Lumbar spondylolisthesis ndiko kutsvedza kwe lumbar vertebra inoenderana ne vertebra iri pazasi uye ichikwevera imwe musana nayo. Mhando nhatu dzespondylolisthesis dzinoenderana nezvikonzero zvitatu zvakasiyana: kudzokorora kwema mechanical stress pamusana, osteoarthritis yemajoini kana congenital malformation. Kuvhiya kuvhiyiwa kunongokurudzirwa kana paine kukundikana kwekurapa kurapwa kana kuvepo kwetsinga mota kana sphincter kusagadzikana.

Tsanangudzo yespondylolisthesis

Lumbar spondylolisthesis ndiko kutsvedza kwe lumbar vertebra kumberi nekudzika kune vertebra iri pazasi uye ichikwevera imwe musana nayo. Spondylolisthesis inopa nhanho ina dzekuwedzera kuomarara uye, mukunyanyisa, kudonha kwe vertebra mudiki pelvis.

Mhando dze spondylolisthésis

Kune marudzi matatu e spondylolisthesis:

• Lumbar spondylolisthesis ne isthmic lysis inobata 4 kusvika 8% yevanhu. Icho chiri chechipiri kune kuputsika kweisthmus, bhiriji rebhoni rinobatanidza imwe vertebra kune imwe. Yechishanu uye yekupedzisira lumbar vertebra (L5) inowanzobatwa. Iyo dhisiki pakati pema vertebrae maviri inopwanyika uye inoderera mukukwirira: tinotaura nezve inosanganiswa disc chirwere;
• Degenerative lumbar spondylolisthesis kana osteoarthritis spondylolisthesis ndeyechipiri pakuvandudzwa kweosteoarthritis yemajoini. Yechina neyechishanu lumbar vertebrae inowanzobatwa asi kutsvedza hakuwanzo kukosha zvakanyanya. Iyo dhisiki pakati pema vertebrae maviri inopera uye inopwanyika uye inoderera mukukwirira, isu tinobva tataura nezveyakabatana disc chirwere;
• Iyo isingawanzo dysplastic lumbar spondylolisthesis ndeye congenital mavambo.

Zvikonzero zve spondylolisthesis

Kusiyana nekutenda kwakakurumbira, lumbar spondylolisthesis ne isthmic lysis haisi nekuda kwekukuvadzwa kumwe chete muhuduku kana kuyaruka asi nekudzokorora kwemagetsi kushungurudza pamusana, izvo zvinotungamirira ku "kuputsika kuneta" kweisthmus (bony bridge pakati pema vertebrae maviri) .

Degenerative lumbar spondylolisthesis kana arthritic spondylolisthesis, sezvinotaurwa nezita, yakabatana neosteoarthritis yemajoini.

Dysplastic lumbar spondylolisthesis ndeyechipiri kune kukanganisa kwekupedzisira lumbar vertebra ine mutsara wakareba zvisina mwero.

Kuongororwa kwespondylolisthesis

I-x-ray ye lumbar spine inobvumira kuongororwa kwemhando ye spondylolisthesis uye kuongororwa kwekuoma kwayo zvichienderana nekutsvedza kwe vertebra.

Iyo radiological assessment inopedzwa ne:

• A scan of the lumbar spine kuti uone kutsemuka kweisthmus;
• Magnetic resonance imaging (MRI) ye lumbar spine inobvumira, kana zvichidikanwa, kutaridzika kuri nani kweiyo yakamanikidzwa tsinga midzi, kuongororwa kwekudzvanywa kweiyo dural fornix kana ponytail (yakaderera chikamu chedura rine midzi mota uye tsinga dzekunzwa dze makumbo maviri ezasi uye bladder uye rectal sphincters) uye kuongororwa kwemamiriro ezvinhu e-intervertebral disc pakati pemaviri maviri;
• Electromyography inoshandiswa kuongorora hutano hwemhasuru uye masero etsinga anoatonga. Zvinongoitwa chete kana murwere asina zviratidzo zvose zvechimiro chespondylolisthesis kana kana zviratidzo zvinyoro.

Vanhu vanobatwa ne spondylolisthesis

Lumbar spondylolisthesis ne isthmic lysis inobata 4 kusvika 8% yevanhu. Inowanzoonekwa muvatambi vepamusoro-soro vachidzidzira mabasa anoda nguva dzose kutenderera kwemusana uye arched postures.

Dysplastic lumbar spondylolisthesis inowanzobata vechidiki uye vechidiki.

