonga inoderedza marwadzo uye kuzvimba. Zvisinei, NSAIDs hazvikurudzirwi kushandiswa kwenguva refu, uye mamwe mishonga inogona kushandiswa kubvisa marwadzo anosanganisira:Sudhir Diwan et al., 2019)

• Tylenol - acetaminophen
• Gabapentin
• Pregabalin
• Opioids yezviitiko zvakanyanya

kusimbisa muviri

Kudzidzira muviri kunogona kuderedza spinal stenosis zviratidzo nekutora kumanikidza kubva patsinga, izvo zvinogona kuderedza marwadzo nekuvandudza kufamba. (Andrée-Anne Marchand et al., 2021) Vatariri vehutano vanozokurudzira maekisesaizi anonyanya kushanda kumunhu. Mienzaniso inosanganisira:

• Zviitwa zveAerobic, senge kufamba
• Akagara lumbar flexion
• Lumbar flexion mukureva nhema
• Kuwedzerwa lumbar kuwedzera
• Hip uye core kusimbisa
• Kumira chiuno chechiuno

Therapy Therapy

Imwe yekutanga spinal stenosis kurapwa ndeye kurapa kwemuviri, iyo inowanzoshandiswa pamwe nemishonga inorwadza. Kazhinji, vanhu vanotora mavhiki matanhatu kusvika masere ekurapa kwemuviri, nezvikamu zviviri kana katatu pasvondo. Kushandisa kurapa kwemuviri kwakaratidzwa kune (Sudhir Diwan et al., 2019)

• Deredza marwadzo
• Wedzera kufamba
• Deredza mishonga yemarwadzo.
• Deredza zviratidzo zvehutano hwepfungwa sekutsamwa, kuora mwoyo, uye kuchinja kwemafungiro.
• Muzviitiko zvakakomba, kurapwa kwepanyama mushure mekuvhiyiwa kunogona kuderedza nguva dzekupora.

Kudzoka Braces

Back braces inogona kubatsira kuderedza kufamba uye kudzvinyirira pamusana. Izvi zvinobatsira nekuti kunyangwe kufamba kudiki kwemuzongoza kunogona kutungamira kune kushatirwa kwetsinga, kurwadziwa, uye kuwedzera zviratidzo. Nokufamba kwenguva, kusungirirwa kunogona kutungamirira kune kuwedzera kwakanaka kwekufamba. (Carlo Ammendolia et al., 2019)

Injections

Epidural steroid jekiseni inogona kukurudzirwa kubvisa zviratidzo zvakakomba. Steroids inoshanda se anti-inflammatories kuderedza marwadzo uye kuzvimba kunokonzerwa nekuzvimba uye kushatirwa kwetsinga dzemusana. Zvinoonekwa sezvisina kuvhiyiwa nzira dzekurapa. Maererano nekutsvakurudza, majekiseni anogona kunyatsogadzirisa marwadzo kwemavhiki maviri uye kusvika kumwedzi mitanhatu, uye imwe tsvakurudzo yakawana kuti mushure mejekiseni remusana, zororo rinogona kupedza mwedzi makumi maviri nemana. (Sudhir Diwan et al., 2019)

Yakaomeswa Ligaments Decompression Procedure

Vamwe vanhu vanogona kukurudzirwa kuita decompression process. Iyi nzira inosanganisira kushandisa tsono yakatetepa inopinzwa kumashure. Iyo yakakora ligament tissue inobviswa kuti ideredze kudzvanywa pamusana netsinga. Tsvagiridzo yakawana kuti maitiro anogona kuderedza zviratidzo uye kudiwa kwekuvhiya kwakawanda. (Nagy Mekhail et al., 2021)

Zvimwe Kurapa

Pamusoro pekurapa kwekutanga, vanhu vanogona kuendeswa kune mamwe marapirwo ekurapa zviratidzo, kusanganisira:

