Aleke wotsɔa pedicle screws dea eme?

Pedicle screw placement mɔnu .

1. Teƒe si wogena ɖo: kɔ, akɔta kple akɔta to vovo;

2. Lé yameʋu ƒe dzogoe si le tsia dzi (TSA) kple Sagittal Plane Angle (SSA) si le screw entry me la ɖe asi: Woate ŋu adzidze TSA ƒe dzogoe la tso CT film la me. Ƒomedodo aɖe le SSA la kple ŋutilã ƒe nɔnɔme dome, eye woate ŋu atsɔ C-arm la akpɔ edzi le dɔwɔwɔ nɛ me.

3. Goglome: Screw la ƒe didime ɖoa 80% le pedicle axis ƒe didime me be woakpɔ biomechanical strength si sɔ, eye ele bɔbɔe be woage ɖe cortical bone me eye wòagblẽ nu le ʋukawo ŋu ne edidi akpa.

4. Didime: Tso aŋea dede teƒe dzi va ɖo 83% le vertebral ŋutilã ƒe ŋgɔgbe lãkusi ƒe didime bliboa me.

Vidzidɔ ƒe Akɔta .

Cervical pedicle screw ƒe tsɔtsɔ de eme ƒe mɔnu .

Mɔnu si wotsɔ dea aŋenu me .

Fifia la, mɔnu vevi siwo wozãna tsɔ dea aŋea mee nye: Abumi mɔnu, ŋutilã ƒe nɔnɔme ƒe dzesi ƒe nɔƒe ƒe mɔnu, nɔnɔmetata ƒe teƒeɖoɖo ƒe mɔnu, kple bubuawo.

Vidzidɔ ƒe Akɔta ƒe gege ɖe teƒe .

• Le 5mm ƒe tsatsam le fli si le tsia dzi le C2 axis ƒe lamina ƒe go si le etame kple 7mm le aklã ƒe mɔ̃a ƒe titina ƒe nugbɔ le gota la te.

• C3-C6 Titina titina 1/4 ƒe fli si le tsia dzi ƒe nutome kple titina gota 1/4 fli si le tsitrenu le axadziblɔa ƒe megbe.

• C7 Axadzi ƒe titina ƒe fli si le tsitrenu kple titina titina 1/4 si le tsia dzi ƒe tsatsam le etame la le etame.

  
  

Vidzidzi ƒe akɔtaƒu ƒe dzogoe ene .

• C2 ƒe ʋuʋudedi 20-25° ƒe ʋuʋudedi 10-15°

• C3-C6 incline 40-45°, yameʋu si le tsia dzi la sɔ kple nuwuƒe siwo le etame kple esiwo le ete .

• C7 inclination 30-40°, yameʋu si le tsia dzi la sɔ kple etame kple ete ƒe nuwuƒewo .

  
  

vidzidɔ ƒe akɔta ƒe ʋuƒo .

• C1マC5 hiã gavi siwo ƒe didime nye 3.5mm eye woƒe goglome nye 20mm .

Ne Atlas la ƒe megbeti ƒe kɔkɔme mede 4mm o la, wotrɔnɛ wòzua lateral mass screw.

Ne axis ƒe pedicle ƒe kɔkɔme alo kekeme mede 5mm o la, woɖo aɖaŋu be woatrɔ ɖe lateral mass screw fixation ŋu.

Cervical lateral mass screw placement .

Magerl ƒe Mɔnu : Screw ƒe gege ɖe teƒe si wogena ɖo la le 1-2mm le axadzigli ƒe megbegli ƒe titina dzi; Screw ƒe gege ɖe eme ƒe mɔfiame nye 25-30° si le axadzi, eye ta la le 30° (sɔ gbɔ ɖe abɔta ƒe akpa si le etame), eye woɖe akpa si le ŋgɔgbekpa dzi; Goglome dzidzedze le screwing le 3.5mm cortical bone screws megbe.

Roy-Camille Method : Screw entry point la le axadzi ƒe akpa si le megbe la titina; Screw ƒe gege ɖe eme ƒe mɔfiame nye 10° le axadzi, woɖea megbeƒu si le tsitrenu la, eye woɖea lãkusi si le ŋgɔgbea; Ne woɖi vɔ la, wotsɔa 3.5mm cortical bone screw ƒoa nu ɖe ​​eme.

