He aha inā loaʻa koke iā ʻoe ka ʻeha nui o ke kua, ka mae ʻana o kou mau wāwae, a me kahi manaʻo hiki ʻole ke kāohi? Manaʻo paha ʻoe, 'ʻAʻole kēia he ʻeha kua maʻamau wale nō,' ʻeā? I kēia lā ke kamaʻilio nei mākou e pili ana i kahi maʻi koʻikoʻi e pono ai ka nānā koke ʻana, akā ʻaʻohe mea e kamaʻilio nui e pili ana i ia mea, i kapa ʻia ʻo Cauda Equina Syndrome (CES). ʻOiai he maʻi kakaikahi loa kēia, he mea nui loa ia e makaʻala no ka mea inā hana ʻia, hiki ke koi ʻia ke ʻoki kino ulia pōpilikia, no laila he mea nui loa ia e makaʻala.
I ka ʻōlelo maʻalahi, he aha ka Cauda Equina Syndrome (CES)?
I mea e hoʻomaopopo ai i kēia, e nānā mua kākou i ko kākou iwi kuamoʻo. Ma ka lalo loa o ko kākou iwi kuamoʻo, aia kahi puʻupuʻu o nā aʻalolo e hoʻolōʻihi ana i lalo mai ke kaula iwi kuamoʻo. Ua like ia me ka huelo o ka lio, no laila ua kapa ʻia ʻo 'Cauda Equina', ʻo ia ka Latina no "huelo o ka lio." Hoʻouna kēia mau aʻalolo a loaʻa nā manaʻo i ko kākou mau wāwae, nā wāwae, a me nā ʻōpū pelvic.
ʻO ka Cauda Equina Syndrome (CES) kahi kūlana kahi e ʻūmiʻi nui ʻia ai ka pūʻolo aʻalolo, i like ke ʻano me ka "huelo o ka lio," no kekahi kumu. ʻO kēia ʻūmiʻi ke kumu o ka hōʻino ʻana i nā aʻalolo.
Ua manaʻo ʻia kēia he pilikia ʻoki kino no ka mea, inā hoʻopaneʻe ʻia ka mālama ʻana, hiki i ka hōʻino ʻana o ke aʻalolo ke mau loa, e alakaʻi ana i nā kīnā koʻikoʻi a no ke ola holoʻokoʻa e like me ka maʻi lolo a me ka incontinence.
No ke aha kēia e hana nei? He aha nā kumu o CES?
ʻO kēia ke ʻano maʻamau i nā pākeke, akā hiki nō hoʻi ke loaʻa i nā keiki me nā kīnā hānau o ka iwi kuamoʻo a i ʻole nā keiki i loaʻa i kahi ʻeha nui i ko lākou iwi kuamoʻo. ʻO nā kumu nui:
- ʻO ka disc haki nui ma ke kua i lalo: ʻO kēia ke kumu maʻamau.
- ʻO ka stenosis o ka iwi kuamoʻo .
- He puʻupuʻu a maʻi ʻaʻai paha e kū ana ma ka iwi kuamoʻo.
- He maʻi, pehu, kahe koko, a i ʻole ka haki ma ka iwi kuamoʻo.
- Ma ke ʻano he pilikia o ka ʻeha o ke kuamoʻo mai kahi ulia koʻikoʻi, e like me kahi ulia kaʻa, hāʻule ʻana, a i ʻole kahi ʻeha pū.
- ʻO kekahi mau kūlana i loaʻa i ka wā hānau, e like me ka pilina maʻamau ʻole ma waena o nā kīʻaha koko ( Arteriovenous Malformation ).
- He pilikia ma hope o ke ʻoki kua.
- Ma ke ʻano he pilikia o ka anesthesia spinal (he mea kākaʻikahi loa kēia).
