Radio\u017eurn\u00e1l <\/p>\n\n\n\n
Bolav\u00e1 z\u00e1da, to je t\u00e9ma pro velkou \u010d\u00e1st \u010desk\u00e9 populace. Asi opravdu jen m\u00e1lokoho nikdy z\u00e1da nebolela. A kdy\u017e u\u017e nepom\u00e1h\u00e1 rehabilitace ani l\u00e9ky<\/strong>, na \u0159adu p\u0159ich\u00e1zej\u00ed chirurgov\u00e9. Jak vypad\u00e1 takov\u00e1 operace p\u00e1te\u0159e a jak m\u016f\u017eeme bolestem zad p\u0159edch\u00e1zet? I o tom bude dne\u0161n\u00ed v\u011bdeckotechnologick\u00fd magaz\u00edn Radio\u017eurn\u00e1lu. Jan \u0160tul\u00edk, moder\u00e1torka Jan \u0160tul\u00edk , moder\u00e1torka Dr. Lucie Selavcov\u00e1 moder\u00e1torka Jan \u0160tul\u00edk, moder\u00e1torka mluv\u010d\u00ed 5, moder\u00e1torka mluv\u010d\u00ed 4, Lucie Selavcov\u00e1, moder\u00e1tor K\u0151v\u00e1ri<\/strong>, mluv\u010d\u00ed 7, K\u0151v\u00e1ri<\/strong>, mluv\u010d\u00ed 7, K\u0151v\u00e1ri<\/strong>, mluv\u010d\u00ed 7, K\u0151v\u00e1ri<\/strong>, mluv\u010d\u00ed 7, K\u0151v\u00e1ri<\/strong> mluv\u010d\u00ed 7, <\/p>\n","protected":false},"excerpt":{"rendered":" Radio\u017eurn\u00e1l Bolav\u00e1 z\u00e1da, to je t\u00e9ma pro velkou \u010d\u00e1st \u010desk\u00e9 populace. Asi opravdu jen m\u00e1lokoho nikdy z\u00e1da nebolela. A kdy\u017e u\u017e nepom\u00e1h\u00e1 rehabilitace ani l\u00e9ky, na […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":15661,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-57027","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/57027","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=57027"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/57027\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/15661"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=57027"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=57027"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=57027"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Rehabilitace, klid na l\u016f\u017eku, l\u00e9ky<\/strong> proti bolesti, fyzioterapie nebo obst\u0159iky. To v\u0161echno m\u016f\u017ee pomoct, kdy\u017e n\u00e1s dlouhodob\u011b bol\u00ed z\u00e1da. Jen necel\u00e9 1 % pacient\u016f s degenerac\u00ed p\u00e1te\u0159e ale skon\u010d\u00ed a\u017e na opera\u010dn\u00edm stole. Pro p\u00e1te\u0159n\u00ed chirurgii z Fakultn\u00ed nemocnice v Motole jsou tyto z\u00e1kroky ka\u017edodenn\u00ed rutinou, staraj\u00ed se i o pacienty, kte\u0159\u00ed pot\u0159ebuj\u00ed reoperaci.<\/p>\n\n\n\n
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V\u017edycky za\u010d\u00edn\u00e1me konzervativn\u00ed l\u00e9\u010dbou, ta operace je v\u017edycky a\u017e to posledn\u00ed.<\/p>\n\n\n\n
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Upozor\u0148uje p\u0159ednosta kliniky spondylochirurgie Fakultn\u00ed nemocnice v Motole Jan \u0160tul\u00edk. Na opera\u010dn\u00edm stole m\u00e1 jedenapades\u00e1tilet\u00e9ho pacienta s degenerativn\u00edm\u00a0onemocn\u011bn\u00edm<\/strong>\u00a0v bedern\u00ed \u010d\u00e1sti p\u00e1te\u0159e.<\/p>\n\n\n\n
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V tomhle tom p\u0159\u00edpad\u011b se jedn\u00e1 o jednu z t\u011bch variant degenerativn\u00edho posti\u017een\u00ed bedern\u00ed p\u00e1te\u0159e, tedy o spondylolist\u00e9zu. Posun obratlu.<\/p>\n\n\n\n
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Pacient je kv\u016fli tomuto probl\u00e9mu na operaci u\u017e pon\u011bkolik\u00e1t\u00e9. Naposledy mu p\u00e1te\u0159n\u00ed chirurgov\u00e9 na jin\u00e9m pracovi\u0161ti vlo\u017eili do oblasti beder speci\u00e1ln\u00ed fix\u00e1tor, obratle ale nesrostly a vznikl pak kloub. <\/p>\n\n\n\n
M\u00e1me dneska za \u00fakol ten fix\u00e1tor p\u016fvodn\u00ed odstranit, vytvo\u0159it lep\u0161\u00ed podm\u00ednky pro sr\u016fst.