Anderson ƒe Mɔnu : Screw ƒe gege ɖe teƒe si woge ɖo la le 1mm le axadzi ƒe titina ƒe titina, screw ƒe gege ɖe eme ƒe mɔfiame nye 20° le axadzi, eye ta la kɔ 20° va ɖo 30° be woatsɔ aku doa, eye woaku tsi si le ŋgɔgbea me.

Nuteƒekpɔkpɔ Kpuie .

(1) Ele be woalé ŋku ɖe gavi si wotsɔ dea ame me ƒe dedienɔnɔ ŋu etɔxɛe. Ele be amekolaa natia mɔnu si sɔ le vidzidɔ ƒe wɔwɔme kple pedicle screw mɔnu ƒe aɖaŋudzedze nu.

(2) lateral mass screw fixation le C3-C6 ƒe akpaa me le bɔbɔe wu eye wòle dedie wu pedicle screw fixation.

(3) Dɔwɔnua mate ŋu age ɖe lãkusia ƒe gotagli la me o, ne menye nenema o la, agblẽ nu le lãmeka siwo te ɖe eŋu kple ʋukawo ŋu.

(4) Ele be dzogoe si dzi woatsɔ gavi ade la nato vovo kple dzogoe si dzi wotsɔ akɔtaƒua ɖo.

(5) Ele be woaƒo asa na ƒu si le lãkusia me ƒe gege ɖe akɔta ƒe ŋutilã ŋgɔ.

(6) fluoroscopy si wowɔna le dɔwɔwɔ me ate ŋu ake ɖe akɔta ƒe ŋutilã kple akɔta ƒe akpa si le akɔta ŋu nyuie, eye woade gavi siwo wotsɔ dea eme pɛpɛpɛ be woatsɔ axe mɔ na ʋuʋudedi ɖe akɔta dome teƒe kple aklã ƒe ʋuka me.

Akɔtaɖonu .

Needle ƒe gege ɖe eme ƒe teƒe:

1. Margel kple Roy Camille tsɔ fli si le tsia dzi le titina ƒe ɖoɖoa ƒe fli si le tsia dzi ƒe tsatsam kple fli si le gota le gota gome le abɔta ƒe dɔwɔwɔ si le etame la me abe teƒe si wogena ɖo ene.

2. Ebraheim do susua ɖa be T1-T2 ƒe pedicle ƒe titina le 7-8 mm le gota gome ƒe go si le abɔta ƒe dɔwɔwɔ me, eye 3-4 mm le titina ƒe ɖoɖoa ƒe titina. ~8mm.

3. Kpa fli si le tsitrenu 3 mm le ƒunukpeƒea ƒe titina ƒe titina, eye nàta fli si le tsia dzi tso gɔmeɖoanyia ƒe gɔmeɖoanyi ƒe akpa 1/3 si le tsia dzi la me, eye fli eveawo ƒe tsatsame nye ɖa ƒe gege ɖe eme ƒe teƒe.

4. Le titina fli ƒe didime ƒe fli si le abɔta ƒe dɔwɔwɔ si le anyime kple fli si le tsia dzi le titina ƒe ɖoɖoa ƒe titina ƒe fli si le tsia dzi ŋu la, 1 mm le akpaa te;

5. Le nɔnɔme sesẽwo me la, enye tiatia si le dedie be woaɖe lamina kple implant pedicle screws ƒe akpa aɖe ɖa le nukpɔkpɔ tẽ me.

Akɔta ƒe akɔta ƒe dzogoe si wotsɔ dea eme .

Sagittal plane : Pedicle ƒe ŋgɔgbedede dzi ɖe kpɔtɔ tso T1 va ɖo T12. T1: 25°; T2: 20°; T3: 15°; T4-9: 10°; T10: 5°; T11-12: 0°.

Ele be akɔta ƒe akpa si le etame ƒe pedicle screws la ƒe dzogoe nanye 10-20° kple sagittal plane, eye ele be pedicle screws siwo le thoracic vertebrae si le titina kple ete la ƒe ŋgɔgbe kple anyime ƒe dzogoe nanye 0-10° kple sagittal plane. Ebraheim do susua ɖa be ele be T1 kple T2 pedicle screws nanye 30-40° ƒe ŋgɔgbedede kple sagittal plane, T3-T11 nanye 20-25°, eye T12 nanye 10°.

Horizontal Plane : Ele be wòasɔ kple nuwuƒe siwo le etame kple esiwo le ete.

Akɔta ƒe Akɔta ƒe Tiatiawɔnu .

