So w’akyi yɛ wo yaw mpɛn pii? Ebia wo nso wote nka sɛ wo nan ase yɛ wo yaw. Nanso fa no sɛ, nea ɛka akyi yaw yi ho no, ɛyɛ den ma wo mpofirim sɛ wobɛtow wo ho anaasɛ wobɛtow wo ho, anaasɛ wuntumi nni so? Eyi nyɛ biribi a wubetumi abu w’ani agu so kɛkɛ ankasa. Eyi betumi ayɛ aduruyɛ tebea a emu yɛ den yiye, a egye ntɛmpɛ a ɛhwehwɛ sɛ wɔyɛ no oprehyɛn ntɛm ara. Eyi ne nea yɛreka ho asɛm nnɛ.
Dɛn ne Cauda Equina Yare no?
Sɛ yɛbɛka no tiawa a, eyi yɛ tebea a ɛntaa nsi koraa nanso anibere wom yiye. Wɔ yɛn akyi berɛmo anaa akyi berɛmo no ase no, ntini ntini a ɛyɛ akuwakuw bi wɔ hɔ. Saa ntini ahorow yi te sɛ ɔpɔnkɔ dua, enti wɔfrɛ no "Cauda Equina" wɔ Latin kasa mu. Saa ntini ahorow yi de nkrasɛm kɔ akwaa a ɛwɔ yɛn nan, yɛn nan, ne yɛn akyi berɛmo mu no mu na efi hɔ ba.
Cauda Equina Syndrome (CES) ba bere a wɔahyɛ ntini a ɛyɛ den yi esiane biribi nti no. Wobu eyi sɛ oprehyɛn a egye ntɛmpɛ . Sɛ wɔtwentwɛn ayaresa no ase a, ebia wɔrentumi nsakra ntini a asɛe no. Eyi kyerɛ sɛ ebia nan abien no nyinaa bɛyɛ obubuafo koraa , na ebetumi aba sɛ akisikuru ne dwensɔtwaa so tumi a ɛbɛtra hɔ daa.
Saa tebea yi betumi aba mpofirim (a emu yɛ den) anaasɛ bere kɔ so no (ɛyɛ nea enni sabea). Nanso, ɛho hia sɛ wokɔ oduruyɛfo nkyɛn bere a yare no ho sɛnkyerɛnne da adi ara pɛ.
Dɛn na ɛde Cauda Equina Syndrome ba?
Ɛwom sɛ saa tebea yi taa ba mpanyimfo mu de, nanso ebetumi aba mmofra a awo mu dɛmdi anaa wɔn akyi berɛmo mu apirakuru kɛse nso so. Nneɛma atitiriw a ɛde ba ne:
- Disk a ɛyɛ mmerɛw wɔ akyi, a ɛpia ntini bi so no ne nea ɛtaa de ba.
- Akyi berɛmo mu akisikuru .
- Akisikuru anaa kokoram a ɛwɔ akyi berɛmo mu.
- Nyarewa, ɔfe, mogya a ɛtɔ, anaa akyi berɛmo mu a ɛpaapae.
- Akyi berɛmo mu opira a efi akwanhyia a emu yɛ den mu (e.g., kar akwanhyia, hwe ase fi soro, tuo a wɔapirapira).
- Sɛ nhwɛso no, awo mu dɛmdi, arteriovenous malformation (AVM).
- Ɔhaw a ɛba bere a wɔayɛ wɔn akyi oprehyɛn akyi.
- Ɔhaw a ɛba bere a wɔde aduru a wɔde kum akyi berɛmo mu.
Red Flag Tebea yi ho sɛnkyerɛnne
Saa sɛnkyerɛnne ahorow yi betumi ayɛ den sɛ wobehu, efisɛ ɛte sɛ nyarewa afoforo de. Nanso sɛ wowɔ "Red Flag Symptoms" a ɛwɔ aseɛ ha no mu baako anaa nea ɛboro saa a, kɔ ayaresabea Emergency Department (ETU) anaa kɔ oduruyɛfoɔ nkyɛn ntɛm ara.