Acupuncture

• Izvi zvinosanganisira kuiswa kwetsono dzakatetepa mumaacupoints akasiyana-siyana kuti abvise zviratidzo.
• Imwe tsvagiridzo yakawana kuti acupuncture inogona kushanda zvakanyanya mukuderedza zviratidzo pane kurapwa kwemuviri chete. Zvose zviri zviviri zvinogoneka uye zvinogona kuvandudza kufamba uye kurwadziwa. (Hiroyuki Oka et al., 2018)

Chiropractic

• Mushonga uyu unoderedza kudzvanywa kwetsinga, unochengetedza musana, uye unobatsira kuvandudza kufamba.

masaja

• Massage inobatsira kuwedzera kutenderera, kuzorodza tsandanyama, uye kuderedza marwadzo nekuoma.

Itsva Kurapa Sarudzo

Sezvo tsvakiridzo yespinal stenosis ichienderera mberi, marapirwo matsva ari kubuda kubatsira kudzoreredza uye kugadzirisa zviratidzo muvanhu vasingadaire kumishonga yechivanhu kana vasingakwanise kutora mishonga yakajairika nekuda kwezvikonzero zvakasiyana. Zvisinei, humwe humbowo hunoratidzwa hunovimbisa; mainishuwarenzi ezvokurapa anogona kuvaona sekuedza uye kusapa kuvharwa kusvikira kuchengetedzwa kwavo kwaratidzwa. Mamwe marapirwo matsva anosanganisira:

Acupotomy

Acupotomy imhando yeacupuncture inoshandisa tsono dzakatetepa nediki, flat, scalpel-type tip kuti ibvise kushushikana munzvimbo dzinorwadza. Tsvagiridzo pamusoro pemhedzisiro yayo ichiri shoma, asi yekutanga data inoratidza kuti inogona kuve inoshanda yekuwedzera kurapwa. (Ji Hoon Han et al., 2021)

Cell Stem Therapy

Stem cells ndiwo maseru anobva kune mamwe maseru ese. Ivo vanoita seyakagadzirwa kuti muviri ugadzire masero akasarudzika ane mabasa chaiwo. (National Institutes of Health. 2016)

• Vanhu vane spinal stenosis vanogona kukura kukuvara kwenyama yakapfava.
• Stem cell therapy inoshandisa stem masero kubatsira kugadzirisa kukuvara kana kurwara matishu.
• Stem cell therapy inogona kubatsira kugadzirisa kana kuvandudza nzvimbo dzakakuvadzwa uye kupa zororo rechiratidzo.
• Zvidzidzo zvekiriniki zvespinal stenosis zvinoshuma kuti inogona kunge iri nzira yekurapa inoshanda kune vamwe.
• Nekudaro, kutsvagisa kwakawanda kunodiwa kusimbisa kana kurapa kwacho kunoshanda zvakakwana kuti ishandiswe zvakanyanya. (Hideki Sudo et al., 2023)

Dynamic Kudzikamisa Zvishandiso

LimiFlex chishandiso chekurapa chiri kutsvagirwa uye kuongororwa kwekugona kwayo kudzoreredza kufamba uye kugadzikana mumusana. Inoiswa kumusana kuburikidza nekuvhiya. Maererano nekutsvakurudza, vanhu vane spinal stenosis vanogamuchira LimiFlex vanowanzoona kuderedzwa kwakanyanya kwemarwadzo uye zviratidzo pane mamwe maitiro ekurapa. (T Jansen et al., 2015)

Lumbar Interspinous Distraction Decompression

Lumbar interspinous distraction decompression ndiyo imwe nzira yekuvhiya yespinal stenosis. Kuvhiyiwa kunoitwa nekuchekwa pamusoro pemusana uye kunoisa mudziyo pakati pema vertebrae maviri kugadzira nzvimbo. Izvi zvinoderedza kufamba uye kudzvinyirira pamitsipa. Mhedzisiro yekutanga inoratidza kunaka kwenguva pfupi kubva kune zviratidzo; data yenguva refu haisati yavepo sezvo iri imwe itsva spinal stenosis yekurapa sarudzo. (UK National Health Service, 2022)

