Kubaga SDR (Selective Dorsal Rhizotomy) ni iki? Ese bifasha abana bafite ubumuga bwo mu mutwe?

Ese umwana wawe afite ikibazo cyo kurwara ubwonko? Ugomba kuba warabonye ko imitsi yo mu ngingo, cyane cyane amaguru, y’abana nk’abo ikomera kandi ikomera bitari ngombwa. Mu buvuzi, ibi tubyita 'spasticity'. Kubera uku gukomera, biragoye cyane ku mwana kugenda, kwiruka, gusimbuka gusa, ahubwo no gukora imirimo ya buri munsi. Uyu munsi rero tugiye kuvuga ku kubagwa kwihariye gukorwa nk'igisubizo kirambye cy'iki kibazo. Ni ukuvuga Selective Dorsal Rhizotomy, cyangwa SDR surgery mu magambo ahinnye.

Mu magambo make, kubaga SDR ni iki?

Uburyo bwo kubaga imitsi yo mu bwonko bukoresha uburyo bwo gukata no gukuraho imitsi yo mu bwonko mu gice cyo hasi cy’umugongo w’umwana butuma imitsi yo mu bwonko ikomera (SDR) burundu. Nubwo ari uburyo bugoye cyane, mu magambo make, bukubiyemo gukata no gukuramo imitsi imwe n’imwe mu gice cyo hasi cy’umugongo w’umwana ituma imitsi yo mu bwonko ikomera.

Igikuru ni uko ubu buryo bwo kubaga budatera ubumuga bw'ingingo z'umwana. Nta ngaruka kandi ku buryo butaziguye ku ngendo z'amaguru. Burekura gusa imitsi ifunze bitari ngombwa.

Ni nde ugomba kubagwa? Ese birakwiriye abana bose?

Kubaga SDR ahanini bikorwa mu rwego rwo kuvura imitsi idakomera (spasticity) iterwa n'indwara yo mu bwonko.

Nkuko mubizi, indwara yo mu bwonko yitwa cerebral palsy (CP) ni indwara igira ingaruka ku bushobozi bw'umwana bwo kugenzura imigendere y'umubiri we. Iterwa no kwangirika kw'ibice by'ubwonko bigenzura imigendere n'imikorere y'umubiri. Abana benshi bafite CP bafite ikibazo cyitwa 'spasticity'. Ibi bivuze ko imitsi imwe n'imwe ihita yikubita cyane iyo umwana agerageje kwimuka cyangwa ahagaze gusa. Ibi bishobora kugora umwana kugenda, gukora imirimo ya buri munsi, ndetse rimwe na rimwe bigatera ububabare.

Kubaga SDR byibanda cyane cyane kuri ibi bikurikira:

• Indwara yo kuvura imitsi yo mu bwonko yitwa Spastic diplegic cerebral palsy: Iyi ndwara ireba abana bafite imitsi ikomeye ifata amaguru cyane cyane.
• Indwara ikomeye yo mu bwonko ya quadriplegic cerebral palsy: Iyi mvugo ireba abana bafite imitsi ikomeye ifata amaguru n'amaboko ane yose.

None se, ni gute ubu buvuzi bugabanya gukomera kw'imitsi?

Kugira ngo tubisobanukirwe, reka dutekereze gato ku mitsi yacu. Imitsi isanzwe y'imitsi y'umubiri wacu igenzurwa n'imikorere y'imitsi iherereye mu ruti rw'umugongo.

Tekereza ko umubiri wacu ufite uburyo bwo kumva imitsi nk'ubwa telefoni.

1. Imitsi yo mu bwonko: Iyi itwara amakuru ava mu mitsi ijya mu ruti rw'umugongo.

2. Imitsi yo mu bwonko: Iyi yohereza amabwiriza ava mu ruti rw'umugongo agaruka mu mitsi kugira ngo "yifatanye gutya."

Ubusanzwe, ubwonko bwacu bugenzura neza uru rugendo rw'ubutumwa. Ibyo bivuze ko dushobora kugenzura imitsi yacu uko tubyifuza. Ariko muri Cerebral Palsy, ubushobozi bw'ubwonko bwo kugenzura iyi mitsi buragabanuka. Icyo bibaho ni uko imitsi imwe n'imwe ikora cyane igakomeza kohereza ibimenyetso bitari byo ku mitsi, ikayibwira ngo "ikaramye, ikomeze."

