interventional vedana maanejment

interventional paine maanejment allengil interventional paine medisin ennathu naashanal unifom claim kammitti (enn. yuu. sii. sii) nirvachicha oru medical upavibhagamaanu, "vedanayumaayi bandhapetta vaikalyangalude roganirnayathinum chikilsaykkum vendi samarppichirikkunna marunninte achadakkam polulla aakramanathmaka edapedalukal pradhaanamaayum upa-acute, vittumaaraatha, sthiramaaya, pariharikkaanaavaattha vedana, swathanthramaayi allengil chikilsayude mattu reethikalumaayi samyojippichu kaikaaryam cheiyunnathil interventional teknikkukal prayogikkunnu". medicare payment advisory kammeeshan (medpack) interventional teknikkukale nirvachichathu, "percutaneous presition soochi placement, targettucheytha pradeshangalil marunnukal sthaapikkuka allengil targettucheytha njarambukalude ableshan ulppedeyulla ettavum kuranja aakramanathmaka nadapadikramangal; koodaathe vittumaaraatha, sthiramaaya allengil pariharikkaanaavaattha vedanayude roganirnayathinum maanejmentinumaayi lazer allengil endoscopic discactomy, intraathekkal infusion pambukal, sushumna naadi uthejakangal thudangiya chila shasthrakriya saankethikavidyakal" ennaanu. facet joyint kuthivayppukal, naadi blokkukal (nirddishta naadeevyavasthayude paathakaliloode vedana signalukalude ozhukk thadassappeduthunnu), neuroagmentation (sushumna naadi uthejanavum peripheral naadi uthejanavum ulppede), vertebroplasty, kaiphoplaasti, nucleoplasty, endoscopic desectomy, implaantabil drugg delivari sisttangal enniva subcuted allengil vittumaaraatha vedana kaikaaryam cheiyunnathinu upayogikkunnu.
charithram.
interventional vedana maanejmentile aadyakaala sramangal praadeshika vedanasamhaarikal, naadi blokkukal ennivayude uthbhavam muthal aarambikkukayum kramena oru prathyeka savisheshathayaayi parinamikkukayum cheythu. 1899-ll vedana niyanthrikkunnathinulla aadyathe chikitsa naadi blockine tuffer vivarichu. vedanayude paatha nirnnayikkaan prokine upayogichu voonn ghaza vedana niyanthrikkunnathil diagnostic block vikasippichu. aadhunikakaala sambhaavakaril bonica, vinni, raaj, rax, bogduk thudangiyava ulppedunnu. interventional paine maanejment" enna padam aadyamaayi upayogichathu paine maanejment specialist steevan dii. 1996ll waldman valarnnuvarunna prathyekathakale nirvachikkaan. interventional paine maanejmentinte upavibhaagathin american aikyanaadukalude deseeya unifom billing kammitti oru prathyeka padavi nalki, athinte pariseelakarkk medicare, mediquide ennivayulppedeyulla federal health cair prograamukal bill cheyyaan anuvadikkunnu. interventional paine maanejment parisheelikkunna doctormaare 1998 ll lakshmaiah manchikanthi, emm. dii. sthaapicha american sosaitti oof interventional paine physicians (assip) ulppede vividha vedana maanejment oorganaiseshanukal prathinidheekarikkunnu, ithu interventional paine maanejment professionalukale maathram prathinidheekarikkunnu.
vikiranam.
asthi metaastaasis (saadhaaranayaayi), mriduvaaya tissue nuzhanjukayattam, censory njarambukalude compression enniva polulla valarunna tumourinte vedana niyanthrikkunnathil marunnu chikitsa paraajayappedumbozhaanu radiotherapy upayogikkunnathu. palappozhum, kuranja alavil vedanasamhaarikal undakkaan mathiyakum, ithu sammarddam kurayukayo allengil tumourinte vedana vardhippikkunna raasavasthukkalude ulppaadanathile edapedal aayirikkam. metaastaattik rogangalude vedana chikilsikkaan nirddishta tumourukale lakshyamidunna radiopharmaceuticals upayogichittundu. chikitsa kazhinju oraazhchaykkullil aashvaasam sambhavikkam, ithu rund muthal naalu maasam vare neendunilkkum.
