I kekahi manawa aia kekahi mau ʻeha i ko kākou ola e like me ka mea ʻaʻole e nalowale me ka nānā ʻole i nā lāʻau lapaʻau a kākou e lawe ai a i ʻole ka hoʻōla kino a kākou e hana ai. Hiki paha i ka ʻeha kua i hoʻopilikia iā kākou no nā makahiki, ka ʻeha ʻāʻī, a i ʻole ka ʻeha hiki ʻole ke hoʻomanawanui e like me ka haʻalulu uila ma kekahi ʻaoʻao o ka maka. ʻO ka poʻe wale nō i ʻike i ia mea e ʻike i ka paʻakikī o ke ola me ia mau kūlana. No laila, i ka wā e hāʻule ai nā mea āpau, i kēia lā e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau kūikawā a nā kauka e ʻōlelo nei. Ua kapa ʻia ʻo Rhizotomy.
I ka ʻōlelo maʻalahi, he aha ka Rhizotomy?
I mea e hoʻomaopopo ai i kēia, e noʻonoʻo mua kākou i ka ʻōnaehana nerve o ko kākou kino. ʻO nā aʻalolo e holo ana ma loko o ko kākou kino ua like ia me nā kaula uila liʻiliʻi. ʻO kēia mau kaula ka mea e hoʻouna i nā leka ma waena o ko kākou lolo a me ke koena o ko kākou kino. ʻO nā mea āpau āu e manaʻo ai, e like me ka pā ʻana, ka ʻeha, a me ka wela, ua hoʻouna ʻia i ka lolo ma o kēia mau aʻalolo, a ma o kēia mau aʻalolo e haʻi aku ai ka lolo iā ʻoe e hoʻoneʻe i kou mau lima a me kou mau wāwae.
Eia nō naʻe, i kekahi manawa, ma muli o kahi hana hewa i loko o kēia ʻōnaehana nerve, hoʻomaka kekahi mau aʻalolo e hoʻouna mau i ka leka "ʻeha" i ka lolo. ʻO ka ʻoiaʻiʻo, hele kēia leka ʻoiai ʻaʻohe maʻi nui ma laila. I loko o kahi lāʻau i kapa ʻia ʻo rhizotomy, ʻo ka mea i hana ʻia, ʻo ia ke ʻike i kēlā mau olonā nerve pilikia e hoʻouna ana i nā leka hewa, hōʻino iā lākou a hoʻōki i ka hele ʻana o ka leka. Ua like ia me ka hoʻokaʻawale ʻana i kahi uea uila pilikia. Ke pau nā hōʻailona ʻeha i ka hele ʻana i ka lolo ma kēia ʻano, nalowale ka ʻeha āu e manaʻo ai a i ʻole e emi nui ʻia.
Pehea ʻoe e hōʻino ai i kēia mau aʻalolo?
Hoʻohana nā kauka i kekahi mau ʻano hana e hana ai i kēia:
- ʻOki ʻoki: I kekahi manawa, ʻoki ʻia a wehe ʻia kēia mau aʻalolo. Hiki ke hana ʻia kēia ma ke ʻano he ʻoki hāmama a i ʻole endoscopically, ʻo ia hoʻi ke hoʻokomo ʻana i kahi kāmela ma o kahi ʻoki liʻiliʻi.
- Ma kahi kemika: Hiki iā ʻoe ke hōʻino i ke aʻalolo i nīnau ʻia ma ka hoʻohana ʻana i kahi kemika e like me ka glycerin.
- ʻO ka hoʻopau ʻana i ke alapine lekiō: Hoʻopili ʻia nā nalu lekiō ikaika kiʻekiʻe a hoʻohana ʻia ka wela hopena e hōʻino i ke aʻalolo. Ua kapa pinepine ʻia kēia ʻano hana ʻo Radiofrequency Ablation (RFA) .
I ka ʻōlelo maʻalahi, ʻo Rhizotomy kahi hana e hoʻōki ai i ka hana o nā aʻalolo e hoʻoulu ai i ka ʻeha a i ʻole ka ʻoʻoleʻa o nā ʻiʻo i makemake ʻole ʻia (spasticity).
