IAAI Iziphumo ezivela kwi-Vertebrae engalungile
Ukungazinzekanga kwe-Atlantoaxial (AAI) yinkinga ejwayelekile yomzimba ebonwa kubantu abane-Down syndrome. Nangona inegama elinzima kwaye livakala ngokungcangcazelisayo, ngenxa yeyona nto ininzi, ayibangeli iingxaki kulabo abanalo. Ukuze ukwazi ukuqonda i-AAI, kubalulekile ukuqonda okufutshane malunga nomsebenzi kunye nesakhiwo somtya womthambo, iimbulunga, i-vertebrae kunye ne-ligaments.
Umgca woMgcini, iMisongo, iVertebrae kunye neLigaments
Umphezulu wentambo yomthambo uyisakhiwo esinjenge-tube-like like element that begins at the bottom of the brain and runs all the way back to the lumbar region. Intambo yomthambo iqulethe umzi womzimba okanye i-neurons. Amagulane ahlobo olukhethekileyo lweeseli oluhambisa imiyalezo phakathi kwengqondo kunye nalo lonke umzimba. I-nerve ifana nekhebula lombane elidlula okwangoku ugesi kwaye lithwala iimpawu phakathi kwamalungu omzimba.
Ii-vertebrae zenziwe ngamathambo angacwangciswanga ngokungaqhelekanga kwikholomu emva komzimba ophuma kwisiseko sobuchopho kwi-pelvis. Intambo yomthambo uyaphumelela kwaye ikhuselwe yile ngqolowa yeertebrae. Kukho ama-vertebrae angama-33, aqhelekileyo aphulwe kwimimandla emine: umlomo wesibeleko (7), i-thoracic (12), i-lumbar (5) kunye ne-vertebra ye-pelvis. I-vertebrae yomlomo wesibeleko ikhona kwingingqi yentamo kwaye isicatshulwa njengeC1-C7. Ukuba ugoba ikhanda lakho phambili kwaye usebenze iminwe yakho ngaphantsi kwekhanda lakho, inkunzi enkulu yokuqala ovakalelwa kukuba uyi-C1 yakho okanye i-vertebra yomlomo wesibeleko.
Omnye wezantsi u-C2 kunye nokunye. I-C1 ibizwa ngokuba yi-atlas vertebra ne-C2 njenge-vertebra ye-axis. Ukungalungisiswa kwezi zintetho kubhekiselwa ku-instancial instability or AAI.
Ii-vertebrae ziqhutywe endaweni kunye nemisipha kunye nemigqa. Imisebenzi yekholam ye-vertebral ibandakanya ukukhuselwa kwentambo yomgogodla kunye nezitho zangaphakathi, inkxaso yenkxaso yentloko kunye nokugcina ukuguquguquka nokuhamba.
Ekubeni abantu abane- Down syndrome banezandi eziphantsi kunye ne-lax ligaments, i-vertebrae yabo ingakwazi ukungalunganga. Xa i-C1 kunye ne-C2 vertebrae idibene, u-AAI. Kubantu abane-Down syndrome, i-ligament esoloko ibandakanyeka kwi-AAI ibizwa ngokuba "ligangqa eguqukayo."
Ukuxilongwa kweAAI
Uninzi lweziganeko ze-AAI ezingabonakaliyo zenziwa ngokucoca ii-ray-ray. Bonke abantwana abane-Down syndrome kufuneka bahlolwe i-AAI ngeminyaka eyi-3. Ukuxilongwa kwe-AAI ephawulekayo ngokuqhelekileyo kwenziwa ngokuhlolwa kwegazi (ukuhlolwa ngokomzimba okuhlola indlela iimbilini ezisebenza ngayo) kunye / okanye nge-x-ray.
Iintlobo zeAAI
Kukho iintlobo ezimbini ze-atlantoaxial ukungazinzi -AAptptatic AAI kunye ne-AAI ye-symptomatic. I-AAI e-Asymptomatic ithetha ukuba i-AAI ibonakala kwi-x-ray, kodwa ayibangeli nayiphi na ingxaki ye-neurologic kumntu onayo. I-Symptomatic AAI ithetha ukuba i-AAI ikhona kwi-x ray, kwaye ibangela ezinye iingxaki ze-neurologic kumntu onayo. Kwindawo ethile phakathi kwe-10% ukuya kwi-20% yabantu abane-Down syndrome bane-AAI kwi-ray-ray, kwaye kuphela i-1% ukuya ku-2% yabantu abane- Down syndrome bane-AAI ephawulekayo.
Iimpawu ze-Neurologic kwi-AAI
Enye yemisebenzi yekholam ye-vertebral kukukhusela intambo yomgudu, ehamba ngaphakathi kwayo.
Intambo yomgogodla iqoqo leentsimbi ezikhuselweyo kwikholam ye-vertebral. I-Symptomatic AAI ibangela iintlobo ezahlukeneyo zeempawu ze-neurologic ezifana ne:
- Ukuxhamla
- Ukungabikho koLawulo
- Unzima ukuhamba
- Ukuhamba kunye neendleko ezingaqhelekanga (oko kukuthi ukuhlambalaza)
- Ukhathala lula
- Intlungu yesibindi okanye amandla okulinganisa ukuhambisa intamo
- Ubuncwane - ukuqina kumisipha
- Ukwahlukana kwe-Clonus - imisipha okanye i-spasms
Ukuba umntu onesifo se-Down syndrome uhlakulela nayiphi na le mpawu yegazi, kufuneka ahlolwe ngokukhawuleza ngunyango. Udokotela ngokuqhelekileyo uya kwenza uvavanyo olupheleleyo lwe-neurologic kunye nokucwangcisa izifundo zokucinga, ezifana ne-x-ray, i-CT okanye i-MRI.
Unyango lwe-AAI
I-AA ye-Asymptomatic ayifuni naluphina unyango. Ngokuqhelekileyo abazali bayacetyiswa ukuba ziphi iimpawu zokubukela kumntu one-AAI.
Ukuba umntu ubonisa iimpawu zokunyanzeliswa kwentambo yomgudu, unyango luboniswa. Iinjongo zokuphatha i-AAI ye-symptomatic kukukhusela intambo yomgogodla, ukuzinzisa umqolo wesigxina okanye i-vertebrae kunye ne-decompress nayiphi na ingozi. Ngokuxhomekeka kubukhulu beengxaki, ukuzinza kwentambo yomgudu kungagqitywa ngokugqoka i-collar ezithambileyo, i-halter traction kunye neyeza zentlungu kunye nokuphucula imisipha kunye nokuhlinzwa.
Imithombo:
I-American Academy ye-Pediatrics, iKomiti yeMicrophelo yeMidlalo. Ukungazinzi kwe-Atlantoaxial kwi-Down syndrome. Pediatrics. Vol. 107 No. 2, Februwari 2001, iphe. 442-449 [/]
U-Alvarez, N. Atlantoaxial Instability kuBantu abane-Down Syndrome, i- Emedicine , ngomhla we-8 ka-2008, 2008.