D\u00e1t tam nov\u00fd fix\u00e1tor a zajistit ten p\u016fvodn\u00ed c\u00edl, to znamen\u00e1 sr\u016fst dvou obratl\u016f k sob\u011b. V tomto p\u0159\u00edpad\u011b L4 a L5. Tady na tom rentgenu m\u016f\u017eeme i vid\u011bt uvoln\u011bnou mati\u010dku a tady je i vid\u011bt posun t\u011bch obratl\u016f.<\/p>\n\n\n\n
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P\u00e1te\u0159n\u00ed chirurg Lucie Selavcov\u00e1 stoj\u00ed p\u0159ed n\u011bkolika sn\u00edmky z rentgenu a magnetick\u00e9 rezonance.<\/p>\n\n\n\n
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Pacienta tr\u00e1pily bolesti bedern\u00ed p\u00e1te\u0159e a m\u011bl vyst\u0159elov\u00e1n\u00ed bolesti do lev\u00e9 doln\u00ed kon\u010detiny.
Te\u010f vynd\u00e1v\u00e1me \u0161rouby, kter\u00fd jsou ale uvoln\u011bn\u00fd, u\u017e tam nedr\u017eej, jak maj\u00ed, kdybych to \u0159ekl hezky \u010desky, tak tam kloktaj\u00ed a tady u\u017e m\u00e1me ten \u0161roubek, co vypadnul. U\u017e p\u0159ed operac\u00ed byla vid\u011bt vypadl\u00e1 mati\u010dka.<\/p>\n\n\n\n
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p\u00e1te\u0159n\u00ed chirurg Jan \u0160tul\u00edk vyjme mati\u010dku z t\u011bla. A pokra\u010duje v odstra\u0148ov\u00e1n\u00ed dal\u0161\u00edch \u0161roub\u016f a ty\u010dek, kter\u00e9 speci\u00e1ln\u00ed fix\u00e1tor spojuj\u00ed. Pacient je b\u011bhem z\u00e1kroku v pln\u00e9 anestezii a le\u017e\u00ed na b\u0159i\u0161e.<\/p>\n\n\n\n
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Tro\u0161ku jinak funguje ventilace, tro\u0161ku jinak funguje hemodynamika, ale pacienti tuhle polohu sn\u00e1\u0161ej\u00ed v podstat\u011b norm\u00e1ln\u011b.<\/p>\n\n\n\n
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Vysv\u011btluje anesteziolog Martin Malo\u0161ek. Pacient je napojen\u00fd na um\u011blou plicn\u00ed ventilaci a pod hlavou m\u00e1 speci\u00e1ln\u00ed podlo\u017eku. Aby nebyl v kontaktu s opera\u010dn\u00edm stolem.
