Mía Ŋu Nya
Changzhou Meditech Mɔ̃ɖaŋununya Co., Ltd., si le Changzhou Science & Education Town, Jiangsu nuto me,isspecialized le ƒumeŋuɖui dede kple dɔwɔnuwo wɔwɔ me.
Le ƒe 10 kple edzivɔ ƒe numekuku kple ŋgɔyiyi megbe la, Míekpɔa nu vevi 10 siwo kplɔ wo nɔewo ɖo eye wonye aklã ƒe ɖoɖo, intramedullary nail system, trauma plate kple screw system, locking plate kple screw system, CMF system, gotagome fixator system, atikewɔŋusẽ dɔwɔnu ɖoɖo, amekoko dɔwɔnuwo ƒe ɖoɖo si le gbadzaa, sterilization nugoe ɖoɖo kple lãwo ƒe ƒumeŋutinunya ƒe ɖoɖo.
Abe atikewɔnuwo dzrala si si ƒe ewo kple edzivɔ ƒe nuteƒekpɔkpɔ le ene, eye CE kple ISO ɖaseɖigbalẽwo le mía si ta la, woɖo míaƒe nuawo ɖe dukɔ geɖe abe USA, Germany, Argentina, Chile, Mexico, India,Thailand, Malaysia, Turkey, Egypt, South Africa, Ivory Coast, kple bubuawo ene.
Le gɔmeɖose si nye 'nyonyo gbã, subɔsubɔdɔ gbã, Numekuku kple Dɔwɔnawo gbã, nu yeyewo dodo ɖe ŋgɔ gbã', míaƒe dɔwɔƒea xɔa ŋkɔ nyui aɖe le dukɔa me kple duta siaa. Dɔwɔƒea bua viɖekpɔkpɔ na dɔnɔwo be enye yeƒe taɖodzinu si anɔ anyi ɖaa eye wòdzea agbagba madzudzɔmadzudzɔe ɖe amegbetɔ ƒe lãmesẽ ta.
Amekoko le Akɔta ƒe Amekoko
Amekoko ƒomevi geɖe li le aklã me, vevietɔ womewɔa dɔ boo aɖeke o eye woʋuna. Woate ŋu awɔ dɔ na akɔta ƒe gbagbã aɖewo, disk ƒe ʋuʋu, aklã me yɔmekpe, scoliosis to amekoko me. Amekoko si me womezãa nu boo aɖeke le o koŋue nye: vertebroplasty, radiofrequency ablation, endoscopic nucleus pulposus removal, percutaneous pedicle screw rod internal fixation, etc. Amekoko le gaglãgbe koŋ lɔ open reduction kple ememe fixation, laminectomy, open decompression kple internal fixation, kple bubuawo ɖe eme Eye míato esiawo vɛ ɖekaɖeka:
A. Vidzidɔ ƒe ƒunukpeƒetetedɔ
Le vidzidɔ ƒe lãkusi ƒe ʋuʋu, vidzidɔ ƒe ƒunukpeƒetetedɔ, kple vidzidɔ ƒe akɔta ƒe megbeƒu didi ƒe ƒu ƒe ʋuʋu gome la, kɔdzi alo ɖɔkta aɖewo wɔa dɔ na wo le ŋgɔgbe alo megbe kokoko. Le nyateƒe me la, amekoko ƒomevi geɖe li nàte ŋu atia. Nuteƒekpɔkpɔ geɖe le amewo si le amekoko siawo ƒomevi me, siwo woate ŋu azã le mɔ si sɔ nu le nɔnɔme vovovowo nu, mɔ̃ɖaŋununya, nɔnɔme, kple susu kpui aɖeke manɔmee, eye wonaa amekoko ƒomevi vovovowo ƒe viɖewo katã wɔa dɔ bliboe. Le vidzidɔ ƒe ƒunukpeƒetetedɔ sesẽ gome la, decompression kple fixation to ŋgɔgbe kple megbe mɔnuwo siaa dzi ate ŋu aɖe kɔdziyiyi ƒe ɣeyiɣia dzi akpɔtɔ ŋutɔ, eye decompression blibo ƒe ŋusẽkpɔɖeamedzi nyo wu.
Anterior cervical decompression kple fusion kple ƒu si wodo ɖe lãme na ame kple ememe fixation:
Ewɔa dɔ na vidzidɔ ƒe spondylosis kple intervertebral discand ƒe nutete ƒe akpa kpuiwo (teƒe 1-3) ƒe dodo le spur numiemiewo me. Viɖe le eŋu be woɖea abi la ɖa tẽ, si le bɔbɔe vie eye wòsɔna. Enye dɔwɔwɔ na ame edziedzi wu eye wònye mɔnu vevitɔ si wozãna tsɔ daa vidzidɔ ƒe ƒunukpeƒetetedɔ.
Vidzidɔ ƒe megbedede ƒe ʋuʋu kple laminoplasty: .
