Ingabe ngezinye izikhathi uthola ubuhlungu obuhlabayo obushaya emhlane wakho njengokwethuka kukagesi? Noma ingabe uhlala uhlushwa ubuhlungu obuvela entanyeni yakho phansi kwengalo yakho? Kunzima kakhulu ukuphila nalolu hlobo lobuhlungu. Uma izinto ezifana ne-physiotherapy kanye nemithi zingasebenzi, enye indlela yokwelapha enconywa odokotela yi-'Epidural Steroid Injection' (ESI). Abantu abaningi bayakwesaba lokhu. Ngakho-ke, ake sixoxe ngakho konke kalula nangokucacile namuhla.
Kalula nje, iyini i-'Epidural Steroid Injection' (ESI)?
Lolu futhi uhlobo lomjovo. Kodwa kulokhu, awutholi umuthi ovamile wokuqeda izinhlungu. Esikhundleni salokho, uthola umuthi okhethekile onciphisa ukuvuvukala nokuvuvukala, obizwa ngokuthi i-steroid (i-'corticosteroid') , ojovwa endaweni lapho imizwa ikhona khona emgogodleni wakho ('indawo ye-epidural').
Cabanga ngomgogodla wethu njengendlela enkulu ethwala imiyalezo esuka ebuchosheni iye kuwo wonke umzimba wethu. Indawo ephephile ezungeze le ndlela yilokho esikubiza ngokuthi 'isikhala se-epidural.' Uma inzwa egijima kule ndlela icasuka noma ivuvukala ngesizathu esithile, kuvela ubuhlungu obukhulu. Lokho okwenziwa yi-ESI ukufaka umuthi emthanjeni ovuvukile, ukunciphisa ukuvuvukala nokukunikeza impumuzo.
Okubaluleke kakhulu: I-'epidural' enikezwa ukunciphisa ubuhlungu ngesikhathi sokubeletha kanye ne-'epidural' enikezwa lobu buhlungu yizinto ezimbili ezihluke ngokuphelele . Ngakho-ke ungaziphambanisi lezi zinto ezimbili.
Lo mjovo unciphisa kanjani ubuhlungu?
Umgogodla wethu wakhiwe ngamathambo amancane (ama-vertebrae) axhumene. Phakathi kwala mathambo amabili kukhona 'idiski' efana nejeli. Yilokhu okunikeza umgogodla ukuguquguquka kwawo kanye nokuvikelwa kwawo.
Ngezinye izikhathi, i-disc ye-herniated (i-disc ye-herniated noma i-disc evuvukele) ingacindezela i-nerve eseduze. Noma, i-nerve ingacindezelwa ngenxa yokuncipha kwesikhala ngaphakathi komgogodla (i-spinal stenosis). Uma i-nerve icindezelwa ngale ndlela, iyavuvukala futhi ivuvuke, okubangela ubuhlungu.
I-ESI ihilela ukufaka i-steroid eduze kwe-nerve evuvukele, ecindezelwe. Lokhu kunciphisa ukuvuvukala nokuvuvukala futhi kunciphisa ingcindezi ye-nerve. Lokhu kunikeza i-nerve isikhathi sokuphulukiswa. Abanye abantu bathola ukukhululeka ebuhlungwini amasonto ambalwa, kanti abanye bangase babe nezinyanga. Ngezinye izikhathi, lo mjovo ungasiza futhi ekuboneni imbangela eqondile yobuhlungu.
Kunconywa umjovo we-ESI ngenxa yaziphi izimo?
Udokotela uvame ukuncoma i-ESI uma ezinye izindlela zokwelapha zehlulekile ukulawula ubuhlungu. Ithebula elingezansi lichaza lokhu kabanzi.
| Isimo | Incazelo elula |
|---|---|
| Idiski Ehlutshiwe/Evuvukele | Idiski elihlungiwe phakathi kwamathambo amabili, licindezela inzwa. |
| I-stenosis yomgogodla | Ukucindezelwa kwemizwa ngenxa yokuncishiswa kwendlela yemizwa ngaphakathi komgogodla. |
| Isifo Sokuhlinzwa Komhlane Esihlulekile | Ubuhlungu obuqhubekayo ngemva kokuhlinzwa emhlane. |
| Ama-Bone spurs (ama-Bone Spurs / ama-Osteophytes) | Ukucindezelwa kwemizwa ngenxa yamaqhubu amancane akheka emathanjeni njengoba ekhula. |
| I-Spondylolysis | Ubuhlungu bubangelwa ukuguguleka kanye noshintsho emathanjeni omgogodla. |
Izinhlobo Zokujova kwe-ESI
Kunezinhlobo eziningana zemijovo ye-ESI. Zihlukaniswe ngokwendawo yomjovo (intamo, umhlane ophakathi, umhlane ongezansi) kanye nendlela yokufaka inaliti.
- Izigaba ngendawo:
- I-ESI yomlomo wesibeletho: Ubuhlungu obuvela entanyeni phansi engalweni.
- I-Thracic ESI: Yobuhlungu obuphezulu nobaphakathi emhlane.
- I-Lumbar ESI: Ubuhlungu obuvela emhlane phansi komlenze (lokhu kuvamile kakhulu).
- Izinhlobo ngokwendlela yokufaka inaliti:
- I-Interlaminar ESI: Ukufaka inaliti phakathi kwamathambo amabili kanye nokufaka umuthi wokujova.
- I-Transforaminal ESI: Umjovo wenziwa ngembobo (`foramen`) lapho inzwa iphuma khona emgogodleni, eduze komthambo ocinyiwe.
- I-Caudal ESI: Ukufaka inaliti ngembobo ekugcineni okuphansi kakhulu komgogodla.
Udokotela wakho uzonquma ukuthi yiluphi uhlobo olufanele wena.
