Pedicle skru a wɔde si hɔ kwan
1. Beae a wɔhyɛn mu: ɛsono kɔn, koko ne asen;
2. Fa skru a wɔde hyɛ mu no anim a ɛkɔ soro (TSA) ne sagittal plane angle (SSA) no mu: Wobetumi asusuw TSA anim no afi CT film no mu. SSA no ne nipadua no gyinabea wɔ abusuabɔ pɔtee bi, na wobetumi de C-abasa no adi so bere a wɔreyɛ oprehyɛn no.
3. Bun: Screw no tenten du pedicle axis no tenten 80% na ama woanya biomechanical ahoɔden a ɛdɔɔso, na ɛnyɛ den sɛ wobɛkɔ cortical bone no mu na sɛ ɛware dodo a asɛe mogya ntini no.
4. Ne tenten: efi baabi a wɔde ade a wɔde hyɛ mu no kosi 83% wɔ akyi berɛmo nipadua no anim ntini no tenten nyinaa mu.
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Awotwaa mu Akyi berɛmo
Ɔkwan a wɔfa so de cervical pedicle screw hyɛ mu
Ɔkwan a wɔfa so de nnade hyɛ mu
Mprempren, akwan titiriw a wɔfa so de nnade hyɛ mu ne: Abumi kwan, anatomical landmark positioning kwan, kɔmputa so mfoniniyɛ kwan a wɔfa so de si hɔ, ne nea ɛkeka ho.
awotwaa mu akyi berɛmo mu kwan a wɔfa so hyɛn mu
Wɔ nhyiam a 5mm wɔ ase kwan a ɛda fam a ɛwɔ soro ano a ɛwɔ lamina no C2 axis no ne 7mm akyi mfinimfini ano a ɛwɔ akyi berɛmo no mu.
C3-C6 Ntamgyinafoɔ a ɛwɔ soro 1/4 a ɛda fam ne mfimfini abɔnten 1/4 a ɛda fam a ɛwɔ afã block no akyi.
C7 Mfinimfini a ɛda hɔ a ɛwɔ akyi block no ne soro mfinimfini 1/4 a ɛda fam no ntam kwan no wɔ soro.
Awotwaa mu akyi berɛmo no screwing angle
C2 a ɛkɔ fam 20-25° a ɛkɔ fam 10-15°
C3-C6 incline 40-45°, horizontal plane no ne soro ne ase endplates no hyia
C7 inclination 30-40°, horizontal plane no ne soro ne ase endplates no hyia
Awotwaa mu akyi berɛmo mu skru
Sɛ atlas no akyi arch no sorokɔ nnu 4mm a, wɔsesa no ma ɛyɛ lateral mass screw.
Sɛ pedicle a ɛwɔ axis no sorokɔ anaa ne tɛtrɛtɛ nnu 5mm a, wɔkamfo kyerɛ sɛ wɔbɛsesa akɔ lateral mass screw fixation so.
Cervical lateral mass screw a wɔde si hɔ
Magerl kwan : Screw entry point no wɔ 1-2mm atifi mfinimfini fã a ɛwɔ akyi ɔfasu a ɛwɔ akyi mass no; skru no kwan a wɔfa so hyɛn mu no kɔ akyi 25-30°, na wɔadan ti no 30° (ɛne atifi ntini no ani pɛ), na wɔatu akyi a ɛwɔ akyi no; bun susudua Afei screwing wɔ 3.5mm cortical bone screws.
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Roy-Camille kwan : baabi a wɔde skru hyɛn mu no wɔ akyi a ɛwɔ akyi no mfinimfini; skru no kwan a wɔfa so hyɛn mu no yɛ 10° wɔ akyi, wɔatu akyi akyi berɛmo a ɛda hɔ no, na wɔatu akyi ntini a ɛne no bɔ abira no; bere a wɔabɔ nnwom awie no, wɔde 3.5mm cortical bone screw bi hyɛ mu.
Anderson kwan : Screw no kwan a wɔfa so hyɛn mu no wɔ 1mm wɔ akyi mass no mfinimfini, screw no kwan a wɔfa so hyɛn mu no yɛ 20° wɔ afã, na wɔdan ti no 20° kosi 30° de tu tokuru no, na wɔtu contralateral cortex no.
