ʻO ka hoʻomaopopo ʻana i ka maʻi Kümmell: He Manaʻo Nui

ʻĀpana

ʻO ka maʻi Kümmell kahi maʻi iwi kuamoʻo kakaʻikahi i hōʻike ʻia e ka lohi ʻana o ke kino vertebral ma muli o ka ischemia a me ka hui ʻole o nā haʻihaʻi. Hōʻike maʻamau kēia maʻi ma hope o ka ʻeha liʻiliʻi, me nā hōʻailona e ʻike ʻia i nā hebedoma a i ʻole mau mahina ma hope. Hoʻopilikia nui ka maʻi i ka poʻe ʻelemakule me ka osteoporosis, e maʻalahi ai lākou i nā haʻihaʻi vertebral a me nā pilikia ma hope.1

Ua wehewehe mua ʻia e Dr. Hermann Kümmell i ka makahiki 1891, pili ka maʻi i ke kaʻina o nā hanana e hoʻomaka ana me kahi ʻeha ʻeha liʻiliʻi. I ka wā mua, hiki i nā mea maʻi ke loaʻa i nā hōʻailona liʻiliʻi a i ʻole nā ​​​​hōʻailona, ​​​​akā i ka wā lōʻihi, loaʻa ka vertebrae i ka ischemic necrosis, e alakaʻi ana i ka hāʻule ʻana. ʻO kēia holomua ka hopena i ka ʻeha hope nui a me ka kyphosis, kahi curvature mua o ka iwi kuamoʻo. 2

ʻO ka pathogenesis o ka maʻi Kümmell pili pili loa i ka necrosis avascular o ka vertebrae. ʻOi aku ka nui o kēia maʻi i nā wahine a pili pū me nā mea pilikia e like me ka osteoporosis, ka hoʻohana ʻana i ka corticosteroid, ka waiʻona, a me ka radiation therapy. ʻO ka necrosis ischemic ke alakaʻi i ka hui ʻole o nā haʻihaʻi, kahi hōʻailona o ka maʻi.

ʻO ka poʻe maʻi me ka maʻi Kümmell e loaʻa pinepine me ka ʻeha hope a me ka kyphosis holomua. Hōʻike pinepine nā hōʻailona i nā pule ma hope o ka ʻeha mua, e paʻakikī ana ka ʻike. ʻO ka lohi o ka hoʻomaka ʻana o nā hōʻailona hiki ke alakaʻi i kahi kuhi hewa a i ʻole lohi i ka mālama kūpono, e hoʻonui ai i ke kūlana o ka mea maʻi. 3

Hana ʻia ka ʻike o ka maʻi Kümmell ma o nā ʻenehana kiʻi e like me nā kukui X, MRI, a me CT scans. Hōʻike kēia mau ʻano kiʻi kiʻi i ka hāʻule ʻana o ka vertebral a me ka hele ʻana o nā ʻokiʻoki intravertebral vacuum, e hōʻike ana i ka maʻi. ʻO ka ʻokiʻoki intravertebral kahi ʻike radiographic pathognomonic, ʻoiai ʻaʻole ia wale nō i ka maʻi Kümmell.

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ʻOkoʻa nā koho lapaʻau no ka maʻi Kümmell ma muli o ke koʻikoʻi o ke ʻano. ʻO ka hoʻokele conservative e pili ana i ka hoʻomaha ʻeha a me ka hoʻōla kino, hiki ke kōkua i ka hoʻohaʻahaʻa i nā hōʻailona a hoʻomaikaʻi i ka maikaʻi o ke ola o ka mea maʻi. I nā hihia koʻikoʻi, pono paha nā hana ʻokiʻoki e like me vertebroplasty a i ʻole kyphoplasty e hoʻopaʻa i ka spine a pale i ka hāʻule hou ʻana.

ʻOkoʻa ka wānana no nā maʻi me ka maʻi Kümmell. He mea koʻikoʻi ka ʻike mua a me ka mālama ʻana no ka hoʻomaikaʻi ʻana i nā hopena. Hiki i ka mālama lohi ʻana ke alakaʻi i ka ʻeha mau, ka ʻeha nui o ke kuamoʻo, a me ke kīnā. No laila, he mea nui ka ʻike ʻana i ka manawa a me ka hoʻokele kūpono o ka maʻi no ka pale ʻana i nā pilikia lōʻihi.