Dore uko bigenda mu gihe cyo kubaga SDR:

Umuganga ubaga ahitamo kandi agakata imizi y'imitsi ituma imitsi ikomera kandi ikaba irimo gukoreshwa bitari ngombwa. Ikizamini cyihariye (EMG) gikoreshwa kugira ngo hamenyekane imitsi ikora neza n'imitsi itanga ibimenyetso bitari byo. Ibi bituma imitsi ikomera gusa igabanuka nta ngaruka ku yindi mirimo.

Muri ubu buryo, iyo imitsi ikomereye, imitsi yo hasi ishobora gutangira gukora neza. Ibi binoza uburyo umwana agenda n'imikorere ye. Binafasha mu gukumira ubusembwa bw'amagufwa n'ingingo bushobora guterwa no gukomera kw'imitsi igihe kirekire.

Witegura ute mbere yo kubagwa?

Kubera ko kubaga umwana mu buryo bwa SDR bidakwiye kuri buri mwana, umwana wawe azasuzumwa n'itsinda ry'inzobere kugira ngo barebe niba byamugirira akamaro. Inzobere zikurikira zikunze kugira uruhare muri iki gikorwa:

Aba bantu bose basuzuma umwana maze bagahurira hamwe nk'ikipe kugira ngo bafate icyemezo cya nyuma niba kubagwa SDR bizagirira akamaro umwana.

Byongeye kandi, ushobora gukenera gukora ibindi bipimo byinshi mbere yo kubagwa:

• Abaganga b’imitsi n’abakora isuzuma ryimbitse kugira ngo basuzume neza ubushobozi bw’umubiri bw’umwana. Bafata amashusho y’ingendo z’umwana kandi bagateganya uburyo bwose bukenewe bwo kuvura nyuma yo kubagwa.
• Gupima ubwonko hakoreshejwe MRI kugira ngo barebe neza ko nta zindi ndwara z'imitsi zihari.
• Niba ufite ibindi bibazo by'imitsi, reba inzobere mu by'imitsi y'abana .
• Ongera uhure n'umuganga w'imitsi kugira ngo muganire ku ngaruka zo kubagwa no gukira.
• Sura umuganga w’indwara zo gusinziriza kugira ngo urebe neza ko umwana wawe ahabwa imiti igabanya ububabare.

Uburyo kubagwa bikorwa intambwe ku yindi

Dore uko kubaga SDR bikunze kubaho:

1. Anesthesia: Ubwa mbere, umuganga w’inzobere mu by’imiti atera umwana anesthesia rusange. Bityo umwana asinzira neza mu gihe cyo kubagwa kandi ntagire ububabare yumva.

2. Gukata: Umuganga w’imitsi akora akantu gato hagati mu mugongo wo hasi w’umwana.

3. Guhura n'imitsi: Binyuze muri uku gukata, agace gatwikiriye umugongo karafunguka, kanyura mu mitsi n'amagufwa, hanyuma imitsi yo hasi ikagaragara.

4. Gutandukanya imitsi: Hanyuma, umuganga ubaga atandukanya imitsi ijyana n'iy'amatwi n'iy'amatwi. Imitsi ijyana n'amatwi irinzwe kugira ngo hirindwe kwangirika kwayo kose.

5. Kumenya imitsi itari yo: Electrodes ubu ziba zifatanye n'imizi y'imitsi yumva, kandi electromyography (EMG) irakorwa.Gukangura amashanyarazi bitangwa hakoreshejwe imashini yitwa stimulator. Ibi bidufasha kumenya neza imitsi itera imitsi gufungana, iyohereza ibimenyetso bitari byo, n'iyo mitsi ikora neza.