Kdy\u017e operat\u00e9r fix\u00e1tor odstran\u00ed, najede nad pacienta rentgenologick\u00e9 rameno, aby mohl p\u00e1te\u0159n\u00ed chirurg zkontrolovat postaven\u00ed obratl\u016f, popisuje l\u00e9ka\u0159ka Lucie Selavcov\u00e1.<\/p>\n\n\n\n
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Te\u010f tam vlastn\u011b vid\u00ed obraz p\u00e1te\u0159e bez t\u00e9 p\u016fvodn\u00ed instrumentace. Chyst\u00e1 se zav\u00e1d\u011bt nov\u00e9.
Jan \u0160tul\u00edk vyz\u00fdv\u00e1 radiologick\u00e9ho asistenta, aby ud\u011blal dal\u0161\u00ed rentgenov\u00fd sn\u00edmek. Pot\u00e9, co zavede v\u0161echny \u0161rouby, posune obratel do spr\u00e1vn\u00e9ho postaven\u00ed. Pou\u017e\u00edv\u00e1 k tomu i repozi\u010dn\u00ed v\u011b\u017ee. Popisuje d\u011bn\u00ed na s\u00e1le p\u00e1te\u0159n\u00ed chirurgyn\u011b Lucie Selavcov\u00e1.<\/p>\n\n\n\n
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Je to n\u00e1stroj, kter\u00fd ke \u0161roubu, jak se dotahuje, p\u0159ibli\u017euje tu ty\u010dku a \u0161roub k sob\u011b, u\u017e m\u016f\u017eeme vid\u011bt, \u017ee tam obratel je srovnan\u00fd ve spr\u00e1vn\u00e9m postaven\u00ed, pak je\u0161t\u011b operat\u00e9r o\u010dist\u00ed obratle od m\u011bkk\u00fdch tk\u00e1n\u00ed a polo\u017e\u00ed na n\u011b kostn\u00ed \u0161t\u011bpy, kter\u00e9 odebere z p\u00e1nve, d\u00edky tomu se p\u0159ihoj\u00ed kost na kost a cel\u00e1 operovan\u00e1 oblast se zpevn\u00ed, pacientovi by se m\u011blo po operaci v\u00fdrazn\u011b ulevit, zpo\u010d\u00e1tku ale mus\u00ed chodit o podpa\u017en\u00edch berl\u00edch a nem\u011bl by sed\u011bt. A to do doby, ne\u017e se zahoj\u00ed.
Po t\u0159ech m\u011bs\u00edc\u00edch m\u016f\u017ee za\u010d\u00edt pacient tak\u00e9 s rehabilitac\u00ed.<\/p>\n\n\n\n
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V magaz\u00ednu Radio\u017eurn\u00e1lu Experiment mluv\u00edme o chronick\u00fdch bolestech p\u00e1te\u0159e, tr\u00e1p\u00ed toti\u017e mnoho lid\u00ed. Nejen o tom, co v\u0161echno se d\u00e1 ud\u011blat pro to, abychom se nedostali a\u017e na opera\u010dn\u00ed st\u016fl, mluvila report\u00e9rka Andrea Skalick\u00e1 s prim\u00e1\u0159kou kliniky rehabilitace a t\u011blov\u00fdchovn\u00e9ho l\u00e9ka\u0159stv\u00ed Fakultn\u00ed nemocnice v Motole Martinou K\u0151v\u00e1ri<\/strong>.<\/p>\n\n\n\n
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M\u011bli bysme se ur\u010dit\u011b od ml\u00e1d\u00ed v\u011bnovat sportovn\u00edm aktivit\u00e1m, kter\u00e9 upravujou na\u0161e svalov\u00e9 dysbalance, proto\u017ee samoz\u0159ejm\u011b kdy\u017e odmali\u010dka sed\u00edme n\u011bkde ve \u0161kole, v lavic\u00edch studujeme, pak m\u00e1me sedav\u00e1 zam\u011bstn\u00e1n\u00ed, tak n\u00e1m vznikaj\u00ed r\u016fzn\u00e9 svalov\u00e9 dysbalance, to znamen\u00e1, m\u016f\u017ee t\u011bmi aktivitami b\u00fdt bruslen\u00ed, m\u016f\u017eou to b\u00fdt b\u011b\u017eky, m\u016f\u017ee to b\u00fdt j\u00edzda na kole, m\u016f\u017ee to b\u00fdt lezen\u00ed, prost\u011b symetrick\u00e9 sporty.<\/p>\n\n\n\n
