Pedikili kuruw bɛ don cogo di?

Pedicle screw bilali fɛɛrɛ

1. Donda yɔrɔ : kɔ, disi ani cɛya tɛ kelen ye;

2. Aw bɛ kuru donna angle horizontal (TSA) ni sagittal plane angle (SSA) minɛ: TSA angle bɛ se ka suman ka bɔ CT filimu na. SSA ni farikolo jɔyɔrɔ bɛ jɛɲɔgɔnya dɔ la, wa a bɛ se ka kunbɛn ni C-bolo ye opereli senfɛ.

3. A jugumanba : Kuru janya bɛ se 80% ma pedikili janya la walasa ka biyomekaniki fanga bɛrɛ sɔrɔ, wa a ka nɔgɔn ka don kɔkolo kolo la ka joli siraw tiɲɛ ni a janya ka ca kojugu.

4. Janya : k’a ta pikirijikɛlan don yɔrɔ la ka se 83% ma kɔkolo ɲɛfɛla janya bɛɛ lajɛlen na.

Kɔnɔbara basigilen

Cervical pedicle screw doncogo

Pikirijikɛlan doncogo

Sisan, pikirijikɛlan doncogo kunbabaw ye : Abumi fɛɛrɛ, farikolo-yɔrɔ-ko-yɔrɔ-yɔrɔ-ko-fɛɛrɛ, ɔridinatɛri-dɛmɛ-jala-jɔ-cogo, a ɲɔgɔnnaw.

kɔnɔbara basigilen don yɔrɔ

• Ni milimɛtɛrɛ 5 bɛ C2 sɔgɔsɔgɔninjɛ lamina sanfɛla da lamini tilennen jukɔrɔ ani milimɛtɛrɛ 7 kɔkolo kanal cɛmancɛ da kɔkan.

• C3-C6 Sanfɛ cɛmancɛ 1/4 tilennen ni cɛmancɛ kɛnɛma 1/4 jɔlen tigɛli kɛrɛfɛ bloki kɔfɛ.

• C7 Kɛrɛfɛla bloki cɛmancɛ jɔlen ni sanfɛla cɛmancɛ 1/4 tilennen cɛtigɛyɔrɔ bɛ sanfɛ.

  
  

Cervical vertebra ka kurukuruni kɛrɛ

• C2 jiginni 20-25° jiginni 10-15°

• C3-C6 bɛ Jigin 40-45°, a bɛ Taa ɲɔgɔn fɛ ni sanfɛla ni duguma dakunw ye

• C7 jiginni 30-40°, plan horizontal bɛ bɛn sanfɛla ni duguma dakunw ma

  
  

Cervical kɔkolo kuru

• C1～C5 bɛ juruw de wajibiya minnu cɛmancɛ ye milimɛtɛrɛ 3,5 ye ani u juguman ye milimɛtɛrɛ 20 ye

Ni atlas kɔfɛla janya tɛ milimɛtɛrɛ 4 bɔ, a bɛ Changé ka kɛ lateral mass screw ye.

Ni aksidan pedicle janya walima a bonya ka dɔgɔn ni milimɛtɛrɛ 5 ye, a ka ɲi ka fɛn caman Changer ka kɛ lateral mass screw fixation ye.

Cervical lateral mass screw bilali

Magerl ka fɛɛrɛ : Kuru donna yɔrɔ bɛ milimɛtɛrɛ 1-2 kɛ kɛrɛfɛla masala kɔfɛ kogo cɛmancɛ sanfɛ; kuru donna sira bɛ 25-30° kɛ kɛrɛfɛ, ani kunkolo bɛ kɔrɔta 30° (a bɛ tali kɛ bolokɔni sanfɛla la), ani kɛrɛfɛla kɔri bɛ sɔgɔ juguya sumani Ni aw ye 3,5mm kolotugudaw kurulenw kɛ a la.

Roy-Camille fɛɛrɛ : kuru dondaw bɛ sɔrɔ kɛrɛfɛla masala kɔkanna cɛmancɛ la; kuru donna sira ye 10° ye kɛrɛfɛ, kɔfɛla jɔlen bɛ sɔgɔ, ani kɛrɛfɛla bɛ sɔgɔ; mankan bɔlen kɔfɛ, kolotuguda kolotuguda dɔ bɛ siri a kɔnɔ min janya ye milimɛtɛrɛ 3,5 ye.

