Kufananidza Kuona Kuonekwa Kwezvisina Kuipa zveSpine

Kufungidzira kuongorora yepamusoro yakabva kune radiographies kusvika ku computed tomography scanning, kana CT scans, umo CT inoshandiswa pamwe chete ne myelography uye munguva ichangopfuura ine magnetic resonance imaging, kana MRI. Aya mafungiro ekufungidzira ari kushandiswa kugadzirisa kuvepo kwezvinhu zvisina kufanira zvepamusoro, scoliosis, spondylolysis uye spondylolisthesis. Nyaya inotevera inotsanangura mhando dzakasiyana-siyana dzekufungidzira uye kushandiswa kwadzo mukuongororwa kwezvirwere zvinowanzoonekwa zvepinal zvinotsanangurwa.

 

Achondroplasia

 

• Achondroplasia ndiyo inonyanya kukonzeresa rhizomelic (mudzi / proximal) ipfupi-mitezo kuderera. Varwere vane njere dzakanaka
• Inoratidza zvinhu zvakasiyana-siyana zvakasiyana-siyana zvemashoko ane chokuita nemapfupa marefu, pelvis, skull, uye maoko.
• Vertebral ikholamu shanduko inogona kuuya neakakosha makiriniki uye neurological kusagadzikana
• Achondroplasia inonzi autosomal yakaremara dambudziko ine mimwe ye80% yematambudziko kubva mukushanduka patsva. Zera rakapfurikidza nevana vemhuri rinowanzobatanidzwa. Achondroplasia inokonzerwa nekugadzirisa mutambo mu fibroblast growth factor gene (FGFR3) iyo inokonzera kusakanganiswa kwekatekete.
• Mafupa ose akaumbwa ne endochondral ossification akabatwa.
• Mabhesi ayo anogadzirwa ne-intra-membranous ossification haasiwo akaenzana.
• Nokudaro, denga rehenya, mapapiro ayaac anowanzoenderana nechepamusoro rehenya, mamwe maziso echiso, vertebral column, uye mapfupa akawanda ehebula haasati aitika.

 

• Dx: inowanzoitwa pakuberekwa nehunhu huzhinji hunoonekwa mumazana mashomanana ekutanga ehupenyu.
• Radiography inoshandisa chikamu chinokosha chekurapa kwechipatara.
• Zvinhu zvinowanzoita zvinosanganisira: kupfupisa uye kuwedzera kwemapfupa erupfuti, metaphyseal flaring, Trident ruoko nemafupi, metacarpals akareba uye akareba uye pakati phalanges. Longer Fibular, Tibial kufugama, kunyanya kwenguva pfupi humeri kazhinji nekubviswa Radial musoro uye nehombambo kuruka deformity.

 

• Mutsipa: hunhu kudzikira kweL1-L5 interpedicular chinhambwe pane AP maonero. Lateral view inoratidza kupfupikiswa kwepedicles uye vertebral miviri, bullet yakaumbwa vertebrae inogona kuve hunhu hunhu. Kuchinja kwekutanga kwekudzikira uye kuderera kwemukoto kunoitika. Iyo yakatwasuka sacral mafungiro chinhu chakakosha.
• Tsanga inoratidza hutungamiri hwepamberi, midface hypoplasia uye yakanyatsoshamisa foramen magnum.
• Pelvis yakafara uye ipfupi ine hunhu champagne girazi kutaridzika kwechiuno.
• Madzimai emisoro misoro inonzi hypoplastic, asi hip arthrosis haigoni kuonekwa kunyange kune vakwegura vangave vakangoita nekuda kwekuderedza kuwedzera uye kurerutsa (50kg) yevarwere.

 

Kutungamirirwa kweAkondroplasia

 

• Recombinant human growth hormone (GH) currentlychino chiri kushandiswa kuwedzera kukwirira kwevarwere vane achondroplasia.
• Zvakawanda zvinetso zveAkondroplasia zvakabatana nemusana: vertebral canal stenosis, thoracolumbar kyphosis, yakagadzirirwa foramen magnum nezvimwe.
• Laminectomy inowedzera kusvika pedicles / lateral recess ne foraminotomies uye discectomies inogona kuitwa.
• Cervical manipulations zvinopesana.