• T1 she hiã screw diameter 3.5マ4.0mm .

• T6ゞT10 hiã 4.0—5.0mm .

• T11, T12 hiã 5.5mm .

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Le ame tsitsiwo gome la, akɔta ƒe pedicle screw ƒe didime mede 5mm o, eye afɔku li be woagbã screw. Le akɔta ƒe titina ƒe akɔta ƒe akpa geɖe la, womate ŋu atsɔ gavi siwo lolo wu milimeta 5 o, si ate ŋu ana pedicle nagbã bɔbɔe.

Agbalẽnyala aɖewo zãa pedicle la ƒe axadzi, si kpɔa kuxi sia gbɔ nyuie ŋutɔ. Zi transverse process la ƒe nugbɔ dzi be nàge ɖe pin la me, eye transverse process la ƒe titina le tsia dzi. Trɔ do sue aɖe gbã, eye awl la ƒe mɔfiame do go kple akɔta ƒe akpa si le axadzi ƒe akpa si le axadzi. Dzogoe si dzi sagittal plane le la nye dzidzenu 25-40, eye degree la dzina ɖe edzi vivivi tso T12 dzi.

Screw si wotsɔ de eme la ato transverse process, costotransverse process ƒe akpa aɖe, costostotebral joint, kple vertebral body ƒe axadzigli la me. Esi wònye be mɔ si dzi wotsɔa ga ƒoa nui la le facet joint la godo ta la, manya wɔ be woage ɖe spinal canal, si le dedie wu la me o. Tsɔ kpe ɖe eŋu la, dzogoe si le ŋgɔgbea ƒe dzidziɖedzi nana gavi la didi wu. , si le kpekpem wu la, wodzia fixation strength ɖe edzi, in implantation angle range la lolo, woate ŋu aɖo screws la ɖe line me, eye kpekpea sɔ wu.

Lumbar Spine .

Lumbar ƒe gege ɖe eme ƒe teƒe .

1. Needle Insertion Method at the apex of the Herringbone Ridge (kpeɖeŋunu ƒe dɔwɔwɔ ƒe ƒuƒoƒo si le articular process ƒe ke ƒe megbekpa dzi kple isthmus ridge ƒe megbe gome), teƒe sia ƒe tɔtrɔ le sue (edzɔ ƒe agbɔsɔsɔme nye 98%), eye wotsɔa kpeɖeŋutɔ ƒe dɔwɔwɔa ƒua gbe.

2. Mɔnu si dzi woato ado go: axis si le tsia dzi ƒe titina fli ƒe nutome kple didime ƒe axis si le akpaa ƒe ƒuƒoƒoa godo, alo abɔta ƒe dɔwɔwɔ si le etame ƒe gota gome, .

3. Le nɔnɔme sesẽwo me la, enye tiatia si le dedie be woaɖe lamina kple implant pedicle screws ƒe akpa aɖe ɖa le nukpɔkpɔ tẽ me.

Lumbar Screw ƒe dzogoe .

• Sagittal plane angle : L1-L3 ƒe inversion degree 5-10, L4-L5 ƒe inversion degree 10-15 le esi.

• Dzogoe si le tsia dzi : L1-4: si sɔ kple nuwuƒea; L5: 10 degrees of downward inclination (L5 vertebral body backward).

  
  

Lumbar Spine Selection Screw .

• L1 she hiã screw diameter 6.5mm, 40-45mml screw .

  
  

Amekoko ƒe afɔɖeɖewo .

1. Hafi woawɔ dɔ nɛ la, ele be akɔta ƒe akɔta ƒe akpa si le ŋgɔgbe kple axadzi si me kɔ nanɔ anyi. Nukpɔkpɔ si le ŋgɔgbea ɖea afisi gavi la le le mɔ si le tsia dzi la fiana, eye axadzinukpɔkpɔa ate ŋu afia afisi gavi la le le nɔnɔme si le tsitrenu la me.

2. Ele be afisi woage ɖo la nade pɛpɛpɛ eye woakekee ɖe enu wòasɔ, eye woate ŋu aɖe ƒu si le sekea teƒe la ɖa to dzogoe etɔ̃ ƒe piramid alo rongeur la ƒe ʋuʋu me.