Maitiro Ekuvhiya

Kune akati wandei maitiro ekuvhiya anowanikwa kune spinal stenosis. Zvimwe zvinosanganisira: (NYU Langone Health. 2024) Kuvhiyiwa kwespinal stenosis kunowanzochengeterwa vanhu vane zviratidzo zvakakomba, senge chiveve mumaoko kana makumbo. Kana zviratidzo izvi zvikakura, zvinoratidza kudzvanywa kunonyanya kuzivikanwa kwetsinga dzemusana uye kudiwa kwekurapa kwakanyanya. (NYU Langone Health. 2024)

Laminectomy

• A laminectomy inobvisa chikamu kana yese yelamina, iyo vertebral bone inovhara musana.
• Iyo nzira yakagadzirirwa kuderedza kumanikidzwa kwetsinga uye musana.

Laminotomy uye Foraminotomy

• Kuvhiya kwese kunoshandiswa kana spinal stenosis yemunhu ikakanganisa kuvhurwa kwevertebral foramen.
• Marunda, shwashwa, kana mamwe matishu anosunga tsinga anobviswa.
• Ose ari maviri anoderedza kudzvanywa kwetsinga dzinofamba neforomeni.

Laminoplasty

• A laminoplasty inobvisa kudzvanywa pamutsipa wemusana nekubvisa zvikamu zvepinal canal's lamina.
• Izvi zvinowedzera musana wemusana uye zvinoderedza kumanikidzwa patsinga. (Columbia Neurosurgery, 2024)

Discectomy

• Kuvhiya uku kunosanganisira kubvisa herniated kana bulging discs ari kuisa kumanikidza pamuzongoza uye tsinga.

Spinal fusion

• Spinal fusion inosanganisira kujoinha mavertebrae maviri uchishandisa zvimedu zvesimbi zvakaita setsvimbo uye screws.
• Iwo vertebrae akanyanya kugadzikana nekuti matanda uye screws zvinoshanda sesimbi.

Ndeupi Kurapa Kwakarurama?

Nekuti zvirongwa zvese zvekurapa zvinosiyana, kuona iyo inonyanya kushanda ndiyo yakanyatsokodzera mupi wehutano. Imwe neimwe nzira ichave yakasarudzika kune munhu. Kuti usarudze kuti ndeupi kurapa kwakanyanya, vatapi vehutano vanoongorora: (National Institute of Arthritis uye Musculoskeletal uye Skin Zvirwere. 2023)

• Kuoma kwezviratidzo.
•  Chiyero chezvino chehutano hwese.
• Chiyero chekukuvadza kuri kuitika muzongoza.
• Chiyero chekuremara uye kuti kufamba uye kunaka kwehupenyu zvinokanganiswa sei.

Injury Medical Chiropractic uye Functional Medicine Clinic ichashanda nemunhu mukuru wehutano hwehutano uye / kana nyanzvi kuti vabatsire kuziva nzira dzakanakisisa dzokurapa uye kunetseka maererano nemishonga kana mamwe maitiro ekurapa.

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Kuvhura Wellness

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References

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Marchand, AA, Houle, M., O'Shaughnessy, J., Châtillon, C. É., Cantin, V., & Descarreaux, M. (2021). Kubudirira kwechirongwa chekudzidzira-based prehabilitation chirongwa chevarwere vakamirira kuvhiyiwa kwelumbar spinal stenosis: chirongwa chekliniki chisingaverengeki. Mishumo yeSainzi, 11(1), 11080. doi.org/10.1038/s41598-021-90537-4

