Lumbar spondylolisthesis ndi kutsetsereka kwa vertebra ya lumbar yokhudzana ndi vertebra yomwe ili pansipa ndikukokera msana wonsewo. Mitundu itatu ya spondylolisthesis imagwirizana ndi zifukwa zitatu zosiyana: kubwerezabwereza kwa kupsinjika kwamakina pa msana, osteoarthritis wa mafupa kapena congenital malformation. Opaleshoni opareshoni akulimbikitsidwa kokha chochitika kulephera kwa mankhwala kapena pamaso pa minyewa galimoto kapena sphincter matenda.

Tanthauzo la spondylolisthesis

Lumbar spondylolisthesis ndi kutsetsereka kwa vertebra ya lumbar kutsogolo ndi pansi pafupi ndi vertebra yomwe ili pansipa ndikukokera msana wonsewo. Spondylolisthesis imapereka magawo anayi a kuwonjezereka koopsa ndi, mopitirira malire, kugwa kwa vertebra mu chiuno chaching'ono.

Mitundu ya spondylolisthésis

Pali mitundu itatu ya spondylolisthesis:

• Lumbar spondylolisthesis ndi isthmic lysis imakhudza 4 mpaka 8% ya anthu. Ndi yachiwiri kwa kupasuka kwa isthmus, mlatho wa bony umagwirizanitsa vertebra imodzi ndi imzake. Wachisanu ndi wotsiriza wa lumbar vertebra (L5) nthawi zambiri amakhudzidwa. Diski pakati pa vertebrae iwiri imaphwanyidwa ndikuchepa msinkhu: timalankhula za matenda okhudzana ndi disc;
• Degenerative lumbar spondylolisthesis kapena osteoarthritis spondylolisthesis ndi yachiwiri ku chitukuko cha osteoarthritis wa mafupa. Mitsempha yachinayi ndi yachisanu ya lumbar nthawi zambiri imakhudzidwa koma kutsetsereka nthawi zambiri sikofunikira kwambiri. Chimbale pakati pa ma vertebrae awiri chimatha ndipo chimaphwanyidwa ndikuchepa msinkhu, timalankhula za matenda okhudzana ndi disc;
• The osowa dysplastic lumbar spondylolisthesis ndi kobadwa nako chiyambi.

Zifukwa za spondylolisthesis

Mosiyana ndi zomwe anthu ambiri amakhulupirira, lumbar spondylolisthesis ndi isthmic lysis sichifukwa cha kuvulala kamodzi paubwana kapena unyamata koma kubwerezabwereza kwa makina opanikizika pa msana, zomwe zimayambitsa "kusweka kwa kutopa" kwa isthmus (bony mlatho pakati pa vertebrae ziwiri) .

Degenerative lumbar spondylolisthesis kapena arthritic spondylolisthesis ndi, monga momwe dzinalo likusonyezera, zogwirizana ndi osteoarthritis wa mafupa.

Dysplastic lumbar spondylolisthesis ndi yachiwiri ku kuwonongeka kwa vertebra yomaliza yokhala ndi kamtunda kosadziwika bwino.

Kuzindikira kwa spondylolisthesis

X-ray ya lumbar msana imalola kuti adziwe mtundu wa spondylolisthesis ndikuwunika kuopsa kwake potengera kutsetsereka kwa vertebra.

Kuwunika kwa radiological kumatsirizidwa ndi:

• Kujambula kwa lumbar msana kuti muwone mwatsatanetsatane kupasuka kwa isthmus;
• Magnetic resonance imaging (MRI) ya lumbar msana imalola, ngati kuli kofunikira, kuyang'ana bwino kwa mizu yoponderezedwa ya minyewa, kusanthula kupsinjika kwa dural fornix kapena ponytail (gawo lotsika la dura lomwe lili ndi mizu yamoto ndi minyewa yamanjenje yamkati). miyendo iwiri yapansi ndi chikhodzodzo ndi rectal sphincters) ndi kusanthula chikhalidwe cha intervertebral disc pakati pa vertebrae ziwiri;
• Electromyography imagwiritsidwa ntchito poyesa thanzi la minofu ndi ma cell a mitsempha omwe amawongolera. Zimangochitika ngati wodwalayo alibe zizindikiro zonse za spondylolisthesis kapena ngati zizindikirozo ndizochepa.

Anthu omwe amakhudzidwa ndi spondylolisthesis

Lumbar spondylolisthesis ndi isthmic lysis imakhudza 4 mpaka 8% ya anthu. Nthawi zambiri zimawonedwa mwa othamanga apamwamba omwe akuchita zochitika zomwe zimafuna kusinthasintha kwa msana pafupipafupi komanso mawonekedwe a arched.

Dysplastic lumbar spondylolisthesis nthawi zambiri imakhudza achinyamata ndi achinyamata.

