![nɔnɔmetata (1) .]( "image (1)")
Anterior cervical discectomy with decompression and implant fusion (ACDF) nye amekokomɔnu siwo wozãna wu dometɔ ɖeka tsɔ daa aklã ƒe ka ƒomevi kple nerve root-type cervical spondylosis, cervical spine trauma kple dɔléle bubuwo, eye viɖe siwo le eŋue nye be eƒe liƒolili le gɔmedzedzea me, fusion ƒe agbɔsɔsɔ si lolo, ŋgɔgbe ƒe convexity si sɔ gbugbɔgaɖoanyi, kple gotagome ƒe anyimanɔmanɔ fixation, etc. Dɔwɔwɔ vɔ megbe si bɔ kuxiwo abe nu mimi sesẽ, akpa siwo te ɖe wo nɔewo ŋu ƒe gbegblẽ, lãmeka siwo gbugbɔ gena ɖe lãkusi me ƒe lãmetutudɔ, ahɔhɔ̃mekawo ƒe tsi ƒe sisi, ʋu ƒe sisi, dɔlékuiwo, kple akɔta ƒe dɔwɔwɔ vɔ megbe kuxiwo ƒe ɖiɖi kple bubuawo.
![按钮 ƒe ŋkɔ]( "按钮")
Le kuxi siwo le etame gbɔ kpɔkpɔ me la, agbalẽnyalawo le dɔ wɔm ɣesiaɣi tso mɔ̃ɖaŋununya ƒe ŋgɔyiyi, susu ƒe ŋgɔyiyi, kple ametia ƒe ŋutilã ƒe dɔwɔwɔ nyuie wu ŋu. Wolɔ̃ ɖe vidzidɔ ƒe akɔta ƒe fusion mɔ̃ si te ŋu nɔa te (zero-trace), si nɔa akɔta ƒe teƒea bliboe eye wòɖea afɔku si le dɔwɔwɔ vɔ megbe ƒe nuɖuɖumadzroame kple akpa si te ɖe eŋu ƒe gbegblẽ dzi kpɔtɔna nyuie la dzi le afisiafi.
Woƒo nu tso dɔwɔwɔ vɔ megbe kuxi siwo dona tso ametia ƒe ŋutilã ƒe akpa aɖewo wɔwɔ me ŋu le ete ——
1.Nyaʋiʋli le nenye be woatso akɔta ƒe ƒunukpeƒe si wotsɔ kɔsɔkɔsɔ wɔe alo womatsoe o ŋu
Fig. 1 Conotruncus, vertebral artery, kple aklã ƒe ka kple lãmeka ƒe kewo ƒe wɔwɔme ƒe nɔnɔmetata.
a. Ƒomedodo si le concha ƒe articular eminence kple vertebral artery dome.
b. Le agbalẽa me la, woɖea ƒunukpeƒea ƒe titina ƒe nugbɔ ɖa, eye wodzraa axadzinu si le axadzi la ɖo nyuie be woagagblẽ nu le akɔta ƒe ʋuka ŋu o.
![2_upscayl_2x_nudzɔdzɔwo ƒe habɔbɔ-x4plus]( "2_upscayl_2x_realesrgan-x4plus")
Fig. 2 Schematic diagram of nerve root compression and decompression to kaka ɖe hyperplastic conical ƒunukpeƒewo.
a. Ƒu ƒe tsitsi kple ƒunukpeƒe siwo le abe kɔnu ene ƒe aklã ƒe gbegblẽ ɖea akɔtaƒuwo dome ƒe akpa si wotso la dzi kpɔtɔna, si wɔnɛ be lãmekawo ƒe kewo tea ɖe wo nɔewo dzi.
b. Intervertebral fusion device/implant ate ŋu aʋu intervertebral space be wòakeke intervertebral foramen ƒe teƒe ɖe enu eye wòaka ɖe lãmeka ƒe ke ƒe nutetea ŋu, eye le ɣeyiɣi ma ke me la, agbugbɔ akɔta ƒe liƒo atrɔ asi le eŋu.
