I-Spondylolisthesis

I-spondylolisthesis yisimo esihlobene nomgogodla esikhula lapho i-vertebra ishelela phambili phezu kwaleyo engaphansi kwayo. Nakuba izimo eziningi zenzeka ku- emuva okuphansi, ezinye iziguli ziyithola entanyeni noma esifundeni esimaphakathi nemuva.

Lesi sihloko sihlanganisa yonke into mayelana ne-spondylolisthesis-kusukela ezinhlotsheni zayo nezimpawu kuya kuzimbangela kanye nokwelashwa. Abafundi bazophinde bafunde isikhathi esifanele sokuthintana nodokotela nezindlela zokusingatha lesi simo.

Iyini i-Spondylolisthesis?

I-spondylolisthesis ivela kumagama esiGreki asho "i-vertebra" kanye "nokushelela." Lesi simo sivela lapho i-vertebra eyodwa ishelela phambili (anterolisthesis) noma emuva (i-retrolisthesis) phezu kwe-vertebra elandelayo. I-spondylolisthesis ivame ukukhula emhlane ophansi (i-lumbar spine), ikakhulukazi ezingeni le-L5-S1, nakuba ngezinye izikhathi ingathinta umgogodla womlomo wesibeletho. 

Izinhlobo ze-Spondylolisthesis

Odokotela bahlanganisa i-spondylolisthesis ngezinhlobo eziyisithupha eziyinhloko ngokusekelwe kulokho okubangela:

• I-Degenerative Spondylolisthesis: Abantu abadala abangaphezu kweminyaka engama-50 bavame ukuthola lolu hlobo ekugqokeni okujwayelekile nasekudabukeni kwamadiski namalunga.
• I-Isthmic Spondylolisthesis: Ukucindezeleka ukwa ku-pars interarticularis kubangela lokhu, futhi kuvamile kubasubathi abasebasha
• I-Dysplastic/Congenital Spondylolisthesis: Abantu bazalwa nalokhu ngenxa yama-vertebrae angazange akheke kahle.
• I-Traumatic Spondylolisthesis: Lokhu kwenzeka ngemva kokulimala kabi ezingozini noma ukuwa
• I-Spondylolisthesis ye-Pathologic: Izifo ezifana nezimila, izifo, noma kwamathambo kuholela kulolu hlobo
• I-Iatrogenic Spondylolisthesis: Lokhu kubonisa ngemva kwezinkinga ezivela ukuhlinzekwa ngomgogodla

Izimpawu ze-Spondylolisthesis

Abanye abantu abane-spondylolisthesis abazizwa izimpawu. Kodwa labo abakwenzayo bangase babe nezimpawu ezilandelayo ze-spondylolisthesis:

• Ukuhlungu obusemhlane lokho kuba kubi nakakhulu lapho umile noma uhamba
• Ubuhlungu obudlulela ezinqeni nasemathangeni
• Imisipha ye-hamstring eqinile
• Imilenze izizwa ndikindiki, iyaluma noma ibuthakathaka
• Izinkinga ezigobela phambili
• Ukuqina kweqolo

I-Spondylolisthesis Izimbangela 

Izinto eziningana zingenza ama-vertebrae ashelele. Umgogodla ngokwemvelo uba buthaka ngokukhula, futhi imisebenzi ephindaphindiwe eyelula umgogodla kude kakhulu ingadala ukuphuka kwengcindezi. Izakhi zofuzo zidlala indima njengoba lesi simo kwesinye isikhathi sisebenza emindenini. Abasubathi abenza i-gymnastics, ibhola lezinyawo, i-weightlifting, kanye ne-track bacindezela kakhulu iqolo eliphansi, okwandisa ingozi yabo. Abantu abazalwa benezinkinga zokuqondisa umgogodla nabo bangase babe maningi amathuba okuba bathole lesi simo.

Izingozi ze-Spondylolisthesis

Abanye abantu banethuba eliphezulu lokuthola i-spondylolisthesis. 

• Abesifazane bathola i-spondylolisthesis ewohlokayo cishe izikhathi ezintathu ngaphezu kwabesilisa. 
• Ingozi yabesifazane abamnyama iphindwe kathathu kuneyabesifazane abamhlophe. 
• Okungaphezu kwesisindo somzimba esifanele kubeka ingcindezi eyengeziwe emgogodleni. 
• Abantu abasha abenza imisebenzi eyelula kakhulu umgogodla wabo ophansi babhekana nobungozi obukhulu.

