Rubatsiro kubva kuNeurogenic Claudication: Kurapa Sarudzo

Vanhu vari kupfurwa, kurwadziwa kunorwadza mumigumo yezasi, uye marwadzo emakumbo epakati anogona kunge achitambura neurogenic claudication. Kuziva zviratidzo kungabatsira here vatapi vehutano kugadzira chirongwa chekurapa chinoshanda?

Neurogenic Claudication

Neurogenic claudication inoitika kana tsinga dzemuzongoza dzichimanikidzwa muchiuno kana pasi pemusana, zvichikonzera kurwadziwa kwemakumbo. Mitsipa yakamanikidzwa mulumbar spine inogona kukonzera marwadzo emakumbo uye makumbo. Marwadzo acho anowanzo wedzera nemafambiro chaiwo kana zviitiko zvakaita sekugara, kumira, kana kukotama kumashure. Inozivikanwawo se pseudo-claudication apo nzvimbo mukati me lumbar spine inotetepa. Chirwere chinozivikanwa se lumbar spinal stenosis. Zvisinei, neurogenic claudication is syndrome kana boka rezviratidzo zvinokonzerwa nepinched spinal nerve, nepo spinal stenosis inotsanangura kuderera kwemashure emusana.

zviratidzo

Neurogenic claudication zviratidzo zvinogona kusanganisira:

• Gumbo cramping.
• Chiveve, kurira, kana kunzwa kupisa.
• Gumbo kuneta uye kushaya simba.
• Kunzwa kurema mugumbo/s.
• Yakapinza, kupfura, kana kurwadziwa kunorwadza kunosvika kuzasi, kazhinji mumakumbo ese.
• Panogonawo kuva nemarwadzo muzasi kana matako.

Neurogenic claudication yakasiyana nemamwe marudzi emarwadzo emakumbo, sezvo marwadzo anochinja-kumira uye kutanga zvisizvo uye kuwedzera nekufamba kwakananga kana mabasa. Kumira, kufamba, kudzika masitepisi, kana kupenengura kumashure kunogona kukonzera marwadzo, ukagara, uchikwira masitepisi, kana kuzembera mberi kunoderedza marwadzo. Zvisinei, nyaya imwe neimwe yakasiyana. Nokufamba kwenguva, neurogenic claudication inogona kukanganisa kufamba sevanhu vanoedza kudzivisa mabasa anokonzera marwadzo, kusanganisira kurovedza muviri, kusimudza zvinhu, uye kufamba kwenguva refu. Muzviitiko zvakakomba, neurogenic claudication inogona kuita kuti kurara kuve kwakaoma.

Neurogenic claudication uye sciatica hazvina kufanana. Neurogenic claudication inosanganisira kudzvinyirira kwetsinga mukati memugero we lumbar spine, zvichikonzera marwadzo mumakumbo ose. Sciatica inosanganisira kudzvinyirirwa kwetsinga midzi inobuda kubva kumativi e-lumbar spine, zvichikonzera marwadzo mune rimwe gumbo. (Carlo Ammendolia, 2014)

Zvinokonzera

Neneurogenic claudication, yakamanikidzwa spinal nerve ndiyo inokonzera marwadzo emakumbo. Muzviitiko zvakawanda, lumber spinal stenosis - LSS ndiyo inokonzera pinched nerve. Kune marudzi maviri e lumbar spinal stenosis.

• Central stenosis ndiyo inonyanya kukonzera neurogenic claudication. Nemhando iyi, iyo yepakati canal ye lumbar spine, iyo inogara mutsara wemusana, inotetepa, ichikonzera marwadzo mumakumbo ose.
• Lumbar spinal stenosis inogona kuwanikwa uye kukura gare gare muhupenyu nekuda kwekuderera kwemusana.
• Congenital zvinoreva kuti munhu anozvarwa aine chirwere ichi.
• Zvose zviri zviviri zvinogona kutungamirira kune neurogenic claudication nenzira dzakasiyana.
• Foramen stenosis imwe mhando ye lumbar spinal stenosis inokonzera kutetepa kwenzvimbo kune rumwe rutivi rwe lumbar spine uko nerve midzi inobuda kubva kumusana. Marwadzo akabatanidzwa akasiyana pakuti angave ari mugumbo rerudyi kana kuruboshwe.
• Marwadzo acho anoenderana nedivi remuzongoza uko tsinga dziri kudzvanywa.

Inowanikwa Lumbar Spinal Stenosis

Lumbar spinal stenosis inowanzowanikwa nekuda kwekuderera kwe lumbar spine uye inowanzobata vanhu vakwegura. Zvikonzero zvekuputika kweganda zvinogona kusanganisira:

• Spinal trauma, senge kubva pakudhumhana kwemotokari, basa, kana kukuvara kwemitambo.
• Disc herniation.
• Spinal osteoporosis - kupfeka-uye-kubvarura arthritis.
• Ankylosing spondylitis - rudzi rwechirwere chearthritis chinokanganisa musana.
• Osteophytes - bone spurs.
• Spinal tumors - kwete-kenza uye kenza.