Osuahu mu nsɛm a wɔaboaboa ano
(1) Ɛsɛ sɛ wɔde adwene si ahobammɔ a ɛwɔ skru a wɔde bɛhyɛ mu no so titiriw. Ɛsɛ sɛ oduruyɛfo a ɔyɛ oprehyɛn no paw ɔkwan a ɛfata sɛnea onim awotwaa no nipadua ne pedicle screw kwan no yiye.
(2) Afã mass screw fixation wɔ C3-C6 fã no yɛ mmerɛw na ahobammɔ wom sen pedicle screw fixation.
(3) Adwinnade no ntumi nkɔ pedicle no akyi ɔfasu no mu, anyɛ saa a ɛbɛsɛe ntini ne mogya ntini a ɛbɛn hɔ no.
(4) Ɛsɛ sɛ ɔkwan a wɔfa so de skru no hyɛ mu no gu ahorow sɛnea akyi berɛmo no anim te.
(5) Ɛsɛ sɛ wɔkwati sɛ cortical bone no bɛkɔ akyi berɛmo nipadua no anim.
(6) Fluoroscopy a wɔde yɛ oprehyɛn no betumi ahu akyi berɛmo nipadua ne akyi berɛmo ntam ahunmu pɛpɛɛpɛ, na wɔde nkɔnsɔnkɔnsɔn ahyɛ mu pɛpɛɛpɛ na amma nkɔnsɔnkɔnsɔn nkɔ akyi berɛmo no ntam ahunmu ne akyi berɛmo no mu kwan no mu.
Thoracic a ɛwɔ akyi
Needle a wɔde hyɛn mu:
1. Margel ne Roy Camille faa ntamgyinafo a ɛda fam a ɛwɔ mfinimfini a ɛwɔ transverse process no mu ne vertical line a ɛwɔ akyi ano a ɛwɔ superior articular process no mu no sɛ baabi a wɔde hyɛn mu.
2. Ebraheim hyɛɛ nyansa sɛ T1-T2 pedicle no mfinimfini wɔ 7-8 mm wɔ superior articular process no akyi ano, na 3-4 mm wɔ transverse process no mfinimfini. ~8mm na ɛwɔ hɔ.
3. Twe nsensanee a ɛda fam a ɛyɛ mm 3 wɔ ase nkwaa no mfinimfini, na twetwe nsensanee a ɛda fam fi soro 1/3 a ɛwɔ transverse process no ase, na nsensanee abien no ntam no ne baabi a nnadewa no hyɛn mu.
4. Wɔ nhyiam a ɛwɔ mfinimfini kwan a ɛwɔ longitudinal axis a ɛwɔ inferior articular process no ne horizontal line a ɛwɔ mfinimfini a ɛwɔ ntini a ɛwɔ transverse process no mu, 1 mm wɔ facet no ase
5. Wɔ nsɛm a emu yɛ den mu no, ɛyɛ ɔkwan a ahobammɔ wom sɛ wobeyi lamina no fã bi na wode pedicle screws ahyɛ mu wɔ anisoadehu tẽẽ ase.
Thoracic akyi berɛmo a wɔde hyɛ mu no anim
Sagittal plane : Pedicle inclination a ɛso tew fi T1 kosi T12. T1: 25° na ɛwɔ hɔ; T2: 20° na ɛwɔ hɔ; T3: 15° na ɛwɔ hɔ; T4-9: 10° na ɛwɔ hɔ; T10: 5° na ɛwɔ hɔ; T11-12: 0° na ɛwɔ hɔ.
Ɛsɛ sɛ pedicle screws a ɛwɔ soro thoracic vertebrae no nya inclination angle a ɛyɛ 10-20° ne sagittal plane, na pedicle screws a ɛwɔ mfinimfini ne ase thoracic vertebrae no nya inclination angle a ɛyɛ 0-10° ne sagittal plane. Ebraheim hyɛɛ nyansa sɛ ɛsɛ sɛ T1 ne T2 pedicle screws no yɛ 30-40° inclination ne sagittal plane, T3-T11 yɛ 20-25°, na T12 yɛ 10°.