Anderson ka fɛɛrɛ : Kuru donna yɔrɔ bɛ milimɛtɛrɛ 1 kɛ kɛrɛfɛla masala cɛmancɛ kɔnɔ, kuru doncogo bɛ kɛ 20° kɛrɛ fɛ, ani kunkolo bɛ kɔrɔta 20° fo 30° walasa ka dingɛ sɔgɔ, ani kɛrɛfɛla kɔkolo bɛ sɔgɔ.

Ko kɛlenw kuncɛcogo

(1) Jateminɛ kɛrɛnkɛrɛnnen ka kan ka kɛ kuru doncogo lakanani na. Operelikɛla ka kan ka fɛɛrɛ bɛnnen sugandi ka kɛɲɛ ni kɔnɔbara basigilen ni pedicle screw fɛɛrɛ dɔnni ye.

(2) Lateral mass screw fixation min bɛ C3-C6 yɔrɔ la, o ka nɔgɔn ani a lakananen don ka tɛmɛ pedicle screw fixation kan.

(3) Baarakɛminɛn tɛ se ka don pedicle kɛnɛma kogo la, n’o tɛ, a bɛna farikolo yɔrɔw ni joli siraw tiɲɛ minnu bɛ a kɛrɛfɛ.

(4) Kuru doncogo yɔrɔ ka kan ka ɲɔgɔn ta ka kɛɲɛ ni kɔkolo yɔrɔ ye.

(5) Kɔrɔlen kolo donni kɔkolo ɲɛfɛla la, o ka kan ka bali.

(6) Fluoroscopie intraoperative bɛ se ka kɔkolo farikolo ni kɔkolo cɛ yɔrɔ dɔn ka ɲɛ, ani ka juruw don a kɔnɔ ka ɲɛ walasa ka kurukuruw bali ka don kɔkolo ni kɔkolo cɛ yɔrɔ la.

Barajuru

Pikirijikɛlan dondaw:

1. Margel ni Roy Camille ye transversale processus cɛmancɛ yɔrɔ tilennen tilennen ni sanfɛla articulaire processus kɛnɛma da la tigɛli ta ka kɛ donyɔrɔ ye.

2. Ebraheim y’a jira ko T1-T2 ka pedicle cɛmancɛ bɛ sɔrɔ milimɛtɛrɛ 7-8 la ɲɛdawolo sanfɛla kɔkanna da la, ani milimɛtɛrɛ 3-4 bɛ sɔrɔ bolokɔni cɛmancɛ la. ~8mm ye.

3. Aw bɛ layini jɔlen dɔ ja milimɛtɛrɛ 3 duguma joli cɛmancɛ yɔrɔ kɔfɛ, ka tigɛli kɛ ka bɔ tigɛli kɛcogo basigilen sanfɛla 1/3 la, ani tigɛli fila ninnu cɛtigɛyɔrɔ ye nɛgɛ donyɔrɔ ye.

4. Inferior articulaire processus longitudinal axis cɛmancɛ cɛmancɛ ni transversal processus ju cɛmancɛ yɔrɔ tilennen cɛtigɛyɔrɔ la, milimɛtɛrɛ 1 ɲɛda jukɔrɔ

5. Ni ko gɛlɛnw don, o ye sugandili ye min tɛ mɔgɔ tɔɔrɔ ka lamina yɔrɔ dɔ bɔ ka pedicle kurukuruw don a la yeli siratigɛ la.

Barajuru kɔkolo doncogo yɔrɔ

Sagittal plane : Pedikili jiginni dɔgɔyali ka bɔ T1 la ka taa T12 la. T1: 25° ye; T2: 20° ye; T3: 15° ye; T4-9: 10° ye; T10: 5° ye; T11-12: 0° ye.

