Sunday, 13 April 2008

(轉貼) 腰酸背痛 - 脊椎側彎(Scoliosis)

腰酸背痛--脊椎側彎(Scoliosis)

什麼是脊椎側彎?

脊椎是人體的主幹,具有保護脊髓、支撐身體重量的功能。脊椎從上而下依序油七節頸椎、十二節胸椎、五節腰椎、一節薦椎及四結尾椎所組成的。從人體正後方看,正常的脊椎呈一條線,若呈彎曲的現象,稱為「脊椎側彎」。女生脊椎側彎的發生率高於男生,每一千人裡面就有3~5個有脊椎側彎。
致病原因

85%的脊椎側彎是原因不明的,剩餘15%的致病原因可分成下面兩大類:
非結構性脊椎側:又稱功能性脊椎側彎,是一種可逆性的脊椎側彎。例:因為肌肉
痙攣或闌尾炎而造成長短腳。
結構性脊椎側彎:是一種不可逆性的脊椎側彎合併椎體旋轉。例:因為一些疾病而
造成的,像先天缺陷、肌肉病變、代謝異常、結締組織病變或馬凡氏症
(Marfan
syndrome)
脊椎側彎的症狀

下面這些症狀與脊椎彎曲相關:
․頭可能會偏離中心
․肩膀不等高、髖骨一高一低
․走路搖搖晃晃
․身體兩側不對稱
․作大量的軀幹運動時,容易疲倦、背部疼痛。
如何診斷

身體健康檢查
檢查背部、胸部、臀部、腿、腳、皮膚,看看肩膀是否平行,頭部是否在肩膀的中
心。此外,也會檢查背部肌肉,當你的身體向下彎曲,看看你的rib cage是否高於其
他,假如有明顯的不對稱,建議照射X光或轉介給一位骨科脊柱專科(有經驗治療患
有脊椎側彎症的醫生)。
X光評估
X光片可明確的顯示你的脊椎,根據脊椎曲線,可以計算出是否必須密切注意或治
療。醫生從X光片計算彎度,他會量測你的脊椎開始和結束的曲線和彎曲的角度,角
度大於20°就可能需要治療。
如何治療

大部分的脊椎側彎並不需要治療。
若彎曲角度小於25°,不需要治療,且小孩需每4~6個月復診。
․若彎曲角度大於25°但小於30°,可使用背架治療。
․若彎曲角度大於45°則需評估是否用手術矯正。主要目的是將彎曲的骨頭接在一起,
保持脊椎是直的,不同類型的手術和不同類型的有效植入裝置。植入的裝置在手術
中插入,手術後它們留在你的背部,保持你的脊椎挺直。
治療方針是防止脊椎曲度惡化比矯正已經彎曲的角度還重要。若還在成長中的小
孩,脊椎彎曲小於
20°需要治療;若已停止生長的小孩,脊椎彎曲小於20°則不需治
療。


參考網址:http://www.emedicinehealth.com/scoliosis/article_em.htm

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1 comment:

Dr Stitzel said...

Scoliosis is a chronic and progressive condition in which the patient's prognosis worsens as the size of the curvature increases. While every case is unique, long-term studies of many cases indicate that curvatures that reach a magnitude of 25-30 or greater see significant progression and complication risks in the short and long-term.

While many early stage scoliosis cases (curvatures 25 degrees or less) respond and stabilize with adequate in office treatment and continued home rehabilitation, most larger curvatures (greater than 25 degrees) will require a more extensive treatment plan and potentially multiple in-office treatment plans over time; especially until the patient reaches skeletal maturity.

One of the key differences that occur as the curvature approaches the 25-30 degree mark is the increasing effect of the "coil down" effect.....much like when a rubber band is twisted from the top and bottom until it "kinks" in the middle. While the mechanism that drives the coiling down effect remains a mystery, we do know its effect on the spine can be minimized and reduced through the use of traction/de-rotation based rehabilitation. The scoliosis traction chair was designed to create the necessary "coil down effect – free" environment for the scoliosis patient with a larger curve to effectively rehabilitate their spine. This traction/de-rotation effect, combined with a specialized whole body vibration, can dramatically improve the patient's chances of stabilizing and even reducing the spinal curvature.

Patients whose curvatures measure larger than 25 degrees at the time they reach skeletal maturity still have a 68% risk of further curve progression during adulthood (1-3 degrees a year on average), so every effort to reduce and stabilize the curvature to this level prior to skeletal maturity is paramount. Adult patients with moderate to severe curvatures can also benefit and reduce their risk of further curve progression post menopause with our non invasive options for treating moderate to severe scoliosis.
http://www.treatingscoliosis.com