{"id":311,"date":"2020-11-07T15:41:37","date_gmt":"2020-11-07T13:41:37","guid":{"rendered":"http:\/\/www.fusioterapeutsandra.veeb.eu\/?p=311"},"modified":"2021-01-27T21:43:32","modified_gmt":"2021-01-27T19:43:32","slug":"skolioosiravi-progressiooniriski-hindamisest","status":"publish","type":"post","link":"https:\/\/fusioterapeutsandra.ee\/en\/skolioosiravi-progressiooniriski-hindamisest\/","title":{"rendered":"Skolioosiravi – progressiooniriski hindamisest"},"content":{"rendered":"

Et tagada teadusp\u00f5hine skolioosiravi, on vaja anda k\u00f5veruse v\u00f5imalikule suurenemisele m\u00f5\u00f5detav v\u00e4\u00e4rtus. V\u00f5ime subjektiivselt \u00f6elda, et riski suurendab naissugu (t\u00fcdrukutel rohkem suuri k\u00f5verusi, v\u00f5rreldes poistega suhe 8.4:1-le<\/a>!). Pikemalt skolioosi kohta kirjutasin siin<\/a>. Kasvuspurt (nt 7-9a, 11-13a), Cobb nurga suurus (mida suurem nurk, seda suurem t\u00f5en\u00e4osus) ja teatud skolioosimustrid (parempoolsed torakolumbaalsed k\u00f5verused kipuvad rohkem progresseeruma) jne. Kuid on olemas ka konkreetselt m\u00f5\u00f5detavate n\u00e4itajatega valem.<\/p>\n\n\n\n

Skolioosi progressiooniriski hindamiseks kasutatakse 1984 Lonstein ja Carlsoni poolt v\u00e4ljat\u00f6\u00f6tatud valemit, kus Cobb nurgast lahutatakse 3x Risseri skoor ja see jagatakse kronoloogilise vanusega. Saadud number n\u00e4itab joonisel progressiooniriski protsentides.<\/p>\n\n\n\n

Siit leitav ka online kalkulaator<\/a>.<\/p>\n\n\n\n

From: Lonstein JE, Carlson JM (1984). \u201cThe prediction of curve progression in untreated idiopathic scoliosis during growth<\/strong>\u201c. J Bone Joint Surg Am<\/em> 66<\/strong> (7): 1061-71. PMID<\/a> 6480635<\/a>.<\/p>\n\n\n\n

\"Lonstein<\/figure><\/div>\n\n\n\n
\n

N\u00e4ide 1<\/strong>: 12aastane neiu, Cobb nurk 30 kraadi, Risseri skoor 0. <\/p>\n\n\n\n

30-(3\u00d70)\/12= 2.5<\/strong> ehk skolioosi progressioonirisk on 100 protsenti.<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

\n

N\u00e4ide 2<\/strong>: 14 aastane neiu, Cobb nurk 30 kraadi, Risser 3<\/p>\n\n\n\n

30-(3\u00d73)\/14= 1.5<\/strong> ehk progressioonirisk 50 protsenti.<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

N\u00e4ide 3:<\/strong> 25aastane naine, Cobb 25 kraadi, Risser 5<\/p>\n\n\n\n

25-(3\u00d75)\/25= 0.4<\/strong> ehk progressioonirisk minimaalne.<\/strong><\/p>\n\n\n\n

Pean tunnistama, et see ei ole valem v\u00f5i info, mida igap\u00e4evaselt oma t\u00f6\u00f6s kasutan. Ortopeedi suunamisel on enamus minuni j\u00f5udvate noorte progressioonirisk v\u00e4ga k\u00f5rge ja nooruk on juba korsetti ootamas. Juhtub ka, et kirurgi vaatev\u00e4ljas. Kuid leian, et hea on kasutada seda valemit n\u00e4itamaks riski (ja enamasti just selle puudumist) kasvueast juba v\u00e4ljas v\u00f5i v\u00e4ikeste k\u00f5veruste puhul. <\/em><\/p><\/blockquote>\n\n\n\n

See \u00fcldjuhul pakub m\u00f5ningast rahu \u00e4revale inimesele, eks? Eriti neile, kes on saanud diagnoosi n\u00e4iteks t\u00e4iskasvanueas, \u00fcldjuhul aasta(k\u00fcmne)id peale skolioosi kujunemist, ja arst on k\u00f5ik tegevused p\u00e4evapealt keelanud. Olgugi, et eelnevalt pole olnud l\u00fclisambaga probleeme \u2013 on k\u00e4idud jooksmas, trennis, s\u00fcnnitatud jne jne. Minuni on j\u00f5udnud mitmeid terveid, \u00fcliaktiivseid ja edukalt toimivaid inimesi, kes peale diagnoosi saamist on viidud arusaamani, et nende tavap\u00e4rane treening ja ka eluviis on neile n\u00fc\u00fcdsest ohtlik. Aga mis muutus? Juurde tuli ainult teadmine diagnoosist, f\u00fc\u00fcsiliselt ei muutunud mitte midagi.<\/strong> Lisandus hirm, millel on kahjuks tihti v\u00e4ga suur j\u00f5ud. See on teema, mis mul juukseid t\u00f5stab, kuid las seekord j\u00e4\u00e4da  <\/p>\n\n\n\n

Skolioosi progressiooniriski hindamise valemis esinevad (v\u00f5\u00f5r)s\u00f5nad.<\/h2>\n\n\n\n

