Spinal muskuler atrofide skolyoz cerrahisi öncesi ve sonrası üst ekstremite performansı ve kavrama kuvvetinin değerlendirilmesi: olgu çalışması

Spinal muskuler atrofi SMA , medulla spinalis ön boynuz hücrelerinin dejenerasyonu sonucu atrofi ve kas zayıflığı ile karakterize genetik bir hastalıktır. Spinal muskuler atrofili bireylerde pelvik obliklik ve instabil oturmayla birlikte zamanla progresif skolyoz gelişir. Skolyoz, solunum kapasitesini, oturma dengesini ve üst ekstremite fonksiyonelliğini olumsuz etkiler. Yazımızda spinal muskuler atrofi tanılı 9 yaşında, 90˚ lumbal skolyoz nedeniyle skolyoz cerrahisi geçirmiş olan erkek olgunun, cerrahi öncesi ve sonrası üst ekstremite performansı, kas kuvveti ve kavrama kuvveti sunulmuştur. Cerrahi sonrası kaba kavrama kuvveti her iki elde azalırken, 3 nokta kavrama kuvveti arttı. Ayrıca lateral kavrama kuvvetinde sol elde nisbeten bir artış gözlenirken, sağ elde azalma saptandı. Kol elevasyon skoru solda azalırken, sağda değişmedi. T-shirt giyme süresi ise postoperatif 1. ayda azalırken postoperatif 3. ayda nisbeten arttığı, postoperatif 6.ayda ise T-shirt giyemediği gözlendi. Bunun yanısıra biceps, triceps, el bileği fleksör ve ekstansör, deltoid kaslarının kuvvetinde azalmalar belirlendi.

Anahtar Kelimeler:

Kavrama kuvveti, skolyoz, spinal muskuler atrofi

Evaluation of upper extremity performance and grip force before and after scoliosis surgery in spinal muscular atrophy: case study

Spinal muscular atrophy SMA is a genetic disorder characterized by atrophy and muscle weakness results from the degeneration of the medulla spinalis anterior horn cells. In individuals with spinal muscular atrophy, progressive scoliosis develops over time with pelvic oblique and instabilized sitting. Scoliosis has a negative effect on respiratuary capasity, sitting balance and upper extremity function. In this study, a 9-year-old man with spinal muscular atrophy and a 90 ° lumbar scoliosis who had undergone scoliosis surgery, preoperative and postoperative upper extremity performance, muscle strength and grip strength is presented. Gross grip strength after surgery decreased with both hands, 3 point grip strength increased. In addition, while the lateral gripping force was relatively high in the left hand, the right hand was detected. While the arm elevation score decreased to the left, it did not change on the right. The duration of wearing T-shirts was decreased in postoperative 1 month, relatively increased in postop 3 months and can’t wearing T-shirt in postoperative 6 month. Biceps, triceps, wrist flexors and extansors, deltoid muscles were found to decrease in strength.

Keywords:

Grip force, scoliosis, spinal muscular atrophy,

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