Izinkinga ze-Spondylolisthesis

I-spondylolisthesis ingabangela izinkinga ezinkulu uma ingelashwa. 

• Izimpande zemizwa zivame ukumpintshwa lapho ukushelela kwenzeka. 
• I-stenosis yomgogodla (umsele womgogodla omncane)
• I-Cauda equina syndrome (ethinta indlela olawula ngayo isinye/amathumbu akho)
• Ubuhlungu besikhathi eside beqolo

Sifo

Odokotela basebenzisa izivivinyo zomzimba kanye nokuhlolwa kwe-imaging ukuze bathole i-spondylolisthesis. Ukuhlola ngokuvamile kuhilela iziguli ezilele phansi ukuze ziphakamise umlenze owodwa uqonde phezulu. Lokhu kunyakaza kuvame ukubangela ubuhlungu ezigulini ezinezintambo eziqinile noma i-sciatica evela ku-spondylolisthesis. Ama-X-ray asebenza njengesiqalo sokukhombisa ukuthi i-vertebra iye yaqhubekela phambili.

Odokotela bangase badinge ukuhlolwa okwengeziwe ukuze bathole isithombe esiphelele:

• I-MRI scans - inketho engcono kakhulu yokuhlola izicubu ezithambile nokucindezelwa kwezinzwa
• Ama-CT scans - akhombisa ukwakheka kwamathambo anemininingwane nokuphuka ngokucacile
• Izikena zethambo - ukusiza ukulandelela ukuphulukiswa kokuphuka okusebenzayo

Ukwelashwa kwe-Spondylolisthesis

• Ukwelashwa okungavamisile: Ukwelashwa kwe-spondylolisthesis okungahlinzeki kusebenza kahle ezigulini eziningi. Indlela ejwayelekile iqala ngokuthi:
  • Ukuphumula nokushintsha amaleveli omsebenzi
  • Imithi elwa nokuvuvukala njenge ibuprofen
  • Ukwelashwa ngokomzimba okwakha amandla ayisisekelo futhi kunwebe ama-hamstrings
  • Imijovo ye-epidural steroid yokunciphisa ubuhlungu
  • Ukubopha okugcina umgogodla uzinzile
• Ukuhlinzwa kwe-spondylolisthesis: Izinketho zokuhlinza ziqala ukusebenza uma ukwelashwa okuvamile kungasebenzi ngemva kwezinyanga ezingu-3-6 noma izimpawu zemizwa ziba zimbi kakhulu. Lezi zinqubo zihlanganisa ukuwohloka komgogodla (i-laminectomy) ukukhulula izinzwa eziboshiwe kanye nokuhlanganiswa komgogodla ukuze kuzinze ama-vertebrae athintekile.

Uzoyibona Nini Udokotela

Ubuhlungu beqolo obuhlala ngaphezu kwamaviki angu-3-4 budinga ukunakekelwa kwezokwelapha, ikakhulukazi uma ubuhlungu busakazeka emathangeni noma ezinqeni zakho. Ungalindi ukuthola usizo oluphuthumayo uma uba ndikindiki i-groin, ulahlekelwa yisinye noma ulawule amathumbu, noma unenkinga yokuhamba. Lezi zimpawu zingase zibhekisele ku-cauda equina syndrome, isimo esibucayi esidinga ukwelashwa ngokushesha.

Prevention

Awukwazi ukuvimbela ngokuphelele i-spondylolisthesis, kodwa lawa masu asiza ukunciphisa ubungozi bakho:

• Gcina isisindo sakho ukuze wehlise ingcindezi yomgogodla
• Yakha imisipha eqinile yomgogodla ngokuvivinya umzimba njalo
• Sebenzisa ukuma okuhle usuku lonke
• Khetha imisebenzi enomthelela omncane njengokubhukuda noma ukugibela ibhayisikili
• Thola okwanele i-calcium ne-vitamin D ukugcina amathambo enempilo

I-Spondylolisthesis vs Spondylosis 

UDkt Priyesh Dhoke

MBBS, MS (I-Orthopedics) FAOS (Australia) AO Spine International Clinical Fellowship, Brisbane (Australia) Ubudlelwano bomtholampilo ku-Minimal invasive Spine Surgery (MISS) (SGH, Singapore)
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529