Mma ntra fie kɛkɛ nsusuw sɛ eyi yɛ akyi yaw a ɛfata. Bere yɛ ade titiriw wɔ ha.
| Nsɛnkyerɛnne a ɛkyerɛ | Nkyerɛkyerɛmu ne nkyerɛkyerɛmu |
|---|---|
| Saddle Anesthesia a Wɔde Ma | Eyi ne sɛnkyerɛnne titiriw ne nea asiane wom sen biara . Fa no sɛ bere a wote ɔpɔnkɔ so no, wo nipadua no afã horow a wɔamia so wɔ atenae no so no. Ɛno kyerɛ sɛ w’asen, w’asen mu, ne baabi a atwa w’akyi ho ahyia no bɛte nka sɛ wo ho ayɛ wo yaw kɛse anaasɛ ayɛ mmerɛw koraa. Ɛte sɛ nea wɔde aduru a ɛma obi dwensɔ saa mmeae no. |
| Ɔhaw ahorow a ɛfa nsu ne dwensɔtwaa a wɔde di dwuma ho | Ebia wobɛte nka mpofirim sɛ ɛho hia sɛ woto wo ho anaasɛ woto wo ho na worentumi nnyae (incontinence). Anaasɛ ebia wobɛte nka sɛ wuntumi ntow anaasɛ wuntumi ntow wo ho bere mpo a worebɔ mmɔden sɛ wobɛtow wo ho anaasɛ wobɛtow wo ho (retention). Ebia wobɛhwere atenka a ɛne sɛ ɛsɛ sɛ woto nsu nso. |
| Akyi yaw a emu yɛ den ne nan mu yaw | Sciatica yɛ ɛyaw bi a ɛte sɛ anyinam ahoɔden a wɔde abɔ nan no ase, na emu yɛ den sen akyi yaw a ɛyɛ daa. Saa ɛyaw yi betumi aba anan abien no nyinaa mu. |
| Mmerewa anaa anan a ɛyɛ mmerɛw | Ebia wobɛte nka sɛ wo nan anaa emu biako reyɛ ayɛ mmerɛw. Ebia ɛbɛyɛ den ama wo sɛ wobɛsɔre afi akongua so, anaasɛ wobɛto hintidua bere a wonam no. Ebia wobɛte nka nso sɛ wo nan ne wo nan ho hyehye wo, anaasɛ wobɛte nka sɛ wo ho ayɛ wo hyew (paresthesia) a ɛte sɛ nea nwansena nantew. |
| Ɔbarima ne ɔbea nna mu dwumadi ho haw ahorow | Ɔbarima ne ɔbea nna mu ɔhaw a ɛba mpofirim anaasɛ nna ho nkate a ɛyera. |
Ɔkwan bɛn so na oduruyɛfo hu eyi?
Sɛ wokɔ ayaresabea a, oduruyɛfo no betie wo yare no ho sɛnkyerɛnne no yiye. Afei ɔbɛhwehwɛ wo nipadua mu, titiriw ahoɔden, sɛnea wotumi yɛ ade, ne sɛnea wote nka wɔ wo nan mu no.
Nanso sɛnea ɛbɛyɛ a wobesi yare yi so dua no, akyinnye biara nni ho sɛ ɛho hia sɛ wɔyɛ MRI mfonini . MRI tumi nya akyi berɛmo ne ntini ahorow ho mfonini a ɛwɔ afã abiɛsa (3D). Afei eyi betumi akyerɛ beae pɔtee a ntini a wɔahyɛ no den no wɔ. Wɔ nsɛm a MRI nni hɔ mu no, wobetumi ayɛ X-ray anaa CT scan a wɔfrɛ no myelogram nso.
Ɔkwan bɛn so na wɔbɛsa? So ɛsɛ sɛ wopere wo ho?
