ʻO ka lumbar spondylolisthesis ka paheʻe ʻana o kahi vertebra lumbar e pili ana i ka vertebra ma lalo iho a kauo i ke koena o ke kuamoʻo me ia. ʻEkolu ʻano o ka spondylolisthesis e pili ana i ʻekolu kumu like ʻole: ka hana hou ʻana i nā koʻikoʻi mechanical ma ka iwi kuamoʻo, osteoarthritis o nā hono a i ʻole kahi malformation congenital. Manaʻo wale ʻia ka hana ʻokiʻoki inā ʻaʻole i hiki ke mālama ʻia i ka lāʻau lapaʻau a i ʻole ka loaʻa ʻana o ka neurological motor a i ʻole nā ​​maʻi sphincter.

Ka wehewehe o ka spondylolisthesis

ʻO ka lumbar spondylolisthesis ka paheʻe ʻana o ka vertebra lumbar i mua a i lalo e pili ana i ka vertebra ma lalo iho a kauo i ke koena o ke kuamoʻo me ia. Hōʻike ka Spondylolisthesis i ʻehā mau ʻanuʻu o ka hoʻonui ʻana i ka paʻakikī me, ma ka ʻoi loa, ka hāʻule ʻana o ka vertebra i ka pelvis liʻiliʻi.

Nā ʻano spondylolisthésis

ʻEkolu ʻano o ka spondylolisthesis:

• Lumbar spondylolisthesis e ka isthmic lysis pili i ka 4 a 8% o ka heluna kanaka. He lua ia ma ka haʻihaʻi ʻana o ka isthmus, ke alahaka iwi e pili ana i kekahi vertebra i kekahi. ʻO ka lima a me ka hope o ka lumbar vertebra (L5) i hoʻopili pinepine ʻia. ʻO ka diski ma waena o nā vertebrae ʻelua ua ʻoki ʻia a emi i ke kiʻekiʻe: ke kamaʻilio nei mākou no ka maʻi diski pili;
• ʻO ka degenerative lumbar spondylolisthesis a i ʻole osteoarthritis spondylolisthesis ka lua i ka ulu ʻana o ka osteoarthritis o nā hui. Hoʻopili pinepine ʻia ka ʻehā a me ka ʻelima o ka vertebrae lumbar akā ʻaʻole koʻikoʻi ka paheʻe. ʻO ka diski ma waena o nā vertebrae ʻelua ua pau a ʻoki ʻia a emi i ke kiʻekiʻe, a laila kamaʻilio mākou no ka maʻi diski pili;
• ʻO ka dysplastic lumbar spondylolisthesis i loaʻa mai ka hānau hānau.

Nā kumu o ka spondylolisthesis

Kūlike ʻole i ka manaʻo kaulana, lumbar spondylolisthesis e ka isthmic lysis ʻaʻole ma muli o kahi trauma hoʻokahi i ka wā kamaliʻi a i ʻole ka wā ʻōpio akā no ka hana hou ʻana i nā koʻikoʻi mechanical ma ka iwi kuamoʻo, kahi e alakaʻi ai i kahi "fatigue fracture" o ka isthmus. .

ʻO ka degenerative lumbar spondylolisthesis a i ʻole arthritic spondylolisthesis, e like me ka inoa i hōʻike ʻia, pili i ka osteoarthritis o nā hono.

ʻO ka dysplastic lumbar spondylolisthesis ka lua o ka hōʻino ʻana o ka vertebra lumbar hope loa me kahi isthmus elongated abnormally.

ʻO ka hōʻailona o spondylolisthesis

ʻO ka x-ray o ka lumbar spine eʻae i ka hōʻailona o keʻano o ka spondylolisthesis a me ka loiloiʻana i kona koʻikoʻi ma muli o ka paheʻe o ka vertebra.