Sanfɛ barajuru kurukuruw ka kan ka kɛ ni 10-20° ye ni sagittal plane ye, ani cɛmancɛ ni duguma barajuru pedicle screws ka kan ka kɛ 0-10° ye ni sagittal plane ye. Ebraheim y’a jira ko T1 ni T2 pedicle screws ka kan ka kɛ 30-40° inclination ye ni sagittal plane ye, T3-T11 ka kan ka kɛ 20-25° ye, ani T12 ka kan ka kɛ 10° ye.

Plan horizontal : ka kan ka kɛ ɲɔgɔn fɛ ni sanfɛla ni duguma dakunw ye.

Barajuru kɔkolo sugandili kuru

• T1～T5 mago bɛ kuru cɛmancɛ la 3,5～4,0mm

• T6～T10 mago bɛ 4,0—5,0mm la

• T11, T12 mago bɛ 5,5mm la

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Mɔgɔkɔrɔbaw ta la, barajuru sɔgɔsɔgɔninjɛ cɛmancɛ tɛ milimɛtɛrɛ 5 bɔ, wa farati bɛ a la ka kurukuru kari. A ka ca a la, barajuru cɛmancɛ kɔkolo, kurukuru minnu janya ka ca ni milimɛtɛrɛ 5 ye, olu tɛ se ka bila, o bɛ se ka kɛ sababu ye ka pedikili kari nɔgɔya la.

Dɔnnibaa dɔw bɛ baara Kɛ ni pedicle (kɛrɛfɛla) bilali ye kɛrɛfɛ, o bɛ o gɛlɛya in ɲɛnabɔ kosɛbɛ. Kɔrɔlen taabolo kun digi walasa ka don pinɛ kɔnɔ, ani tigɛli kɛcogo cɛmancɛ bɛ kɛ tilennen ye. Aw bɛ dingɛ fitini dɔ wuli fɔlɔ, o la, awl fan bɛ ɲɔgɔn sɔrɔ ni kɔkolo ɲɛda kolotuguda kɛrɛfɛla ye. Kɔnɔna ni sagittal plane ye degere 25-40 ye, degere bɛ bonya dɔɔni dɔɔni ka Bɔ T12 la ka Taa san fɛ.

Kuru min donna a kɔnɔ, o bɛna tɛmɛ tɛmɛsira fɛ, o ye costotransverse taabolo dɔ ye, kɔkolo kolotuguda la, ani kɔkolo farikolo kɛrɛfɛ kogo fɛ. Ikomi kuru doncogo sira bɛ ɲɛda joli kɔkan, a tɛ se ka don kɔkolo la, o min ka fisa. Ka fara o kan, ni dɔ farala a jiginni yɔrɔ kan, o bɛ kɛ sababu ye ka kuru janya. , a ka bon, a sirili fanga bɛ bonya, a doncogo yɔrɔ ka bon, a juruw bɛ se ka sigi layini dɔ la, wa a lajɛcogo ka nɔgɔn.

Kɔnɔbara kɔkolo

Kɔnɔnatumu dondaw

1. Pikirijikɛlan doncogo fɛɛrɛ min bɛ kɛ jirisunba kuncɛyɔrɔ la (a bɛ kɛ sababu ye ka fɛn wɛrɛw sɔrɔ yɔrɔ min na, o bɛ kɛ yɔrɔ min na, o min bɛ kɛ sababu ye ka ɲɛgɛnɛsira sanfɛla ni sɔgɔsɔgɔninjɛ jirisunba ju la kɔfɛla la), o jɔyɔrɔ caman ɲɔgɔn tɛ (a kɛcogo hakɛ ye 98%) ye, wa a kɛcogo bɛ kin ni a jɔli ye.

2. Kɔrɔɲɔgɔnma fɛɛrɛ : tigɛli-taamasenɲɛ cɛmancɛ-yɔrɔ ni janya-yɔrɔ cɛmancɛ-yɔrɔ min bɛ ɲɛda-joli kɔkan, walima sanfɛla-yɔrɔ-yɔrɔ kɛnɛma-dakun cɛtigɛcogo,

3. Ni ko gɛlɛnw don, o ye sugandili ye min tɛ mɔgɔ tɔɔrɔ ka lamina yɔrɔ dɔ bɔ ka pedicle kurukuruw don a la yeli siratigɛ la.