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Jak vypad\u00e1 vlastn\u011b ta modern\u00ed rehabilitace, ty modern\u00ed rehabilita\u010dn\u00ed metody?<\/p>\n\n\n\n
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J\u00e1, kdy\u017e jsem za\u010d\u00ednala d\u011blat rehabilitaci a p\u0159edt\u00edm jsem d\u011blala neurologii, rehabilitace se sp\u00ed\u0161 sest\u00e1vala z takov\u00fdch m\u011bkk\u00fdch technik a mobilizac\u00ed p\u00e1te\u0159e, tak\u017ee pacienti, kdy\u017e m\u011bli n\u011bjak\u00e9 pot\u00ed\u017ee, p\u0159i\u0161li a do\u017eadovali se takov\u00e9 t\u00e9 akutn\u00ed mobilizace, ale v podstat\u011b se nic ned\u011blalo pro prevenci, aby ty pot\u00ed\u017ee se neopakovaly, to se zm\u011bnilo, \u0159ekla bych, tak posledn\u00edch 15 – 20 letech, aby na\u0161e pot\u00ed\u017ee t\u0159eba p\u0159echodn\u00e9 blok\u00e1dy bedern\u00ed p\u00e1te\u0159e, aby se nevracely, tak mus\u00edme proti tomu aktivn\u011b bojovat, tzn, \u017ee pacienti by m\u011bli preventivn\u011b cvi\u010dit a m\u011bli by se v\u011bnovat….. ve fitnessu tomu \u0159\u00edkaj\u00ed st\u0159ed t\u011bla. My tomu \u0159\u00edk\u00e1me posilovat stabiliza\u010dn\u00ed syst\u00e9m p\u00e1te\u0159e.<\/p>\n\n\n\n
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M\u016f\u017eeme si n\u011bkter\u00e9 ty speci\u00e1ln\u00ed metody techniky bl\u00ed\u017ee p\u0159ibl\u00ed\u017eit, co t\u0159eba obn\u00e1\u0161ej\u00ed?<\/p>\n\n\n\n
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V na\u0161ich kon\u010din\u00e1ch, ale nejen v na\u0161ich kon\u010din\u00e1ch, proto\u017ee ta technika se pom\u011brn\u011b \u0161\u00ed\u0159\u00ed celosv\u011btov\u011b dynamick\u00e1 neuromuskul\u00e1rn\u00ed stabilizace, jej\u00ed\u017e tv\u016frcem je pan prof. Pavel Kol\u00e1\u0159, tato technika, ale nejen tato technika pracuje s tou stabilza\u010dn\u00ed funkc\u00ed p\u00e1te\u0159e, jsou to na\u0161e b\u0159i\u0161n\u00ed svaly, jsou to na\u0161e paravertebr\u00e1ln\u00ed svaly, neboli svaly pod\u00e9l p\u00e1te\u0159e, sou\u010d\u00e1st\u00ed d\u016fle\u017eitou je br\u00e1nice, p\u00e1nevn\u00ed dno a potom hlubok\u00e9 oh\u00fdba\u010de, neboli my tomu \u0159\u00edk\u00e1me flexory kr\u010dn\u00ed, tyhle ty svaly by se m\u011bly cvi\u010dit tzv. synergi\u00ed.<\/p>\n\n\n\n
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Jak dlouh\u00e1 ta terapie vlastn\u011b by m\u011bla b\u00fdt?<\/p>\n\n\n\n