Rhizotomy, Ablation, Neurotomy... Ua like anei ke ʻano o kēia mau huaʻōlelo?
ʻAe, hiki i kēia mau huaʻōlelo ke huikau iki, akā he maʻalahi loa ko lākou manaʻo.
- Rhizotomy:ʻO kēia ka inoa maʻamau no kēia ʻano lapaʻau. ʻO ia hoʻi, hiki ke kapa ʻia kekahi kaʻina hana e hōʻino ana i kahi olonā pilikia.
- ʻO ka hoʻopau ʻana i nā aʻalolo: ʻO kēia kekahi huaʻōlelo i hoʻohana ʻia no Rhizotomy. ʻO ka ablation ke ʻano o ka wehe ʻana a i ʻole ka luku ʻia ʻana.
- ʻO ka Radiofrequency Ablation (RFA): He ʻano hana kūikawā kēia i hoʻohana ʻia e hana i kahi rhizotomy. Pili ia i ka hōʻino ʻana i ke aʻalolo me ka hoʻohana ʻana i ka wela mai nā nalu lekiō.
- Neurotomy: He huaʻōlelo lapaʻau kēia no ka ʻoki ʻana a i ʻole ka luku ʻana i kahi aʻalolo.
ʻO ia hoʻi, ʻo ke kumu like kēia mau huaʻōlelo a pau. No laila, mai hopohopo inā hoʻohana like kāu kauka i kēia mau huaʻōlelo.
He aha nā kūlana e kōkua ai ka mālama ʻana iā Rhizotomy?
He mea nui loa kēia. ʻAʻole ʻo Rhizotomy ka lāʻau lapaʻau mua no nā ʻeha a pau. Hoʻāʻo mua nā kauka i nā mea e like me ka hoʻōla kino, nā lāʻau anti-inflammatory nonsteroidal (NSAID), a i ʻole nā poloka aʻalolo. Manaʻo ʻia kēia lāʻau lapaʻau inā ʻaʻole holo pono kēia mau mea a pau .
Aia nā ʻano like ʻole o nā mālama rhizotomy, e pili ana kēlā me kēia i nā aʻalolo like ʻole o ke kino.
| ʻAno Rhizotomy | Nā aʻalolo i manaʻo ʻia | Nā kūlana i mālama ʻia |
|---|---|---|
| ʻO ka Rhizotomy o ka Ganglion Trigeminal | Aia nā puʻupuʻu aʻalolo trigeminal ma nā ʻaoʻao ʻelua o ka maka. |
|
| ʻO ka Rhizotomy Facet | Nā aʻa aʻalolo e hele ana ma waena o nā hono facet o ka iwi kuamoʻo. | |
| ʻO ke koho ʻana o ka dorsal Rhizotomy (SDR) | Kekahi mau olonā aʻalolo sensory ma ka ʻaoʻao haʻahaʻa o ke kaula kuamoʻo. |
Pehea e hoʻomākaukau ai ma mua o kēia lāʻau lapaʻau?
Inā hoʻoholo ʻoe e loaʻa i kēia lāʻau lapaʻau, e hāʻawi kāu kauka a me ka hui lapaʻau iā ʻoe i nā kuhikuhi maopopo e pili ana i ka hoʻomākaukau ʻana no ia. Mai makaʻu e nīnau i kekahi mau nīnau āu e loaʻa ai.
ʻO ka maʻamau, pono ʻoe e hana i kekahi mau hoʻokolohua e hōʻoia inā e kōkua maoli kēia lāʻau iā ʻoe.
- Nā hoʻāʻo kiʻi: Nā mea e like me ka MRI scan a i ʻole X-ray.
- Poloka o ke aʻalolo: No ka ʻike pono ʻana i ke aʻalolo e hoʻokumu nei i ka pilikia, hāʻawi ʻia kahi inikini manawa pōkole i ke aʻalolo e ʻike ai inā e emi ana ka ʻeha.