Hoʻolauna

ʻO ka maʻi Kümmell, i wehewehe mua ʻia i ka hopena o ke kenekulia 19, he maʻi iwi kuamoʻo i ʻike ʻia e ka lohi ʻana o ka vertebral collapse ma hope o ka ʻeha liʻiliʻi. Hoʻopilikia nui kēia maʻi i nā poʻe maʻi ʻelemakule e loaʻa ana i ka osteoporosis, e maʻalahi ai ko lākou mau iwi i nā haʻihaʻi a me nā pilikia ma hope.

Ua ʻike mua ʻia ka maʻi e Dr. Hermann Kümmell i ka makahiki 1891, nāna i ʻike i ke ʻano o nā maʻi e ʻike ana i ka hāʻule ʻana o ke kino vertebral i nā hebedoma a i mau mahina ma hope o nā hōʻeha koʻikoʻi. Hoʻopili ʻia kēia hāʻule lohi i ka ischemia a me ka hui ʻole ʻana o nā haʻihaʻi o ke kino vertebral mua.

ʻO ka maʻi Kümmell ka mea maʻamau i waena o ka poʻe ʻelemakule, ʻoi aku ka poʻe me ka osteoporosis. ʻOi aku ka maʻamau o kēia maʻi i nā wahine, ma muli paha o ka piʻi ʻana o ka osteoporosis i nā wahine postmenopausal. ʻO nā kumu pilikia ʻē aʻe e pili ana i ka hoʻohana ʻana i ka corticosteroid, ka waiʻona, a me ka radiation therapy, ʻo ia mau mea āpau e hiki ke kōkua i ka nāwaliwali o ka iwi.

ʻO ka pathogenesis o ka maʻi Kümmell e pili ana i ka necrosis avascular o nā kino vertebral. ʻO kēia kaʻina hana ischemic ke alakaʻi i ka make ʻana o ka iwi iwi, ka hopena i ka hāʻule ʻana o ka vertebrae. He mea liʻiliʻi paha ka ʻeha mua, akā ʻo ke ʻano o ka iwi lalo e hoʻonui i ka pōʻino i ka manawa. 4

ʻO ka poʻe maʻi me ka maʻi Kümmell e loaʻa pinepine me ka ʻeha hope a me ka kyphosis holomua, kahi curvature mua o ka iwi kuamoʻo. Hōʻike pinepine kēia mau hōʻailona i nā hebedoma ma hope o ka ʻeha mua, e hoʻemi ana i ka pilina ma waena o ka ʻeha a me ka hāʻule ʻana o ka vertebral hope. 5

Moolelo Moolelo

Ua wehewehe mua ʻo Dr. Hermann Kümmell, he kauka lapaʻau Kelemania i ka maʻi e kapa ʻia ma hope o kona inoa i ka makahiki 1891. Ua kākau ʻo ia i kahi ʻano o nā maʻi i ʻike i ka lohi ʻana o ka spinal collapse ma hope o nā ʻeha liʻiliʻi. ʻO kēia maʻi, i kapa ʻia i kēia manawa ʻo ka maʻi Kümmell, ua hōʻike ʻia e ka manawa mua o ka ʻano asymptomatic pili, a ukali ʻia e kahi kyphosis holomua a ʻeha ma ka ʻōpū lalo a i ʻole ka ʻāpana lumbar luna.

ʻO ka ʻike ʻana a Kümmell he mea hoʻokalakupua i kēlā manawa, ʻoiai lākou i hoʻolauna i ka manaʻo o ka lohi ʻana o ke kino vertebral post-traumatic. He mea koʻikoʻi kēia i nā kumu i ʻike ʻia o ka hāʻule ʻana o ke kino vertebral, ʻo ia hoʻi ka maʻi maʻi, neoplasia malignant, a me ka ʻeha koke. Hōʻike ka hana a Kümmell i kahi papa lapaʻau kū hoʻokahi kahi i noho ʻole ai ka poʻe maʻi no nā mahina a i ʻole mau makahiki ma mua o ka hoʻomohala ʻana i nā deformes koʻikoʻi koʻikoʻi.

