※ 引述《yaml (秘密)》之铭言： : 其实我复健之前做了大概三个月有吧 都是隔一天去做的 : 就是牵引 干扰波 红外线 热敷 : 刚做完的确都很好 问题是半小时後或是一小时後又不舒服了 : 如果开刀能让我舒服10-20年 我真的非常愿意 : 总比这10-20年彷佛如废人一般坐立难安 : 不能搭超过两小时以上的飞机 : 不能去电影院看电影 不能去看舞台剧 : 不能坐着看书 就连现在打字我都得用站着的 : 这样的人生 真的很绝望 好像每次讲到这个话题我就会又跳出来了XD 第一 手术的风险是没有人敢保证的 不管是自己亲自执刀的名医用嘴巴执刀的名医 如果能够肯定手术够舒服个十到二十年 那该有多好 有空的话可以去搜寻一下failed back surgery sydrome 我曾经看到一个二十几岁的女大学生日志 开完以後每个医师都推皮球 都说手术成功 : ※ 引述《meouLONE (婆)》之铭言： : : 开刀其实也算不是一劳永益的办法 : : 开刀後未来的问题有二: 1.疼痛的关节处理好了,但上下的关节反而受影响而痛 这叫做 adjacent level disease : : 2.人工椎间盘或放钉子,大约维持10~20年,之後可能 : : 必须面临汰旧换新(再开一次刀)~ 前阵子才看到一位三十几岁男性的钉子断掉 : : 你还不是最最严重的 严重的病人最後都是被推去疼痛科 用长期的吗啡类药物治疗 不太会出现在一般的外科门诊了 因为他们已经知道手术对他们没有帮助 : : 因此建议先做一阵子保守治疗如下: : : 去挂复健科=> 请医师帮你安排做物理治疗 : : (治疗师会教你做改善疼痛的活动 & 看情况帮你徒手治疗) : : => 物理治疗连续做2个月(甚至更久一点) : : 疼痛的程度若毫无改善 : : 那时你再重新考虑手术的事~ : : 注: 治疗几次後,若你痛的程度有减弱(例如痛的感觉从10分变成6分) : : or疼痛发生的频率有变少 : : 这就表示治疗有效喔!=>那就继续耐心接受物理治疗 我故意把里面有些中文字翻译成英文专有名词 如果有网路paper查询资源的可以自己查查看 Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline Spine 2009 May 1;34(10):1094-109. 结论 Surgery for radiculopathy with herniated lumbar disc and symptomatic spinal stenosis is associated with short-term benefits compared to nonsurgical therapy, though benefits diminish with long-term follow-up in some trials. For nonradicular back pain with common degenerative changes, fusion is no more effective than intensive rehabilitation, but associated with small to moderate benefits compared to standard nonsurgical therapy. ---------------------------------------------------------------------------- Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial. BMJ. 2008 Jun 14;336(7657):1355-8. Epub 2008 May 23. 结论 Early surgery achieved more rapid relief of sciatica than conservative care, but outcomes were similar by one year and these did not change during the second year. ----------------------------------------------------------------------------- The outcomes of lumbar microdiscectomy in a young, active population: correlation by herniation type and level. Spine 2008 Jan 1;33(1):33-8. 结论 Microdiscectomy for symptomatic lumbar disc herniations in young, active patients with a preponderance of leg pain who have failed nonoperative treatment demonstrated a high success rate based on validated outcome measures, patient satisfaction, and return to active duty. Patients with disc herniation s at the L5-S1 level had significantly better outcomes than did those at the L4 -L5 level. Patients with sequestered or extruded lumbar disc herniations had significantly better outcomes than did those contained herniations. Patients with contained disc herniations, a predominanc\ e of back pain, on restricted duty and smoking should be counseled before surg\ ery of the potential for less satisfaction, poorer outcomes scores, and decrea\ sed return to duty rates. -- 因为只有痛过的人,才能了解正在受苦的人,是多麽的难受阿 --

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