- Nā hoʻāʻo koko a me ka mimi: E ʻike i kou kūlana olakino holoʻokoʻa.
Hana pinepine ʻia kēia lāʻau lapaʻau ma lalo o ka anesthesia laulā. ʻO ke ʻano kēia ua hiamoe loa ʻoe. No laila, pono ʻoe e hālāwai me kahi anesthesiologist e hōʻoia i ka palekana nou.
Eia kekahi, inā ʻoe e lawe ana i kekahi mau lāʻau lapaʻau, e like me nā mea hoʻokahe koko/anticoagulants, pono paha ʻoe e hoʻōki i ka lawe ʻana iā lākou i kekahi mau lā ma mua o kāu lāʻau lapaʻau. Eia naʻe, mai hoʻōki i ka lawe ʻana i kāu mau lāʻau lapaʻau me ka ʻole o ke aʻo ʻana a kāu kauka.
He aha ka mea e hana maoli ana i ka wā o ka mālama ʻana?
He mea maʻamau ke manaʻo iki i ka makaʻu ke lohe ʻoe i kēia, akā ua hoʻolālā maikaʻi ʻia kēia kaʻina hana a palekana hoʻi. Aia paha he mau ʻokoʻa iki ma muli o ke ʻano o ka mālama ʻana, kou kūlana, a me ke aʻalolo i kuhikuhi ʻia.
Eia nā ʻanuʻu i hahai pinepine ʻia:
1. Anesthesia a i ʻole Sedation
ʻO ka hapa nui o ka manawa, e hoʻohiamoe loa ʻia ʻoe, no laila ʻaʻole ʻoe e ʻeha. I kekahi mau hihia, hiki ke hoʻohiamoe māmā ʻia ʻoe (sedation) a i ʻole e hoʻomāʻū wale ʻia ka wahi (local anesthetic).
2. Ke ʻimi nei i ke aʻalolo kūpono (Alakaʻi Kiʻi)
E hoʻohana ke kauka i kahi ʻano hana X-ray kūikawā i kapa ʻia ʻo fluoroscopy e ʻike pono i ke aʻalolo pilikia. E kōkua kēia iā ʻoe e ʻike pono i kahi e kau ai i ka nila. I kekahi manawa, hiki ke hoʻokomo ʻia kahi wai kūikawā (contrast dye) i loko o kahi aʻalolo e ʻike nui ʻia ai ke aʻalolo.
3. Ke hoʻāʻo ʻana i ke aʻalolo
Ma mua o ka hōʻino ʻana i ke aʻalolo, pono e hōʻoia i ka pololei o ke aʻalolo i kuhikuhi ʻia. No ka hana ʻana i kēia, hāʻawi ʻia kahi hoʻoulu uila liʻiliʻi ma o kahi nila. I kekahi manawa hoʻohana ʻia kahi hoʻāʻo i kapa ʻia ʻo EMG (Electromyography) no kēia.
4. Ke luku ʻana i ke aʻalolo
Ke hōʻoia ʻia ke aʻalolo pololei, hoʻohana ʻia kekahi o nā ʻano i kūkākūkā ʻia ma mua (nā nalu lekiō, nā kemika, a i ʻole ke ʻoki ʻoki) e hoʻōki i ka hana ʻana o ke aʻalolo.
Pehea ka maikaʻi o kēia lāʻau lapaʻau?
ʻO ka hapa nui o ka poʻe e hana ana i ka rhizotomy e ʻike i ka hōʻoluʻolu ʻeha lōʻihi a i ʻole ka hoʻomaikaʻi nui ʻana i ka ʻoʻoleʻa o nā ʻiʻo. ʻIke kekahi poʻe i nā makahiki o ka hōʻoluʻolu ʻeha.