Congenital Lumbar Spinal Stenosis

Congenital lumbar spinal stenosis zvinoreva kuti munhu anozvarwa aine hurema hwemuzongoza hunogona kusaoneka pakuzvarwa. Nokuti nzvimbo iri mukati memugero wepelinha yatove yakamanikana, musana wemuzongoza uri panjodzi kune chero shanduko sezera remunhu. Kunyange vanhu vane arthritis yakapfava vanogona kuona zviratidzo zveneurogenic claudication kutanga uye kutanga zviratidzo mu30s uye 40s yavo pane yavo 60s uye 70s.

kuongorora chirwere

Kuongororwa kweurogenic claudication kunonyanya kuenderana nenhoroondo yezvehutano hwemunhu, kuongororwa kwemuviri, uye kufungidzira. Kuongororwa kwemuviri uye kuongorora kunoratidza kuti marwadzo arikupi uye riinhi. Mutariri wehutano anogona kubvunza:

• Pane nhoroondo yemarwadzo ekumusana here?
• Kurwadza kwegumbo rimwe chete here kana kuti ose?
• Kutambudzika kunogara kuripo here?
• Marwadzo anouya oenda here?
• Kurwadza kunowedzera here kana kuwedzera kana wakamira kana kugara?
• Ko kufamba kana kuita zvinokonzeresa zviratidzo zvinorwadza uye manzwiro?
• Pane chero manzwiro akajairika paunenge uchifamba?

mabatiro

Kurapa kunogona kusanganisira kurapwa kwemuviri, spinal steroid jekiseni, uye marwadzo meds. Kuvhiya inzira yekupedzisira apo mamwe marapirwo ese asingakwanisi kupa rubatsiro runoshanda.

Therapy Therapy

A kurapwa kuronga ichasanganisira kurapa kwemuviri kunosanganisira:

• Zuva nezuva kutambanudza
• Kusimbisa
• Aerobic kurovedza
• Izvi zvichabatsira kuvandudza uye kudzikamisa mhasuru dzepazasi uye kugadzirisa matambudziko ekumira.
• Occupational therapy ichakurudzira kuchinja kwemabasa kunokonzera zviratidzo zvinorwadza.
• Izvi zvinosanganisira ma mechanics akakodzera emuviri, kuchengetedza simba, uye kuziva zviratidzo zvinorwadza.
• Mabhandi ekumashure kana mabhandi anogonawo kukurudzirwa.

Spinal Steroid Majekiseni

Vashandi vehutano vanogona kukurudzira epidural steroid majekiseni.

• Izvi zvinopa cortisone steroid kune chikamu chekunze chemuzongoza kana epidural space.
• Majekiseni anogona kupa zororo rekurwadziwa kwemwedzi mitatu kusvika kumakore matatu. (Sunil Munakomi et al., 2024)

Kurwadziwa Medhi

Mishonga yemarwadzo inoshandiswa kurapa intermittent neurogenic claudication. Izvi zvinosanganisira:

• Pamusoro-the-counter analgesics seacetaminophen.
• Nonsteroidal anti-inflammatory drugs kana NSAIDs senge ibuprofen kana naproxen.
• Mishonga yeNSAID inogona kunyorerwa kana ichidiwa.
• NSAIDs dzinoshandiswa nekusingaperi neurogenic kurwadziwa uye inofanira kushandiswa chete kana ichidiwa.
• Kushandiswa kwenguva refu kweNSAIDs kunogona kuwedzera njodzi yezvironda zvemudumbu, uye kunyanya kushandiswa kweacetaminophen kunogona kutungamirira kuhutu hwechiropa uye kukanganisa kwechiropa.

Surgery

Kana kurapa kwekuchengetedza kusingakwanisi kupa rubatsiro runoshanda uye kufamba uye / kana hupenyu hwehupenyu hunokanganiswa, kuvhiyiwa kunozivikanwa se laminectomy kunogona kukurudzirwa kuti decompress lumbar spine. Iyo nzira inogona kuitwa:

• Laparoscopically - ine diki incisions, scopes, uye yekuvhiya chiridzwa.
• Kuvhiya kwekuvhura - ne scalpel uye sutures.
• Munguva yekuita, zvikamu zve vertebra zvinobviswa zvishoma kana zvachose.
• Kuti ape kugadzikana, mapfupa dzimwe nguva anosanganiswa ne screws, ndiro, kana tsvimbo.
• Mitemo yekubudirira yezvose zviri zviviri kana zvishoma zvakafanana.
• Pakati pe85% uye 90% yevanhu vari kuvhiyiwa vanowana kwenguva refu uye / kana kusingaperi kurwadziwa. (Xin-Long Ma et al., 2017)

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Movement Medicine: Chiropractic Care

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References

Ammendolia C. (2014). Degenerative lumbar spinal stenosis uye vanyengeri vayo: nyaya nhatu dzezvidzidzo. The Journal of the Canadian Chiropractic Association, 58 (3), 312-319.

Munakomi S, Foris LA, Varacallo M. (2024). Spinal Stenosis uye Neurogenic Claudication. [Yakagadziridzwa 2023 Aug 13]. Mu: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Inowanikwa kubva: www.yori.nlm.nih.gov/books/NBK430872/

Ma, XL, Zhao, XW, Ma, JX, Li, F., Wang, Y., & Lu, B. (2017). Kubudirira kwekuvhiya kunopesana nekuchengetedza kurapwa kwe lumbar spinal stenosis: A system review uye meta-analysis ye randomized controlled trials. International magazini yekuvhiya (London, England), 44, 329-338. doi.org/10.1016/j.ijsu.2017.07.032