Ewɔa dɔ ɖe vidzidɔ ƒe ƒunukpeƒetetedɔ si me akɔta ƒe ʋukawo dome ʋuka ƒe nutete kple aklã ƒe mɔ̃ ƒe ʋuʋu ƒe xexlẽme kple eƒe akpa aɖe le, kpakple ŋgɔgbe ƒe ʋuʋu sesẽ (ossification of posterior longitudinal ligament, intervertebral disc). Enye decompression si metso tẽ o, si ƒe viɖee nye be ekpɔa vidzidɔ ƒe ʋuʋu ƒe dɔwɔwɔ ta eye wòle dedie vie.
Vidzidɔ ƒe disk si wowɔ kple asi ɖɔliɖɔli: .
Ewɔa dɔ na dɔnɔ siwo mexɔ ƒe 60 haɖe o siwo ƒe akpa kpui aɖe le ŋgɔgbe ƒe akɔtaƒuwo dome. Togbɔ be eɖea aklã ƒe tete ɖa eye wòɖea eƒe nutete dzi kpɔtɔna hã la, eléa vidzidɔ ƒe akɔta ƒe dɔwɔwɔ ɖe te, eɖea alesi wòate ŋu adzɔe be wòana akpa siwo te ɖe wo nɔewo ŋu ƒe gbegblẽ kabakaba dzi kpɔtɔna, ale be dɔnɔwo nate ŋu aʋuʋu kaba le amekoko vɔ megbe eye dɔwɔwɔa te ɖe ŋutilã ƒe nɔnɔme ŋu wu.
Akpa gbãtɔ ƒe ŋgɔgbe kple megbe vidzidɔ ƒe decompression kple fixation
Decompression nye blibo eye mele dedie o, esɔ na vidzidɔ ƒe ƒunukpeƒetetedɔ sesẽ kple etɔxɛ. Le vidzidɔ ƒe ƒunukpeƒetetedɔ si me clamp type alo long segment spinal stenosis kple ŋgɔgbe ƒe nutete gã aɖe le gome la, seɖoƒe aɖewo li le ŋgɔgbe alo megbe dɔwɔwɔ ɖeɖeko me. Míexɔa nɔnɔme si me míenɔa anyi ɖo hena megbedɔwɔwɔ, eye emegbe míexɔa nɔnɔme si me míenɔa anyi ɖo hena ŋgɔdonya ƒe dɔwɔwɔ, kple afɔɖeɖe gbãtɔ ƒe ŋgɔgbe kple megbe ƒe decompression.
Viɖe siwo le eŋu : Ne woɖe megbe ƒe tete ɖa vɔ la, vidzidɔa ƒe aklã ate ŋu adzo ayi megbe, teƒe si le vidzidɔa ƒe aklã ŋgɔ dzina ɖe edzi vie, eye nyaƒoɖeamenu si le aklã ƒe mɔa me dzi ɖena kpɔtɔna, si wɔnɛ be afɔku si le ŋgɔdonyawo me dzi ɖena kpɔtɔna. Le ɣeyiɣi ma ke me la, akpa eve ƒe nutetea dzi ɖena kpɔtɔna, woɖea nutetea ɖa keŋkeŋ, ŋusẽ si wòkpɔna ɖe ame dzi dzena, eye wòkpena ɖe ame ŋu le aklã ƒe dɔwɔwɔ ƒe hayahaya me; eɖea dɔnɔwo ƒe vevesese dzi kpɔtɔna eye wònɔa bɔbɔe na dɔnɔwo be woalɔ̃ ɖe edzi. Eƒoa asa na kuxi siwo dona tso kɔdziyiyi zi eve, amekoko evelia, dɔléle si nɔa anyi didi, eye wòɖea kɔdziyiyi ƒe gazazãwo dzi kpɔtɔna.
Megbe vidzidɔ ƒe foraminal decompression kple discectomy
Ne wotsɔe sɔ kple ŋgɔgbe mɔnu la, megbe vidzidɔ ƒe foraminal decompression mehiã be woatsɔ ƒu aƒo ƒu o eye mebua vidzidɔa ƒe akɔta ƒe ʋuʋu ƒe didime o. Wowɔa posterolateral cervical disc herniation nucleus pulposus ɖeɖeɖa to megbe mɔnu dzi le nukpɔkpɔ tẽ te eye wòle bɔbɔe vie, eyata ele dedie eye kakaɖedzi le eŋu. Nusiwo woate ŋu afia: akɔta ƒe ʋuka ƒe ʋuʋu le megbe, akɔta dome ʋuka ƒe ʋuʋu le ɖoƒe ɖeka, akɔta dome ʋuka ƒe ʋuʋu le ɖoɖo geɖe nu si me titina aklã ƒe mɔ ƒe ʋuʋu mele o, kple ke ƒe dzesi siwo nɔa anyi ɖaa le ŋgɔgbe ƒe lãkusi ɖeɖeɖa kple fusion megbe.
Amekoko na kɔ ƒe akpa si le etame ƒe dɔléle
Nuveviwɔame kple dɔléle siwo le vidzidɔa ƒe akpa si le etame ate ŋu ana aklã ƒe dɔmawɔmawɔ nyuie vevie. Le ŋutilã ƒe wɔwɔme si sesẽ ta la, kɔdzi akpa gãtɔ mate ŋu ada wo o. Le kpɔɖeŋu me, woate ŋu azã atlantoaxial fracture and dislocation, atlanto occipital malformation, kple rheumatoid upper cervical spondylopathy, anterior release kple posterior fixation atsɔ aɖe ʋuʋu dzi akpɔtɔ, aɖe aklã ƒe tete dzi akpɔtɔ, eye wòaɖe amewo ƒe agbe.