Horizontal plane : ɛsɛ sɛ ɛne soro ne ase endplates no hyia.
Thoracic akyi berɛmo a wɔpaw skru
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Wɔ mpanyimfo fam no, thoracic pedicle screw no ntwemu nnu 5mm, na asiane wɔ hɔ sɛ screw no bebubu. Wɔ nsɛm pii mu wɔ akyi berɛmo no mfinimfini no, wontumi mfa nkɔnsɔnkɔnsɔn a ne kɛse boro mm 5 nsi hɔ, na ebetumi ama ntini no apaapae ntɛm.
Nhomanimfo binom de pedicle no a wɔde si nkyɛnkyɛn no di dwuma, na ɛno di ɔhaw yi ho dwuma yiye. Klik transverse process no ano na hyɛ pin no mu, na transverse process no mfinimfini no yɛ horizontal. Di kan dan tokuru ketewaa bi, na awl no kwankyerɛ ne akyi berɛmo no anim nkwaa no akyi ano no twam. Angle a ɛne sagittal plane no yɛ digrii 25-40, na degree no kɔ soro nkakrankakra fi T12 kɔ soro.
Screw a wɔde ahyɛ mu no bɛfa transverse process no mu, costotransverse kwan no fã, costovertebral joint, ne vertebral nipadua no akyi ɔfasu no mu. Esiane sɛ ɔkwan a wɔfa so de skru hyɛ mu no wɔ facet joint no akyi nti, ɛrentumi nyɛ yiye sɛ wɔbɛhyɛn akyi berɛmo no mu, na ɛyɛ nea ahobammɔ wom. Nea ɛka ho no, sɛnea ɛkɔ soro no ma skru no yɛ tenten. , a ɛyɛ den no, ahoɔden a wɔde si hɔ no kɔ soro, sɛnea wɔde hyɛ nipadua no mu no yɛ kɛse, wobetumi de nkɔnsɔnkɔnsɔn no asi nhama bi mu, na nhyiam no yɛ mmerɛw kɛse.
Lumbar akyi berɛmo
Lumbar a wɔde hyɛn mu
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2. Ntwamu kwan: ntwamu a ɛda mfinimfini kwan a ɛwɔ transverse axis a ɛwɔ transverse process no mu ne longitudinal axis a ɛwɔ facet joint no akyi, anaasɛ akyi ano a ɛwɔ superior articular process no ntam, .
3. Wɔ nsɛm a emu yɛ den mu no, ɛyɛ ɔkwan a ahobammɔ wom sɛ wobeyi lamina no fã bi na wode pedicle screws ahyɛ mu wɔ anisoadehu tẽẽ ase.
Lumbar skru no anim
Sagittal plane angle : L1-L3 wɔ 5-10 digrii a ɛdannan, L4-L5 wɔ 10-15 digrii a ɛdannan.
Horizontal plane angle : L1-4: ɛne endplate no hyia; L5: Digrii 10 a ɛkɔ fam (L5 akyi berɛmo nipadua no kɔ akyi).
Lumbar akyi berɛmo a wɔpaw skru
Ahwɛyiye a Wɔde Yɛ Oprehyɛn
1. Ansa na wɔbɛyɛ oprehyɛn no, ɛsɛ sɛ wohu akyi berɛmo no anim ne akyi pefee. Anim hwɛbea no kyerɛ baabi a skru no wɔ wɔ ɔkwan a ɛkɔ soro so, na akyi hwɛbea no betumi akyerɛ baabi a skru no wɔ wɔ gyinabea a ɛda hɔ no.
2. Ɛsɛ sɛ baabi a wɔde hyɛn mu no yɛ pɛpɛɛpɛ na wɔma ɛyɛ kɛse sɛnea ɛfata, na wobetumi ayi cortical bone a ɛwɔ anchor point no denam pyramid a ɛyɛ ahinanan anaa rongeur no a wobebue no so.