Zinthu zomwe zimathandizira spondylolisthesis

Lumbar spondylolisthesis ndi isthmic lysis imakondedwa ndi izi:

• Masewera anthawi zonse omwe amakhudza kusinthasintha kwa msana pafupipafupi komanso kaimidwe kokhotakhota monga kuchita masewera olimbitsa thupi, kuvina, masewera oponya, kupalasa kapena kukwera pamahatchi;
• Malo ogwirira ntchito omwe amafunikira kutsamira patsogolo;
• Kunyamula katundu wolemera nthawi zonse kapena chikwama cholemera mwa ana.

Degenerative lumbar spondylolisthesis ikhoza kukondedwa ndi:

• Kusiya kusamba ;
• Kufooka kwa mafupa.

Pansirani ululu wammbuyo

Kulekerera kwanthawi yayitali, spondylolisthesis nthawi zambiri imapezeka mwamwayi pakuwunika kwa X-ray kwa chiuno kapena pauchikulire panthawi ya ululu woyamba wa msana.

Kupweteka kwakumbuyo kwenikweni

Chizindikiro chimodzi cha spondylolisthesis ndi kupweteka kwa msana, kumasulidwa ndi malo otsamira kutsogolo ndi kuipitsidwa ndi malo otsamira kumbuyo. Kuchuluka kwa ululu wammbuyowu kumasiyanasiyana kuchokera kukumverera kosautsika kumunsi kwa msana mpaka kupweteka kwadzidzidzi mwadzidzidzi - nthawi zambiri kumatsatira kunyamula katundu wolemera - wotchedwa lumbago.

Sciatica ndi cruralgia

Spondylolisthesis imatha kuyambitsa kupsinjika kwa muzu wa mitsempha komwe mitsempha imatuluka msana ndikupangitsa kupweteka m'miyendo imodzi kapena yonse. Sciatica ndi cruralgia ndi oimira awiri.

Cauda equina syndrome

Spondylolisthesis imatha kuyambitsa kupsinjika ndi / kapena kuwonongeka kosasinthika ku mizu ya minyewa ya dural cul de sac. Matenda a cauda equina awa amatha kuyambitsa kusokonezeka kwa sphincter, kusowa mphamvu kapena kudzimbidwa kwanthawi yayitali komanso kosazolowereka ...

Kupuwala pang'ono kapena kwathunthu

Spondylolisthesis ikhoza kuyambitsa kufooka pang'ono - kumva kwa bondo, kulephera kuyenda chala chala kapena chidendene cha phazi, kuwoneka ngati phazi likuphwanya pansi poyenda ... kuwonongeka ndi zotsatira zomaliza za ziwalo zonse.

Zizindikiro zina

• Neurogenic claudication kapena udindo woyimitsa pakadutsa mtunda wina;
• Paresthesias, kapena kusokonezeka kwa kukhudza, monga dzanzi kapena kumva kulasalasa.

Chithandizo chamankhwala chikulimbikitsidwa pamene spondylolisthesis ndi yowawa koma palibe chizindikiro cha minyewa chomwe chimapezeka. Mankhwalawa amasiyanasiyana malinga ndi ululu:

• Analgesics monga chithandizo choyambirira cha ululu wa m'mimba wokhudzana ndi mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs) kwa 5 kwa masiku 7 pakagwa vuto;
• Kukonzanso kuphatikizapo kuchita masewera olimbitsa thupi kulimbikitsa mimba ndi lumbar minofu;
• Pakachitika kuphulika kwaposachedwa kwa isthmus kapena kupweteka kwapang'onopang'ono kwa msana, kusasunthika ndi Bermuda cast kuphatikiza ntchafu kumbali imodzi yokha kungalangizidwe kuti athetse ululu.

Pakachitika kulephera kwa chithandizo chamankhwala kapena kukhalapo kwa minyewa yamagalimoto kapena sphincter, opaleshoni ya spondylolisthesis ingafunike. Zimapangidwa ndikuchita arthrodesis kapena kuphatikizika kotsimikizika kwa ma vertebrae awiri opweteka. Arthrodesis ikhoza kugwirizanitsidwa ndi laminectomy: opaleshoniyi imakhala ndi kutulutsa minyewa yoponderezedwa. Kuchitapo kanthu kumeneku kungathe kuchitidwa pang'onopang'ono pogwiritsa ntchito njira ziwiri zazing'ono zam'mbali, ndi ubwino wochepetsera kwambiri ululu wammbuyo wammbuyo.

Njira zina zodzitetezera ziyenera kuchitidwa kuti mupewe mawonekedwe kapena kuwonjezereka kwa spondylolisthesis:

• Pemphani kusintha kwa ntchito ngati ntchito ili ndi zopinga zamphamvu: kutsamira mobwerezabwereza, kunyamula katundu wolemera, ndi zina zotero.
• Pewani zochitika zamasewera pakukulitsa hyper;
• Osanyamula zikwama zolemera tsiku ndi tsiku;
• Osachotsa mchitidwe wamasewera osangalatsa omwe, m'malo mwake, amalimbitsa minofu ya lumbar ndi m'mimba. ;
• Chitani ma radiographic monitoring zaka zisanu zilizonse.