{"id":17837,"date":"2014-10-09T14:02:00","date_gmt":"2014-10-09T12:02:00","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=17837"},"modified":"2014-10-09T14:05:01","modified_gmt":"2014-10-09T12:05:01","slug":"mam-stale-bolesti-patere-pomuze-gelovy-implantat","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=17837","title":{"rendered":"M\u00e1m st\u00e1le bolesti p\u00e1te\u0159e. Pom\u016f\u017ee gelov\u00fd implant\u00e1t?"},"content":{"rendered":"

Dotaz: Man\u017eel je po operaci vyh\u0159ezl\u00e9 plot\u00e9nky, ale st\u00e1le m\u00e1 velk\u00e9 bolesti. Za\u010d\u00e1tkem \u0159\u00edjna byl na CT a dle neurolog. l\u00e9ka\u0159ky ji\u017e nen\u00ed co nab\u00eddnout – pouze ti\u0161\u00edc\u00ed l\u00e9ky, obst\u0159iky nebo opi\u00e1tov\u00e9 n\u00e1plasti. Je mo\u017en\u00e1 aplikace gelov\u00e9ho implant\u00e1tu? Odpov\u00edd\u00e1 prim\u00e1\u0159 Odd\u011blen\u00ed zobrazovac\u00edch metod SurGal Clinic MUDr. Jan K\u0159\u00edstek, Ph.D.<\/strong><\/p>\n

Tazatelka dop\u0148uje k dotazu, \u017ee akceptuje, \u017ee operace nen\u00ed hrazena poji\u0161\u0165ovnou a je ochotna si z\u00e1krok zaplatit.<\/p>\n

ilustra\u010dn\u00ed foto: Flickr.com<\/p>\n

Odpov\u011b\u010f:<\/strong><\/p>\n

Dobr\u00fd den,
\npostopera\u010dn\u00ed stavy je obt\u00ed\u017en\u011b \u0159e\u0161iteln\u00fd probl\u00e9m, v\u011bt\u0161inou se jedn\u00e1 o zajizven\u00ed kolem nervov\u00e9ho ko\u0159ene v opera\u010dn\u00edm poli, m\u00e9n\u011b \u010dasto o recidivu v\u00fdh\u0159ezu plot\u00e9nky. Recidiva se v\u011bt\u0161inou \u0159e\u0161\u00ed reoperac\u00ed, u zajizven\u00ed (postopera\u010dn\u00ed fibroza) nejsou v\u00fdsledky \u017e\u00e1dn\u00e9ho z\u00e1kroku nijak zvl\u00e1\u0161\u0165 \u00fa\u010dinn\u00e9.<\/p>\n

P\u0159edpokl\u00e1d\u00e1m, \u017ee \u010dten\u00e1\u0159 m\u00e1 gelem na mysli vst\u0159\u00edknut\u00ed materi\u00e1lu DiscoGel do plot\u00e9nky. V tomto p\u0159\u00edpad\u011b se ob\u00e1v\u00e1m, \u017ee by \u00fa\u010dinek nem\u011bl, pou\u017e\u00edv\u00e1 se jako alternativn\u00ed metoda na specializovan\u00fdch pracovi\u0161t\u00edch m\u00edsto p\u0159\u00edpadn\u00e9 operace u st\u0159edn\u011b rozs\u00e1hl\u00fdch v\u00fdh\u0159ez\u016f. Pacient je u\u017e po operaci.<\/p>\n

Doporu\u010dil bych doplnit vy\u0161et\u0159en\u00ed bedern\u00ed p\u00e1te\u0159e (jedn\u00e1 se o bedern\u00ed oblast, \u017ee?) na magnetick\u00e9 rezonanci, kter\u00e1 uk\u00e1\u017ee m\u00edru zajizven\u00ed a stav plot\u00e9nky l\u00e9pe, ne\u017e CT. S v\u00fdsledky je pak mo\u017en\u00e1 konzultace na specializovan\u00e9m pracovi\u0161ti, co\u017e b\u00fdv\u00e1 interven\u010dn\u00ed radiologie, neurochirurgie nebo ambulance pro l\u00e9\u010dbu bolesti, kde by m\u011bl specialista posoudit mo\u017enosti.<\/p>\n

U fibrozy asi opravdu nelze o\u010dek\u00e1vat n\u011bjak\u00fd z\u00e1zrak, je mo\u017eno se pokusit o aplikaci hyazy, ozonu nebo kortikoid\u016f a analgetik k posti\u017een\u00e9mu nerv. ko\u0159eni. K optim\u00e1ln\u00edmu zac\u00edlen\u00ed se v\u011bt\u0161inou z\u00e1krok prov\u00e1d\u00ed pod CT navigac\u00ed.<\/p>\n

Pokud nic z toho nebude fungovat, tak opravdu asi nic jin\u00e9ho, ne\u017e symptomatick\u00e1 l\u00e9\u010dba nezb\u00fdv\u00e1.<\/p>\n

Jedn\u00e1- li se o recidivu hernie, pak je mo\u017en\u00e1 bu\u010f klasick\u00e1 reoperace nebo n\u011bjak\u00e1 z nov\u00fdch alternativ- Disc-FX, Herniatome nebo automatick\u00e1 perkutann\u00ed diskektomie. DiscoGel, laser, RFA apod. v tomto p\u0159\u00edpad\u011b, mysl\u00edm, vhodn\u00e9 nejsou.<\/p>\n

Co naopak vhodn\u00e9 je, je pracovat se \u0161ikovn\u00fdm rehabilita\u010dn\u00edm l\u00e9ka\u0159em a fyzioterapeutem. Spr\u00e1vn\u00fdm cvi\u010den\u00edm se d\u00e1 alespo\u0148 \u010d\u00e1ste\u010dn\u011b bolesti omezit a zabr\u00e1nit dal\u0161\u00edmu zhor\u0161ov\u00e1n\u00ed stavu.<\/p>\n

S pozdravem<\/p>\n

prim. MUDr. Jan K\u0159\u00edstek, Ph.D.
\nOdd\u011blen\u00ed zobrazovac\u00edch metod SurGal Clinic
\nDrobn\u00e9ho 38-40 Brno 602 00
\nCzech Rep.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Dotaz: Man\u017eel je po operaci vyh\u0159ezl\u00e9 plot\u00e9nky, ale st\u00e1le m\u00e1 velk\u00e9 bolesti. Za\u010d\u00e1tkem \u0159\u00edjna byl na CT a dle neurolog. l\u00e9ka\u0159ky ji\u017e nen\u00ed co nab\u00eddnout […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14877,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-17837","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/17837","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=17837"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/17837\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14877"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=17837"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=17837"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=17837"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}