Ngingalungiselela kanjani ngaphambi komjovo?
Udokotela wakho uzokunikeza imiyalelo ethile ekhethekile ngaphambi kokujova. Kubaluleke kakhulu ukuyilandela kahle.
- Uma ukhulelwe noma usola ukuthi kungenzeka ukuthi ukhulelwe , qiniseka ukuthi utshela udokotela wakho.
- Tshela udokotela wakho ngayo yonke imithi oyithathayo (ikakhulukazi imithi yokunciphisa igazi) . Angase akucele ukuthi uyeke ukuyithatha izinsuku ezimbalwa.
- Ungase ucelwe ukuthi uzile ukudla amahora ambalwa ngaphambi komjovo.
- Ngezinye izikhathi, kungacelwa i-MRI noma i-CT scan ukuze kutholakale imbangela eqondile yobuhlungu.
- Uzocelwa ukuthi ulethe othile ekhaya ngosuku lokujova, njengoba ngezinye izikhathi unganikezwa umuthi wokudambisa ukuze uphumule.
Kwenzekani ngempela uma umjovo unikezwa?
Lokhu kuvame ukwenziwa esibhedlela noma emtholampilo. Yonke inqubo ithatha cishe imizuzu eyi-15-30.
1. Okokuqala, uzolaliswa esiswini sakho embhedeni bese ulaliswa phansi.
2. Udokotela uhlanza kahle indawo yomjovo bese efaka umuthi wokulwa namagciwane.
3. Okulandelayo, inalithi encane izoyenza indawo ibe nesiyezi . Ngale ndlela, ngeke uzwe ubuhlungu obukhulu lapho inalithi enkulu ifaka umuthi.
4. Bese, usebenzisa into efana nomshini we-X-ray (`Fluoroscopy`) , inaliti iqondiswa endaweni eqondile (`isikhala se-epidural`). Kubaluleke kakhulu ukuthi uhlale unganyakazi phakathi nalesi sikhathi.
5. Uma inaliti isisendaweni efanele, ngezinye izikhathi kufakwa uketshezi olubizwa ngokuthi i-contrast bese ukusabalala komuthi kubhekwa esikrinini.
6. Ekugcineni, umuthi we-steroid uzofakwa emthanjeni. Ngalesi sikhathi, ungase uzizwe uthukuthele kancane noma umuzwa wokuhlaba. Lokhu kuvamile.
7. Ngemva komjovo, kuzobekwa ucezu lukakotini endaweni bese kufakwa iplasta. Ngemva kwalokho, uzocelwa ukuba uphumule isikhashana bese uthunyelwa ekhaya uma kungekho zinkinga.
Ingabe kukhona imiphumela emibi kanye nezingozi ngemva komjovo?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunemiphumela emibi emincane kanye nezingozi ezinkulu ezingavamile.
| Uhlobo lwengozi | Incazelo |
|---|---|
| Imiphumela emibi emincane nevamile | |
| Ukwanda kwesikhashana kobuhlungu | Ubuhlungu bungase bukhule kancane izinsuku ezingu-2-3 kuze kube yilapho umuthi uqala ukusebenza. Lokhu kuvamile. |
| Amazinga kashukela egazini akhuphukile | Uma unesifo sikashukela, amazinga kashukela egazini lakho angase abe phezulu izinsuku ezimbalwa. |
| Ubuhlungu endaweni yokujova | Kungase kube nobuhlungu noma ukuklwebheka okuncane endaweni yokufaka inaliti. |
| Izingozi ezinkulu ezingase zenzeke kaningi kakhulu | |
| Ikhanda elibuhlungu kakhulu | Uma inaliti ingena ngengozi oketshezini lomgogodla, ingabangela ikhanda elibuhlungu elivela uma uvuka. |
| Izifo | Akuvamile kakhulu ukuthi amagciwane angangena futhi abangele ukutheleleka. |
| Ukopha | Umthambo wegazi wonakele futhi kwakheka ihlule legazi (i-hematoma) emgogodleni. |
| Ukulimala kwemizwa | Akuvamile kakhulu ukuthi inzwa yonakale. |
Khumbula ukuthi lezi zingozi ezinkulu azivamile , ikakhulukazi uma zenziwa udokotela oqeqeshiwe noqeqeshiwe.
Yiziphi izimpawu ezidinga usizo lwezokwelapha ngokushesha?
Uma uhlangabezana nanoma yiziphi izimpawu ezingezansi lapho ufika ekhaya ngemva komjovo, shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
- Ikhanda elibuhlungu elibuhlungu elivela uma usukuma noma uhlala phansi (lokhu kuyaphela uma ulele phansi).
- Umkhuhlane noma intamo eqinile.
- Ukungakwazi ukulawula umchamo noma indle.
- Ukuzwa sengathi imilenze ayinamandla noma ibuthakathaka .
Ungazinaki lezi zimpawu.
Umlayezo Wokuya Nawe Ekhaya
- I-ESI iyindlela yokwelapha yesikhashana yobuhlungu bomhlane nentamo, hhayi ukwelashwa okwelapha ngokuphelele lesi sifo.
- Kubaluleke kakhulu ukusizakala ngokukhululeka kobuhlungu okunikezwa yilokhu futhi wenze lokho kanye okunconywa udokotela wakho, njengokwelashwa ngokuzivocavoca umzimba.
- Uma lokhu kwelashwa kwenziwa udokotela onolwazi nonekhono, izingozi zezinkinga ezinkulu ziphansi kakhulu.
- Khuluma nodokotela wakho ngokukhululekile nganoma yikuphi ukwesaba noma ukungabaza onakho ngaphambi kokujova.
- Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile ngemva komjovo, funa iseluleko sezokwelapha ngokushesha.
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