Ua hālāwai mua ʻia ka maʻi me ka kānalua a paʻakikī no ka ʻae ʻana i loko o ke kaiāulu olakino. ʻAʻole maopopo nā haʻawina radiographic mua, e alakaʻi ana i kekahi e nīnau i ke ʻano o ka lohi ʻana o ka vertebral collapse. Eia nō naʻe, me ka holomua ʻana o ka ʻenehana kiʻi kiʻi, ʻoi aku ka hiki ʻana mai o nā hihi-X, ua ʻike maopopo ʻia ka kyphosis i ʻike ʻia i nā maʻi o Kümmell ma muli o ka lohi ʻana o ke kino vertebral.

ʻO Carl Schulz, he haumāna o Kümmell, ka mea mua i kapa i ka maʻi ma hope o kona kumu aʻo i ka makahiki 1911. Ma ka manawa like, ua wehewehe kekahi kauka lapaʻau Farani ʻo Verneuil i kahi ʻano like, e alakaʻi ana i kekahi mau manawa i kapa ʻia ai ka maʻi ʻo Kümmell-Verneuil. maʻi maʻi. ʻOiai ʻo kēia mau wehewehe mua ʻana, ʻaʻole maopopo a ʻike ʻia ke kūlana no nā makahiki he nui.

ʻAʻole a hiki i ka waena o ke kenekulia 20 i hoʻomaka ai ke kaiāulu lapaʻau e ʻike nui a kākau i ka maʻi Kümmell. ʻO nā pepa a Rigler i ka makahiki 1931 a me ka Steel i ka makahiki 1951 i hōʻike maopopo i ka hāʻule ʻana o ke kino vertebral i kēia mau maʻi i ʻike ʻia ma nā kiʻiʻoniʻoni lohi, e hōʻoiaʻiʻo ana i nā ʻike kumu a Kümmell. Ua kōkua kēia mau haʻawina i ka hoʻopaʻa ʻana i ka hoʻomaopopo ʻana i ka maʻi a me kāna papa lapaʻau.

ʻOiai ʻo kāna palapala mua, ʻo ka maʻi Kümmell kahi maʻi kakaʻikahi a ʻike pinepine ʻia. ʻO ka hoihoi hou i nā makahiki i hala iho nei ua alakaʻi i kahi ʻike maikaʻi aʻe o kāna pathophysiology a me ka hōʻike lapaʻau. Eia nō naʻe, ua kaupalena ʻia nā palapala e pili ana i ke kumuhana, me ka liʻiliʻi o nā hihia i hōʻike ʻia mai kona wehewehe mua ʻana i hoʻokahi haneli i hala.

Nā kumu a me nā mea pilikia
 

ʻO ka maʻi Kümmell ka mea pili i ka avascular necrosis o ka vertebrae, kahi kūlana kahi e hoʻopau ʻia ai ke koko i ka iwi, a hiki i ka make ʻana o ka iwi. Hoʻopilikia nui kēia maʻi i ka poʻe ʻelemakule i loaʻa i ka osteoporosis, kahi maʻi i hōʻike ʻia e nā iwi nāwaliwali i ʻoi aku ka maʻalahi o ka haki.

ʻO nā kumu pilikia no ka hoʻomohala ʻana i ka maʻi Kümmell, ʻo ia ka hoʻohana ʻana i ka steroid maʻi, hiki ke alakaʻi i ka hoʻonui ʻana i ka momona intramedullary a me ka hoʻopau ʻana i nā vascular. ʻO nā kumu koʻikoʻi koʻikoʻi ʻo ia ka waiʻona, hiki ke hoʻoulu i ka microscopic fat emboli i loko o nā aʻa hope, a me ka radiation therapy, hiki ke hōʻino pololei i ka vascularity.

ʻO nā kumu pilikia hou aʻe no ka necrosis avascular o ka vertebrae he hemoglobinopathies, e like me ka maʻi sickle cell, hiki ke hopena i ka occlusion vascular a me ka ischemia kino vertebral. ʻO nā kūlana e like me nā vasculitides a me ka maʻi maʻi i hoʻopili pū ʻia i ka pilikia, ʻoiai ʻaʻole maopopo ka hana pololei o ka maʻi diabetes.