3. Sɛ wuhu ɔkwan a wobɛfa so akɔ baabiara awie a, fa ahoɔden a ɛfata bue ɔmansin no yiye. Ɛnsɛ sɛ blunt-tip probe no hyia ɔsɔretia a ɛda adi pefee bere a wɔde ade rehyɛ mu no. Ɛnsɛ sɛ 'di nkogu' anaasɛ mpofirim a wɔsɔre tia ho ntease biara ba. Sɛ wohyia resistance wɔ 5 ~ 15mm a edi kan no mu a, ɛsɛ sɛ ɛyɛ ne bere mu de. Siesie baabi a wɔde ade no hyɛn mu ne baabi a ɛwɔ no. Sɛ wuhyia ɔsɔretia a emu yɛ den a, wɔkamfo kyerɛ sɛ di kan fi mu na san paw ɔkwan a wobɛfa so akɔ mu. Hwɛ hu sɛ wubedi akwankyerɛ a pedicle no kyerɛ no akyi. Pedicle no mu yɛ cancellous bone na akyi yɛ cortical bone, a wobetumi akyerɛ no kwan ara kwa, sɛ baabi a ɛkɔ mu no yɛ pɛpɛɛpɛ na ɛyɛ kɛse yiye a; Fa 10-15° kɔ mfinimfini kwan no so, hwɛ wimhyɛn a ɛne akyi berɛmo nipadua no atifi ano hyia no yiye, na fa emu dɔ bɛyɛ 3cm. Nkate ho hia.
4. Ɛho hia paa sɛ wode pedicle probe no hwehwɛ afasu anan no mu, titiriw no, emu, ase ne ase afasu no.
5. Sɛ nipadua mu nsonsonoe a ɛda ahurututu a ɛwɔ fam ne akyi berɛmo no ntam no mu nna hɔ a, keka ɔkwan a ɛka ho no ne ntini a ɛwɔ fam no, na afei keka ntini a ɛwɔ soro no fã bi, na hwɛ pedicle no mu ɔfasu ne pedicle no ano tẽẽ.
6. Ɛyɛ papa sɛ wobɛkɔ abɔnten sene sɛ wobɛkɔ mu, wobɛforo na woankɔ fam; rotation ne ade titiriw, na anim ne ade a wɔde ka ho; bere a worekɔ w’anim na worehwehwɛ nneɛma mu no, gyae bere a wuhu denneennen no, yɛ nsakrae wɔ bere mu, fa nsateaa ahoɔden nkutoo di dwuma, mfa ahoɔden nkyinkyin.
7. Ɛnsɛ sɛ skru no ntwemu boro pedicle no akyi cortex no ntwemu 83%.
Sɛnea Wɔtɔ Nnompe a Wɔde Si Nnompe Mu ne Nnompe Ho Nnwinnade!
Ma CZMEDITECH , yɛwɔ nneɛma a edi mũ yiye a ɛyɛ nnompe oprehyɛn a wɔde hyɛ nipadua mu ne nnwinnade a ɛne no hyia, nneɛma no ka ho akyi berɛmo mu nneɛma a wɔde hyɛ nipadua mu, nnadewa a ɛwɔ medullary mu, trauma mprɛte, mprɛte a wɔde to mu, cranial-maxillofacial a ɛwɔ anim, afiri a wɔde yɛ nipadua no, nnwinnade a wɔde anyinam ahoɔden yɛ, abɔnten so fixators, ntini mu nhwehwɛmu, mmoa ho ayaresa ne nnwinnade a wɔde boa wɔn.
Bio nso, yɛasi yɛn bo sɛ yɛbɛkɔ so ayɛ nneɛma foforo na yɛatrɛw nneɛma ahorow mu, sɛnea ɛbɛyɛ a yebedi nnuruyɛfo ne ayarefo pii oprehyɛn ahiade ho dwuma, na yɛama yɛn adwumakuw no nso asi akan kɛse wɔ wiase nyinaa nnompe a wɔde hyɛ nipadua mu ne nnwinnade adwuma no nyinaa mu.
Yɛde nneɛma kɔ wiase nyinaa, enti wubetumi di yɛn ho nkɔmmɔ wɔ email address song@orthopedic-china.com na woanya asɛm bi a wontua hwee, anaa fa nkra mena wɔ WhatsApp so na woanya mmuae ntɛmntɛm +86- 18112515727 .
Sɛ wopɛ sɛ wuhu nsɛm pii a,kliki CZMEDITECH na woahu nsɛm pii.