Cobb nurk<\/strong> on r\u00f6ntgenilt m\u00f5\u00f5detud nurk kahe maksimaalselt kallutatud l\u00fcli vahel. Vastavalt skolioosi mustrile m\u00f5\u00f5detakse k\u00f5ige tavalisemalt kaks Cobb nurka, vahel ka rohkem, vahel ainult \u00fcks. Seda teeb radioloog ning tavaliselt l\u00fclisambaga tegelev spetsialist m\u00f5\u00f5dab ka ise \u00fcle. M\u00f5\u00f5tmisvead on sagedased ning tavaliselt on lubatud vea vahemik +- 3-5 kraadi. On oluline \u00fcles m\u00e4rkida ja t\u00e4hele panna, millised l\u00fclid on m\u00f5\u00f5tmiseks valitud. Need ei pruugi spetsialistidel \u00fchtida ning sellest ka suuremad ja v\u00e4iksemad erinevused m\u00f5\u00f5tmistulemustes.<\/p>\n\n\n\n

\"CobbEnter a caption<\/a><\/p>\n\n\n\n

\n\n\n\n

Skolioosiravis m\u00e4\u00e4ratakse Risseri skooriga <\/a>luulist vanust. R\u00f6ntgenilt hinnatakse vaagnaluu harja luustumist \u2013 0 \u2013 ei ole luustunud\u2026. 5 \u2013 on t\u00e4ielikult luustunud. Prantsuse ja Ameerika s\u00fcsteemides on 2-4 staadiumite m\u00e4\u00e4ramised natukene erinevad, kuid skoor m\u00f5lemal 0-5 vahemikus. Ameeriklastel on luustumise ulatus jagatud neljandikeks, prantsuse s\u00fcsteemis kolmandikeks ning prantsuse s\u00fcsteemis on Risser 4 juba luustunud, kui USA s\u00fcsteemis t\u00e4histab seda Risser 5. <\/p>\n\n\n\n

\"Skolioosiravi<\/figure><\/div>\n\n\n\n

Pean oluliseks mainida, et veel t\u00e4psemaks meetodiks luulise vanuse hindamisel peetakse Sandersi k\u00fcpsuse skaalat<\/strong> (SMS \u2013 Sanders Maturity Scale), mida hinnatakse 0-8 palli skaalal vasaku labak\u00e4e r\u00f6ntgenilt. On leitud<\/a>, et Sandersi skaala ennustab t\u00e4psemalt k\u00f5veruse kiireid muutuseid kasvuspurdil ning oleks seet\u00f5ttu korsettravi m\u00e4\u00e4ramises t\u00e4psem. Skaala korreleerub laialt kasutusel oleva Risseri m\u00e4rgi ning menstruatsiooni staatusega, kuid on v\u00e4hemlevinud ning ei ole skolioosi ravijuhistes sees. Risseri kasutamise eeliseks on selle m\u00e4\u00e4ramise v\u00f5imalikkus olemasolevalt l\u00fclisamba (t\u00e4ispikkuses) r\u00f6ntgenilt, Sandersi jaoks on vajalik lisa r\u00f6ntgen\u00fclesv\u00f5te randmest.<\/p>\n\n\n\n

Lisaks \u00fclaltoodule on veel mitmeid rohkem ja v\u00e4hemlevinud skoore, skaalasid, m\u00f5\u00f5dikuid jm n\u00e4itajaid. <\/p>\n\n\n\n

Ma pole kindel, kas see postitus tegi asju selgemaks v\u00f5i keerulisemaks, aga .. kirja ta sai!  Ka teadlased n\u00f5ustuvad, et pole \u00fchtset ega \u00fchte head ja konkreetset v\u00f5imalust skolioosi progressiooniriski hindamiseks \u2013 see on \u00fcldjuhul kogum erinevatest asjadest. Kirjuta mulle, kui soovid midagi k\u00fcsida. Ehk oskan vastata v\u00f5i edasi suunata :)!<\/p>\n\n\n\n\n\n

Sandra<\/strong> \ud83d\ude42<\/p>","protected":false},"excerpt":{"rendered":"

Et tagada teadusp\u00f5hine skolioosiravi, on vaja anda k\u00f5veruse v\u00f5imalikule suurenemisele m\u00f5\u00f5detav v\u00e4\u00e4rtus. V\u00f5ime subjektiivselt \u00f6elda, et riski suurendab naissugu (t\u00fcdrukutel rohkem suuri k\u00f5verusi, v\u00f5rreldes poistega suhe 8.4:1-le!). Pikemalt skolioosi kohta kirjutasin siin. Kasvuspurt (nt 7-9a, 11-13a), Cobb nurga suurus (mida suurem nurk, seda suurem t\u00f5en\u00e4osus) ja teatud skolioosimustrid (parempoolsed torakolumbaalsed k\u00f5verused kipuvad rohkem progresseeruma) jne. …<\/p>\n

Skolioosiravi – progressiooniriski hindamisest<\/span> Read More »<\/a><\/p>","protected":false},"author":1,"featured_media":321,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"categories":[6],"tags":[15,14,16,12,7,13],"class_list":["post-311","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-skolioos","tag-cobb-nurk","tag-progressioonirisk","tag-risseri-skoor","tag-schroth","tag-skolioos","tag-skolioosiravi"],"yoast_head":"\nSkolioosiravi - 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