R&D nhyehyɛe foforo

MIS | Mfiridwuma mu Nkɔso - Mfiridwuma mu Mfaso - Oprehyɛn akyi Nea efi mu ba | czmeditech na ɛyɛ adwuma

Minimally Invasive Spine System (MIS) yɛ mfiridwuma a ɛyɛ foforo a ɛma wotumi sa yare pɛpɛɛpɛ denam ntwitwiridii nketenkete so ma tebea horow te sɛ ntini a ɛyɛ mmerɛw ne akyi berɛmo a ɛyɛ mmerɛw.

Nsusuwii foforo ho nsɛm a ɛkɔ akyiri

Mfaso a ɛba fam koraa

Ahodwiriw a wɔatew so

Ntwitwiridii nketewa a wɔayɛ:

Ntwitwiridii a wɔtaa yɛ no yɛ sɛntimita 1-2 pɛ, na ɛtew ntini a ɛtwetwe ne ntini a ɛyɛ mmerɛw a ɛsɛe so.

Mfiridwuma a wɔde kyerɛ baabi a obi wɔ pɛpɛɛpɛ:

Pɛpɛɛpɛ a ɛkɔ anim wɔ implant placement mu denam intraoperative navigation (sɛ nhwɛso no O-arm, 3D-C-arm) anaa robɔt mmoa (sɛ nhwɛso no Mazor X, Globus Medical).

Mogya a ɛtɔ wɔ oprehyɛn mu a ɛso tew:

mfiridwuma a wɔde di dwuma a wɔmfa nhyɛ mu pii no brɛ asiane a ɛwɔ hɔ sɛ ntini mu opira no ase, titiriw wɔ ayarefo a wɔn mfe akɔ anim anaa wɔn a wɔwɔ yare foforo no fam.

Oprehyɛn akyi ahoɔden a ɛba ntɛmntɛm

Ayaresabea a wɔbɛtra bere tiaa bi:

woyi ayarefo dodow no ara fi ayaresabea nnɔnhwerew 24-48 wɔ oprehyɛn akyi, bere a wɔde toto nnafua 3-5 ho wɔ oprehyɛn a wɔabue ano a wɔyɛ no amanne kwan so no.

Nneɛma a wɔde tu kwan ntɛm:

Ɛyaw a ɛba fam ne ntini ahorow a wɔbɔ ho ban yiye ma ayarefo san kɔ wɔn da biara da dwumadi ahorow so ntɛmntɛm.

Biomechanical a wɔde di dwuma yiye

Nneɛma foforo a wɔde di dwuma:

s.e. 3D a wɔatintim titanium alloys, PEEK (polyether ether ketone) nneɛma a ɛbɛma wɔanya modulus a ɛyɛ elasticity a ɛbɛn dompe de no na ɛtew adwennwen masking so.

Nhyehyɛe ahorow a ɛma nneɛma gyina pintinn a ɛyɛ nnam:

nneɛma bi a wɔde hyɛ nipadua mu (sɛ nhwɛso no, Dynesys, Coflex) kora akyi berɛmo no mu nkɔso so na ɛtew asiane a ɛwɔ hɔ sɛ afã a ɛbɛn no bɛsɛe no so.

Nsɛnkyerɛnne a wɔatrɛw mu

Ɛkata akyi berɛmo mu nyarewa ahodoɔ pii te sɛ degenerative disc disease, lumbar spinal stenosis, spondylolisthesis a ɛnyɛ den ne vertebral fractures.

临床案列 na ɛwɔ hɔ

Nea edidi so yi yɛ ananmusifo nhwehwɛmu nsɛm a wɔayɛ wɔ nnansa yi mfe mu:

1. Sɔhwɛ a wɔanhyɛ da a wɔde di dwuma wɔ akyi berɛmo mu akyi berɛmo a wɔde afrafra (TLIF) ho .

Adesua nhyehyɛe:

prospective multicenter RCT (2022) a ɛde MIS-TLIF (a ɛnyɛ den koraa) toto TLIF a wɔabue ho.

Nhwɛsode no kɛse:

Ayarefo 120 a wɔwɔ akyi berɛmo mu yare a ɛyɛ ɔfã biako.

Nsunsuansoɔ:

Bere a wɔde yɛ oprehyɛn:

kyɛ kakra wɔ MIS kuw no mu (kyerɛ sɛ simma 150 ne simma 130), nanso mogya a ɛba no sua 60% (<100 ml hyia 250 ml).

Ɛyaw a ɛba wɔ oprehyɛn akyi:

VAS nkontabuo so tew 50% dapɛn 1 wɔ oprehyɛn akyi wɔ MIS kuw no mu, nsonsonoe titiriw biara nni akuw abien no ntam wɔ asram 3 akyi.

Fusion rate: 1 .

Afe 1 oprehyɛn akyi CT kyerɛɛ >90% fusion rate wɔ akuw abien no nyinaa mu.

Nsɛnnennen a ɛde ba:

Nyarewa dodow 2% wɔ MIS kuw no mu vs. 8% wɔ kuw a wɔabue mu.

2. Bere tenten mu nhwehwɛmu a wɔde di akyi wɔ dynamic stabilization system (Coflex) ho .

Adesua nhyehyɛe:

Europa mfeɛ 5 akyi nhwehwɛmu (2021) a ɛhwɛ Coflex a wɔde hyɛ nipadua mu de sa akyi berɛmo mu akisikuru.

Nhwɛsode no kɛse:

ayarefo 80 na wɔwɔ hɔ.

NSUNSUANSOƆ:

Dwumadi mu nkɔso:

ODI (dysfunction index) no so tew fii nsɛntitiriw 45 wɔ mfiase no kɔɔ nsɛntitiriw 20 wɔ mfe 5 mu.

ƆFA A ƐBƐYƐ NSƐM:

Ayarefo 12% pɛ na wonyaa ɔhaw ahorow a ɛfa ɔfã a ɛbɛn ho, a ɛba fam kɛse sen fusion a wɔtaa de di dwuma (~30%).

Oprehyɛn a wɔsan yɛ no dodow:

mfeɛ 5 a wɔsan yɛ oprehyɛn a wɔaboaboa ano a ɛyɛ 8%, titiriw esiane implant a ɛyɛ mmerɛw (4%) anaasɛ sɛnkyerɛnne a ɛsan ba bio nti.

3. Nhwehwɛmu a wɔyɛe wɔ mmeae pii wɔ MIS a wɔde robɔt boa ho

Adesua nhyehyɛe:

retrospective nhwehwɛmu a wotintimii wɔ afe 2023 mu de hwehwɛɛ nea efii MIS screw placement mu bae denam Mazor robɔt mmoa so.

Nhwɛsode no kɛse:

500 a wɔde skru gu mu (thoracolumbar spine).

Nsunsuansoɔ:

Pɛpɛɛpɛ:

98.6% wɔ screw gyinabea ahorow no mu no yɛ nea abotɔyam wom (Gertzbein-Robbins grading A/B).

Nsɛnnennen a ɛde ba:

ntini ntini mu opira dodow 0.4% sɛ wɔde toto 3-5% ma freehand placement a wɔtaa de di dwuma no.

Sɛ wopɛ nneɛma ho nimdeɛ ne nsɛm pii a, yɛsrɛ wo, di yɛn ho nkɔmmɔ!