Spondylolysis ndi matenda a msana omwe amakhudza makamaka achinyamata othamanga omwe amasewera masewera omwe amafuna kuthamangitsidwa ndi kuthamanga mobwerezabwereza-kutanthauza kugwedeza ndi kupotoza-msana. Chofunika kwambiri ndi kuvulaza ndi kuvulaza.
Spondylolysis imayamba ndi kupasuka kwapadera m'dera laling'ono la fupa kumbuyo kwa vertebra yotchedwa pars interarticularis. Ngati kupweteka kwa nkhawa / spondylolysis kumaloledwa kuwonjezereka, kungabweretse mkhalidwe wofanana wotchedwa spondylolisthesis.
Mu spondylolisthesis, fupa limasuntha kuchoka pamalo ndipo limakhala losakhazikika.
Kupuntha, Kukhazikika ndi Kuchita Zochita
Kuyezetsa koyambirira ndi chithandizo ndikofunika kwambiri kuti mubwerere kuchitapo kanthu mukakhala ndi spondylolysis. Chithandizochi chimaphatikizapo nthawi yopumula yomwe imatha pakati pa milungu iwiri ndi miyezi isanu ndi umodzi, ikuwombera kuti imuthandize kuchepetsa vutoli (lumbar lordosis) lomwe limagwirizanitsidwa ndi kusakhazikika komanso / kapena kupuma kwa msana.
Ngati kupweteka kumbuyo kukupitirira miyezi isanu ndi umodzi, dokotala wa mwana wanu angakuuzeni opaleshoni.
Tinayankhula ndi Dr. Lyle Micheli, dokotala wa opaleshoni wamatenda ndi Mtsogoleri wa Masewera a Zamankhwala ku Boston Children's Hospital, komanso Katswiri wa Chipatala wa Opaleshoni ya Opaleshoni ku Harvard Medical School. Dr. Micheli amagwira ntchito zosiyanasiyana ndi US Rugby Football Foundation, US Kujambula Skating ndi Boston Marathon.
Pachipatala cha Ana ku Boston, akuti, odwala ambiri ali achinyamata komanso achinyamata omwe amaphunzitsa mozama masewera amodzi.
Kumeneko, odwala ali pafupi ndi masabata 4 mpaka 6 kapena mpaka kupweteka kwawo, makamaka pamene akuyendetsa msana, wapita. Pa masabata 4 mpaka 6, maola 23 patsiku, odwala amavala nsalu zomwe zimalepheretsa msana. Chigoba chimathandiza kuchepetsa ubongo wa mphutsi komanso kumathandiza fupa m'malo ovulala-mwachitsanzo
pars-kuchiza. Komanso pakadali pano, odwala amapita kuchipatala kuti athandize kulimbikitsa minofu yomwe imachititsa kuti msanawo usagwedezeke komanso kuti ukhale wosinthasintha.
Mwatsoka kwa wothamanga, ntchitoyo imayikidwa pa nthawi ya machiritso ndi chithandizo cha kuvulazidwa kumeneku kungawoneke kwa wothamanga wamng'onoyo movutikira kwambiri kuposa choipacho. Komabe, ntchitoyi panthawiyi imangokhala ndi zochitika zolimbitsa thupi, njinga yamoto komanso masewera ena osambira. Chilichonse chimene chimapangitsa msanawo kupeĊµa.
Pambuyo pa masabata 4 mpaka 6, wodwalayo ali ndi spondylolysis amafufuzidwanso chifukwa cha kupuma kwa msana ndi kupweteka kwakukulu. Ngati ululu ukadalipo, kuvala kwa nsalu komanso mankhwala opatsirana kumapitirira.
Mu miyezi inayi, kuchiritsidwa kachiwiri kumayesedwanso, nthawi ino mwa kupyolera ndi kuunika kwa CT. Panthawiyi, dokotala akuyang'ana kuti awone ngati ndi bwino kuti mafupawo adziritse. Ngati zotsatira za mayeso zikuwonetsa mgwirizano wa bony wa pars, ndi / kapena ngati wothamanga alibe ululu, wothamanga amavomerezedwa kuti azisewera masewera. Iye kapena iye akhoza kuyamba pang'onopang'ono kusiya kupita.
Pamene kuvala zolimba ndi kuchita machitidwe opatsirana thupi kumakhala kokwanira kuchiritsa spondylolysis ndikulola wothamanga kubwerera kwathunthu ku masewera, Micheli amandiuza.
Koma pafupifupi 22 peresenti ya milanduyi, njira zina zothandizira ndizofunika. Ndondomeko yatsopano yomwe ingathandize kuchiritsa fupa ndi kukakamiza magetsi, iye akunena.
Kafukufuku wopangidwa ndi Micheli ndi ena amasonyeza kuti kukondoweza kwa magetsi kumathandiza kuchepetsa kupweteka ndi kuchiza kupweteka pa pars. Koma malinga ndi ndemanga ya 2016, chitsanzo cha kukula (chiwerengero cha odwala omwe akugwira nawo phunziro) chinali chochepa kwambiri kuti chilole kuti chigamulo chotsimikizika chikhoke; Chifukwa cha ichi, olemba olemba mapeto akusiya kulemba zotsatira za anthu ena ndi spondylolysis.
Lumbar Fusion
Njira yomaliza yopangira chithandizo ndi opaleshoni kuti zikhazikitse msana, kawirikawiri zimakhala zowonongeka.
Izi zimayesedwa kokha pambuyo poti njira zonse zothandizira zowonongeka zatsimikiziridwa kuti sizingatheke. Pambuyo pa opaleshoni, odwala amaikidwa pamtunda kwa miyezi itatu, mwina miyezi isanu ndi umodzi, ndipo amauzidwa kuti asachite masewera kwa chaka chimodzi opaleshoni.
Ndipo ngati mumasewera masewera oterewa, mulibe chitsimikizo chobwerera kumunda nthawi zonse mutatha opaleshoniyi.
Zotsatira:
> AAOS. Spondylolysis ndi Spondylolisthesis. Webusaiti ya OrthoInfo.
> Fellander-Tsai L, Micheli L. Kuchiza kwa spondylolysis ndi kutulutsa kwa magetsi kunja: lipoti la milandu iwiri. Clin J Sports Med 1998.
> Sonne-Holm, S., Jacobsen, S., Rovsing, HC, Monrad, H., & Gebuhr, P. Lumbar spondylolysis: moyo wautali? Kufufuza kwapakati pa anthu akuluakulu 4141. Eur Spine J, Nov 22 2006.
> Lawrence K., Elser T., Stromberg R. Lumbar spondylolysis mu wothamanga wachinyamata. Phys Ther Sport. July 2016.
> Micheli, LMD, Curtis, C. Stress Fractures mumsana ndi Sacrum. Clin Sports Med 25 (2006).