 

Kufungidzira kuongororwa kunoitisa chinzvimbo chakakosha pakuongorora kweiyo scoliosis, kusanzwisisika kwemuzongoza uyo unofungidzirwa kuti unoitika nekuda kwechikonzero chehutano, kunyange hazvo zviitiko zve scoliosis zviri idiopathic. Zvakawanda pamusoro, radiographies, CT scans, uye MRI, pakati pevamwe, zvinogona kubatsira kuongorora shanduko yekuremara kwemuzongoza kwakabatana neichi kuratidzwa kwemuzongoza. Chiropractors vanogona kupa imaging diagnostics kune varwere vane scoliosis vasati vaenderera mberi nekurapwa

Dr. Alex Jimenez DC, CCST

Scoliosis

 

• Scoliosis inotsanangurwa seisina kujairika lateral curvature yemuzongoza> 10-degree kana ichiongororwa neCobb s nzira yekuchenesa.
• Scoliosis inogona kurondedzerwa semashure uye maitiro.
• Postural scoliosis haisi yakasimbiswa uye inogona kuvandudzwa nekufamba kwechipiri kune rumwe rutivi rwehuwandu.
• Chirongwa chechikoro chinokonzera zvikonzero zvakawanda kubva:
  ? Idiopathic (> 80%)
  ? Kuberekwa (wedge kana hemivertebra, yakavharika vertebra, Marfan syndrome, skeletal dysplasias)
  ? Neuropathic (neurofibromatosis, neurological mamiriro senge yakasungwa tambo, musana dysraphism, nezvimwewo)
  ? Scoliosis d / t Spinal neoplasms
  ? Post-inoshungurudza etc.
• Idiopathic scoliosis ndiyo inowanzoshandiswa (> 80%).
• Idiopathic scoliosis inogona kuva ye3-types (vana vaduku, vechidiki, vechidiki).
• Idiopathic vechidiki scoliosis kana varwere> 10y.o.
• Mucheche scoliosis kana <3 yo M> F.
• Juvenile scoliosis kana> 3 asi <10-yo
• Idiopathic Adolescent scoliosis ndiyo inonyanya kufanana naF: M 7: 1 (vasikana vechidiki vari pangozi chaiyo).
• Etiology: hazvizivikanwe kuti ndeye chikonzero chekuvhiringidzika kwekutonga kwakanaka kwepamusoro uye musana wemusana, mamwe mafungiro aripo.
• Zvizhinji zvinowanikwa munharaunda yekutambudza uye inowanzotaridzika kune yakarurama.
• Dx: full spine radiography ne gonadal uye mazamu ekudzivirira (kunyanya PA inotaridzivirira kuchengetedza mutezo wemvere).

 

Rx: 3-Os: Kucherechedza, Orthose, Kushandiswa kwebasa

 

Makakombama ari makumi mashanu-madhigirii kana akakura uye achikurumidza kufambira mberi kunoda kushanda kweanodzivirira kudzivirira kuora kwakanyanya kwechipfuva & mbabvu zvinotungamira mukukanganisa kwemoyo.
? Kana curvature iri <20-degree, hapana kurapwa kunodiwa (kucherechedzwa).
? Kune macurves ari> 20-40-degrees bracing inogona kushandiswa (orthosis).

 

• Milwaukee (metal) brace (kuruboshwe).
• Boston brace polypropylene yakakonzerwa ne polyethylene (kurudyi) inowanzodiwa nekuti inogona kupfeka pasi pekupfeka.
• Bracing wearing inotarisirwa kwemaawa 24 kwenguva yakareba yekurapa.

 

• Cherekedza nzira yeCobbs yekuchenesa kuti utore musana wakakombama. Iyo ine zvimwe zvisingakwanisike: 2D imaging, isingakwanise kufungidzira kutenderera, nezvimwe.
• Cobbobs nzira ichiri yakajairwa kuongororwa kunoitwa muScoliosis zvidzidzo.
• Nash-Moe nzira: inosarudza pedicle rotation mu scoliosis.

