I-Spondylolysis yimeko yomgulane echaphazela kakhulu abadlali bezemidlalo abadlala imidlalo abafuna i-hyperextension ephindaphindiweyo kunye nokujikeleza-oko kukuthi ukuququzela kunye nokuguquka-kwintsipho. Okubaluleke kakhulu ukuguga nokusila.
I-Spondylolysis iqala ngokuphazamiseka kwengcinezelo kwindawo encinane yethambo emva kwe-vertebra ebizwa ngokuba yi-pars interarticularis. Ukuba ukuphazamiseka kwengxaki / i-spondylolysis ivumelekile ukuba yenzeke ngakumbi, ingabangela imeko echaphazelekayo ebizwa ngokuba yi-spondylolisthesis.
Kwi-spondylolisthesis, ithambo liphuma kwindawo kwaye liba lizinzile.
Ukuqhaqha, ukuPhumela kunye nokuQinisekisa
Ukuxilongwa kwangaphambili kunye nonyango kubalulekile ekubuyiseni kwisenzo xa unesipondylolysis. Unyango ngokubanzi lubandakanya ixesha lokuphumla elihlala phakathi kweeveki ezimbini kunye neenyanga ezi-6, ukukhawuleza ukukunceda ukunciphisa i-posture (lumbar lordosis) ehambelana nokungazinzi kunye / okanye ukunyanzeliswa kwemisipha.
Ukuba intlungu yangaphaya idlulela kwiinyanga ezi-6, udokotela wengane wakho angachaza ukuhlinzwa.
Sathetha noDkt. Lyle Micheli, ugqirha wezobugqirha kunye noMlawuli weSebe lezeMpilo kwiZibhedlele kwiBoston Children's Hospital, kunye noNjingalwazi wezonyango ze-Orthopedic Surgery eHarvard Medical School. UDkt. Micheli usebenza ngeendlela ezihlukeneyo kunye ne-US Rugby Football Foundation, i-US Ukubonisa isakhono kunye neBoston Marathon.
KwiSibhedlele sabantwana eBoston, uthi, ezininzi izigulane zikhulile kunye nabantu abadala abasenokuba baqeqesha ubuncinane kwimidlalo emibini.
Kulapho, izigulane ziphezu kweeveki ezi-4 ukuya kweyesi-6 okanye intlungu yabo, ingakumbi xa iphakamisa umlenze, ihambe. Ngethuba leveki ezi-4 ukuya kwezi-6, iiyure ezingama-23 ngosuku, izigulane zambatha i-brace enqanda ukongezwa komgudu. I-brace inceda ukunciphisa i-lordosis ye-lumbar spine kwaye inceda ithambo kwindawo yokulimala-okt
i-pars-ukuphilisa. Kwakhona ngelo xesha, izigulane ziya kwipilisi yokwenyama ukuze zomeleze izihlunu ezigcina umgudu ungagxininisi kunye nokuhlakulela ukuguquguquka kwemisipha yomzimba.
Ngelishwa kubadlali, umda wokusebenza owenziwe kuwo ngexesha lokuphulukiswa kunye nonyango le nzakalo kunokubonakala ngathi umgijimi omncinci unokuba bubuhlungu ngaphezu kokulimala ngokwawo. Sekunjalo, umsebenzi ngeli xesha likhawulelwe ekuziphatheni okonyango, ukuhamba ngebhayisekile kunye nokubetha ezithile. Nantoni na eyenza umlenze uyagwenywa.
Emva kweeveki ezi-4 ukuya kwezi-6, isigulane esine-spondylolysis sihlaziywa kwakhona ngokunyanzeliswa komgudu kunye nesantya sentlungu. Ukuba intlungu ikhona, ukugqithwa kwe-brace kunye nokunyanga kwonyango kuyaqhubeka.
Kwiinyanga ezi-4, ukuphulukiswa kuphinda kuhlolwe kwakhona, ngeli xesha ngokuhlolwa kunye ne-CT scan. Kule nkalo, ugqirha uyakhangeleka ukuba abone indlela kunye nokuba ithambo liphilile kwi-pars liphilile. Ukuba iziphumo zokuvavanya zibonisa imbumbano yebony yama-pars, kunye / okanye ukuba umdlali akayiyo intlungu, umgijimi uyavunyelwa ukuba abuyele imidlalo ngokugcwele. Yena okanye unokuqalisa kwakhona ngokukhawuleza ukuvumela ukuhamba kwe-brace.
Ngethuba ukugqoka i-brace kunye nokwenza izifo zonyango kudla ngokwaneleyo ukuphilisa i-spondylolysis kwaye uvumele umdlali ukuba abuyele ngokugcwele kwimidlalo, uMicheli uyazisa.
Kodwa malunga ne-22% yamatyala, ezinye iindlela zonyango ziyadingeka. Inkqubo entsha enokunceda ukuphulukisa ithambo kukuvuselela ugesi, uthi.
Izifundo ezenziwe nguMicheli nabanye zibonisa ukuba ukuvuselelwa kwamandla angaphandle kunokunceda ukunciphisa intlungu kunye nokuphulukana nokuqhekeka kwi-pars. Kodwa ngokokuhlaziywa kuka-2016, ubungakanani besampula (inani lezigulane ezithatha inxaxheba ekufundeni) lincinci kakhulu ukuba livumele ukufikelela kwisigqibo esipheleleyo; Ngenxa yoko, abalobi bahlalutyo banqabile ukuvelisa iziphumo kubo bonke abantu abasebenzisa i-spondylolysis.
Lumbar Fusion
Inketho yokugqibela yonyango yonyango ukuzinzisa umlenze, ngokubanzi i-fusion lumbar .
Oku kuvivinywa kuphela emva kokuba zonke iinkqubo zokunyamekela ezinonophelo zibonakalise zingasebenzi. Emva kokuhlinzwa, izigulane zifakwe kwi-cast or brace ubuncinane kwiinyanga ezi-3, mhlawumbi ukuya kwiinyanga ezi-6, kwaye ziyalelwe ukuba zingadlali nxaxheba kwimidlalo yonyaka.
Yaye ukuba udlala imidlalo yeqhagamshelwano, awukho mqinisekiso yokubuyela ensimini yonke emva kokuhlinzwa.
Imithombo:
> AAOS. Spondylolysis kunye ne-Spondylolisthesis. Website yeOrthoInfo.
> Fellander-Tsai L, Micheli L. Ukwelashwa kwe-spondylolysis kunye nokuvuselelwa kombane kwangaphandle: ingxelo yeemeko ezimbini. Iiklinikhi J Sports Med 1998.
> Sonne-Holm, S., Jacobsen, S., Rovsing, HC, Monrad, H., & Gebuhr, uP. Lumbar spondylolysis: ubomi obunzima obude? Uphononongo olunqamlezileyo lwabantu abadala abangama-4141. Eur Spine J, Novemba 22 2006.
> Lawrence K., Elser T., uStromberg R. Lumbar spondylolysis kumdlali osemtsha. Phys Ther. Julayi 2016.
> Micheli, i-LMD, i-Curtis, i-C. Stress Fractures kwi-Spine neSigrum. Iiklinikhi zeMidlalo yeMidlalo 25 (2006).