B.Akɔta ƒe ʋuʋudedi, akɔta ƒe akɔta ƒe ʋuʋu, akɔta ƒe ƒunukpeƒetetedɔ, akɔta ƒe vevesese si tso discogenic
Intervertebral fusion mehiã be woaɖe akɔtaƒu ɖa le akɔta ƒe akɔta ƒe ʋuʋu alo akɔta ƒe ƒunukpeƒetetedɔ si susu vovovowo hena vɛ ta o. Taɖodzinu gbãtɔ si le amekokoa ŋue nye be woaɖe lãmekawo ƒe tete ɖa. Ne akɔta meli ke o la, wokpɔa akɔta ƒe fusion le alesi gbegbe meli ke o kple alesi gbegbe akɔta ƒe ʋuʋudedi le nu. Wotiaa posterolateral spinal bone graft (PLF) alo interbody bone graft (PLIF) le nenye be esɔ na pedicle screw internal fixation nu. Le PLIF me la, wozãa vertebral arch bliboa si woɖe kple inferior articular process complex (median incision) abe interbody bone graft fast ene, si menye ɖeko wòkpɔa ƒu si wodona ƒe nu nyuitɔ kekeake ko o, ke eƒoa asa na ƒu ɖeɖe tso akɔta alo be woaƒle interbody fusion cage hã, si ɖea kuxi siwo dona tso ƒu ɖeɖeɖa me ɖa eye wòɖea dɔwɔwɔ ƒe gazazã dzi kpɔtɔna ŋutɔ.
Le dɔléle ƒomevi vovovowo nu la, wotiaa fenestration of nucleus pulposus, laminectomy kple discectomy (ɣeaɖewoɣi kple ƒu ƒe ƒoƒo ƒe fusion kple ememe fixation) kple artificial disc replacement.
Woate ŋu aɖe aklã ƒe mɔ kple lãmeka ƒe ke ƒe ʋuʋu dzi akpɔtɔ. Le dɔnɔ siwo ƒe aklã meli ke o gome la, ele be woawɔ dynamic fixation alo fusion fixation tiatiatɔe, ale be dɔnɔwo nate ŋu aɖo atikewɔwɔ ƒe taɖodzinua gbɔ le ga suetɔ kekeake me eye woakpɔ emetsonu siwo ana dzidzeme wo.
1) Dynamic fixation of lumbar spine - menye ɖeko wònaa akɔta la li ke o, ke eléa akɔta ƒe ʋuʋu ƒe dɔwɔwɔ hã me ɖe asi. Viɖe siwo le eŋu dometɔ aɖewoe nye: (1)ate ŋu aɖe akɔta ƒe lãkusi ƒe nyaƒoɖeamenu dzi akpɔtɔ ŋutɔ eye wòaxe mɔ ɖe akɔta dome lãkusi ƒe gbegblẽ nu; (2)Elastic kadodoa léa be eye wògbugbɔa akpa etɔ̃ ƒe dadasɔ si le ʋuʋu ƒe akpaa me la ɖoa anyi.
2) Minimally invasive spinal canal decompression surgery with muscle integrity preserved - amekokomɔnu deŋgɔ aɖe si woto vɛ tso duta. Ne wogawɔ ŋgɔyiyi bubuwo vɔ la, woɖea lãmeka sue aɖe, meɖea lãmekawo o, eléa lãkusiwo kple akɔtaƒuwo ƒe nɔnɔme me ɖe asi, eye kakaɖedzi blibo le ne woɖe asi le eŋu le ahuhɔ̃e si lolona kple nusuekpɔmɔ̃ te, megblẽa nu le akɔta ƒe liƒo ŋu o, eye dɔwɔwɔ vɔ megbe wɔa nu bɔbɔe. Dɔnɔwo ateŋu azɔ le ŋkeke evelia dzi, eye woadzo le kɔdzi le ŋkeke 5-7 megbe.
Enye dzesi nyuitɔ kekeake na decompression kple reduction, bone graft fusion, kple pedicle internal fixation. Enye amekoko ƒomevi si bɔ wu hã si me wozãa titanium plate fixation. Amekokoa sesẽ eye wòlolo ŋutɔ. Nusi gbɔ spondylolisthesis tso alo eƒe gɔmedzedze, si nye lumbar spondylolysis, gbɔ kpɔkpɔ le bɔbɔe wu le ɣeyiɣi aɖe megbe.
1) Akɔta ƒe ƒunukpeƒetetedɔ ate ŋu atso akɔta ƒe akpa aɖe (isthmus, ƒunukpeƒe suewo) ƒe gbagbã le ɖeɖiteameŋu ta le kamedede enuenu ta. Ne meda gbe le eŋu o la, be woaxe mɔ ɖe akɔta ƒe ƒunukpeƒetetedɔ nu, vevietɔ ne dzesiawo dze ƒã la, woate ŋu azã ƒu si wodo ɖe ƒunukpeƒea ŋu atsɔ adzra ƒunukpeƒea ɖo, gavi eve kple titanium ka, si le bɔbɔe eye wòle dedie.
