Ephakathi kwama-vertebrae angomakhelwane, izingxenyana zezinhlangothi zinikeza inqolobane yomgogodla ngobuqotho. Benza lokhu ngokubambisana ukuze baqondise futhi bahlale behlola ukunyakaza okuvamile umgogodla wenza kanje:
- i-flexion
- isandiso
- i-lateral flexion
- uxhumano
- ukuhlanekezela (ukujikeleza)
Ngamanye amazwi, izingxenyana zezinhlangothi zizogcina umgogodla ungaphambuki kakhulu, ubuyele emuva kakhulu, nokunye ukunyakaza okudlulele.
Amalungu e-facet nawo asiza ekuvimbeleni i-vertebra ukuba isuke phambili ngaphasi kwayo (okuthiwa i-spondylolisthesis.)
Amajoyina amancane afakwe ngemuva kwezidumbu zama-vertebrae futhi enza njengendlela yesitimela esinqunyiwe noma ithrekhi yomzila lapho ususa isiqu sakho. I-vertebrae ngayinye ixhunyiwe komunye nomunye ngamabili wezinhlanganiso zezinhlangothi, ezimbili ezingenhla nambili ngezansi. Ukuhlanganiswa kwesinye isici sinomsebenzi ophansi we-bony obizwa ngokuthi inqubo engaphansi kwe-articular, ephuma ku-vertebra ngenhla, futhi okukodwa okuklanyelweyo, okubizwa ngokuthi inqubo ephakeme ye-articular, evela ku-vertebra engezansi. Izakhiwo eziphambene nalezi zinqubo zithinte futhi zihambisane. Ngosizo lwemigqa eminingi, yilokho amathambo omgogodla angu-26 ahlangana ndawonye ukwenza ikholomu. Amalungu e-facet nawo ahlinzeka ukuzinza emgodini.
Amalungu e-facet ahlotshaniswa, ahlukene futhi ahlotshaniswa ngendlela ehlukile ngokuya endaweni yomgogodla.
Lokhu kuhlukahluka kusho ukuthi izindawo ezithile zomgogodla zivame ukuguquguquka kunezinye.
Amalungu e-facet entanyeni afanelwe ukuhamba kuzo zonke izinkomba. Ezindaweni ezingenhla nangemuva, okuthiwa i-thoracic umgogodla, izici zenziwe nge-angled ngendlela yokuthi zenzele ukujikeleza okuhle (ukujika nokuguqula), kodwa ukutholakala komgqa wakho wokudoba kunciphisa ukunyakaza.
Esikhathini sendawo, izingxenyana zezinhlangothi zibhekana, okuyinto, ngokungafani nezinhlobonhlobo ze-thoracic, ivame ukunciphisa ikhono lakho lokushintshanisa (ukuhlanekezela) emuva kwakho okuphansi.
Isihlanganisi sendikimba yi-joint synovial, okusho ukuthi ihlanganiswe i-capsule eyenziwe ngezicubu ezixhunyiwe. I-capsule ibizwa ngokuqondile ngokuthi i-capsule ehlangene ye-facet.
Ukulimala kwezihlanganisi zezinhlangothi kuyisinye sezizathu ezivamile zokuhlukunyezwa okungapheli komgogodla. Ucwaningo lwe-2004 ku- BMC Musculoskeletal Disorders luhlolisise abantu abangu-500 abanezinhlungu ezingemuva zangemva futhi bathola ukuthi lezi zinhlangothi zazibhekene namacala angu-55%. Izinkinga ezimbili ezivame kakhulu ezibangelwa ubuhlungu obuhlangene bobuciko zihlanganisa i-osteoarthritis ne- whiplash .
I-Facet Hypertrophy Joint and Arthritis
Amathambo ezinhlobonhlobo ahlanganiswe ne-cartilage, ehlangene ne-joint. I-osteoarthritis yomgogodla iyenzeka lapho i-cartilage iphuma, okwenza ithambo lisetshenziswe ngethambo.
I-osteoarthritis kanye / noma isifo se-disenerative yizimo zokugqoka nokugqabhuka ezingase ziholele ekubunjweni kwama-osteophyte (bone spurs) kanye / noma kubumbano ohlangene wokuxhuma (ukukhulisa nokuvuvukala kokuhlanganiswa kwesici). Njengoba lezi zinguquko ezishintshashintshayo emgodini zenzeka, isikhala emgodini ongasemgogodini kanye / noma i-neuroforamen ingaba yancipha.
I- stenosis elula, ebizwa ngokuthi i- stenosis , ingabangela ukucasuka kwentambo yomgogodla yakho, kanye / noma izimpande zakho zomgogodla , futhi kubangele izimpawu ze-myelopathy kanye / noma i- radiculopathy (i-radiculopathy ngokuvamile ibhekwa njengezinhlungu kanye nezimpawu zesibindi eziwela phansi ingalo noma umlenze) .
Enye indlela ebalulekile yokuvimbela noma yokuphatha lezi zimo ukuqhuba njalo. Ukuzivocavoca kwandisa ukuguquguquka komgogodla, okusiza ekunciphiseni ukuqina. Ibuye iqinise imisipha yakho eyokwazi ukuvikela isici kanye namanye amalunga omgogodla. Yiqiniso, kufanele ubuze udokotela wakho uhlelo oluphelele lwezokwelapha ngesimo sakho esivumelana nesici.