E makaʻala! Eia nā hōʻailona hōʻike o CES
Hiki ke paʻakikī ke ʻike i ka CES i kekahi manawa. ʻOkoʻa nā hōʻailona mai kēlā kanaka a kēia kanaka a hiki ke loaʻa ma nā ʻano like ʻole. Hiki ke like nā hōʻailona me nā kūlana ʻē aʻe, no laila hiki ke kuhihewa maʻalahi ʻia. Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, e ʻike koke i ke kauka. Inā hiki, e hele pololei i ka ʻOihana Pilikia o ka haukapila (ETU).
| ʻO ka maʻi Cauda Equina (CES) - ʻŌlelo Aʻo "Nā hōʻailona hae ʻulaʻula" | |
|---|---|
| Hōʻailona | Ua wehewehe maʻalahi ʻia |
| Anesthesia noho lio | ʻO kēia ka hiʻohiʻona kūikawā loa. Ua like ia me kou noho ʻana ma luna o ka lio, ʻo nā wahi e kaomi ai ka noho lio iā ia (nā puʻupuʻu, a puni nā ʻōpū, nā ʻūhā o loko) e lilo i mea mae a ʻaʻole ʻoe e manaʻo i kekahi mea. |
| ʻEha nui ke kua a me ka wāwae | ʻEha i ʻoi aku ka ʻino ma mua o ka ʻeha kua maʻamau, i kekahi manawa e pālahalaha ana i lalo i nā wāwae (sciatica). |
| Nā pilikia me ka kaohi ʻana o ka urinary a me ka bowel | ʻO ka paʻakikī koke i ka mimi/feces (paʻa ʻana) a i ʻole ka liki ʻole i makemake ʻia (incontinence). ʻO ka manaʻo ʻole i ka pono e mimi kekahi hōʻailona pili . |
| Ka nāwaliwali o nā wāwae | Ka nāwaliwali koke ma kekahi a i ʻole nā wāwae ʻelua, ka manaʻo paʻa ʻole, a i ʻole ka paʻakikī ke ala aʻe mai kahi noho. |
| Nā pilikia hana moekolohe | Ka hana moekolohe koke a i ʻole ka nalowale o ka manaʻo. |
ʻOkoʻa ma waena o ka CES piha a me ka CES piha ʻole
Ua hoʻokaʻawale nā kauka i kēia ʻano i ʻelua ʻano, ma muli o ka nui o kona hopena i kāu kaohi mimi a me ka ʻōpū.
- CES piha ʻole: I kēia hihia, manaʻo ʻoe i ka pono e mimi, akā he mea paʻakikī iki ia. ʻAʻole paha ʻoe e hiki ke hoʻokahe loa i kou ʻōpū mimi. Akā, loaʻa nō iā ʻoe kekahi mana. Inā hana ʻia ʻoe i ke ʻoki kino i ka wā mua, ʻoi aku ka maikaʻi o kou manawa e hoʻōla piha ai.
- CES piha: I kēia hihia, nalowale loa ka mana o ka mimi a me ka fecal. ʻAʻohe manaʻo o ka pono e mimi (paʻa). ʻOiai me ke ʻoki ʻana ma hope o ka hiki ʻana i kēia pae, he mea paʻakikī paha ke hoʻoponopono i ka pōʻino i nā aʻalolo.
No laila he mea nui e ʻimi i ke kōkua lapaʻau i ka wā e hoʻomaka ai nā hōʻailona, i ke ola holoʻokoʻa.
Pehea e ʻike ai i ka maʻi?
Ke hālāwai ʻoe me ke kauka, e hana ʻo ia i kēia mau mea.
1. Mōʻaukala lapaʻau: Nīnau e pili ana i kāu mau hōʻailona, pehea lākou i hoʻomaka ai, a me nā pilikia olakino ʻē aʻe.
2. Hoʻokolokolo kino: E hoʻāʻo ʻia kou mau wāwae no ka ikaika, ka manaʻo, a me nā reflexes.
3. MRI scan: ʻO kēia ke ala maikaʻi loa e ʻike ai i ka CES. Hoʻohana ia i kahi kahua magnetic e hana i nā kiʻi ʻekolu-dimensional (3D) maopopo o kou iwi kuamoʻo a me nā aʻalolo. Hiki i kēia ke hōʻike pololei i kahi i ʻūlū ʻia ai nā aʻalolo.