Eia naʻe, ʻaʻole i loaʻa i nā kānaka a pau nā hopena like. Aia kekahi mau hihia kahi i emi nui ʻole ai ka ʻeha no kahi poʻe liʻiliʻi loa. Eia kekahi, i ka hala ʻana o ka manawa, hiki i nā aʻalolo ke hoʻōla i kekahi ʻano a hiki ke ʻike hou ʻia ka ʻeha. Inā hana ʻia kēia, pono paha ʻoe e hana hou i kēia lāʻau. E wehewehe kāu kauka iā ʻoe i nā kikoʻī hou aku e pili ana i ka holomua o kēia lāʻau ma muli o kou kūlana.
Aia kekahi mau hopena ʻaoʻao a i ʻole nā pilikia?
E like me nā hana lapaʻau a pau, hiki i ka Rhizotomy ke loaʻa kekahi mau pilikia a me nā hopena ʻaoʻao. Eia nō naʻe, he mea liʻiliʻi ka hapa nui o kēia mau mea, a he kakaikahi nā pilikia koʻikoʻi. ʻOkoʻa kēia mau pilikia ma muli o ke ʻano o ke kaʻina hana a me ke aʻalolo i kuhikuhi ʻia.
ʻO ka mea nui loa, e kūkākūkā ākea kāu kauka i nā pilikia āpau me ʻoe ma mua o ka mālama ʻana, no laila mai makaʻu.
| Nā hopena ʻaoʻao/nā pilikia | Wehewehena |
|---|---|
| Nā kūlana maʻamau a me nā mea i manaʻo ʻia | |
| ʻEha iki a me ka palapū | Aia paha kekahi ʻeha, palapū, a pehu paha ma kahi o ke kui a i ʻole ka ʻoki ʻana no kekahi mau lā. Nalo pinepine kēia i loko o kekahi mau lā. |
| Māʻule | Ma hope o ka rhizotomy trigeminal, ʻoi aku hoʻi ma nā aʻalolo maka, hiki iā ʻoe ke ʻike i ka ʻūlū a i ʻole ka mae ʻana ma kekahi mau wahi o ka maka. He hopena ʻaoʻao kēia i manaʻo ʻia. |
| Nā kūlana e pono e hōʻike koke ʻia i ke kauka (kākaʻikahi ka hanana) | |
| Nā hōʻailona o kahi maʻi | Nā hōʻailona e like me ka ʻulaʻula nui, ka pehu ʻana, ka pus e kahe ana mai ka wahi i mālama ʻia, a me ke kuni. |
| ʻEha nui a i ʻole nā pilikia aʻalolo | ʻEha nui, ʻeha wela, nāwaliwali o nā ʻiʻo, a i ʻole he maneo hou i loko a i ʻole a puni ka wahi i mālama ʻia. |
| Kahe nui ʻana o ke koko | Inā he kahe koko mau mai ka wahi i mālama ʻia. |
Ma hope o ka lāʻau lapaʻau, e loaʻa iā ʻoe nā ʻōlelo aʻoaʻo maopopo e pili ana i nā hōʻailona e makaʻala ai a me ka wā e hoʻi ai e ʻike i kāu kauka.
Leka Lawe-Home
- He lāʻau lapaʻau kūikawā ʻo Rhizotomy no ka ʻeha mau loa, ʻeha nui a i ʻole ka ʻoʻoleʻa o nā ʻiʻo (spasticity) ke hāʻule ʻole nā lāʻau ʻē aʻe, e like me ka lāʻau lapaʻau a i ʻole ka hoʻōla kino.
- Hoʻopau kēia i ka hana o nā aʻalolo pilikia e lawe ana i nā hōʻailona ʻeha i ka lolo a hoʻomaha i ka ʻeha.
- ʻOiai he lāʻau lapaʻau maikaʻi loa kēia, ʻaʻole hiki i nā kānaka a pau ke loaʻa nā hopena like.
- E like me nā lāʻau lapaʻau a pau, aia nā pilikia a me nā hopena ʻaoʻao, a na kāu kauka e hoʻomaopopo piha iā ʻoe.
- ʻO kāu kauka wale nō ke hoʻoholo inā kūpono kēia lāʻau lapaʻau iā ʻoe. No laila, e kamaʻilio me ia e pili ana i kou ʻeha a nīnau i kāu mau koho.
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