Imiphumela ye-AAI Kusukela ku-Vertebrae engalungile
Ukungazinzile kwe-Atlantoaxial (AAI) kuyinkinga ejwayelekile yomuthi ebonwe kubantu abane-Down syndrome. Nakuba linalo igama eliyinkimbinkimbi futhi lizwakala lisongela, ikakhulukazi, alibangeli izinkinga kulabo abanalo. Ukuze uqonde i-AAI, kubalulekile ukuqonda okuncane mayelana nomsebenzi nesakhiwo sezintambo zomgogodla, izinzwa, ama-vertebrae kanye nemigqa.
Umgogodla, amaNerve, ama-vertebrae namaLigamenti
Ingxenyeni yomgogodla isakhiwo esiyinkimbinkimbi se-tube-like eqala engxenyeni yobuchopho futhi iqhubekela phambili emuva ngemuva kwesifunda se-lumbar. Umgogodla uqukethe imisipha yomzimba noma i-neurons. Izinzwa zihlobo oluthile lweseli eliphethe imiyalezo phakathi kobuchopho nomzimba wonke. I-nerve ifana nekhebula kagesi elidlula umbane kagesi futhi liphethe izimpawu phakathi kwamalungu omzimba.
Ama-vertebrae angamathambo angenasici ahlelwe ibe ikholomu ngemuva komzimba ogijima ovela ebuchosheni kuze kube sekhanda. Umthambo womgogodla ugijima futhi uvikelwe yi-stack of vertebrae. Kukhona ama-vertebrae angu-33, ngokuvamile aphukile ezindaweni ezine: umlomo wesibeletho (7), i-thoracic (12), i-lumbar (5) ne-vertebra ye-pelvis. I-vertebrae yomlomo wesibeletho itholakala esifundeni sezintanyeni futhi isifinyeziwe njengo-C1-C7. Uma uphonsa ikhanda lakho phambili futhi ugijime iminwe yakho ngemuva kwekhanda lakho, i-bump enkulu yokuqala ozwayo yi-C1 yakho noma i-vertebra yomlomo wesibeletho.
Esilandelayo phansi yi-C2 nokunye. I-C1 ibizwa ngokuthi i-atlas vertebra ne-C2 njenge-vertebra e-axis. Ukungalungi kwalezi zinhlobo kubhekiswa njengokungazinzile kwe-atlantoaxial noma i-AAI.
I-Vertebrae iqhutshwa endaweni ngamasipha kanye nemigudu. Imisebenzi yekholomu ye-vertebral ihlanganisa ukuvikelwa kwentambo yomgogodla nezitho zangaphakathi, ukwesekwa kwesakhiwo senhloko nokugcina kokubili ukuguquguquka nokuhamba.
Njengoba abantu abane- Down syndrome benamazwi aphansi e-muscle nemigqa ye-lax, ama-vertebrae abo angahle ahlukumezeke. Lapho i-C1 ne-C2 vertebrae engalungile, unayo i-AAI. Kubantu abanesifo se-Down syndrome, i-ligament ngokuvamile ehilelekile ku-AAI ibizwa ngokuthi "ligament eguquguqukayo."
Ukuxilongwa kwe-AAI
Amacala amaningi e-AAI asymptomatic akwenziwa ngokusebenzisa ukuhlola ama-x-ray. Zonke izingane ezine-Down syndrome kufanele zihlolwe i-AAI eneminyaka engu-3. Ukuxilongwa kwe-AAI ephawulekayo ngokuvamile kwenziwa ngokuhlolwa kwegazi (ukuhlolwa ngokomzimba okuhlola indlela izinzwa ezisebenza ngayo) kanye / noma i-x-ray.
Izinhlobo ze-AAI
Kunezinhlobo ezimbili ze-atlantoaxial instability - i-AAI e-asymptomatic ne-AAI ephawulekayo. I-AAI engabonakali isho ukuthi i-AAI ingabonwa kwi-x ray, kodwa ayibangeli izinkinga ze-neurologic kumuntu onayo. I-AAI ye-Symptomatic kusho ukuthi i-AAI ikhona kwi-x ray, futhi kubangela izinkinga ezithile ze-neurologic kumuntu onayo. Endaweni ethile phakathi kuka-10% kuya ku-20% wabantu abanesifo se-Down syndrome bane-AAI engavamile kwi-ray, futhi kuphela 1% kuya ku-2% yabantu abane- Down syndrome bane-AAI ephawulekayo.
Izimpawu Neurologic ku-AAI
Omunye wemisebenzi yekholomu ye-vertebral ukuvikela intambo yomgogodla, egijima ngaphakathi kwayo.
Intambo yomgogodla iqoqo lezinzwa ezivikelwe ikholomu ye-vertebral. I-AAI ye-Symptomatic ibangela izimpawu ezihlukahlukene zezinzwa ze-neurologic ezifana nalezi:
- Ukuhlushwa
- Ukuntuleka kokuxhumanisa
- Kunzima ukuhamba
- Ukuhamba nge-gait engavamile (ie ukuxosha)
- Ukhathele kalula
- Ubuhlungu bezinzwa noma ikhono elilinganiselwe lokuhambisa intamo
- Ukuphambana - ukuqina emisipha
- I-Clonus - imisipha ye-muscle noma i-spasms
Uma othile one-Down syndrome eqala noma iyiphi yalezi zimpawu zezinzwa, kufanele ngokushesha ahlolwe udokotela. Udokotela ngokuvamile uzokwenza ukuhlolwa okuphelele kwe-neurologic nokuhlolwa kwe-imaging, njenge-x-ray, CT noma i-MRI.
Ukwelashwa kwe-AAI
I-AA engajwayelekile ayidingi ukwelashwa. Ngokuvamile abazali baqondiswa ukuthi yini izimpawu okufanele zibuke kumuntu ono-AAI.
Uma umuntu ekhombisa izimpawu zokucindezelwa komgogodla, ukwelashwa kuboniswa. Imigomo yokwelapha i-AAI ephawulekayo ukuvikela umgogodla, ukuqinisa ikholomu yomgogodla noma i-vertebrae nokudambisa noma yikuphi ukuhlinzekwa kwezinzwa. Kuye ngesilinganiso sezinkinga, ukuqina komgogodla ukuqiniswa kungatholakala ngokugqoka ikhola elithambile, i-halter traction nemithi yobuhlungu kanye nokuphumula kwemisipha kanye nokuhlinzwa okungenzeka.
Imithombo:
I-American Academy of Pediatrics, iKomidi Lemithi Yezemidlalo. Ukungazinzile kwe-Atlantoaxial ku-Down syndrome. Izingane zokwelapha. I-Vol. 107 No. 2, February 2001, iphe. 442-449 [/]
I-Alvarez, N. Atlantoaxial Ukukhubazeka Kwabanye abane-Down Syndrome, i- Emedicine , ngomhlaka 8th, 2008.