ʻO nā maʻi maʻi, nā maʻi ʻino, a me nā hoʻololi post-radiation kekahi mau kumu predisposing. No ka laʻana, hiki i nā hoʻololi post-radiation ke alakaʻi i nā hopena cytotoxic pololei e hōʻino i ka vascularity o ka vertebrae. Pēlā nō, pili nā kūlana e like me ka pancreatitis a me ka cirrhosis me ka compression vascular a me nā mīkini ʻike ʻole, kēlā me kēia, e hāpai ana i ka hoʻomohala ʻana o ka necrosis avascular.

ʻOi aku ka maʻi maʻi Kümmell i nā wahine, ʻo ia hoʻi ke kumu o ka piʻi ʻana o ka osteoporosis i nā wahine, ʻoi aku ka nui o nā wahine postmenopausal. Hōʻike pinepine ka maʻi i nā hebedoma i nā mahina ma hope o kahi hōʻeha ʻeha liʻiliʻi, e hōʻike ana i ke ʻano lohi o ka hāʻule ʻana o ka vertebral i nā poʻe i hoʻopilikia ʻia.

Nā hōʻailona a me ka hōʻike ʻana i ke kino

ʻO ka poʻe maʻi me ka maʻi Kümmell e loaʻa pinepine me ka ʻeha hope a me ka kyphosis holomua. Hoʻopaneʻe pinepine ʻia ka hoʻomaka ʻana o nā hōʻailona, ​​ʻike ʻia nā hebedoma a i nā mahina ma hope o ka ʻeha liʻiliʻi mua. Hiki i kēia lohi ke alakaʻi i kahi manawa o ka maikaʻi ma mua o ka ʻike ʻia ʻana o nā hōʻailona.

Hoʻokaʻawale ʻia ka papa lapaʻau o ka maʻi Kümmell i ʻelima mau pae. I ka wā mua, hiki i nā maʻi ke loaʻa i kahi ʻeha liʻiliʻi me ka ʻole o nā hōʻailona koke. Hoʻopili ʻia kēia me ka wā post-traumatic me nā hōʻailona liʻiliʻi a ʻaʻohe palena o ka hana. ʻO ka latent interval, kahi manawa o ke olakino pili, hiki ke mau mai nā pule a i nā mahina ma mua o ke komo ʻana o ke kīnā.

I ka papa hana hou, hoʻomaka ka poʻe maʻi e ʻike i ka ʻeha hoʻomau, localized back pain, hiki ke lilo i peripheral me ka ʻeha aʻa. Hōʻike ʻia kēia pae e ke ʻano holomua o nā hōʻailona, ​​e alakaʻi ana i ka hōʻeha nui a me ke kīnā.

ʻO ka pae hope loa, i kapa ʻia ʻo ka terminal stage, pili i ke kūkulu ʻana i kahi kyphosis mau. Hiki i kēia ke hana me ka ʻole a i ʻole ke kaomi ʻana i ke aʻa o ke kuamoʻo a i ʻole ke kaula. ʻO ka hoʻopaʻapaʻa Neurologic, ʻoiai kakaʻikahi, he hoʻopiʻi koʻikoʻi hiki ke ala mai i kēia wā.

Hoʻonui pinepine ʻia nā hōʻailona o ka maʻi Kümmell e nā kumu e like me ka hoʻohana mau ʻana i ka steroid, osteoporosis, ka waiʻona, a me ka radiation therapy. Hāʻawi kēia mau mea pilikia i ka necrosis avascular o ke kino vertebral, e alakaʻi ana i ke ʻano o ka lohi ʻana o ka vertebral collapse a me nā hōʻailona pili.

ʻIkepili

Loaʻa ka hōʻoia ʻana o ka maʻi Kümmell ma o nā ʻenehana kiʻi e like me nā X-ray, MRI, a me CT scans. He mea nui kēia mau ʻano kiʻi i ka hōʻike ʻana i ka hāʻule ʻana o ke kino vertebral (VBC) a me ka hele ʻana o nā kahe wai, kahi e hōʻike ai i ka maʻi. ʻO ka hana mua e pili ana i ka loaʻa ʻana o ka mōʻaukala maʻi maʻi a me ka hoʻokō ʻana i kahi loiloi olakino maʻamau e kāpae i nā kūlana ʻē aʻe e hōʻike like ana, e like me ka neoplasm, ka maʻi, a me ka osteoporosis.