4. Nā hoʻokolohua ʻē aʻe: Inā ʻaʻole loaʻa kahi MRI, hiki ke hana ʻia kahi Myelogram (kahi X-ray a i ʻole CT scan kahi e hoʻokomo ʻia ai kahi wai kūikawā i loko o ke kaula spinal) a i ʻole nā hoʻokolohua e ana i ka hana aʻalolo e like me EMG/NCS .
He aha nā lāʻau lapaʻau?
ʻO ke ʻano lapaʻau kūleʻa wale nō no CES ʻo ia ke ʻoki kino ulia pōpilikia e hoʻokuʻu i ke aʻalolo i hoʻopaʻa ʻia. Ua kapa ʻia kēia ʻoki kino he Lumbar Laminectomy .
ʻOi aku ka maikaʻi o ke ʻoki ʻana i loko o 48 mau hola o ka hoʻomaka ʻana o nā hōʻailona . Hiki i ka hana ʻana pēlā ke hōʻemi nui i ka pilikia o ke kīnā mau loa.
Ma waho aʻe o ke ʻoki ʻana, pono paha nā lāʻau ʻē aʻe, ma muli o ke kumu:
- Corticosteroids: Hāʻawi ʻia nā lāʻau steroid kiʻekiʻe e hōʻemi i ka pehu a puni nā aʻalolo.
- Nā lāʻau antibiotic: Inā he maʻi ka kumu, hāʻawi ʻia nā lāʻau antibiotic.
- Ka radiation a i ʻole chemotherapy: Inā he maʻi kanesa ke kumu, pono paha kēia mau lāʻau ma hope o ke ʻoki ʻana.
Ke noho nei me CES a me ka hoʻoponopono hou ʻana
ʻOiai ma hope o ke ʻoki ʻana, hiki ke hoʻomau kekahi ʻoluʻolu ʻole ma muli o ka hōʻino ʻia o nā aʻalolo. ʻO ia ke ʻano o CES. Inā hana ʻia kēlā, ʻo ka mea nui loa ke aʻo e noho me nā loli. Nui nā poʻe loea a me nā ʻano hana e hiki ke kōkua iā ʻoe.
- Kauka Lapaʻau Kino: Kōkua i ke kūkulu hou ʻana i ka ikaika ma nā wāwae a aʻo e hele.
- Luna Hoʻōla Hana: Ke aʻo aku nei iā ʻoe i nā ʻano hana a me nā lako e pono ai e hana i nā hana o kēlā me kēia lā me ke kūʻokoʻa.
- Kākā'ōlelo Hoʻomau: Kūkākūkā i nā hoʻonā no nā pilikia mimi a me ka kaohi ʻana i ka ʻōpū (e.g., ka hoʻohana ʻana i ka catheter, nā pads kūikawā).
- Kākā'ōlelo: Kōkua i ka hoʻokele ʻana i ke kaumaha a me ke kaumaha e kū mai ana i ka wā e kū nei i kahi pilikia a i ʻole ke kūlana koʻikoʻi e like me kēia.
He mea waiwai nui nō hoʻi ke kākoʻo o kou ʻohana ma kēia huakaʻi. Eia kekahi, ʻo ka hui pū ʻana me nā poʻe ʻē aʻe e hele nei i kēia kūlana he kumu ikaika nui ia.
Leka Lawe-Home
- ʻAʻole wale ka Cauda Equina Syndrome (CES) he pilikia kua maʻamau, he pilikia olakino ia.
- E makaʻala mau i nā hōʻailona "hae ʻulaʻula" e like me ka anesthesia noho lio (ka maneʻo ma kahi noho lio), ka nalowale o ka mana mimi/fecal, a me ka nāwaliwali koke o nā wāwae.
- Inā ʻike ʻoe i hoʻokahi a ʻoi aku paha o kēia mau hōʻailona, mai hoʻonele i ka manawa a hele i ka Emergency Department (ETU) o ka haukapila a i ʻole e ʻike koke i kāu kauka .
- ʻO ka hoʻopaneʻe ʻana i ka mālama ʻana hiki ke alakaʻi i nā kīnā mau loa no ke ola holoʻokoʻa. Hiki i ka mālama mua ʻana ke hōʻemi nui i kēlā pilikia.
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