2) Wotsɔ amekoko ƒe ʋuʋu dzi ɖeɖe kpɔtɔ, intervertebral bone graft fusion (PLIF), kple pedicle internal fixation da akɔta ƒe ƒunukpeƒetetedɔ. Taɖodzinu gbãtɔ si le amekokoa ŋue nye be woaɖe lãmekawo ƒe tete ɖa. Ne wowɔ PLIF peek lumbar fusion cage la, wozãa vertebral cage arch bliboa kple inferior articular process complex (median incision) abe interbody bone graft kabakaba ene, si menye ɖeko wòate ŋu akpɔ ƒu graft material nyuitɔ kekeake ko o, ke aƒo asa na ƒu ɖeɖe tso pelvis alo be wòaƒle interbody fusion device (interbody fusion cage), aɖe kuxi siwo dona tso ƒu ɖeɖeɖa me hã ɖa, eye wòɖea dɔwɔwɔ ƒe gazazã dzi kpɔtɔna ŋutɔ.
Discogenic akɔta ƒe vevesese
Wotia akɔtaɖonu si me ŋusẽ le, disk si wowɔ kple asi ɖɔliɖɔli kple ŋutilãwo dome fusion (ŋgɔgbe alo megbe).
C. Akɔta ƒe gbagbã
Tso vidzidɔa ƒe akpa si le etame ƒe gbagbã dzi va ɖo akɔtaƒu ƒe gbagbã dzi la, woxɔa ŋgɔgbe alo megbe ƒe decompression kple akɔta ƒe ƒoƒo ɖe teƒe ɖeka.
1. Dɔwɔwɔ me myelography kple transpedicular decompression
Le akɔta ƒe gbagbã dzi ɖeɖe kpɔtɔ, decompression kple ememe fixation me la, woate ŋu alé ŋku ɖe decompression ƒe ŋusẽkpɔɖeamedzia ŋu nyuie be woaɖe iatrogenic abixɔxɔ dzi akpɔtɔ.
2. Minimally invasive percutaneous kyphoplasty hena ame tsitsiwo ƒe akɔta ƒe ʋuʋu ƒe gbagbã dada
Ƒumeŋuɖui ƒe aŋe ɖeka koe woate ŋu ado. Enye mɔ̃ɖaŋununya ŋutɔŋutɔ si mewɔa nu boo aɖeke o si ɖea vevesese dzi kpɔtɔna eye wòfɔna tso aba dzi le amekokoa megbe ŋkeke 1-3.
D. Amekoko si me womewɔa nu boo aɖeke le o ƒe akɔta
A. Taɖodzinu si le akɔtadɔ si me womezãa nu boo aɖeke le o (MISS) ŋue nye be woakpɔ amekoko ƒe atikewɔwɔ si bɔ ƒe ŋusẽkpɔɖeamedzi gbɔ eye woaɖe amekoko ƒe nuveviwɔame dzi akpɔtɔ alesi woate ŋui, ale be woaɖe kuxiwo, ʋu si dona le amekoko me, kɔdzi nɔnɔ, kple bubuawo dzi akpɔtɔ, ale be dɔnɔwo nate ŋu ahaya eye woatrɔ ayi agbe si sɔ me ahawɔ dɔ kaba ale si woate ŋui.
Amekoko si me womezãa nu boo aɖeke le o koŋ ƒe akpa aɖewoe nye:
Mɔ̃ɖaŋununya si wozãna tsɔ léa ŋku ɖe dɔlékuiwo ŋu
Spinal endoscopy fia be amekola, le X-ray alo mɔzɔzɔ ƒe mɔfiafia te le dɔwɔwɔ nɛ me, zãa dɔwɔnu siwo kekea tomenuwo ɖe enu tsɔ doa to tso ŋutigbalẽa dzi yia aklã ƒe abiwo gbɔ, ɖoa dɔlékuiwo ƒe dɔwɔwɔ ƒe mɔnuwo kple amekoko ƒe mɔnuwo, zãa tsi abe nusi woatsɔ awɔ dɔe ene, doa ememe emetsonuwo kple abiawo ɖe edzi heɖea wo fiana le screen si woɖena fiana si ƒe nɔnɔme deŋgɔ dzi to endoscopic system la dzi, eye ɖɔktaa wɔa dɔ to screen la dzi nɔnɔmetata. Amekokomɔnu siwo wozãna wu dometɔ aɖewoe nye: lateral lumbar foraminal endoscopy, posterior lumbar lamina approach endoscopy, kple posterior cervical endoscopic surgery. Ne wotsɔe sɔ kple amekoko si wowɔna tsã alo amekoko suesuesuewo la, viɖe siwo gbɔna le eŋu: (1) Eƒe dzesiwo keke ta, ʋu suesuesuewo dona kple nuveviwɔame, megblẽa nu le aklã ƒe wɔwɔme si sɔ ŋu o, eye zi geɖe la, afisi wotsoe la mede sentimeta 1 o; (2) Woate ŋu atia amekoko le atike si naa alɔ̃dɔdɔ ame le teƒea me, eye kadodo le ɣeyiɣi ŋutɔŋutɔ me le ɖɔktawo kple dɔnɔwo dome be wòana dɔwɔwɔ nanɔ bɔbɔe eye woaƒo asa na abixɔxɔ le lãmekawo