Sɛ wohu sɛ ɔwɔ saa tebea yi a, ayaresa no ne sɛ wɔbɛyɛ oprehyɛn ntɛm ara de ayi ntini a ayɛ mmerɛw no afi hɔ. Wɔfrɛ saa oprehyɛn yi akyi berɛmo mu laminectomy .
Kae sɛ oprehyɛn a wɔyɛ wɔ nnɔnhwerew 48 akyi bere a yare no ho sɛnkyerɛnne no afi ase no ma wonya hokwan a eye sen biara sɛ wobesiw ɔsɛe a ɛtra hɔ daa ano na ne ho atɔ no.
Oprehyɛn akyi no, wobetumi de ayaresa afoforo ama a egyina nea ɛde ba no so:
- Nnuru a wɔde di dwuma kɛse a wɔde steroid (corticosteroids) di dwuma de tew ɔfe so.
- Nnuru a ekum ɔyare mmoawa sɛ nea ɛde ba no yɛ ɔyare mmoawa a.
- Sɛ nea ɛde ba no yɛ kokoram akisikuru a, wobetumi de mframa a wɔde sa yare anaa nnuru a wɔde sa yare ama obi bere a wɔayɛ no oprehyɛn awie no.
Wɔ oprehyɛn akyi mpo no, ebia egyina sɛnea ntini a asɛe no kodu so no, ɛrensa koraa. Nanso, ebia ebegye mfe pii ansa na nneɛma te sɛ akisikuru ne dwensɔtwaa a wɔde siw ano no asan ayɛ nea ɛfata.
Living with CES - Dɛn na ɛsɛ sɛ wuhu?
Sɛ biribi sɛe daa wɔ oprehyɛn akyi a, ɛsɛ sɛ wusua sɛnea wobɛtra ase ne nsakrae no. Honam ne nkate fam mmoa ho hia wo yiye wɔ akwantu yi mu.
Ka eyi ho asɛm kyerɛ w’abusua na nya wɔn mmoa. Wubetumi nso anya mmoa afi adwumayɛfo ahorow hɔ, te sɛ:
- Apɔw-mu-teɛteɛ Ho Ɔbenfo
- Adwuma mu Ɔyaresafo
- Ɔbarima ne Ɔbea Nna Ho Ɔyaresafo
- Ɔfotufo anaa Adwene ne Nkate Ho Ɔbenfo
Sɛ wowɔ ɔhaw ahorow wɔ wo nsu anaa wo nsu mu a, nneɛma yi betumi aboa:
- Fa catheter yi wo dwonku mu koraa mprɛnsa kosi anan da biara.
- Nom nsu pii na ho tew na amma woannya ɔyare mmoawa wɔ nsu mu.
- Sɛ ɛho hia a, fa glycerin suppositories anaa enemas di dwuma na aboa ma nsu atumi akɔ mu.
- Hyɛ nneɛma a ɛbɔ wo ho ban.
Wo ne wo duruyɛfo nka eyinom nyinaa ho nkɔmmɔ pefee. Ɔbɛma wo akwankyerɛ a wuhia.
Nkrasɛm a Wɔde Kɔ Fie
- Cauda Equina Syndrome (CES) nyɛ akyi yaw a ɛtaa ba kɛkɛ, ɛyɛ aduruyɛ mu tebea a egye ntɛmpɛ .
- Sɛ wuhu sɛnkyerɛnne ahorow te sɛ w’asen ne wo honam ani fã a ɛyɛ mmerɛw (saddle anesthesia), nsu/nsu a ɛmma wuntumi nni so, anaasɛ wo nan ahoɔden a ɛyera a, kɔ ayaresabea ntɛm ara .
- Ayaresa titiriw ne oprehyɛn a wɔyɛ no ntɛm wɔ nnɔnhwerew 48 ntam. Dodow a ɛkyɛ no, dodow no ara na hokwan a ɛwɔ hɔ sɛ ɛbɛsɛe no daa no yɛ kɛse.
- Wɔ oprehyɛn akyi mpo no, ebetumi agye bere ansa na ne ho atɔ no. Aduruyɛ mu afotu ne abusua mmoa ho hia.
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