 

• Risser index inoshandiswa kuenzana nemaspinal skeletal maturity.
• Iliac kukura apophysis inowanikwa pa ASIS (F- 14, M-16) uye inofambira mberi mukati uye inotarisirwa kuvharwa mu 2-3-makore (Risser 5).
• Kufambira mberi kweScoliosis kunopera paRisser 4 muvakadzi & Risser 5 mune varume.
• Munguva yehudhigrasheni yekuongorora ye scoliosis, zvakakosha kurondedzera kana Risser kukura apophysis inoramba izaruka kana yakavharwa.

 

Spondylolysis uye spondylolisthesis ndezvehutano hunogona kukonzera kurwadziwa shure. Spondylolysis inotendwa inokonzerwa nehuwandu hwe microtrauma inotungamirira kumanikidziro anoputsika mu pars interarticularis. Varwere vane zvikanganiso zvepakati pevamwe vanogona kukudziridza spondylolisthesis, uko chidimbu chekutsvaira kwechemberi vertebrae kunogona kufambira mberi zvishoma nezvishoma. Varwere vane chokwadi chokuti spondylolysis uye spondylolisthesis vanogona kutanga kuongororwa nemarwadzo e-radiography. Chiropractic kuchengetedza inogonawo kubatsira kupa mafungiro ekufungidzira kwezvinhu izvi zvehutano.

Dr. Alex Jimenez DC, CCST

Spondylolysis & Spondylolisthesis

 

• Chiremera cheSpondylolysis mu pars interarticularis kana bhurusi risina simba pakati pepamusoro uye pasi pemaitiro articular.
• Chirwere chepfungwa chinokanganisa kuputika, kutendwa kuva mushure mokudzokidzwa kwechidiki microtrauma pamusoro pezvidzidzo Varume> Vakadzi, zvinokanganisa 5% yevanhu vakawanda kunyanya mumitambo yevechidiki.
• Chirwere chepachipiri chekuyaruka mushure mekutadza matambudziko chingangobatanidzwa nehutano.
• Kazhinji spondylolysis inoramba isymptomatic.
• Spondylolysis inogona kuvapo kana kuti w / o spondylolisthesis.
• Spondylolysis inowanikwa mu 90% paL5 pamwe chete ne10% muL4.
• Inogona kunge yakabatanidzwa kana yakafanana.
• Mu65% of cases, spondylolysis inosangana ne spondylolisthesis.
• Zvinyorwa zveRadiographic: kuputsa muStyty dog ​​mbiru yakakomberedza mutsipa pane oblique lumbar maonero.
• Radiography ine hutsika hunoenzaniswa neE SPECT. SPECT inobatanidza neyonizing rayation, uye MRI ino ndiyo nzira inofanirwa yekufungidzira kufungidzira.
• MRI inogona kubatsira kuratidza kukanganisa marrow edema pedyo nekuputsika kwepfumi kana w / o chirema chinonzi chinenge chiripo kana kuti chinogona kukura spondylolysis.

 

Mhando dzeSpondylolisthesis

 

• Ita 1 - Dysplastic, isingawaniki uye inowanikwa mu congenital dysplastic malformation ye sacrum inobvumira anterior displacement yeL5 paS1. Kakawanda hapana chiremara chemafu.
• Ita 2 - Isthmic, yakajairika, kazhinji inokonzerwa nekudengenyeka kwepfungwa.
• Tora 3 - Degenerative kubva pakugadzirisa kwemaitiro articular.
• Tora 4 - Traumatic in an acute posterior arch fracture.
• Tora 5 - Pathologic nemhaka yezvirwere zvirwere munzvimbo yako kana kuti generalized.

 

Gwaro re spondylolisthesis rakabva paChirongwa cheMyereding.
Ichi chikamu chinoreva chikamu chakanyanyisa chemuviri wepamusoro pakatarisana ne-anterior-posterior chikamu chemuviri wepasi.

