Te Mātāpono o te Reera i roto i te Maimoatanga o te PLDD
Ko te Percutaneous Laser Disc Decompression (PLDD) he tikanga iti rawa te whakaekenga e whakamahia ana hei rongoā i ngā hernia o te kōpae hope, o te kōpae kaki rānei. Ko te kaupapa o te whakamahi i te pūngao laser i roto i te PLDD e aro ana ki te tango wera me te mimiti o te nucleus pulposus—te pokapū ngohengohe, rite ki te tine o te kōpae intervertebral.
Ngā Mātāpono Matua o te Whakamahinga Taiaho i roto i PLDD:
● Te Tukunga Pūngao Whaiaro:
Ka whakaurua he muka whatu angiangi mā roto i te kiri ki roto i te kōpae herniated i raro i te arataki whakaahua (te nuinga o te wā he fluoroscopy, he CT rānei). Kia whakanohoia ki roto i te nucleus pulposus, ka tukuna tika te kaha laser ki te wāhi e pāngia ana.
● Pānga Whakaata-wera:
Ko te taiaho (e whakamahi ana i ngā roangaru pēnei i te 980nm te taio (ngā taiaho Nd:YAG rānei) ka whakaputa wera ina mimitia e te wai me ngā pūmua i roto i te nucleus pulposus. Ka puta tēnei:
● Te whakamomona o te nui o te wai i roto i te kiko o te kōpae.
● Te whakapūmau wera me te whakakorenga o te collagen me ētahi atu pūmua.
● Te whakaiti i te pēhanga intradiscal nā te tangohanga me te whakaititanga o te kiko.
● Te Whakaiti i te Rōrahi o te Kōpae:
Mā te tango i tētahi rahinga iti (1–2 mL te nuinga) o te nucleus pulposus, ka heke te pēhanga whānui i roto i te kōpae. Ka āwhina tēnei ki te hoki whakamuri i te wāhanga herniated, ā, ka whakamama i te pēhanga i runga i ngā pakiaka io tata me te whakamamae i te mamae.
● He iti noa te whakaekenga, ā, ka tiakina te hanganga tinana:
Kāore i rite ki te tango i te wheua i te pokanga tuwhera, kāore te PLDD e hiahia ki te tango i te wheua, ki te whakararuraru nui rānei i ngā kiko e karapoti ana. Ka noho tonu te annulus fibrosus (te paparanga kōpae o waho), e mau tonu ana te pumau o te tuaiwi.
● Whakaohooho Whakaora Koiora:
E kī ana ētahi taunakitanga ka taea e te whara wera kua whakahaeretia te whakaoho i ngā urupare whakaora ā-rohe me te whakaiti i ngā takawaenga mumura (hei tauira, ngā cytokine pēnei i te TNF-α me te IL-6) e whai wāhi ana ki te mamae radicular.
Ngā Painga Matua:
● Te tikanga tūroro-waho
● He wā poto te whakaora
● He iti te mōrearea o te mate urutā, o te whara rānei
● Ka taea te mahi anō mēnā e tika ana
Hei whakarāpopototanga, ko te mahi a te taiaho i roto i te PLDD mā te te tango tika me te whakaiti i te kiko kōpae mā te pūngao photothermal, ā, ka whakaitihia te pēhanga o roto i te kōpae me te riri o te pakiaka io me te iti rawa o te whara ki ngā hanganga e karapoti ana.