Majinyacin tiyata da kurakuran rukunin yanar gizo suna da tsanani kuma ana iya hana su. A cewar Hukumar Haɗin gwiwa kan Amincewar Ƙungiyoyin Kula da Lafiya, ana iya yin irin waɗannan kurakurai a cikin kashi 41% na aikin tiyatar orthopedic/na yara. Don aikin tiyata na kashin baya, kuskuren wurin tiyata yana faruwa lokacin da ɓangaren vertebral ko lateralization ba daidai ba ne. Bugu da ƙari ga kasawa don magance alamun marasa lafiya da ilimin cututtuka, kurakurai na yanki na iya haifar da sababbin matsalolin kiwon lafiya irin su hanzarin lalatawar diski ko rashin kwanciyar hankali a cikin in ba haka ba asymptomatic ko sassan al'ada.
Hakanan akwai batutuwan shari'a da ke da alaƙa da kurakuran ɓangarori a cikin tiyatar kashin baya, kuma jama'a, hukumomin gwamnati, asibitoci, da ƙungiyoyin likitocin ba su da juriya ga irin waɗannan kurakuran. Yawancin tiyata na kashin baya, irin su discectomy, fusion, laminectomy decompression, da kyphoplasty, ana yin su ta amfani da hanya ta baya, kuma matsayi mai kyau yana da mahimmanci. Duk da fasahar hoto na yanzu, kurakuran yanki har yanzu suna faruwa, tare da adadin abubuwan da suka faru daga 0.032% zuwa 15% da aka ruwaito a cikin wallafe-wallafen. Babu wani ƙarshe game da wace hanya ta wuri ta fi dacewa.
Masanan daga Sashen Nazarin Orthopedic na Makarantar Magunguna ta Dutsen Sinai, Amurka, sun gudanar da wani binciken tambayoyi na kan layi wanda ya nuna cewa mafi yawan likitocin kashin baya suna amfani da wasu hanyoyi ne kawai na ganowa, kuma bayanin da aka saba da shi na kuskure zai iya yin tasiri a rage kurakuran sashin tiyata, a cikin labarin da aka buga a watan Mayu 2014 a cikin Spine J. An gudanar da binciken ta amfani da tambayoyin imel. An gudanar da binciken ta amfani da hanyar haɗin imel zuwa takardar tambayoyin da aka aika wa mambobin Ƙungiyar Spine Society ta Arewacin Amirka (ciki har da likitoci na orthopedic da neurosurgeons). An aika takardar tambayar sau ɗaya kawai, kamar yadda Ƙungiyar Spine Society ta Arewacin Amirka ta ba da shawarar. Jimlar likitocin 2338 sun karɓa, 532 sun buɗe hanyar haɗin gwiwa, kuma 173 (7.4% amsa yawan amsa) sun kammala tambayoyin. Kashi 72 cikin 100 na masu kammala aikin likitocin kashin baya ne, kashi 28% sun kasance likitocin neurosurgeons, kuma 73% likitocin kashin baya ne a horo.
Tambayoyin ta ƙunshi jimlar tambayoyin 8 (Fig. 1) wanda ke rufe hanyoyin da aka fi amfani da su na gida (duka alamomin jiki da kuma yanayin hoto), abubuwan da suka faru na kurakurai na ɓangaren tiyata, da haɗin kai tsakanin hanyoyin da ake amfani da su da kuma kurakurai. Tambayoyin ba a gwada matukin jirgi ko ingantacce ba. Tambayoyin suna ba da damar zaɓin amsa da yawa.
Hoto na 1 Tambayoyi takwas daga cikin tambayoyin. Sakamakon ya nuna cewa intraoperative fluoroscopy ita ce hanyar da aka fi amfani da ita na gida don aikin tiyata na baya na thoracic da lumbar (89% da 86%, bi da bi), tare da radiyo (54% da 58%, bi da bi). Likitoci 76 sun zaɓi yin amfani da haɗin hanyoyin biyu don ganowa. Hanyoyin da aka yi amfani da su da kuma pedicles masu dacewa sun kasance mafi yawan amfani da alamun anatomic don aikin tiyata na thoracic da lumbar (67% da 59%), sannan kuma matakai na spinous (49% da 52%) (Fig. 2). 68% na likitoci sun yarda cewa sun yi kurakurai na yanki a cikin aikin su, wasu daga cikinsu an gyara su a cikin ciki (Fig. 3).
Hoto na 2 Hoto da hanyoyin gano alamomin jiki da aka yi amfani da su.
Hoto 3 Likita da gyaran ciki na kurakuran sashin tiyata.
Don kurakurai a cikin gida, 56% na waɗannan likitocin sun yi amfani da radiyo na farko da 44% suka yi amfani da fluoroscopy na ciki. Dalilan da aka saba don kurakurai na matsayi na farko sun gaza yin hangen nesa da sanannen ma'anar tunani (misali, ba a haɗa kashin baya a cikin MRI ba), bambance-bambancen jiki (lumbar da aka kora daga haƙarƙari ko 13-tushen haƙarƙari), da rikice-rikice na ɓarna saboda yanayin jikin mai haƙuri. yanayin (nuni na X-ray na gaba). Abubuwan da ke haifar da kurakurai na intraoperative sun haɗa da rashin isassun sadarwa tare da masu aikin fluoroscopist, gazawar sakewa bayan matsayi (motsi na allurar sakawa bayan fluoroscopy), da kuma wuraren da ba daidai ba a lokacin matsayi (lumbar 3/4 daga haƙarƙarin ƙasa) (Figure 4).
Hoto na 4 Dalilai na kurakurai na wuri na farko da na ciki.
Sakamakon da ke sama ya nuna cewa ko da yake akwai hanyoyi da yawa na gano wuri, yawancin likitocin suna amfani da kaɗan ne kawai. Ko da yake kurakuran sashin tiyata ba safai ba ne, a zahiri ba su nan. Babu wata hanya madaidaiciya don kawar da waɗannan kurakurai; duk da haka, ɗaukar lokaci don yin matsayi da kuma gano abubuwan da aka saba da su na kuskuren matsayi na iya taimakawa wajen rage yawan kurakuran ɓangarori na tiyata a cikin kashin thoracolumbar.
Lokacin aikawa: Yuli-24-2024
