AAI Mhinduro Kubva kuMasaligned Vertebrae
Atlantoaxial instability (AAI) chirwere chinowanikwa mumatope anoonekwa nevanhu vane Down syndrome. Kunyange zvazvo ine zita rakaoma uye rinonzwika zvingangovhundutsa, nokuda kwechikamu chikuru, haigumisi matambudziko kune avo vane. Kuti unzwisise AAI, zvinokosha kunzwisisa zvishoma pamusoro pebasa uye sarudzo yemutsara wepelinha, nerve, vertebrae uye ligaments.
Mutsara Wemutsipa, Mitsipa, Vertebrae uye Ligamende
Musoro wemutsara wepelinha isimbi yakakura-seyakagadzikana inotanga panheyo yeuropi uye inomhanya kusvika kumucheto kunharaunda. Mutsipa wepelinha une mitsipa yemuviri kana neuroni. Mitsipa inorudzi rwemhando yesero inotakura mameseji pakati pehupi nehumwe muviri wose. Mutsara wakafanana nekambani yemagetsi inopfuura magetsi uye inotakura zviratidzo pakati pemativi emuviri.
Vertebrae mapfupa asina kuumbwa akagadzirirwa muhomwe mushure momuviri unomhanya kubva muchero hweuropi kuenda kumawere. Mutsipa wepelinha unofamba uye unodzivirirwa nehutu hwe vertebrae. Kune 33 vertebrae, iyo inowanzoputswa munzvimbo ina: cervical (7), thoracic (12), lumbar (5) uye vertebra yemapapu. Cervical vertebrae iri munzvimbo yemutsipa uye inopfupiswa seC1-C7. Kana iwe ukakotamisa musoro wako mberi uye shandisa minwe yako pasi mushure memusoro wako, gomba guru rekutanga raunofunga kuti ndiro C1 yako kana cervical-1 vertebra.
Icho chinotevera pasi chiri C2 nezvimwe zvakadaro. C1 inonzi "atlas vertebra" uye C2 se "axis vertebra". Kusanzwisiswa kwemashoko aya kunonzi "atlantoaxial instability" kana AAI.
Vertebrae inobatanidzwa munzvimbo nemisungo nemirasi. Mabasa ehutenderedzwa yakavharidzirwa anosanganisira kuchengetedzwa kwemutsipa wepelinha uye nhengo dzomukati, sangano rekusimbisa musoro uye kuchengetedza zvose zviri nyore uye kufamba.
Sezvo vanhu vane Down syndrome vane pasi musinga tema uye mishonga yemarara, vertebrae yavo inogona kushandiswa zvisina kunaka. Apo C1 neC2 vertebrae zvisakanganiswa, une AAI. Mune vanhu vane Down syndrome, inonzi ligament inowanzobatanidzwa muAAI inonzi "inotenderera."
Kuongororwa kweAAI
Kazhinji maitiro eAymptomatic AAI anoshandiswa kuburikidza nekuongororwa x-rays. Vose vana vane Down syndrome vanofanira kuongororwa neAAI nezera remakore matatu. Kuongororwa kwechiratidzo cheAAI inowanzoitwa kana kuburikidza nekuongorora kwepfungwa (mumuviri wekuongorora unofunga kuti mishonga inoshanda sei uye / kana ne x-ray).
Mhando dzeAAI
Kune marudzi maviri eatlantoaxial instability - asymptomatic AAI uye zviratidzo zveAAI. Asymptomatic AAI zvinoreva kuti AAI inogona kuonekwa pa-x-ray, asi haisi kukonzera matambudziko ehutano mumunhu ane. Symptomatic AAI zvinoreva kuti AAI iripo pane x-ray, uye iri kukonzera mamwe matambudziko eurologic kune munhu ane. Pane imwe nguva pakati pe10% kusvika 20% yevanhu vane Down syndrome vane maitiro eAAI pa x-ray, uye 1% chete kusvika 2% yevanhu vane Down syndrome vane chiratidzo cheAAI.
Neurologic Symptoms in AAI
Imwe yemabasa e vertebral column ndeyekuchengetedza rwonzi rwepelinha, runomhanya mukati maro.
Mutsipa wepelinha ishongwe yemitsipa iyo inodzivirirwa ne vertebral column. Symptomatic AAI inokonzera zviratidzo zvakasiyana-siyana zveeurologic zvakadai se:
- Clumsiness
- Kusakwanisa Kugadziriswa
- Zvakaoma kufamba
- Kufamba nemararamiro asina kunaka (kureva kurema)
- Kuneta kuneta nyore nyore
- Nhamo kurwadziwa kana kukwanisa kushandiswa mutsipa
- Kufarira - kusimba mumisungo
- Clonus - musungo zvinopesana kana zvishoma
Kana mumwe munhu ane Down syndrome achikura chero ipi zvayo yezviratidzo zvepfungwa, anofanira kunge akabva aongororwa nachiremba. Chiremba anowanzoita chirwere chakakwana chekuongorora neurologic uye kuronga zvidzidzo zvekufungidzira, zvakadai se x-ray, CT kuongorora kana MRI.
Kurapa kweAAI
Asymptomatic AA hairevi chero kurapwa. Kazhinji kazhinji vabereki vanongorayirwa kuti zviratidzo zvinotarisirwa mumunhu ane AAI.
Kana munhu ari kuratidza zviratidzo zvepelinha cord compression, kurapa kunoratidzwa. Zvinangwa zvekuita zviratidzo zveAAI ndekudzivirira rwonzi rwepelinha, kugadzirisa korona yemupfupa kana vertebrae uye decompress chero musungo wakabatwa. Zvichienderana nehuwandu hwechinetso chacho, mutsara unogadziriswa unogona kugadziriswa kuburikidza nokupfeka kororera, halter traction nemishonga inorwadza uye musikana unozorodza uye zvichida kuvhiyiwa.
Sources:
American Academy of Pediatrics, Komiti Yemutambo Mushonga. Atlantoaxial instability mu Down syndrome. Pediatrics. Vol. 107 Nha. 2, February 2001, mapeji 442-449 [/]
Alvarez, N. Atlantoaxial Kuzvigadzika kune Vose vane Down Syndrome, Emedicine , Dec 8th, 2008.