neurolytic block.
rasavasthukkal prayogikkunnathiloodeyo (eee saahacharyathil eee prakriya "neurolysis" ennu vilikkunnu) allengil freesing allengil heating ("neurotomy") polulla physical ejantukal prayogikkunnathiloodeyo oru nadic manappoorvvam parukkelkkunna avasthayaanu neurolytic block. eee edapedalukal nadiyude naarukalude apachayathinum vedanayude signalukal kaimarunnathil thaalkkaalika edapedalinu kaaranamaakunnu. eee nadapadikramangalil, naadi naarukalkk chuttumulla nerttha samrakshana paaliyaya basel lamina samrakshikkappedunnu, angane kedupaadukal sambhavicha fiber veendum valarumbol, athu athinte basel lamina tubinullil sanjarikkukayum sariyaaya ayanja attavumayi bandhippikkukayum pravartthanam punasthaapikkukayum cheyyum. shasthrakriyayiloode oru naadi murikkunnath eee basel lamina tyoobukale verthirikkunnu, avaa illaathe veendum valarunna naarukal avayude nashtappetta kanakshanukalilekku nayikkaan, vedanaajanakamaaya neuroma allengil deferentation vedana vikasichekkaam. athukondaanu sasthrakriya blokkinekkaal neurolytic thiranjedukkunnathu.
naadeekoshangalude murikkal allengil nasham.
peripheral allengil central naadeekoshangalude sasthrakriya muricalo nashamo ippol vedanayude chikilsayil apoorvamaayi maathrame upayogikkunnulloo. neurectomy, cordotamy, dorsal root entry soonn lessioning, singulottami enniva nadapadikramangalil ulppedunnu.
neurectomy oru naadi murikkunnath ulkkollunnu, ithu (apoorvvamaayi) phalapradamallaathatho asahishnuthayo kaaranam mayakkumarunnu therapic anuyojyamallaatha hraswa aayurdairkhyamulla rogikalil upayogikkunnu. dorsal root allengil dorsal root ganglian (kooduthalum censory signalukal vahikkunna) upayogapradamaayi targettucheyyaam (rhisotamy ennu vilikkunnu); dorsal root ganglian kooduthal phalapradamaaya lakshyamaayirikkam, kaaranam chila censory naarukal dorsal root gangliyanil ninnu "ventral" (motor) root vazhi sushumna naddle praveshikkunnu, iva dorsal root neurectomy vazhi thadassappedilla. njarambukal palappozhum censory, motor naarukal vahikkunnathinaal, motor vaikalyam neurectomyude paarshwafalamaanu. eee prakriyayude oru saadhaarana phalam "deferentation vedana" aanu, avide shasthrakriyaykk sesham 6 muthal 9 maasam vare vedana kooduthal theevrathayode madangivarunnu.
sushumna nadic munnilulla/vashathulla (aantarolaattal) naaluvashathekku kadannupokunna spinothalamic tractukalilekku murichu thalachorilekku choodum vedana nalkunnathaanu cordotamy.
paankoost tumour vedana dorsal root entry soonn (dress) shathangal upayogichu phalapradamaayi chikilsichittundu-peripheral vedana signalukal sushumna naadi naarukalilekku kadakkunna sushumna nadiyude oru pradeshathe nasippikkunnu. ithu oru pradhana shasthrakriyayaan, ithu ganyamaaya neurological paarshwafalangalkkulla saadhyatha vahikkunnu.
singulate gyrasil ninnu thalachorile entorhinal courtexilake nerittu signalukal vahikkunna naarukal murikkunnath singulottamiyil ulppedunnu. ithu vedanayude asukhakaramaaya avastha kuraykkunnu (athinte theevrathaye baadhikkathe), pakshe vaijnjaanika paarshwafalangal undakam.
