Hoʻohui iwi kuamoʻo

Spinal fusion ke ʻoki kino e pili paʻa mau i ʻelua a ʻoi paha iwi i ka iwi kuamoʻo no laila ʻaʻohe neʻe ma waena o lākou. Kapa ʻia kēia mau iwi he vertebrae.

Hāʻawi ʻia ʻoe i ka anesthesia laulā, kahi e hoʻokomo ai iā ʻoe i loko o kahi hiamoe nui no laila ʻaʻole ʻoe e ʻeha i ka wā o ke ʻoki.

E ʻoki ke kaukipoki i kahi ʻoki ʻoki (incision) e ʻike i ka ʻiwi. ʻO nā ʻokiʻoki ʻē aʻe, e like me kahi diskectomy, laminectomy, a i ʻole foraminotomy, kokoke hana mau ʻia ma mua. Hiki ke hana ʻia ka iwi kuamoʻo:

• Ma kou kua a ʻāʻī paha ma luna o ka iwi kuamoʻo. E moe paha ʻoe i lalo. E hoʻokaʻawale ʻia nā mākala a me nāʻiʻo e hōʻike ai i ka iwi kuamoo.
• Ma kou ʻaoʻao, inā ke ʻoki ʻia ʻoe ma kou kua haʻahaʻa. E hoʻohana ka kaukoki i nā pono hana i kapa ʻia he retractors e hoʻokaʻawale mālie, paʻa i nā mea palupalu e like me kou ʻōpū a me nā kīʻaha koko ma kahi kaʻawale, a he wahi e hana ai.
• Me kahi ʻoki ma mua o ka ʻāʻī, i ka ʻaoʻao.

E hoʻohana ka kaukipō i kahi graft (e like me ka iwi) e paʻa (a fuse) i nā iwi pū paʻa mau. Nui a hewahewa nā ala o ka hoʻopili ʻana i nā vertebrae.

• Hiki ke kau ʻia i nā ʻāpana o nā iwi graft ma luna o ka ʻaoʻao hope o ka iwi kuamoʻo.
• Hiki ke kau ʻia nā mea iwi iwi ma waena o ka vertebrae.
• Kau ʻia nā hīnaʻi kūikawā ma waena o ka vertebrae. Hoʻopili ʻia kēia mau hīnaʻi implantable me nā mea hoʻopili iwi.

Hiki i ke kaukipō ke kiʻi i ka iwi iwi mai nā wahi like ʻole:

• Mai kahi ʻāpana o kou kino (maʻa mau i kou iwi pelvic). Kapa ʻia kēia he autograft. E ʻokiʻoki kou kaukipoki ma luna o kou iwi pelvic a hemo i kekahi iwi mai ka hope o ka palena o ka pelvis.
• Mai kahi peʻa iwi. Kapa ʻia kēia he allograft.
• Hiki ke hoʻohana ʻia i kahi pani iwi kūpale.

Hoʻopaʻa pū ʻia ka vertebrae me nā koʻokoʻo, nā ʻāpana, nā pā, a nā pā. Hoʻohana ʻia lākou e mālama i ka vertebrae mai ka neʻe ʻana a hiki i ka hoʻōla piha ʻana o nā iwi iwi.

Hiki ke hana ʻoki kino i 3 a 4 mau hola.

Hana pinepine ʻia ka iwi kuamoʻo a me nā kaʻina hana ʻē aʻe o ka iwi kuamoʻo. E hana ʻia paha:

• Me nā kaʻina hana ʻē aʻe no ka stenosis spinal, e like me foraminotomy a i ʻole laminectomy
• Ma hope o ka diskectomy i ka ʻāʻī

Hiki ke hana ʻia ka fusion inā loaʻa iā ʻoe:

• Ka ʻeha a haki paha i nā iwi i ka iwi kuamoo
• Nāwaliwali a paʻa ʻole paha o ke kuamoʻo i hoʻokumu ʻia e nā maʻi a me nā tumors
• Spondylolisthesis, kahi ʻano e paheʻe ai kekahi vertebrae ma luna o kekahi
• Nā curvature maʻamau, e like me nā scoliosis a i ʻole kyphosis
• ʻO ka maʻi o ka iwi kuamoʻo, e like me ka stenosis spinal

Hiki iā ʻoe a me kāu kauka ke hoʻoholo ke pono ʻoe i kahi ʻoki.