3. Ne ènya mɔfiame si le gbadzaa vɔ la, zã ŋusẽ si sɔ nàtsɔ aʋu nutome suea nyuie. Mele be blunt-tip probe la nado go tsitretsitsi si dze ƒã le aŋe dede me o. Mele be gɔmesese aɖeke nanɔ 'failure' alo tsitretsitsi kpata ŋu o. Ne wodo go tsitretsitsi le 5 ~ 15mm gbãtɔ me la, ele be wòasɔ ɖe ɣeyiɣia nu. Trɔ asi le aŋea ƒe gege ɖe eme kple dzogoe ŋu. Ne èdo go tsitretsitsi sesẽ la, wokafui be nàdo le eme gbã eye nàgatia mɔ si dzi nàto age ɖe eme. Kpɔ egbɔ be yewɔ ɖe pedicle la ƒe mɔfiame dzi. Pedicle la ƒe eme nye cancellous bone eye gota gome nye cortical bone, si woate ŋu afia mɔe le eɖokui si vie, nenye be teƒe si woge ɖo la de pɛpɛpɛ eye wòkeke ɖe enu nyuie ko; Miɖo 10-15° ɖe titina fli la dzi, lé ŋku ɖe yameʋu si sɔ kple akɔta ƒe akpa si le etame la ŋu, eye wòalé goglome si ade 3cm. Seselelãme le vevie.

4. Ele vevie ŋutɔ be woazã pedicle probe la atsɔ aku nu me le gli eneawo ŋu, vevietɔ gli siwo le eme, esiwo le ete kple ete.

5. Ne ŋutilã ƒe vovototo si le akɔta kple akɔta ƒe akɔta ƒe akpa si le anyime dome mekɔ o la, ɖua kpeɖeŋutɔ ƒe dɔwɔwɔ kple abɔta ƒe akpa si le ete, eye emegbe wòɖua abɔta ƒe akpa si le etame la ƒe akpa aɖe, eye wòléa ŋku ɖe pedicle ƒe gli ememetɔ kple afɔti ƒe mɔnu ŋu tẽ.

6. Anyo be nàdo go wu le eme, yi dzi eye mègaɖiɖi o; Trɔtrɔe nye nu vevitɔ, eye ŋgɔgbee nye kpeɖeŋutɔa; Ne èle ŋgɔ yim hele nu me kum la, tɔ te ne èkpɔe sesĩe, trɔ asi le eŋu le ɣeyiɣi me, zã asibidɛ ƒe ŋusẽ ko, mègatrɔ asi le eŋu sesĩe o.

7. Mele be gavi la ƒe didime nawu 83% le eƒe gotagome lãkusi si le pedicle la me o.

Ale Si Nàƒle Ƒumeŋutinunya Kple Ƒumeŋuɖuiwo ƒe Dɔwɔnuwo)

na . CzmediTech , Míekpɔa atike ƒomevi aɖe si de blibo ŋutɔ le ƒumeŋutinunya ƒe dɔwɔwɔ na ame ƒe ŋutilã kple dɔwɔnu siwo sɔ kplii ŋu, atikeawo dometɔ aɖewoe nye . Akɔta ƒe nusiwo wotsɔ dea akɔtae ., Intramedullary ƒe ɖawo ., nuveviwɔame ƒe agbalẽvi ., Locking Plate ., Tagbɔ-maxillofacial ., Ametia ƒe akpa aɖe ., Ŋusẽ Dɔwɔnuwo ., External fixators ., Arthroscopy ., Lãwo ƒe dɔlélewo gbɔ kpɔkpɔ kple woƒe dɔwɔnu siwo kpena ɖe wo ŋu.

Tsɔ kpe ɖe eŋu la, míeɖoe kplikpaa be míayi edzi anɔ atike yeyewo tum ɖo eye míakeke atikewo ɖe enu, ale be míakpɔ ɖɔkta kple dɔnɔ geɖe ƒe amekoko ƒe nuhiahiãwo gbɔ, eye míana míaƒe dɔwɔƒea hã nakpɔ hoʋiʋli geɖe wu le xexeame katã ƒe ƒumeŋutinunya kple dɔwɔnuwo ƒe dɔwɔƒe bliboa me.

Míeɖoa wo ɖe xexeame katã, ale be nàte ŋu awɔ . Ka ɖe mía dzi le email adrɛs song@orthopedic-china.com hena nyayɔyɔ femaxee, alo ɖo gbedasi ɖe WhatsApp hena ŋuɖoɖo kaba +86- 18112515727 .

Ne èdi be yeanya nyatakaka bubuwo la,zi edzi CzmediTech be nàkpɔ nyatakaka bubuwo.