Hoʻopau ʻia ka loiloi radiological e:

• He scan o ka lumbar spine e nānā i ka haʻi o ka isthmus;
• ʻO ka magnetic resonance imaging (MRI) o ka lumbar spine e hiki ai, inā pono, ke ʻike maikaʻi aʻe o ke aʻa aʻalolo i hoʻopaʻa ʻia, ka nānā ʻana i ka hoʻopaʻa ʻana o ka dural fornix a i ʻole ponytail (ʻāpana haʻahaʻa o ka dura i loaʻa nā aʻa a me nā aʻalolo sensory o ka ʻelua mau lālā haʻahaʻa a me ka ʻōpū a me nā sphincters rectal) a me ka nānā ʻana i ke kūlana o ka disc intervertebral ma waena o nā vertebrae ʻelua;
• Hoʻohana ʻia ka electromyography e nānā i ke olakino o nā ʻiʻo a me nā pūnaʻi nerve e hoʻomalu iā lākou. Hana wale ia inā ʻaʻole i loaʻa i ka mea maʻi nā hōʻailona o ka spondylolisthesis a i ʻole nā ​​​​hōʻailona maʻalahi.

ʻO nā kānaka i loaʻa i ka spondylolisthesis

Lumbar spondylolisthesis e ka isthmic lysis pili i ka 4 a 8% o ka heluna kanaka. ʻIke pinepine ʻia i nā mea pāʻani kiʻekiʻe e hoʻomaʻamaʻa i nā hana e koi ana i ka hoʻololi pinepine ʻana i ka spine a me nā posture arched.

Hoʻopilikia pinepine ka dysplastic lumbar spondylolisthesis i nā ʻōpio a me nā ʻōpio.

Nā mea e makemake ai i ka spondylolisthesis

ʻO ka lumbar spondylolisthesis e ka isthmic lysis i makemake ʻia e nā kumu penei:

• ʻO nā hana haʻuki maʻamau e pili ana i ka hoʻololi pinepine ʻana o ka iwi kuamoʻo a me ke kū ʻana o ka pio e like me ka haʻuki mele, ka hula, ka hoʻolei ʻana i nā haʻuki, ka hoe a i ʻole ka holo lio;
• Nā kūlana hana e pono ai ke kū i mua;
• ʻO ka lawe mau ʻana i nā ukana kaumaha a i ʻole ka ʻeke ʻeke kaumaha i nā keiki.

Hiki ke hoʻohana ʻia ka degenerative lumbar spondylolisthesis e:

• Menopause ;
• Osteoporosis.

E hoʻokuʻu i kaʻeha

ʻIke pinepine ʻia ka spondylolisthesis ma kahi loiloi X-ray o ke pelvis a i ʻole i ka wā makua i ka wā o ka ʻeha mua o ke kua.

ʻO kaʻeha hope loa

ʻO kahi hōʻailona o ka spondylolisthesis ka ʻeha haʻahaʻa hope, hoʻomaha ʻia e kahi kūlana lean i mua a hoʻonui ʻia e kahi kūlana lean back. ʻO ka ikaika o kēia ʻeha haʻahaʻa haʻahaʻa ʻokoʻa mai ka manaʻo o ka ʻeha ma ke kua i lalo a hiki i ka ʻeha ʻoi o ka hoʻomaka koke - ma hope o ka lawe ʻana i kahi haʻahaʻa kaumaha - i kapa ʻia ʻo lumbago.

Sciatica a me cruralgia

Hiki i ka Spondylolisthesis ke alakaʻi i ka paʻi ʻana o kahi aʻa aʻalolo kahi e puka ai ke aʻalolo mai ka iwi kuamoʻo a hoʻoulu i ka ʻeha ma nā wāwae hoʻokahi a ʻelua paha. ʻO Sciatica a me cruralgia nā ʻelele ʻelua.