Angle de vis lumbar

• Sagittal plane angle : L1-L3 bɛ ni degere 5-10 ye, L4-L5 bɛ ni degere 10-15 ye.

• Plan horizontal angle : L1-4: a bɛ bɛn labanyɔrɔ ma; L5 : a bɛ jigin degere 10 la (L5 kɔkolo farikolo bɛ kɔsegin).

  
  

Lumbar spine sugandili juru

• L1～L5 mago bɛ kuru cɛmancɛ la 6,5mm, 40-45mml kuru

  
  

Opereli kɛcogo minnu ka kan ka kɛ

1. Sani opereli ka kɛ, a ka kan ka kɔkolo ɲɛda ni a kɛrɛfɛla lajɛ ka jɛya. Kɔnɔna lajɛ bɛ kurukuru jɔyɔrɔ jira ka taa a fɛ, ani kɛrɛfɛla lajɛ bɛ se ka kuru jɔyɔrɔ jira a jɔlen na.

2. Donda ka kan ka kɛ cogo bɛnnen na ani ka bonya ka ɲɛ, ani kɔkolo kolo min bɛ ankɔri yɔrɔ la, o bɛ se ka bɔ ni piramidi kɛrɛ saba walima rongeur dabɔli ye.

3. I kɛlen kɔ ka sira bɛɛ lajɛlen dɔn, i bɛ fanga bɛnnen kɛ walasa ka kafoda da wuli ka ɲɛ. Blunt-tip sonda man kan ka kunbɛncogo jɛlen sɔrɔ pikirijikɛlan dontuma na. 'dɛsɛ' walima barika kɛlɛli hakilina man kan ka kɛ. Ni rezisti sɔrɔla 5~15mm fɔlɔ la, a ka kan ka kɛ waati bɛnnen na. Aw bɛ pikirijikɛlan don yɔrɔ ni a kɛrɛ ladilan. Ni aw ye kɛlɛ barikama sɔrɔ, a ka ɲi aw ka bɔ fɔlɔ ka don sira sugandi kokura. Aw bɛ aw jija ka tugu pedikili la. Pedikili kɔnɔna ye kansɛri kolo ye ani kɛnɛma ye kɔkolo kolo ye, min bɛ se ka bilasira a yɛrɛma, ni a donna yɔrɔ bɛnnen don ani ni a bonyalen don ka ɲɛ Aw bɛ aw biri 10-15° ka taa cɛmancɛ la, ka aw janto plan (yɔrɔ) la min bɛ bɛn kɔkolo sanfɛla da ma, ka sɔrɔ ka a juguman minɛ min bɛ se santimɛtɛrɛ 3 ɲɔgɔn ma. Dusukunnata nafa ka bon.

4. A nafa ka bon kosɛbɛ ka baara kɛ ni pedicle probe ye walasa ka kogo naani sɛgɛsɛgɛ, kɛrɛnkɛrɛnnenya la kɔnɔna, duguma ani duguma kogow.

5. Ni danfara min bɛ barajuru duguma ni kɔkolo kɔkanna cɛ farikolo la, o ma jɛya, aw bɛ senkɔni dɛmɛnan ni kɔkolo duguma taabolo kin, o kɔ aw bɛ bolokɔni sanfɛla yɔrɔ dɔ kin, ka sɔrɔ ka ɲɛgɛnɛsira kɔnɔna kogo ni kɔkolo dondaw lajɛ k’a ɲɛsin a ma.

6. A ka fisa ka bɔ kɛnɛma ka tɛmɛ kɔnɔna kan, ka wuli ka sɔrɔ i kana jigin; jiginni de ye koba ye, ɲɛfɛla ye farali ye; ni aw bɛ taa ɲɛfɛ ani ka sɛgɛsɛgɛli kɛ, aw bɛ jɔ ni aw ye gɛlɛya ye, aw bɛ aw ladilan waati kɔnɔ, aw bɛ bolokɔni fanga dɔrɔn de kɛ, aw kana a wuli ni fanga ye.

7. Kurukuru janya man kan ka tɛmɛ 83% kan pedikili kɛnɛma sɔgɔsɔgɔninjɛ cɛmancɛ la.

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