He waiwai nui ka MRI i ka ʻike ʻana i ka maʻi Kümmell no ka mea hiki iā ia ke hoʻokaʻawale i ka necrosis avascular mai nā neoplasms malignant a i ʻole nā ​​​​maʻi. Hōʻike maʻamau ka hiʻohiʻona MR o ka necrosis avascular i nā hiʻohiʻona ʻokoʻa i ʻike ʻole ʻia i nā maʻi ʻino a i ʻole nā ​​​​maʻi. No ka laʻana, hōʻike pinepine nā neoplasms malignant i ka emi ʻana o ka ikaika o ka hōʻailona ma nā kiʻi paona T1 a me ka hoʻonui ʻana i ka ikaika o ka hōʻailona ma nā kiʻi paona T2, me ka ʻoi aku ka nui o ka hōʻailona kiʻekiʻe a me ke komo ʻana o ka ʻiʻo palupalu paravertebral.

He mea koʻikoʻi ke kiʻi kiʻi kiʻi no ka ʻike ʻana i ka maʻi Kümmell, no ka mea, hiki iā ia ke hōʻike i kahi kino vertebral kino ma hope o ka ʻeha, a ukali ʻia e VBC i ka wā e ulu ana nā hōʻailona. ʻO ka hoʻohālikelike ʻana i nā kiʻi hou me nā kiʻiʻoniʻoni kahiko hiki ke kōkua i ka hoʻoholo ʻana inā he koʻikoʻi a maʻi paha ka haʻihaʻi paʻa. I ka loaʻa ʻole o nā kiʻiʻoniʻoni mua, hiki i kahi scan iwi a i ʻole MRI ke kōkua i ka hoʻokumu ʻana i ka makahiki o ka haki. He mea pono nā iwi scans, me ka SPECT a i ʻole SPECT/CT imaging, no ka hoʻoholo ʻana i ke kiʻekiʻe o ka hana i nā haʻi o ka makahiki ʻike ʻole ʻia a me ka ʻike ʻana i nā haʻihaʻi hou.

ʻO ka intravertebral vacuum cleft (IVC) kahi hiʻohiʻona radiological koʻikoʻi o ka maʻi Kümmell. Hiki i nā kiʻi CT a me MRI ke hoʻomaopopo i kēia mau māwae, i ʻike ʻia he ʻano haʻahaʻa haʻahaʻa ma nā kiʻi paona T1 a me ka ikaika o ka hōʻailona kiʻekiʻe ma nā kaʻina T2-kaumaha, e hōʻike ana i ka hōʻiliʻili wai. ʻO ka loaʻa ʻana o nā IVC he manaʻo ia no ka hāʻule maikaʻi ʻana a ʻaʻole pili pinepine ʻia me nā haʻihaʻi koʻikoʻi, nā maʻi, a i ʻole nā ​​​​malina. Hiki ke hōʻike i ka neʻe ʻana o nā IVC ma nā ʻano like ʻole o ke kino ke hōʻike i ka paʻa ʻole i loko o ka haʻihaʻi, e hoʻopili ʻia me ka ʻeha nui a hoʻomau.

Manaʻo ʻia nā iwi scan kekahi o nā mea hana kiʻi maʻalahi no ka ʻike mua ʻana o ka ischemic necrosis i ka maʻi Kümmell. Hiki ke ʻike ʻia ka hoʻonui ʻia ʻana o nā mea hōʻailona osteophilic radiolabeled ma ka pae vertebral ma mua o ka hiki ʻana o ka hāʻule ʻana. Eia nō naʻe, i nā ʻeha maʻamau, hōʻike ʻia nā iwi scans a i ʻole ka lawe liʻiliʻi ʻana ma muli o ka nele o ka pane osteoblastic maʻamau. ʻAʻole koi ʻia nā biopsies no ka ʻike ʻana i ka maʻi Kümmell inā ʻaʻole i manaʻo ʻia ka maʻi ʻino a i ʻole he ʻāpana o ke kaʻina hana vertebroplasty a i ʻole kyphoplasty.