 

• Bhuku 1 - 0-25% anterior slip
• Bhuku 2 - 26-50%
• Bhuku 3 - 51% -75%
• Bhuku 4 - 76-100%
• Giredhi 5 -> 100% spondyloptosis

 

• Cherechedza chinotyisa che spondylolisthesis paL4 uye retrolisthesis paL2, L3.
• Izvo zvisina kufanira zvinoitika nekuda kwekutsvaga kwezvinhu uye disk uye kuderera kwehutano hwemunharaunda.
• Kazhinji inopfuurira mberi kweBanga 2.
• Inofanira kuonekwa mumugumo wemifananidzo.
• Inokonzera kugadzikana kweganda canal stenosis.
• Canal stenosis iri nani kudonongedzwa nemuchinjikwa-sectional imaging.

 

• Chikwangwani cheNapoleon chakachinjika chikwangwani -chinoonekwa kumberi kwemakumbo / pelvic radiographs paL5-S1.
• Inoratidzira zvakagadziriswa spondylolysis nekaratidza anterolisthesis yeL5 paS1 kakawanda ne spondyloptosis uye yakarongerwa kuwedzererwa kwemazuva ose.
• Spondylolysis inokonzerwa nehuwandu hwepondylolisthesis inowanzotanga kufanana uye / kana kushungurudzika kwakabva uye kusanyanya kuderera.
• Iyo "brim" yehuti inoumbwa nekushandura kwepasi kwemaitiro anotenderera, uye "dome" yehayi inoumbwa nemuviri weL5.

 

Mukupedzisa, imaging diagnostics yeiyo musana inokurudzirwa kune varwere vane zvakasarudzika zvemuzongoza, zvisinei, kushandiswa kwavo kwakawedzera kunogona kubatsira kusarudza - kwavo kwakanyanya kurapwa sarudzo. Kunzwisisa kusagadzikana kwemuzongoza kunotsanangurwa pamusoro kunogona kubatsira vashandi vezvehutano nevarwere kugadzira chirongwa chekurapa kugadzirisa zviratidzo zvavo. Chiyero cheruzivo rwedu chinogumira kuchiropractic pamwe nekukuvara kwepamuviri nemamiriro. Kuti ukurukure nyaya yacho, ndapota inzwa wakasununguka kubvunza Dr. Jimenez kana kutibata nesu pa us915-850-0900 .

 

Yakarongedzwa naDkt Alex Jimenez

 

Zvimwe Zvimwe Zvinyorwa: Zvakanaka Kudzoka Pain

 

Kutambudzika shureIchi ndicho chimwe chezvikonzero zvakanyanya zvehurema uye nemazuva akarasika pabasa pasirese. Kutambudzika kwekuseri kunopa kune chechipiri chikonzero chakajairika chekushanyirwa kwehofisi yechiremba, kuwanda chete nehutachiona hwepamusoro-hwekufema. Vanenge makumi masere muzana muzana yevagari vanozorwadziwa nemusana kamwechete kamwe muhupenyu hwavo hwese. Iyo musana chivakwa chakaomarara chakaumbwa nemapfupa, majoini, mitsipa, uye mhasuru, pakati pezvimwe zvinyoro zvinyoro. Nekuda kweizvi, kukuvara uye / kana mamiriro akawedzeredzwa, sengeherniated discs, zvinogona kutungamirira kune zviratidzo zvekurwadziwa shure. Kukuvara kwemitambo kana kukuvara kwepamberi yemotokari kazhinji kunowanzokonzera kukonzera kurwadziwa, zvisinei, dzimwe nguva kufamba kwakanyanya kunogona kuva nemigumisiro inorwadza. Nenzira yakanaka, nzira dzakasiyana dzokurapa, dzakadai sechiropractic, dzinogona kubatsira kuderedza marwadzo shure kuburikidza nekushandurwa kwepelinha nekugadzirisa maitiro, pakupedzisira kunatsiridza marwadzo ekurwadziwa.

 

EXTRA EXTRA | NHAURWA INOKOSHA: Chiropractic Neck Pain Treatment