intrahecal infusion.
morphin, hydromorphone, fentanail, sufentanail allengil meperidine thudangiya opiyoyidukal nerittu suberachnoid arayilekku (sushumna nadiyude aantharika, jalanirodhitha aavaranathinum athinte baahya samrakshana aavaranangalkkum edayilulla idam) athikkunnathu mechappetta vedanasamhaarikal nalkukayum vyavasthaapitha paarshwafalangal kuraykkukayum cheiyunnu, koodaathe sukhappeduthaanaavaatha kesukalil vedanayude alavu kuraykkukayum cheiyunnu. ansiolitic clonydine allengil nonpeoid analgesic seconotide, bupivaakain, roppivaakain allengil tetrakine polulla praadeshika anaesthetics ennivayum opioyidinoppam cherkkaam.
epidural infusion.
sushumna nadic chuttumulla ettavum puram, samrakshana aavaranathe dura mettar ennu vilikkunnu. ithinu chuttumulla kasherukkalkkidayil connective tissue, kozhuppu, rakthakkuzhalukal enniva niranjathum nattellu naadi verukal kadakkunnathumaya epidural space undu. anaesthesiayo vedanasamhaarikalo nalkunnathinaayi moonnu muthal aarr maasam vare eee sthalathu oru katheettar cherkkaam. marunnu vahikkunna line charmmathinu keezhil izhanju rogiyude munvashath prathyakshappedaam, tunneling ennu vilikkunna oru prakriya. epidural speysilethunna eksitt saittil eathenkilum anubaadhaykkulla saadhyatha kuraykkunnathinu deerghakaala upayogathode ithu shupaarsha cheiyunnu.
sushumna naadi uthejanam.
sushumna nadiyude dorsal nirakalude vaidyutha uthejanam vedanasamhaarikal undaakkum. aadyam, rogiyude report fluoroscopy vazhi nayikkunna leedukal sthaapikkukayum falaprapti vilayiruthunnathinayi janarettar niravadhi divasathekku baahyamaayi dharikkukayum cheiyunnu. vedana pakuthiyiladhikam kurayukayaanengil, therapy anuyojyamaanennu kanakkakkunnu. oru cheria pokkatt pinbhaagathinteyo nenjinteyo vayarudeyo charmmathinu thaazheyulla tissuevilekku murichu, uttejaka saitt muthal pokkatt vare charmmathinu keezhil izhacherkkunnu, avide avaa sukhapradamaaya janarettaril gadippichirikkunnu. nosiseptive vedanayekkaal neuropathic, ischemic vedanaykku ithu kooduthal sahaayakaramaanennu thonnunnu, ithu palappozhum cancer vedanayude chikilsayil upayogikkunnilla.
aazhathilulla mastishka uthejanam.
thalachorinullile aazhathilulla gadanakalude thudarchayaaya vaidyutha uthejanam-nosiseptive vedanaykku perikvidaktal gray, periventricular gray, aantharika capsule, ventral postarolaattaral nucleus, neuropathic vedanaykku ventral posteromedial nucleus enniva chila rogikalil aakarshakamaaya phalangal nalkiyittundu, pakshe phalangal vyathyaasappedunnu, uchithamaaya rogiyude thiranjeduppu pradhaanamaan. sukhappeduthaanaavaatha cancer vedanayulla pathinezh rogikalil nadatthiya oru padanatthil pathimoonnu perr phalatthil vedanayillaathavaraanennum edapedalinu sesham ashupathriyil ninnu mochippikkumbol naalu opioid vedanasamhaarikal maathrame aavashyamulloovennum kandethi. mikkavarum aathyanthikamayi opiyoyidukal avalambikkunnu, saadhaaranayaayi jeevithathinte avasaanathe eathaanum aazhchakalil.
hypophysectomy.
pityoottari grandhiyude naashamaan hypophysectomy, ithu metaastaattik sthanaarbudathilum prostettu cancer vedanayilum vijayakaramaayi upayogichittundu.