me le dɔwɔwɔ me; (3) Kuxi siwo mesɔ gbɔ o, hayahaya kabakaba, ate ŋu afɔ tso aba dzi le amekoko vɔ megbe, ado le eme le ŋkeke 1-2 megbe, alo amekoko le kɔdzi; (4) Dɔlékuiwo xɔxɔ ƒe agbɔsɔsɔ si mede o; (5) Woƒoa asa na kuxi si nɔa anyi ɣeyiɣi didi si nye akpa siwo te ɖe wo nɔewo ŋu ƒe gbegblẽ kabakaba le fusion kaba me. Nusiwo gblẽ le eŋu dometɔ aɖewoe nye: (1) Agbɔsɔsɔme aɖe li be dɔlélea gbugbɔna dzɔna. Ne egadze egɔme ko la, dɔwɔwɔ na ame ake asesẽ wu eye afɔku anɔ eme le abi si lé ɖe ame ŋu le dɔwɔwɔ gbãtɔa me ta. (2) Kuxi aɖewo li, abe nucleus pulposus ƒe nutete susɔea, dural kple nerve root ƒe abixɔxɔ, intervertebral space infection, ʋu ƒe dodo, seselelãme ƒe dɔmawɔmawɔ nyuie le dɔwɔwɔ vɔ megbe; (3) Amekoko ƒe dzesiwo nye ɖeka ko, vevietɔ na akɔta ƒe lãkusi ƒe ʋuʋu bɔbɔe dada. Le akɔta ƒe ʋuʋudedi si sesẽ alo aklã ƒe ʋuʋu ƒokpli gome la, woate ŋu adae hã. Ne ŋusẽkpɔɖeamedzia mede ame dzi o la, egahiã be woawɔ dɔ na ame le gaglãgbe ake.
2. Minimally invasive fusion kple ememe fixation mɔ̃ɖaŋununya
Lumbar fusion kple internal fixation nye amekokomɔnu vevi aɖe si wozãna tsɔ daa akɔtadɔlélewo. To akɔta ƒe ŋgɔgbe, ŋgɔgbe, axadzi, megbe kple megbe mɔnuwo dzi la, ƒu ƒe dodo alo fusion cage, wotsɔa facet joint kple intertransverse process dea akɔta ƒe teƒea, ale be ƒu ƒe kadodo nate ŋu adzɔ le akɔta ƒe ƒunukpeƒewo dome, si wɔnɛ be akɔta ƒe akɔta ƒe liƒo nanɔ anyi eye wòalé eme ɖe asi. Le nukpɔsusu nu la, amekoko ƒe akpaa magadzɔ ake o. Fusion kple ememe fixation mɔnu siwo me womewɔa nu boo aɖeke le o dometɔ aɖewoe nye transforaminal lumbar interbody fusion si me womewɔa nu boo aɖeke le o (MIS-TLIF) kple lateral lumbar interbody fusion (LLIF) si mewɔa nu boo aɖeke o. LLIF hã lɔ vertical lateral fusion cage (DLIF) kple oblique lateral fusion (OLIF) si ame geɖe lɔ̃a zazã wu ɖe eme. Fusion internal fixation mɔ̃ɖaŋununya si mexɔa nu boo aɖeke o la koŋ toa kekeɖenudɔ tɔxɛwo kple tubular retractors vɛ be woaɖe lãmeka falɛfalɛwo ƒe gbegblẽ dzi akpɔtɔ eye wòana woakpɔ dɔwɔwɔ ƒe teƒea nyuie wu. Ate ŋu awɔ nu aduadu kple nusuekpɔmɔ̃ si wotsɔ wɔa dɔe alo nusuekpɔmɔ̃ si loloa nu si ŋu ŋusẽ le ŋutɔ be wòana amekokoa ƒe nukpɔkpɔ ƒe akpaa nalolo, ale be wòaɖe ŋutigbalẽa ƒe lãɖeɖe kple lãmeka siwo le eme ƒe gbegblẽ dzi akpɔtɔ, eye wòana amekoko na aklã be wòawɔ atikewɔwɔ si wɔa dɔ wu la ŋudɔ eye iatrogenic ƒe nugbegblẽ boo aɖeke manɔ eŋu o. Ne wotsɔe sɔ kple amekoko si wowɔna le gaglãgbe la, mɔ̃ɖaŋununya si nye minimally invasive fusion internal fixation technology doa tso eme nyuie wu le kɔdzi nɔnɔ, ʋu ƒe gege, ɣeyiɣi si woatsɔ ahaya kple ɣeyiɣi si woatsɔ atrɔ ayi agbenɔnɔ si sɔ me. Le ɣeyiɣi ma ke me la, le dzɔdzɔme nu la, ate ŋu alé akɔta ƒe megbesɔti ƒe wɔwɔme ɖe te, aɖe lãmekawo ƒe gbegblẽ dzi akpɔtɔ, eye wòato esia me aɖe vevesese le dɔwɔwɔ vɔ megbe dzi akpɔtɔ. Fusion kple internal fixation mɔ̃ɖaŋununya si me womezãa nu boo aɖeke le o la ɖea dzesi vovovowo, siwo dometɔ aɖewoe nye aklã ƒe dɔléle vovovo siwo gblẽa nu le ame ŋu, aklã ƒe ʋuʋu, disk ƒe ʋuʋu sesẽ, malikenyenye, scoliosis, kple bubuawo.