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Aby ten pacient byl schopen dob\u0159e a kvalitn\u011b cvi\u010dit s\u00e1m v autoterapii, na\u010de\u017e je pak kladen velk\u00fd d\u016fraz, tak si mysl\u00edm, \u017ee to chce takov\u00fdch 3\u20135 n\u00e1v\u0161t\u011bv u toho fyzioterapeuta, ale s t\u00edm, \u017ee o t\u011bchhle t\u011bch technik\u00e1ch jsou v sou\u010dasn\u00fd dob\u011b edukov\u00e1ni i nap\u0159\u00edklad tren\u00e9\u0159i ve fitness, tak\u017ee i pokud bych t\u0159eba chodila do fitness, tak bych se zaj\u00edmala o to, zda ten m\u016fj tren\u00e9r m\u00e1 n\u011bjak\u00e9 rehabilita\u010dn\u00ed vzd\u011bl\u00e1n\u00ed v tomto duchu a m\u016f\u017ee se pak spoustu v\u011bc\u00ed doladit i s n\u00edm, pokud je to jenom prevence, samoz\u0159ejm\u011b, pokud u\u017e ten pacient m\u00e1 n\u011bjak\u00e9 bolesti p\u00e1te\u0159e, projekce, to je pro n\u00e1s takov\u00fd, my tomu \u0159\u00edk\u00e1me retflex, to znamen\u00e1 \u010derven\u00e1 vlajka, \u017ee u\u017e ty bolesti najednou se propagujou do kon\u010detiny, jdou t\u0159eba i do prst\u016f, tak u\u017e je to pro n\u00e1s signalizace, \u017ee mus\u00ed opravdu chodit k odborn\u00edkovi a rehabilita\u010dn\u00edmu l\u00e9ka\u0159i<\/strong>.<\/p>\n\n\n\n
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Jedna v\u011bc je cvi\u010den\u00ed pod dohledem, druh\u00e1 v\u011bc je vlastn\u011b u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f<\/strong> na bolest, jak se to z va\u0161eho pohledu d\u00e1, \u0159ekn\u011bme, ide\u00e1ln\u011b kombinovat?<\/p>\n\n\n\n
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Pokud m\u011b za\u010dnou pobol\u00edvat z\u00e1da po n\u011bjak\u00e9 v\u011bt\u0161\u00ed fyzick\u00e9 z\u00e1t\u011b\u017ei, t\u0159eba po dom\u00e1c\u00edm \u00faklidu nebo po n\u011bjak\u00fd v\u011bt\u0161\u00ed sportovn\u00ed aktivit\u011b tak nen\u00ed t\u0159eba \u017e\u00e1dn\u00e1 analgetika u\u017e\u00edvat. Ty bolesti jenom zna\u010d\u00ed, \u017ee jsem si p\u0159et\u00ed\u017eila sv\u016fj pohybov\u00fd syst\u00e9m a odezn\u00ed samy. Pokud ty pot\u00ed\u017ee u\u017e m\u00e1m del\u0161\u00ed dobu, m\u00e1m rann\u00ed ztuhlosti, v noci se bud\u00edm bolest\u00ed, pak si mysl\u00edm, \u017ee je na m\u00edst\u011b konzultovat l\u00e9ka\u0159e<\/strong> a o medikaci se pobavit, proto\u017ee ta medikace nen\u00ed jenom na \u00fatlum bolesti, ale je proti z\u00e1n\u011btu a otoku, kter\u00fd u chronick\u00e9ho p\u0159et\u011b\u017eov\u00e1n\u00ed pohybov\u00e9ho syst\u00e9mu vznik\u00e1.<\/p>\n\n\n\n
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Dod\u00e1v\u00e1 prim\u00e1\u0159ka kliniky rehabilitace a t\u011blov\u00fdchovn\u00e9ho l\u00e9ka\u0159stv\u00ed Fakultn\u00ed nemocnice v Motole Martina K\u0151v\u00e1ri<\/strong>. <\/p>\n\n\n\n