ʻAulelo Cauda equina

Hiki i ka spondylolisthesis ke hoʻoulu i ka pōʻino a me / a i ʻole ka hoʻihoʻi hou ʻana i nā aʻa aʻa o ka dural cul de sac. Hiki i kēia maʻi cauda equina ke kumu i nā maʻi sphincter, impotence a i ʻole constipation lōʻihi a ʻokoʻa ...

ʻO ka lolo hapa a i ʻole holoʻokoʻa

Hiki i ka spondylolisthesis ke kuleana no ka ma'i ma'i hapa - ka mana'o o ka ho'oku'u 'ana i ke kuli, hiki'ole ke hele ma ka manamana wāwae a ku'eku'e wāwae paha, ka mana'o o ka wāwae e 'oki ana i ka lepo i ka wā e hele ana... 'O ke kaumaha o ke a'a a'a e hiki ke ho'ololi 'ole. pōʻino me ka hopena hope loa o ka lolo piha.

ʻO nā hōʻailona ʻē aʻe

• Neurogenic claudication a i ʻole ke kuleana e kū ma hope o kahi mamao i hele ai;
• Paresthesias, a i ʻole ka haunaele i ke ʻano o ka hoʻopā ʻana, e like me ka numbness a i ʻole ke kani ʻana.

Manaʻo ʻia ka lāʻau lapaʻau inā ʻeha ka spondylolisthesis akā ʻaʻohe hōʻailona neurological i ʻike ʻia. ʻOkoʻa kēia lāʻau ma muli o ka ʻeha:

• ʻO nā analgesics ma ke ʻano he lapaʻau maʻamau no ka ʻeha lumbar e pili ana me nā lāʻau anti-inflammatory non-steroidal (NSAIDs) no 5 a 7 mau lā i ka wā o kahi pilikia;
• Hoʻomaʻamaʻa me nā hana e hoʻoikaika i nā ʻiʻo o ka ʻōpū a me ka lumbar;
• I ka wā o ka haʻihaʻi ʻana o ka isthmus a i ʻole ka ʻeha haʻahaʻa haʻahaʻa, hiki ke ʻōlelo ʻia ka immobilization me ka Bermuda cast i hoʻokomo i ka ʻūhā ma kekahi ʻaoʻao wale nō e hoʻomaha i ka ʻeha.

Inā ʻaʻole hiki ke mālama i ka lāʻau lapaʻau a i ʻole ke alo o ka motor neurological a i ʻole nā ​​maʻi sphincter, pono ke ʻoki ʻia no ka spondylolisthesis. Aia i loko o ka hana ʻana i ka arthrodesis a i ʻole ka hui ʻana o nā vertebrae ʻeha ʻelua. Hiki ke hoʻopili ʻia ʻo Arthrodesis me kahi laminectomy: aia kēia hana i ka hoʻokuʻu ʻana i nā aʻalolo paʻa. Hiki ke hana ʻia kēia hana me ka liʻiliʻi liʻiliʻi me ka hoʻohana ʻana i ʻelua mau ʻoki liʻiliʻi liʻiliʻi, me ka maikaʻi o ka hōʻemi nui ʻana i ka ʻeha hope o ke kua hope.

Pono e mālama ʻia kekahi mau mea e pale aku ai i ka ʻike ʻana a i ʻole ka piʻi ʻana o ka spondylolisthesis:

• E noi i ka hoʻololi ʻana i ka hana inā loaʻa nā hana me nā kaohi ikaika: hilinaʻi pinepine i mua, lawe i nā ukana kaumaha, etc.
• Hōʻalo i nā hana haʻuki ma hyper extension;
• Mai halihali i nā ʻeke kaumaha i kēlā me kēia lā;
• Mai hoʻopau i ka hoʻomaʻamaʻa ʻana i nā haʻuki leʻaleʻa e hoʻoikaika i nā ʻiʻo lumbar a me ka ʻōpū. ;
• Hana i ka nānā ʻana i ka radiographic i kēlā me kēia ʻelima makahiki.