3. Akɔta ƒe dɔwɔwɔ to ŋutigbalẽ me
Enye amekoko si me womewɔa nu boo aɖeke le o, si dometɔ aɖewoe nye percutaneous vertebroplasty (PVP) kple percutaneous balloon kyphoplasty (PKP) tɔ. Enye mɔ̃ɖaŋununya si me wodoa ƒu ƒe siminti si wowɔ le atikewɔwɔ me alo ƒu ƒe nugbagbevi siwo wowɔ kple asi la ɖe akɔta ƒe ŋutilã si ŋu dɔlélea le me to ŋutigbalẽ ƒe dodo me be woado ŋusẽ akɔta ƒe ŋutilã. Dɔléle siwo woate ŋu azã dometɔ aɖewoe nye: 1. Ƒumeŋuɖui ƒe akɔta ƒe gbagbã, si mewɔa dɔ le akɔtaɖonu alo atikewo zazã me o; 2. Dɔdzẽ siwo me dɔlékui aɖeke mele o alo dɔdzẽ vɔ̃ɖi siwo kaka ɖe akɔta ƒe ŋutilã me; 3. Akɔta ƒe gbagbã kple ƒumeŋuɖui alo nonunion le gbagbã megbe; 4. Mali ke nutete gbagbã alo multi akpa akɔta ƒe nutete gbagbã; 5. Burst fracture kple megbegli si me gblẽ o le vertebral ŋutilã. Dɔwɔwɔ sia ƒe nɔnɔmewo: 1. Dɔdamɔnu si me womezãa nu boo aɖeke le o si wozãna le atike si wua alɔ̃dɔdɔ le teƒea me la ƒe dɔwɔwɔ ƒe ɣeyiɣi kpui aɖe, lãɖeɖea le 0.5cm me, ʋu si dona le eme la nye 2-3ml, eye vevesesenutsitike ƒe ŋusẽkpɔɖeamedzia dzena. Dɔ le esi be wòaɖe vevesese dzi akpɔtɔ eye wòagbugbɔ ƒu ƒe biomechanical ŋusẽ atu ɖo le ɣeyiɣi ɖeka me. 2. Le dɔnɔ tsitsiwo kple dɔnɔ siwo gbɔdzɔ gome la, amekoko ƒe afɔkua le sue, eye woƒoa asa na kuxi siwo ate ŋu ado tso eme ne womegate ŋu ʋãna o. 3. Amekoko megbe hayahaya kabakaba eye ɣeyiɣi si woatsɔ anɔ kɔdzi hã nɔa kpuie. 4. Le vevesese dzi ɖeɖe kpɔtɔ le ɣeyiɣi nyuitɔ dzi ta la, woƒoa asa na vevesesenutsitikewo nono ƒe nugbegblẽ le ame ŋu kple atikewo zazã, eye agbenɔnɔ ƒe nyonyome nyona ɖe edzi. 5. Eɖea ɣeyiɣi si dɔnɔwo xɔna ɖe aba dzi eye wohiãa dɔnɔdzikpɔlawo dzi kpɔtɔna ŋutɔ.
4. Robot kpena ɖe ame ŋu eye wòkplɔa amekoko le aklã me
Amekoko bia be ɖɔktawo nawɔ dɔ na ame wòade pɛpɛpɛ ŋutɔ, eye vodada suesuesuewo ahe emetsonu gbegblẽwo vɛ. Le kpɔɖeŋu me, le akɔta ƒe lãkusi ƒe gavi dede mɔ̃ɖaŋununya gome la, le gavi la dede eme ƒe ɖoɖoa me la, ele be woakpɔ egbɔ be wotsɔ gavi la da ɖe ʋuƒoa me. Akɔta ƒe didime anɔ abe milimeta 8 ene, eye akɔta ƒe akpa si le eme kple esi le ete nye lãmeka ƒe wɔwɔme veviwo. Míaƒe gavi ƒe didime nye milimeta 6.5, si fia be ne gavi la nya to pedicle ƒe gli ememetɔwo kple ete ko la, lãmekawo ate ŋu agblẽ vevie. Eyata alesi wotsɔa gavi dea eme pɛpɛpɛ kple dedienɔnɔ le vevie ŋutɔ. Ƒumeŋutinunya ƒe robot kple mɔfianu si wotsɔ 3D nɔnɔmetatawo fiaa mɔe la ate ŋu aɖo gaviawo ɖe mɔ si ŋu wowɔ ɖoɖo ɖo nu, aƒo gaviawo le eɖokui si alo le wo ɖokui si ƒe afã, ana lãmeka siwo ƒo xlãe kple lãkusi falɛfalɛ bubuwo ƒe gbegblẽ dzi naɖe akpɔtɔ, eye wòakpɔ egbɔ be amekokoa de pɛpɛpɛ eye wòle dedie. Le endoscopic mɔ̃ɖaŋununya gome la, mɔfiame ƒokpli hã ate ŋu aɖe dɔwɔwɔ na ame ƒe toɖeɖe, lãmeka falɛfalɛwo ƒe gbegblẽ kple dɔnɔwo ƒe vevesese le dɔwɔwɔ na wo me dzi akpɔtɔ ŋutɔ. Robot ƒe kpekpeɖeŋu kple mɔfianu ƒe amekoko si wowɔna le aklã me zazã aɖe vi na dɔnɔ siwo ŋu aklãdɔlélewo le ŋutɔ.