Nā koho lapaʻau

Hoʻopili ʻia ka mālama ʻana i ka maʻi Kümmell i nā hōʻailona o ka mea maʻi a me nā ʻike lapaʻau. Ma muli o ka liʻiliʻi o ke kūlana a me nā palapala liʻiliʻi, ʻaʻole i hoʻokumu maikaʻi ʻia nā protocol lapaʻau kūikawā. ʻO ka mōʻaukala, ʻo ka hoʻokele conservative ke ala mua, akā makemake nā ʻano hou i nā hana ʻokiʻoki no nā hopena maikaʻi aʻe.

Hoʻopili ʻia ka mālama ʻana i ka ʻeha me nā lāʻau analgesic, hoʻomaha moe, a me ka bracing. Manaʻo pinepine ʻia kēia ala inā ʻaʻohe pilikia neurological a paʻa mau ka paia vertebral hope. I kekahi mau hihia, hiki ke hoʻohana ʻia ka teriparatide, kahi ʻano recombinant o ka hormone parathyroid, e hoʻopiha i ka ʻāpana osseous, hoʻomaha i ka ʻeha, a hoʻomaikaʻi i ka hana.

Ke hāʻule ʻole ka mālama conservative a i ʻole nā ​​hihia me ka deformity kyphotic koʻikoʻi, hōʻike ʻia nā kaʻina hana hōʻemi liʻiliʻi e like me vertebroplasty a i ʻole kyphoplasty. Ke manaʻo nei kēia mau kaʻina hana e hoʻopaʻa i ka haʻihaʻi, hoʻihoʻi i ka alignment spinal, a hoʻēmi i ka ʻeha. Hoʻokomo ka Vertebroplasty i ka hoʻokomo ʻana i ka sima iwi i loko o ke kino vertebral e hoʻopaʻa i ka haʻihaʻi, aʻo ka kyphoplasty ka hana hou o ka hana ʻana i kahi lua me ka baluna ma mua o ka hoʻoheheʻe ʻana i ka sima.

No ka vertebroplasty, hoʻonoho ʻia nā mea maʻi i kahi kūlana me ka hyperlordosis e wehe i ka ʻāʻī a hoʻihoʻi i ke kiʻekiʻe vertebral. Hiki ke hoʻohana ʻia nā Cavity-grams me ke ʻano ʻokoʻa no ka pale ʻana i ka leaka sima, a ʻōlelo ʻia ka hoʻopiha piha ʻana i ka ʻāʻī no ka hoʻopaʻa ʻana. Eia nō naʻe, hiki ke hoʻopaʻapaʻa nā hopena o ka vertebroplasty, e pili ana i ka hoʻoponopono kyphosis a me ka extrusion sima.

I nā hihia o ka hāʻule ʻana o ke kino vertebral maʻi (VBC) a i ʻole VBC koʻikoʻi me ka hoʻohaunaele ʻana i ka paia o hope, pono ka hoʻopaʻa ʻana i ka hana ma o ka hui ʻana. Inā loaʻa ka neurological compromise, pono ka decompression me ka stabilization. Hiki ke hoʻokokoke ʻia ka decompression ma mua a ma hope paha, me ka maʻalahi o ka ʻenehana no ka wehe ʻana i nā ʻāpana retropulsed. Eia nō naʻe, ʻoi aku ka maikaʻi o nā kaʻina hana hope i nā poʻe maʻi maʻi me nā comorbidities nui.

Ma keʻano holoʻokoʻa, ʻo ka koho ma waena o ka mālama conservative a me ka ʻokiʻoki e pili ana i nā mea e like me ke ʻano o ka ʻeha, ke ʻano o ka deformity, a me ka hele ʻana o nā hemahema neurological. Hiki i ka hana mua ke alakaʻi i nā hopena maikaʻi aʻe, ʻoiai ʻo ka hoʻopaneʻe ʻana o ka mālama ʻana hiki ke hopena i ka ʻeha mau a me ke kīnā.