Ammendolia, C., Rampersaud, YR, Southerst, D., Ahmed, A., Schneider, M., Hawker, G., Bombardier, C., & Côté, P. (2019). Mhedzisiro yeprototype lumbar spinal stenosis bhandi zvichienderana nerutsigiro rwechiuno pakufamba kugona mu lumbar spinal stenosis: muedzo wakasarudzika unodzorwa. The spine magazine: yepamutemo magazini yeNorth American Spine Society, 19 (3), 386-394. doi.org/10.1016/j.spinee.2018.07.012

Mekhail, N., Costandi, S., Nageeb, G., Ekladios, C., & Saied, O. (2021). Kugara kwemaitiro mashoma ekuderedza lumbar decompression muvarwere vane symptomatic lumbar spinal stenosis: Kutevera kwenguva refu. Marwadzo maitiro: iyo yepamutemo magazini yeWorld Institute of Pain, 21 (8), 826-835. doi.org/10.1111/papr.13020

Oka, H., Matsudaira, K., Takano, Y., Kasuya, D., Niiya, M., Tonosu, J., Fukushima, M., Oshima, Y., Fujii, T., Tanaka, S., & Inanami, H. (2018). Chidzidzo chekuenzanisa chemishonga mitatu yekuchengetedza muvarwere vane lumbar spinal stenosis: lumbar spinal stenosis ne acupuncture uye physical therapy study (LAP study). BMC yekuwedzera uye imwe mushonga, 18(1), 19. doi.org/10.1186/s12906-018-2087-y

Han, JH, Lee, HJ, Woo, SH, Park, YK, Choi, GY, Heo, ES, Kim, JS, Lee, JH, Park, CA, Lee, WD, Yang, CS, Kim, AR, & Han , CH (2021). Kubudirira uye kuchengetedzwa kweacupotomy pane lumbar spinal stenosis: pragmatic randomized, controlled, pilot clinical trial: A study protocol. Mushonga, 100(51), e28175. doi.org/10.1097/MD.0000000000028175

Sudo, H., Miyakoshi, T., Watanabe, Y., Ito, YM, Kahata, K., Tha, KK, Yokota, N., Kato, H., Terada, T., Iwasaki, N., Arato, T., Sato, N., & Isoe, T. (2023). Protocol yekurapa lumbar spinal canal stenosis nemusanganiswa we ultrapurified, allogenic bone marrow-derived mesenchymal stem cells uye in situ-forming gel: a multicentre, anotarisira, maviri-mapofu randomized controlled controlled. BMJ vhura, 13(2), e065476. doi.org/10.1136/bmjopen-2022-065476

National Institutes of Health. (2016). Stem cell basics. US Department of Health and Human Services. Zvakatorwa kubva stemcells.nih.gov/info/basics/stc-basics

Jansen, T., Bornemann, R., Otten, L., Sander, K., Wirtz, D., & Pflugmacher, R. (2015). Vergleich dorsaler Dekompression nicht stabilisiert und dynamisch stabilisiert mit LimiFlex™ [Kuenzaniswa kweDorsal Decompression uye Dorsal Decompression Yakasanganiswa neDynamic Stabilization Device LimiFlex™]. Zeitschrift fur Orthopadie und Unfallchirurgie, 153(4), 415–422. doi.org/10.1055/s-0035-1545990

UK National Health Service. (2022). Kuvhiyiwa kweLumbar decompression: Kunoitwa sei. www.nhs.uk/conditions/lumbar-decompression-surgery/what-happens/

NYU Langone Health. (2024). Kuvhiya kwespinal stenosis. nyulangone.org/conditions/spinal-stenosis/treatments/surgery-for-spinal-stenosis

Columbia Neurosurgery. (2024). Cervical laminoplasty nzira. www.neurosurgery.columbia.edu/patient-care/treatments/cervical-laminoplasty

National Institute of Arthritis uye Musculoskeletal uye Skin Zvirwere. (2023). Spinal stenosis: Kuongororwa, kurapwa uye matanho ekutora. Zvakatorwa kubva www.niams.nih.gov/health-topics/spinal-stenosis/diagnosis-treatment-and-steps-to-take