Ne míagblɔe kpuie la, mɔ̃ɖaŋununya si mexɔa ame ƒe akɔta boo o ate ŋu aɖo atikewɔwɔ ƒe taɖodzinua gbɔ dedie eye wòawɔ dɔ nyuie to abi si woxɔ la dzi ɖeɖe kpɔtɔ alesi wòanya wɔe me. Togbɔ be ekpɔa ŋusẽ si sɔ alo esi nyo wu abe amekoko si wowɔna le aklã me ene hã la, ate ŋu aɖe dɔnɔwo ƒe amekoko ƒe nuveviwɔame dzi akpɔtɔ, ana woƒe hayahaya kaba, eye wòaɖe amekoko ƒe emetsonuwo dzi akpɔtɔ. Gake amekoko si me womewɔa nu boo aɖeke le o mate ŋu axɔ ɖe akɔtadɔ si wowɔna tsã la teƒe keŋkeŋ o. Ele be woatso nya me le dɔwɔwɔ ƒe ɖoɖo tɔxɛa ŋu le dɔnɔa ƒe nɔnɔme, atikewɔwɔ ƒe mɔ̃ɖaŋununya, kadodo si le ɖɔktawo kple dɔnɔwo dome kple nu bubuwo nu. Nuteƒekpɔkpɔ siwo woƒo ƒu le amekoko si wowɔna le gaglãgbe si wozãna ɖaa mee nye nusi dzi wotu amekoko si me womezãa nu boo aɖeke le o. Ne amekoko si me womezãa nu boo aɖeke le o do go kuxiwo la, ehiã be woatrɔe wòazu amekoko si woaʋu le ɣeyiɣi nyuitɔ dzi be woakpɔ egbɔ nyuie wu be dɔnɔwo le dedie eye amekokoa nawɔ dɔ nyuie wu. Mlɔeba la, ele be míaɖo ŋku edzi na dɔnɔ siwo wowɔ dɔ na be beléle nɛ nyuie kple kamedede le dzɔdzɔmeŋutinunya me le amekoko dzidzedzetɔe megbe hã le vevie ŋutɔ, si ate ŋu ana ɖɔɖɔɖo ƒe nyonyome nanyo ɖe edzi nyuie ko o, ke ate ŋu aƒo asa na akɔtadɔléle si gbugbɔgadzɔ alo esi te ɖe eŋu hã.
E. Akɔta ƒe dɔdzẽ kple dɔdzẽ
Tumor, yɔmekpe kple suppurative inflammation le vidzidɔ, akɔta kple akɔta ƒe akɔtaƒuwo me.
F. Nyataƒoƒo
1. Teƒe aɖeke meli si me ŋkuagbãtɔ le le aklãdɔdada me o
Dedienɔnɔ kple kakaɖedzi nye nu gbãtɔ si woti amekoko na aklã me. Ekpɔa aklã ƒe dɔléle siwo gblẽa nu le ame ŋu koŋ hedaa wo, abe vidzidɔ ƒe ƒunukpeƒetetedɔ, akɔta ƒe lãkusi ƒe ƒu ƒe ʋuʋu, akɔta ƒe akɔta ƒe ʋuʋu, disk ƒe ʋuʋu le akpa ɖesiaɖe tso vidzidɔ ƒe akɔta yi akɔta ƒe akɔta, kple megbeƒu ƒe ƒu ƒe ʋuʋu. Gakpe ɖe eŋu la, ekpɔa abi kple dɔléle ƒomevi ɖesiaɖe si dzɔna le aklã me hã gbɔ, abe aklã ƒe gbagbã kple eƒe ʋuʋu, aklã ƒe dɔmawɔmawɔ nyuie, aklã ƒe dɔdzẽ (gbãtɔ kple esi kaka), aklã me yɔmekpe alo suppurative infection.