Ka wānana a me nā hopena

ʻO ka wānana o

hiki ke loli nui ma muli o ka manawa o ka maʻi a me ka hoʻomaka ʻana o ka lāʻau. He mea koʻikoʻi ka ʻike mua ʻana a me ka hana ʻana i ka mālama pono ʻana i ke kūlana a me ka hoʻomaikaʻi ʻana i nā hopena maʻi. Keʻike muaʻia, hiki i nā lāʻau lapaʻau e like me ka mālamaʻana i kaʻeha a me ka hoʻoikaika kino ke kōkua i ka hoʻohaʻahaʻa i nā hōʻailona a pale i ka hāʻule houʻana o ka vertebral.6

I nā hihia kahi i ʻike ʻia ai ka maʻi ma kahi pae kiʻekiʻe, pono paha nā koho ʻokiʻoki e like me vertebroplasty a i ʻole kyphoplasty e hoʻopaʻa i ka spine a hōʻemi i ka ʻeha. Hiki i kēia mau kaʻina hana ke hāʻawi i kahi hōʻoluʻolu nui a hoʻomaikaʻi i ka maikaʻi o ke ola no nā poʻe maʻi, ʻoiai hiki mai lākou me kā lākou mau pilikia a me nā pilikia e hiki mai ana.

ʻO ka lohi ʻana o ka mālama ʻana i ka maʻi Kümmell e alakaʻi pinepine ai i ka ʻeha mau a me ka holomua o ka spinal deformity, e like me kyphosis. Hiki i kēia ke hopena i ke kīnā lōʻihi a me ka emi ʻana o ka hiki ke hana i nā hana o kēlā me kēia lā. No laila, he mea nui ka hana lapaʻau i ka manawa e pale ai i kēia mau hopena ʻino a mālama i ka maikaʻi o ke ola no nā poʻe i hoʻopilikia ʻia.

ʻO ka holoʻokoʻa, hilinaʻi nui ka wānana no nā maʻi me ka maʻi Kümmell i ke kahua i ʻike ʻia ai ka maʻi a me ka wikiwiki o ka mālama ʻana. Hiki i ka hoʻokele mua a me ke kūpono ke hoʻomaikaʻi nui i ka prognosis, akā ʻo ka mālama ʻana i hiki ke alakaʻi i nā hoʻopiʻi koʻikoʻi a me ka maikaʻi ʻole o ke ola.

Heluhelu hou

No ka poʻe e ʻimi nei i ka ʻike hohonu o ka maʻi Kümmell, nui nā ʻatikala a me nā haʻawina hihia i loaʻa ma nā ʻikepili olakino a me nā puke pai. Hāʻawi kēia mau kumuwaiwai i nā ʻike piha i ka pathophysiology, hōʻike hōʻike hōʻike, a me nā hoʻolālā hoʻokele o kēia maʻi iwi kuamoʻo.7

Hoʻopuka pinepine nā nūpepa lapaʻau e like me ka Journal of Orthopedic Surgery and Research and Spine Journal i nā hōʻike kikoʻī a me nā loiloi e pili ana i ka maʻi Kümmell. Hāʻawi kēia mau puke i ka ʻike koʻikoʻi e pili ana i nā ʻenehana diagnostic hou a me nā ʻano lapaʻau. 8

No ka hiʻohiʻona mōʻaukala, ʻo ka nānā ʻana i nā wehewehe kumu a Kauka Hermann Kümmell a me nā haʻawina hope e hiki ke hāʻawi i ka pōʻaiapili i ka ulu ʻana o ka ʻike a me ka mālama ʻana i ka maʻi. Kuhi pinepine ʻia kēia mau palapala mōʻaukala ma nā ʻatikala noiʻi o kēia wā. 9

ʻO nā hale waihona puke lapaʻau pūnaewele e like me PubMed a me Google Scholar he wahi hoʻomaka maikaʻi loa ia no ke komo ʻana i nā ʻatikala i loiloi ʻia e nā hoa a me nā alakaʻi alakaʻi. Hāʻawi kēia mau kahua i kahi waihona nui o nā pepa noiʻi e uhi ana i nā ʻano like ʻole o ka maʻi Kümmell, mai ka maʻi maʻi a hiki i nā hopena ʻoki. 10

No nā kauka a me nā mea noiʻi, hiki i ka hele ʻana i nā ʻaha kūkā a me nā symposia e pili ana i nā maʻi spinal hiki ke hāʻawi i nā manawa e aʻo ai e pili ana i nā holomua hou loa i ka maʻi a me ka mālama ʻana i ka maʻi Kümmell. Hoʻopuka pinepine ʻia nā kaʻina hana mai kēia mau hanana ma nā nūpepa lapaʻau kūikawā. 11