Zvinhu zvinokurudzira spondylolisthesis

Lumbar spondylolisthesis ne isthmic lysis inofarirwa nezvinhu zvinotevera:

• Zviitiko zvenguva dzose zvemitambo zvinosanganisira kutenderera kwemusana nguva dzose uye arching postures senge rhythmic gymnastics, kutamba, mitambo yekukanda, kukwasva kana kutasva bhiza;
• Zvinzvimbo zvebasa zvinoda kutsamira mberi zvimiro;
• Kutakura nguva dzose kwemitoro inorema kana bhegi rinorema muvana.

Degenerative lumbar spondylolisthesis inogona kufarirwa ne:

• Kuenda kumwedzi ;
• Osteoporosis.

Kunzwa kurwadziwa kwepamusoro

Yakareba zvakashivirirwa, spondylolisthesis inowanzoonekwa nemukana pa X-ray kuongororwa kwepelvis kana pakukura panguva yekutanga kurwadza kwemusana.

Kutambudzika kwakadzoka shure

Chimwe chiratidzo chespondylolisthesis marwadzo ekudzokera shure, anorerutswa nekurenda kumberi uye akawedzera nekurenda kumashure. Kusimba kweiyi marwadzo emusana kunosiyana kubva pakunzwa kusagadzikana muzasi kusvika kumarwadzo akajeka ekutanga kamwe kamwe - kazhinji kunotevera kutakura mutoro unorema - unonzi lumbago.

Sciatica uye cruralgia

Spondylolisthesis inogona kutungamira mukutsikirira kwetsinga midzi apo tsinga inobuda musana uye inokonzera kurwadziwa mune rimwe kana makumbo maviri. Sciatica uye cruralgia ndivo vamiririri vaviri.

Cauda equina syndrome

Spondylolisthesis inogona kukonzera kudzvanya uye / kana kusinga gadzirise kukuvara kumidzi yetsinga yedural cul de sac. Iyi cauda equina syndrome inogona kukonzera kusagadzikana kwe sphincter, kushaya simba kana kugara kwenguva refu uye kusajairika kuvimbiswa ...

Kuoma mitezo kana kuperera

Spondylolisthesis inogona kukonzera kuoma mitezo - kunzwa kuregedza ibvi, kusakwanisa kufamba pachigunwe kana chitsitsinho chetsoka, kufungidzira kwetsoka inokwenya pasi paunenge uchifamba ... kukuvadzwa nemhedzisiro yekupedzisira yekuoma mitezo.

Zvimwe zviratidzo

• Neurogenic claudication kana chisungo chekumira mushure meimwe chinhambwe chakafamba;
• Paresthesias, kana kuvhiringidzika mupfungwa yekubata, zvakadai sechiveve kana kurira.

Kurapa kwekurapa kunokurudzirwa kana spondylolisthesis inorwadza asi hapana chiratidzo chetsinga chinowanikwa. Kurapa uku kunosiyana zvichienderana nekurwadziwa:

• Analgesics semushonga wekutanga wekurwadziwa kwechiuno kunobatanidza ne-non-steroidal anti-inflammatory drugs (NSAIDs) kwemazuva mashanu kusvika ku5 pakaitika dambudziko;
• Rehabilitation kusanganisira maekisesaizi kusimbisa dumbu uye lumbar tsandanyama;
• Muchiitiko chekuputsika kwechangobva kuitika kweisthmus kana kurwadziwa kwakanyanya kuderera shure, immobilization neBermuda yakakanda inobatanidza chidya kune rumwe rutivi chete inogona kukurudzirwa kubvisa marwadzo.

Muchiitiko chekukundikana kwemishonga yekurapa kana pamberi pehutano hwemagetsi kana sphincter, kuvhiyiwa kwepondylolisthesis kunogona kudiwa. Inosanganisira kuita arthrodesis kana kuti definitive fusion yezviviri zvinorwadza vertebrae. Arthrodesis inogona kubatanidzwa nelaminectomy: kuvhiyiwa uku kunosanganisira kuburitsa tsinga dzakamanikidzwa. Kupindira uku kunogona kuitwa zvishoma nezvishoma kushandisa zvinyorwa zviviri zviduku zvepashure, nekubatsira kwekuderedza zvakanyanya mushure mekurwadziwa kwepashure.

Dzimwe dziviriro dzinofanirwa kutorwa kudzivirira kutaridzika kana kuipa kwespondylolisthesis:

• Kumbira kugadziridzwa kwebasa kana zviitiko zvemabasa zvine zvipingamupinyi zvakasimba: kudzokorora kusendamira mberi chinzvimbo, kutakura mitoro inorema, nezvimwe.
• Dzivisa zviitiko zvemitambo mu hyper extension;
• Usatakura mabhegi anorema zuva nezuva;
• Usabvisa tsika yemitambo yekuvaraidza iyo, pane zvinopesana, inosimbisa lumbar uye mudumbu tsandanyama. ;
• Ita radiographic monitoring makore ese mashanu.