Nā pōpilikia no ka anesthesia a me ke kahakaha ma nā ʻano āpau:

• Nā hopena i nā lāʻau, nā pilikia hanu
• Kahe ʻana o ke kahe, ke koko, maʻi

ʻO nā pōʻino no kēia ʻoki ʻana:

• ʻO ka maʻi i ka ʻeha a iwi iwi ākea paha
• Hoʻopilikia i kahi ʻāʻī o ke kuamoʻo, ke kumu o ka nāwaliwali, ʻeha, nalo ʻana o ka naʻau, nā pilikia me kou ʻōpū a i ʻole ka waiū
• ʻO ka vertebrae ma luna a ma lalo o ka fusion e ʻoi aku ka luhi, e alakaʻi ana i nā pilikia ma hope
• Kaha o ka wai ʻōiwi e koi paha i kahi ʻoki hou aʻe
• Poʻo poʻo poʻo

E haʻi i kāu kauka i nā lāʻau āu e lawe nei. Hoʻopili kēia i nā lāʻau, nā mea kanu, a me nā mea hoʻopiha āu i kūʻai ai me ka ʻole o ka lāʻau.

I nā lā ma mua o ke kaha ʻana:

• E hoʻomākaukau i kou home no ka wā e haʻalele ai i ka haukapila.
• Inā he puhipaka ʻoe, pono ʻoe e hoʻokū. ʻO ka poʻe i loaʻa ka iwi kuamoʻo a hoʻomau i ka puhipaka ʻaʻole paha e hoʻōla pū kekahi. E noi i kāu kauka no ke kōkua.
• ʻElua mau pule ma mua o ke kahakaha ʻana, e noi paha kāu kauka iā ʻoe e haʻalele i ka lawe ʻana i nā lāʻau e paʻakikī ai i ke kō ʻana o kou koko. Hoʻopili kēia i ka aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), a me nā lāʻau ʻē aʻe e like me kēia.
• Inā loaʻa ʻoe i ka maʻi diabetes, maʻi maʻi puʻuwai, a i ʻole nā ​​pilikia olakino ʻē aʻe, e noi ana kāu kauka iā ʻoe e ʻike i kāu kauka maʻamau.
• E kamaʻilio me kāu kauka inā inu nui ʻoe i ka waiʻona.
• E noi i kāu kaukipona i nā lāʻau e pono ai ʻoe e lawe i ka lā o ke ʻoki.
• E hoʻomaopopo i kāu kauka lāʻau e pili ana i ke anuanu, ka maʻi palū, ke kuni, ka haki herpes, a i ʻole nā ​​maʻi ʻē aʻe āu e loaʻa ai.

I ka lā o ke kaha:

• E hāhai i nā ʻōkuhi e pili ana i ka inu ʻole ʻana a me ka ʻai ʻana i kekahi mea ma mua o ke kaʻina hana.
• E lawe i nā lāʻau i haʻi ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E hōʻea i ka haukapila i ka manawa.

Noho paha ʻoe i ka haukapila a hiki i 3 a 4 mau lā ma hope o ke kaha ʻana.

E loaʻa iā ʻoe nā lāʻau ʻeha ma ka haukapila. Hiki paha iā ʻoe ke ʻai i ka lāʻau ʻeha ma ka waha a i ʻole i ka pū kī a i ʻole ka laina intravenous (IV). Loaʻa paha iā ʻoe kahi pauma e ʻae iā ʻoe e kaohi i ka nui o ka lāʻau ʻeha e loaʻa iā ʻoe.

E aʻo ʻia ʻoe pehea e neʻe pono ai a pehea e noho ai, kū a hele wāwae ai. E haʻi ʻia ʻoe e hoʻohana i kahi ʻenehana "loiloi lola" ke hele i waho o kahi moe. ʻO kēia ka neʻe ʻana o kou kino holoʻokoʻa i ka manawa hoʻokahi, me ka wili ʻole o kou iwi kuamoʻo.