6. Gukata imitsi: Witondeye cyane, ijanisha runaka ry'imitsi idasanzwe igaragara irakatwa. Imitsi n'ingano yayo biratandukana bitewe n'umwana.

7. Gufunga ishinya: Iyo ishinya rirangiye, ishinya ridodwa hamwe urwego ku rundi.

8. Gukira: Nyuma yo kubagwa, umwana yimurirwa mu cyumba cyita ku barwayi barembye cyane (ICU) cyangwa mu cyumba cyihariye cyo gukira kandi agakurikiranirwa hafi n'itsinda ry'abaganga.

Ubusanzwe ubu buvuzi bumara amasaha ane cyangwa atanu.

Ni iki kibaho nyuma yo kubagwa?

Abana bazakenera kuguma mu bitaro iminsi itanu nyuma yo kubagwa. Mu masaha 24-48 ya mbere, umwana azakenera kuguma mu buriri. Ubuvuzi bw'umubiri buzatangira mu minsi mike nyuma yo kubagwa.

Ni izihe nyungu z'ubu buvuzi?

Ibisubizo byo kubagwa kwa SDR bishobora gutandukana bitewe n'uko umwana ameze. Nanone, kugira ngo iki gikorwa kigende neza biterwa gusa n'ubuvuzi bukomeye bukorwa nyuma yo kubagwa.

Nk’uko bigenda kuri buri kubagwa, hari ingaruka zishobora guterwa?

Yego, nk'uko bigenda mu kubaga kose, kubagwa kwa SDR bifite ingaruka zimwe na zimwe, ariko ingorane zidashira ni gake cyane.

Itsinda ry’abaganga b’umwana wawe rizaganira nawe ku buryo burambuye kuri izi ngaruka zose mbere yo kubagwa.

Igihe cyo gukira n'akamaro ko kuvura umubiri

Iki ni cyo gice cy'ingenzi kandi cy'ingenzi cyane mu ntsinzi y'ubuvuzi bwa SDR. Kubaga ni intambwe ya mbere gusa mu rugendo. Gusubira mu buzima ni ingenzi kugira ngo ugere ku musaruro nyawo.

Ubuvuzi bw'umubiri n'ubuvuzi bw'akazi bitangira mu minsi mike nyuma yo kubagwa. Umwana agomba kwitabira ubu buvuzi iminsi myinshi mu cyumweru mu gihe cy'amezi atatu kugeza kuri atandatu nyuma yo kubagwa.

• Umuganga w’umubiri: Imyitozo yo gukomeza, kunanura no kunoza imitsi y’umwana. Mu ntangiriro, umuganga azakora iyo myitozo, kandi uko umwana agenda akira, umwana ubwe agakora iyo myitozo.
• Umuvuzi w'akazi: Afasha umwana gukora imirimo ya buri munsi (urugero: kwambara, gukina) mu buryo bworoshye kandi ku giti cye.

Intego z'ingenzi z'iyi myitozo ni izi zikurikira:

• Ingufu ziyongera.
• Guteza imbere uburinganire no kwifata neza mu gihe wicaye cyangwa uhagaze.
• Gutegura ibirenge kugira ngo bihagarare.
• Imyitozo yo gukora ingendo, nko guhagarara wicaye, irushaho kugenda neza.

Ni ryari ugomba kuvugana na muganga?

Niba ubonye ibimenyetso by'ingorane nyuma yo kuzana umwana wawe mu rugo avuye kwa muganga, hamagara muganga wawe ako kanya.

• Iyo aho babaze habaye umutuku, habyimbye, cyangwa hari amabyi asohoka (ibimenyetso by'ubwandu).
• Iyo umwana afite umuriro mwinshi.
• Niba utakaje ubushobozi bwo kugenzura inkari cyangwa amabyi yawe.

Niba ubonye ibimenyetso bidasanzwe nk'ibi, shaka ubufasha bwa muganga ako kanya.