
diastematomyelia

diastematomyelia (kabhi-kabhi diastomelia) ack janmajaat vikaar haye jisamen reedh kii huddy kaa ack hissa vibhajit hotaa haye, aamtaur parr anudairdhya (sagital) disha mein oopari cutty kasheruka key star parr. purushon kii tulanaa mein mahilaaen adhik prabhaavit hoti hain. yeh sthiti reedh kii huddy key kendriya bhaag mein ack ausius, cartilogenous yaa reshedar septum kii upasthiti mein hoti haye joe phir reedh kii huddy key dou hemicord mein poorna yaa apoorna sagital vibhajan kaa utpaadan karati haye. jaba vibhajan door seey spur mein phir seey naheen milata haye, tou sthiti koo diplomilia key roop mein sandarbhit kiya jaataa haye, joe reedh kii huddy kaa sahee dohrao haye.
sanket aur lakshan.
diastematomyelia key sanket aur lakshan jeevan key kissy bhee samay dikhaai dey sakate hain, halanki nidan aamtaur parr bachpan mein kiya jaataa haye. twacha key ghaav (yaa stigmata), jaise kii baalon kaa patch, dimple, hemangioma, subcutaneous maas, lipoma yaa reedh key prabhaavit kshetra parr terratoma aadhe seey adhik mamalon mein paae jaate hain. tantrika sambandhi lakshan anirdisht hain, joe cord tethering key anya karanon seey aprabhedya hain. lakshan ootak sanlagnak key kaaran hotey hain joe reedh kii huddy key bheetar reedh kii huddy kii gati koo seemit karate hain. yeye sanlagnak reedh kii huddy key asamanya khinchaav kaa kaaran banate hain.
vikaar kaa crum pragatisheel haye. bachchon mein, lakshnon mein oopar ullikhit "kalank" aur/yaa pair aur reedh kii huddy kii vikritiyaan shamil hoe sakati hain; pairon mein kamjori; peeth kaa dard; paarshvagoodhata; aur asanyam. vayaskata mein, sanketon aur lakshnon mein aksar pragatisheel samvedi aur motor samasyaaen aur aantr aur mootrashay niyantran kaa nuksan shamil hotaa haye. lakshnon kii yeh vilambit prastuti samay key saath reedh kii huddy parr rakhe gaye tanaav kii degree seey sambandhit haye.
tatered spinal cord syndrome bhroon key vikas key dauran tantrika nully key anuchit vikas kaa parinam prateet hotaa haye, aur spina bifida seey nikatata seey judaa huaa haye.
reedh kii huddy kii chot key baad bhee teathering vikasit hoe sakati haye aur nishan ootak reedh kii huddy key chaaron or taral padarthon key pravaah koo avaruddh curr sakate hain. drav dabaav seey reedh kii huddy mein sist bunn sakate hain, ack sthiti jise syringomyelia kahaa jaataa haye. isase andolan, bhavna yaa dard yaa swaayatt lakshnon kii shuruat kii atirikt haani hoe sakati haye.
grieva diastematomyelia teevra aghaat key parinamswarup lakshanaatmak hoe sakata haye, aur anyatha halke aghaat key parinamswarup hemiperasis jaisi pramukh tantrika sambandhi kamee kaa kaaran bunn sakata haye.
nimnalikhit paribhaashaaen kuchh sambandhit sansthaon koo samajhane mein madad curr sakati hainh
pathophysiology.
diastematomyelia agyaat bhroon mool kii ack "dysrephic sthiti" haye, lekin shayed ack sahayak neuranteric nahar (ack atirikt bhroon reedh kii huddy kii nahar) dwara shuru kii jaati haye.) yeh sthiti ack alag ghatana hoe sakati haye yaa kasheruki nikaayon kii anya khandiya visangatiyon jaise kii spina bifida, kyphoscoliosis, titali kasheruka, hemivertebra aur block kasheruka seey judee hoe sakati haye joe adhikansh mamalon mein dekhi jaati haye. inmein seey aadhe seey adhik rogiyon mein scoleosis kii pehchaan kii jaati haye. adhikansh rogsoochak rogiyon mein, reedh kii huddy koo ack asthi spicule yaa reshedar patti dwara aadhe bhaag mein vibhajit kiya jaataa haye, pratyek aadhaa ack dural thaili seey ghiraa hotaa haye. anya sthitiyon, jaise intramdular tumour, tethered cord, dermoids, lipoma, syringomyelia, hydromyelia aur arnold-chiyari vikritiyon kaa varnan chikitsa saahitya mein kiya gayaa haye, lekin way asadharan roop seey durlabh hain.