ʻAʻole hiki iā ʻoe ke ʻai i nā meaʻai maʻamau no 2 a 3 mau lā. E hāʻawi ʻia ʻoe i nā meaola ma o ka IV a ʻai pū i ka meaʻai palupalu. Ke haʻalele ʻoe i ka haukapila, pono ʻoe e komo i ka pale kuʻi hope a i ʻole ka hoʻolei.

E haʻi aku kāu mea kauka iā ʻoe pehea e mālama ai iā ʻoe iho ma ka home ma hope o ke kuamoʻo o ka iwi kuamoʻo. E hāhai i nā ʻōkuhi pehea e mālama ai i kou kua i ka home.

ʻAʻole hiki ke hoʻomaʻemaʻe i ke ʻoki kino i nā manawa a ma nā hihia, hiki ke hōʻeha. Eia nō naʻe, i kekahi poʻe hiki ke kūpono i ke kaha ʻana no ka ʻeha nui ʻaʻole maikaʻi me nā lāʻau ʻē aʻe.

Inā loaʻa iā ʻoe ka ʻehaʻeha hope ma mua o ke kahakaha ʻana, loaʻa paha iā ʻoe kahi ʻeha ma hope. ʻAʻole hiki i ka fusion fusion ke lawe i kou ʻeha a me nā ʻōuli ʻē aʻe.

He paʻakikī e wānana i ka poʻe e hoʻomaikaʻi a me ka nui o ke kahakaha kōkua e hāʻawi ai, ʻoiai ke hoʻohana nei i ka scan MRI a i ʻole nā ​​hoʻokolohua ʻē aʻe.

ʻO ka lilo ʻana o ke kaupaona a me ka hoʻoikaika kino ʻana e hoʻonui ai i ka manawa o ka maikaʻi.

Hiki ke loaʻa nā pilikia o ka iwi i ka wā e hiki mai ana ma hope o ke kaʻi ʻana o ka ʻōiwi. Ma hope o ka hoʻohui ʻōiwi, ʻaʻole hiki ke neʻe hou kahi i hoʻohui ʻia. No laila, ʻoi aku ka koʻikoʻi o ke kolamu o ke kuamoʻo ma luna a ma lalo o ka fusion ke neʻe ke kuamoʻo, a e hoʻomaka i nā pilikia ma hope.

Hoʻohui Vertebral interbody; Pākuʻi ʻōiwi posterior; ʻO Arthrodesis; Hoʻohui iwi kuamoʻo anterior; ʻOki kuaina - fusion spinal; ʻEha ʻeha haʻahaʻa - fusion; Diska Herniated - hoʻohui; Spen stenosis - hoʻohui; Laminectomy - hoʻohui; Hoʻohui iwi kuamoʻo; Hoʻohui iwi kuʻi Lumbar

• Ka palekana i ka lumipaku no nā mākua
• Pāleʻa ka pale ʻana
• Ke pale nei i ka hāʻule - he aha e nīnau aku ai i kāu kauka
• ʻOki kua - hoʻokuʻu
• Mālama ʻeha ʻeha - wehe

• Scoliosis
• Hoʻohui kuamoʻo - series

ʻO Bennett EE, Hwang L, Hoh DJ, Ghogawala Z, Schlenk R. Nā hōʻailona no ka hoʻohui fina no ka ʻeha axial. I: Steinmetz MP, Benzel EC, eds. ʻO Benzel's Spine Surgery: Nā Hana Hana, Pilikia Kūpono, a me ka Hoʻokele. ʻEhā ed. Piladelapia, PA: Elsevier; 2017: chap 58.

Liu G, Wong HK. Laminectomy a me ka hoʻohui. I: Shen FH, Samartzis D, Fessler RG, nā hua. Puka puke o ka iwi kuamoʻo. Piladelapia, PA: Elsevier; 2015: chap 34.

Wang JC, Dailey AT, Mummaneni PV, et al. Hoʻohou i ke alakaʻi no ka hana o nā kaʻina fusion no ka maʻi degenerative o ka iwi kuamoo. Mahele 8: lumbar fusion no ka herniation disk a me ka radikulopathy. ʻO J Neurosurg Spine. 2014; 21 (1): 48-53. PMID: 24980585 www.ncbi.nlm.nih.gov/pubmed/24980585.