I-spondylolysis yisimo somgogodla esithinta ikakhulukazi abagijimi abasha abadlala imidlalo efuna ukuqhutshwa kwe-hyperextension kanye nokujikeleza-okusho ukuguqulwa nokuguquka-komgogodla. Ngokuyinhloko ukulimala nokudabuka.
I-spondylolysis iqala ngokuphazamiseka kwengcindezi endaweni encane yethambo emhlane we-vertebra okuthiwa i-pars interarticularis. Uma ukuphazamiseka kwengcindezi / i-spondylolysis kuvunyelwe ukuba kubi kakhulu, kungaholela esimweni esihlobene esibizwa ngokuthi i-spondylolisthesis.
Ku-spondylolisthesis, ithambo liphuma endaweni futhi lihlale lizinzile.
Ukuqhaqhaza, ukuthutha nokuzivocavoca
Ukuxilongwa kokuqala kanye nokwelashwa kuyisihluthulelo sokubuyela emuva esenzweni uma une-spondylolysis. Ukwelashwa ngokuvamile kuqukethe isikhathi sokuphumula esihlala phakathi kwamasonto amabili nenyanga eziyisithupha, ukukhandla ukuze kusize ukunciphisa ukuma (i-lordosis) ehambisana nokungazinzi nokuzivocavoca.
Uma ubuhlungu emuva buqhubeka budlule izinyanga ezingu-6, udokotela wengane yakho angase akhombise ukuhlinzwa.
Saxoxa noDkt. Lyle Micheli, udokotela ohlinzayo wamazinyo noMqondisi weDokotela wezeMidlalo eBoston Children's Hospital, kanye noProfesa wezokwelapha wezokwelapha ze-Orthopedic eHarvard Medical School. UDkt. Micheli usebenza ngendlela ehlukahlukene ne-US Rugby Football Foundation, i-US Ukubonisa i-Skating ne-Boston Marathon.
Ebhedlela yezingane eBoston, uthi, iziguli eziningi zingabantu abadala kanye nabantu abadala abasha abaqeqeshe okungenani umdlalo owodwa.
Lapho, iziguli zihlala eceleni kwamasonto angaba ngu-4 kuya kwangu-6 noma kuze kube yilapho ubuhlungu babo, ikakhulukazi uma bendlulisela umgogodla, buphelile. Phakathi nalamaviki angu-4 kuya kwangu-6, amahora angu-23 ngosuku, iziguli zigqoka i-brace evimbela ukwandiswa komgogodla. I-brace isiza ukunciphisa i-boneosis ye-lumbar spine futhi isisiza amathambo endaweni yokulimala-okungukuthi
i-pars-ukuphulukisa. Kanti futhi ngalesi sikhathi, iziguli zenza ukwelashwa ngokomzimba ukuze kusize ukuqinisa imisipha egcina umgogodla ungasuki futhi uthuthukise izimo zemisipha yomzimba.
Ngeshwa ngomdlali, umkhawulo womsebenzi ubeka phezu kwabo ngesikhathi sokuphulukiswa nokuphulukiswa kwalesi ukulimala kungase kubonakale kumgijimi osemusha ubuhlungu ngisho nokulimala ngokwayo. Noma kunjalo, umsebenzi phakathi nalesi sikhathi kunomkhawulo wokuzivocavoca umzimba, ukuhamba ngebhayisekili kanye nokushaya okuthile okubhukuda. Noma yini elula umgogodla igwenywe.
Ngemuva kwamaviki angu-4 kuya ku-6, isiguli esine-spondylolysis siphinde sihlolwe ngokuqiniswa komgogodla kanye nobukhulu bobuhlungu. Uma ubuhlungu bukhona, ukugqoka i-brace nokuvivinya umzimba kuyaqhubeka.
Ezinyangeni ezingu-4, ukuphulukiswa kuphinda kuhlolwe, ngalesi sikhathi ngokuhlolwa kanye ne-CT scan. Ngalesi sikhathi, udokotela ubheke ukubona ukuthi ngabe amathambo ase-pars aphilile kanjani nokuthi kanjani. Uma imiphumela yokuhlola ibonisa inyunyana ye-bony yama-pars, futhi / noma uma umdlali engenabuhlungu, lo mdlali uyavunyelwa ukuba abuyele ezemidlalo ngokugcwele. Angakwazi futhi ukuqala kancane kancane ukuvumela ukuhamba kwe-brace.
Ngenkathi ukugqoka i-brace nokwenza izivivinyo zokwelapha ngokwemvelo kuvame ukwelapha i-spondylolysis futhi uvumele umgijimi ukuba abuyele ngokugcwele emidlalweni, uMikheli uyangitshela.
Kodwa kuma-22% wamacala, ezinye izindlela zokwelapha ziyadingeka. Inqubo emisha kakhulu engasiza ukuphulukisa ithambo ukugqugquzela ugesi, uthi.
Izifundo ezenziwe nguMikheli nabanye zibonisa ukuthi ukugqugquzela kwangaphandle kagesi kungasiza ukunciphisa ubuhlungu nokuphulukisa ukuhlukana emaphakathini. Kodwa ngokubuyekezwa kuka-2016, ubukhulu besampula (inani leziguli ezihlanganyela kulolu cwaningo) lincane kakhulu ukuvumela isiphetho esiqondile sokudonsa; Ngenxa yalokhu, abalobi bokubukeza benqabe ukukhiqiza imiphumela yabo bonke abantu abane-spondylolysis.
I-Lumbar Fusion
Ukukhethwa kokugcina ukwelashwa ukuhlinzwa ukuze kuqiniswe umgogodla, ngokuvamile ukuhlanganiswa kwe-lumbar .
Lokhu kuvivinywa kuphela emva kokuba zonke izinqubo zokunakekelwa okuzimele ziboniswe zingasebenzi. Ngemuva kokuhlinzwa, iziguli zifakwa endaweni yokukhwabanisa noma izinsimbi okungenani izinyanga ezingu-3, mhlawumbe kuze kufike ezinyangeni ezingu-6, futhi ziyalwa ukuba zingadlali nezezemidlalo yokuhlinzwa kwonyaka.
Futhi uma udlala imidlalo yokuxhumana, awunazo iziqinisekiso zokubuyela ensimini nhlobo ngemva kwalokhu kuhlinzwa.
Imithombo:
> AAOS. I-Spondylolysis ne-Spondylolisthesis. Iwebhusayithi ye-OrthoInfo.
> Fellander-Tsai L, Micheli L. Ukwelashwa kwe-spondylolysis nge-stimulation yangaphandle kagesi: umbiko wamacala amabili. I-Clin J Sports Med 1998.
> Sonne-Holm, S., Jacobsen, S., Rovsing, HC, Monrad, H., & Gebuhr, uP. Lumbar spondylolysis: isimo sokuphila eside eside? Ucwaningo olunqamulelayo lwabadala abangu-4141. Eur Spine J, Nov 22 2006.
> Lawrence K., Elser T., Stromberg R. Lumbar spondylolysis kumdlali osemusha. Phys Ther Sport. July 2016.
> Micheli, i-LMD, i-Curtis, i-C. Stress Fractures e-Spine ne-Sacrum. I-Clin Sports Med 25 (2006).