diastematomyelia aamtaur parr reedh kii huddy key 9vein vaksh aur 1vein trick star key beach hotaa haye jisamen adhikansh oopari cutty kasheruka key star parr hotaa haye. cervical diastematomyelia ack bahut hii durlabh ikai haye. reedh kii huddy kii seema (yaa lambai) ack prabhaavit vyakti seey dusare mein bhinn hoti haye. diastematomyelia key lagbhag 60 pratishat rogiyon mein, donon hemicord, pratyek piyaa arachnoid kii ack akshunna parat seey dhake hue, ack ekal dural thaili seey ghire ekal subrachnoid sthaan seey gujarate hain. pratyek hemicard kii apani poorvavarti reedh kii dhamani hoti haye. diastematomyelia kaa yeh roop kissy bhee asthi spur yaa reshedar patti key saath naheen hotaa haye aur shayed hii kabhi lakshanaatmak hotaa haye jaba taka kii hydromyelia yaa teathering maujood naa hoe. anya 40 pratishat rogiyon mein ack asthi spur yaa ack reshedar patti hoti haye joe dou hemicord seey gujarati haye. inn mamalon mein, dura aur arachnoid dou alag-alag dural aur arachnoidal thaili mein vibhajit hotey hain, pratyek sambandhit hemicord key aspas hotaa haye joe aavashyak roop seey samamit naheen hotey hain. pratyek hemicord mein ack kendriya nahar, ack prishthiya seeng (ack prishthiya tantrika jarh koo janm dene vaalaa), aur ack nilay seeng (ack nilay tantrika jarh koo janm dene vaalaa) hotaa haye.) ack adhyayan seey pataa chalaa kii huddy kaa spur aamtaur parr dural cleft key sabse nichale pahalu parr sthit hotaa haye. unhone salah dee kii yadi imaging anyatha dikhaai detee haye, tou doosara spur (diastematomyelia key lagbhag 5 pratishat rogiyon mein maujood) maujood honey kii sambhavana haye.inn diastematomyelia rogiyon mein seey 75 pratishat seey adhik mein conus medularis ell2 star seey neeche sthit haye. aadhe seey adhik mamalon mein philam terminal kaa motaa honah dekhaa jaataa haye. jabaki daraar kaa star parivartansheel haye, yeh aamtaur parr cutty kshetra mein paaya jaataa haye. donon hemicord aamtaur parr daraar mein phir seey juda jaate hain. halanki, kabhi-kabhi, daraar asamanya roop seey cumm hoe jaayegi aur door dou alag-alag shanku medulare aur dou fila terminal (diplomelia) key saath samaapt hogi.
nidan.
diastematomyelia mein vayask prastuti asamanya haye. aadhunik imaging takneekon key saath, badhati aavritti key saath vayaskon mein vibhinn prakaar key reedh kii huddy key dysraphism kaa nidan kiya jaa rhaa haye. ghaav kaa sabse aam sthaan pahale seey teesare cutty kasheruka taka hotaa haye. lumbosecral vayask diastematomyelia aur bhee durlabh haye. asthi vikriti aur dysplasia koo aam taur parr saade aiks-ray parr pahachaana jaataa haye. aim. aar. aaee. scanning aksar jaanch aur nidan kii pahali pasand hoti haye. aim. aar. aaee. aam taur parr reedh kii huddy kii vikritiyon kaa paryaapt vishleshan kartaa haye, halanki isaki huddy kii vistrit shareer rachana dene mein kuchh seemaaen hain. sanyukt myelographic aur post-myelographic ct scan prabhaavit aur aasann reedh kii huddy key star aur huddy key spur kii vistrit huddy, intradural aur pratyarpan pathological anatomy kaa pradarshan karane mein sabse prabhaavi naidaanik upkaran haye.
iss visangati kaa prasavpurv ultrasound nidan aamtaur parr teesari timahi key madhya seey shuru mein sambhav haye. bhroon kii reedh kii huddy key beach ack atirikt pashch ecogenic phocus pashch tatvon key khelane key saath dekhaa jaataa haye, iss prakaar praarambhik shalya chikitsa hastakshep kii anumati detaa haye aur ack anukool purvanuman hotaa haye. prenet ultrasound yeh bhee pataa lagaa sakata haye kii kyaa diastematomyelia twacha key saath alag haye, yaa kissy gambhir tantrika nully dosh key saath judaa huaa haye. pragatisheel tantrika sambandhi ghaav diastematomyelia ghatana yaa kissy bhee sambandhit vikaar jaise kii myelodysplasia, reedh kii huddy key dysrephia dwara "tethering cord syndrome" (reedh kii huddy kaa nirdhaaran) key parinamswarup hoe sakate hain.
upchaar.
shalya chikitsa
shalya chikitsa una rogiyon mein aavashyak haye joe nae shuruat tantrika sambandhi sanketon aur lakshnon key saath upasthit hotey hain yaa pragatisheel tantrika sambandhi abhivyaktiyon kaa itihas rakhate hain joe iss asamanyata seey sambandhit hoe sakate hain. diastematomyelia key prabhaavi upchaar key liye aavashyak shalya chikitsa prakriya mein tantrika tatvon kaa apghatan (shalya chikitsa) aur asthi spur koo hataana shamil haye. yeh pratichhedan key saath yaa binaa kiye aur duplicate dural thaili kii marammat key saath puuraa kiya jaa sakata haye. duplicate dural thaili key vichhedan aur marammat koo prathamikta dee jaati haye kyonki dural asamanyata aanshik roop seey iss sthiti key lakshnon key liye jimmedaar "tethering" prakriya mein yogdan curr sakati haye.
post-myelographic ct scanning vyaktigat vistrit maanchitra pradaan kartaa haye joe cervical diastematomilia key shalya chikitsa upchaar koo saksham kartaa haye, joe pahali baar 1983 mein kiya gayaa thaa.
avalokan
lakshanheen rogiyon koo shalya chikitsa upchaar kii aavashyakta naheen hoti haye. inn rogiyon koo niyamit roop seey tantrika sambandhi jaanch karani chaahiye kyonki yeh gyaat haye kii sthiti bigad sakati haye. yadi kissy bhee pragati kii pehchaan kii jaati haye, tou ack vichhedan kiya jaanaa chaahiye.