2. Vidzidɔ ƒe dɔwɔwɔ si seɖoƒe meli na o
Le vidzidɔ ƒe ƒunukpeƒetetedɔ kple ƒu ƒe ʋuʋu le vidzidɔ ƒe akɔta ƒe lãkusi didi gome la, kɔdzi alo ɖɔkta aɖewo wɔa dɔ na wo le ŋgɔgbe alo megbe ko. Le nyateƒe me la, dɔwɔwɔ ƒomevi vovovowo li woatia tso wo dome - ŋgɔgbe vidzidɔ ƒe ʋuʋu kple ƒu ƒe ʋuʋu kple ememe ƒoƒo, megbe vidzidɔ ƒe laminoplasty (ʋɔtru ɖeka, ʋɔtru eve), kple afɔɖeɖe ɖeka ƒe ŋgɔgbe kple megbe ƒe ʋuʋu kple ememe ƒoƒo. Míekpɔ nuteƒekpɔkpɔ geɖe dzidzedzetɔe le dɔwɔwɔ siawo ƒomevi me, si woate ŋu azã le mɔ si sɔ nu le nɔnɔme vovovowo nu, Mexe mɔ nɛ to mɔ̃ɖaŋununya, nɔnɔme kple susu kpui aɖeke dzi o, eye wònaa fefe bliboe na viɖe siwo le mɔnu vovovowo ŋu.
3. Akɔta ƒe akɔta ƒe dɔwɔwɔ le bɔbɔe eye kakaɖedzi le eŋu
Le akɔta ƒe megbeƒu ƒe ƒu ƒe ʋuʋu, si sesẽ eye kɔdzi gã geɖe vɔ̃na na la, míewɔ akpa aɖewo ƒe megbeƒu ƒe ʋuʋu. Le dɔnɔ siwo ŋu ŋgɔgbe ƒe nutete (ƒuwo ƒe ʋuʋu alo akɔta dome diskwo ƒe dodo) le gome la, wowɔ akɔta ƒe ŋgɔgbe ƒe nutete ɖeɖeɖa to mɔ̃memimɔ̃a dzi be woakpɔ 360 ° ƒe nutete keŋkeŋ ƒo xlã aklãa, si ƒo asa na ŋgɔgbe ƒe nutete to akɔta ɖeɖeɖa me eye wòɖe nuveviwɔame dzi kpɔtɔ ŋutɔ. Wozãa 360 ° decompression mɔnu sia hã tsɔ wɔa dɔ na abɔ kple afɔ ƒe lãmetutudɔ si tsoa akɔta ƒe akɔta dome disk ƒe gege kple ƒu ƒe nutete ƒe gbagbã gbɔ.
4. Intervertebral fusion mehiã be woaɖe ƒu le akɔta o
Le akɔta ƒe ʋuʋu alo akɔta ƒe ƒunukpeƒetetedɔ si susu vovovowo hena vɛ ta la, taɖodzinu gbãtɔ si le dɔwɔwɔ na ame ŋue nye lãmekawo ƒe teteɖeanyi. Ne akɔta meli ke o la, wokpɔa akɔta ƒe fusion le alesi gbegbe meli ke o kple alesi gbegbe akɔta ƒe ʋuʋudedi le nu. Wotiaa posterolateral spinal bone graft (PLF) alo interbody bone graft (PLIF) le nenye be esɔ na pedicle screw internal fixation nu. Le PLIF me la, wozãa vertebral arch bliboa si woɖe kple inferior articular process complex (median incision) abe interbody bone graft fast ene, si menye ɖeko wòkpɔa ƒu si wodona ƒe nu nyuitɔ kekeake ko o, ke eƒoa asa na ƒu ɖeɖe tso akɔta alo be woaƒle interbody fusion cage hã, si ɖea kuxi siwo dona tso ƒu ɖeɖeɖa me ɖa eye wòɖea dɔwɔwɔ ƒe gazazã dzi kpɔtɔna ŋutɔ.
Elabena CZMEDITECH , míekpɔa adzɔnuwo ƒe hatsotso si de blibo ŋutɔ aklãdɔdada ƒe nusiwo wotsɔ dea ame me kple corresponding instruments , nusiwo wowɔ dometɔ aɖewoe nye 5.5mm kple 6.0mm aklã pedicle screw ɖoɖo, ŋgɔgbe vidzidɔ ƒe agbalẽvi ɖoɖo, megbe vidzidɔ ƒe ʋuƒo ɖoɖo, ŋgɔgbe akɔta ƒe agbalẽvi ɖoɖo, ŋgɔgbe akɔta ƒe agbalẽvi ɖoɖo, titanium mesh atɔ, peek atɔ ɖoɖo, titanium aka, megbe vidzidɔ laminoplasty ɖoɖo, minimally invasive pedicle screw ɖoɖo kple woƒe haƒonu siwo wotsɔ kpena ɖe wo ŋu ƒe hatsotsowo. Tsɔ kpe ɖe eŋu la, míeɖoe kplikpaa be míayi edzi anɔ atike yeyewo wɔm eye míakeke adzɔnuwo ƒe hatsotsowo ɖe enu, ale be míakpɔ ɖɔkta kple dɔnɔ geɖe ƒe amekoko ƒe nuhiahiãwo gbɔ, eye míana míaƒe dɔwɔƒea hã nate ŋu aʋli ho geɖe wu le xexeame katã ƒe ƒumeŋuɖui kple dɔwɔnuwo ƒe dɔwɔƒe bliboa me.