I-Whiplash ne-Facet Paint Pain
Ubuhlungu besimo ngemuva kwengozi yemoto akuyona into engavamile. Izifundo ezimbili ezenziwe nguBarnsley neNkosi phakathi nango-1990 futhi zanyatheliswa ku- Spine zathola ubuhlungu obuhlangene obubuhlungu obuhambisanayo obuba yinto ejwayelekile, uma ingeyona ejwayelekile, uphawu kubantu abaye babhekana ne-whiplash. Lolu hlobo lwezinhlungu ezihlangene zomzimba lungase luzizwe lufana nobubele besisindo ohlangothini lwesiphambano. (Yilapho izixhumanisi zezinhlangothi zitholakala khona.)
Uma ngabe uhilelekile engozini yemoto nanoma yikuphi okunye ukuhlukumezeka lapho umgogodla wakho uhambelana ne-whiplash, sicela ubheke udokotela wakho. Ukuthola ukulimala komgogodla ohlotshiwe kuhlolwe futhi kuphathwe kusencane kuyisihluthulelo sokugwema isimo esibuhlungu esingapheli esingakudlulela iminyaka bese sikuphanga ikhwalithi yakho yokuphila.
Ukufelwa kwe-Facet
Izifo zisetshenziselwa kokubili ukuhlonza nokuphatha ubuhlungu obuhlangene. Omunye umjovo onjalo okuthiwa igatsha lesigceme eliphakathi kuthathwa njengabanye njengendlela ecacile kuphela yokutshela uma ubuhlungu bakho bomgogodla bubangelwa ukulimala kokuhlanganiswa kwesici. Udokotela wakho uzofaka inzwa yendawo yokubulala izinzwa endaweni. Uma lokho kukhulula ubuhlungu bakho, angase akubone ukuthi unenkinga ehlangene yezinhlangothi. Ukubuyekezwa kuka-2008 kwezifundo zezokwelapha ezanyatheliswa kuMdokotela Wezinhlungu ezibheke ukusizwa kwamagatsha amakhulu okuthola ukuhlolwa nokuphatha ubuhlungu bezinhlangothi zitholwe ubufakazi obuningi bokubili ukusizwa isikhathi eside nesikhathi esifushane. Noma kunjalo, ukusetshenziswa kwezijovo ezinjalo kuvame ukulinganiselwa ekuqinisekiseni ukuthi ubuhlungu bakho ngempela buvela ezihlanganisweni zezinhlangothi.
Umjovo owaziwa ngokuthi i-radiofrequency medial branch neurotomy uvame ukuhlinzekwa ngosizo lwezinhlungu zesikhathi eside. Ebizwa nangokuthi i-RF neurotomy, lolu hlobo lomjovo ludla igatsha eliphakathi lezinzwa eziya ehlangothini lwesibindi, liwubulale. Umqondo ukuvimbela noma yisiphi isignali esibuhlungu esivela ekuhlanganyeleni kwesici, kodwa ubufakazi bokuthi lokhu kusebenza ngephutha ngeshwa kunciphile.
Ngokuvamile, umjovo wezinhlungu zesinkwa unikezwa kuphela ngemva kokuthi uvivinye amasonto amane kuya kwanguyisithupha ukwelashwa okunamandla ngokuncane noma akukho impumelelo.
I-Medical Way Yokukhuluma I-facet
Odokotela nama-anatomists bavame ukubhekisela ezinhlanganisweni zezinhlangothi njengezixhumanisi zygapophysial. Ngakho uma ubona leli gama embikweni wakho wemitholampilo noma ukuxilongwa, yazi ukuthi libhekisela ezingxenyeni zezinhlangothi ngemuva kwekholomu lomgogodla.
Imithombo:
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UBowellwell MV, uColson JD, Sehgal N, Dunbar EE, Epter R. Ukubuyekezwa okuhlelekile kokungenelela okuhlanganyelwe okuhlangene ekuhluphekeni okungapheli komgogodla. Udokotela Wezinhlungu. 2007 Jan; 10 (1): 229-53. http://www.ncbi.nlm.nih.gov/pubmed/17256032
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Nkosi SM, Barnsley L, Wallis BJ, McDonald GJ, Bogduk N. I-neurotomy yomsakazo we-percutaneous we-syndical zygapophyseal-joint joint. N Engl J Med. Dec 5 1996; 335 (23): 1721-6. http://www.ncbi.nlm.nih.gov/pubmed/8855458
Nkosi SM, Barnsley L, i-Wallis BJ, i-Bogduk N. Isihlungu somlomo wesibeletho senyango zygapophysial ngemuva kwe-whiplash. Ukutadisha ukulawulwa kwesifo se-placebo. Isiphambano (Phila Pa 1976). 1996 Aug 1; 21 (15): 1737-44; ingxoxo 1744-5. http://www.ncbi.nlm.nih.gov/pubmed/8855458
Manchikanti L, Boswell MV, Singh V, Pampati V, Damron KS, Beyer CD. Ukuvama kobuhlungu obuhlangene bobuchopho obuhlungu obungapheli bomgogodla wezifunda zomlomo wesibeletho, i-thoracic ne-lumbar. BMC Musculoskelet Disord. Meyi 28 2004; 5: 15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC441387/
UW Medicine. I-Orthopedics neMithi Yezemidlalo. Ukuzivocavoca ne-Arthritis. Iwebhusayithi ye-UW Medicine. http://www.orthop.washington.edu/PatientCare/OurServices/Arthritis/Articles/ExerciseandArthritis.aspx Kugcine ukubuyekezwa: NgoLwesibili, ngoJanuwari 26, 2010.
Windsor, R. MD. et. al. I-Cervical Facet Syndrome. I-Medscape. Kugcine ukubuyekezwa: Meyi 24, 2011. http://emedicine.medscape.com/article/93924-overview#a0199