Alesi wòhiã be woawɔ dɔ na vidzidɔa ƒe ŋgɔgbe ƒe akɔta be woaɖe hook vertebral joint la nye ƒu si ŋu woʋlia nya le tso esime wodze mɔnu sia gɔme
Robinson kple Smith ye ƒo nu tso ŋgɔgbe ƒe vidzidɔ ƒe nutete ɖeɖeɖa kple nusi wotsɔ dea ʋuka me kple ememe fixation ŋu le ƒe 1955 me si me wògblɔ le be dɔdamɔnua mehiã be woaɖe leptokyphotic joint osteophyte ɖa o. Cloward, si nye ACDF ɖola bubu, te gbe ɖe edzi be ele be woaɖe nutete katã ɖa, eye be hyperplastic leptokyphosis ɖeɖeɖa tẽ le vevie na decompression, gake Robinson ɖo eŋu be woate ŋu agbugbɔ leptokyphosis la axɔ ne woɖo akɔta ƒe liƒo anyi eye ne mɔ̃ɖaŋununya ƒe ŋusẽ siwo mesɔ o bu, eye be wosusu be malikenyenye siawo do ƒome kple the leptokyphosis ƒe dɔléle.
Reservisttɔwo ƒe nukpɔsusu
Nutakpɔlawo ʋlia nya be kɔsɔkɔsɔ ƒe ƒunukpeƒea wɔa akpa ɖesiaɖe ƒe liƒo ƒe 48% va ɖo 60% eye wònaa liƒo gãtɔ kekeake le vidzidɔa ƒe megbekpa dzi, eye be vidzidɔ ƒe foraminotomy decompression si wozãna ɖaa ɖea kɔsɔkɔsɔa ƒe megbekpa kple ahɔhɔ̃meka ƒe akpa si le ŋgɔgbe gome dzi kpɔtɔna, evɔ le nyateƒe me la, ƒunukpeƒea ƒe akpa si li ke wue nye woɖee ɖa, kple malikenyenye kpakple ʋuʋu le woƒe aƒewo me ƒe nɔnɔme si wotsɔ dea lãme na ame la ɖea fusion la ƒe dzidzedzekpɔkpɔ dzi kpɔtɔna.
Ne woate ŋu akpɔ dɔdamɔnu siwo sɔ kple wo nɔewo ne womeɖe kɔsɔkɔsɔ ƒe akɔtaƒu ƒe ƒunukpeƒea o la, le nukpɔsusu nu la, kɔsɔkɔsɔ ƒe akɔtaƒu ƒe ƒunukpeƒea takpɔkpɔ ate ŋu ana nɔnɔme si sɔ wu na fusion ƒe agbɔsɔsɔme si lolo wu. Gakpe ɖe eŋu la, hook vertebral joint takpɔkpɔ kpena ɖe ame ŋu be mɔnukpɔkpɔ siwo li be vertebral subluxation nanɔ anyi le dɔwɔwɔ vɔ megbe dzi ɖena kpɔtɔna, eye wode dzesii be ne woɖe hook vertebral joint ƒe teƒe si wu 38% la, interbody fusion subluxation ƒe agbɔsɔsɔme adzi ɖe edzi ŋutɔ.
![3_upscayl_2x_nudzɔdzɔwo ƒe habɔbɔ-x4plus]( "3_upscayl_2x_realesrgan-x4plus")
Nukpɔsusu si nye excisionist
Le resection sukua ƒe susu nu la, le ŋutilã ƒe wɔwɔme nu la, leptospondylar ƒunukpeƒe ƒe megbeglie nye lãmeka ƒe ke ƒe ŋgɔgbegli, eye ƒu ƒe akpa si susɔ tso leptospondylar ƒunukpeƒe ƒe dzidziɖedzi fũ ate ŋu ahe intervertebral foraminal stenosis vɛ.
Le dɔdamɔnu siwo li fifia me la, wogaʋlia nutete dzi ɖeɖe kpɔtɔ to leptokyphosis la ɖeɖeɖa me ɖe ŋgɔ le dɔnɔ siwo ŋu leptokyphotic ƒunukpeƒetetedɔa ƒe nutete sesẽ le ŋu, be woatsɔ aɖe lãmeka alo akɔta ƒe ʋuka ƒe nutete dzi akpɔtɔ kaba ale si woate ŋui.
Le nusianu me la, nyaʋiʋli nɔ anyi ɣesiaɣi, gake tiatia be woakpɔ kɔsɔkɔsɔ ƒe spondylolisthesis ta, adzra eƒe akpa aɖe ɖo, alo aɖee ɖa keŋkeŋ le dɔnɔa ƒe nɔnɔme nu va zu nusi dzi woda asi ɖo le dɔdamɔnu vovovowo me. Gake atikewɔwɔmɔnu si wozãna na ame ɖekaɖekawo la bia nu geɖe tso ametia ƒe lolome ŋu.
![4_upscayl_2x_nudzɔdzɔwo ƒe habɔbɔ-x4plus]( "4_upscayl_2x_realesrgan-x4plus")
Zero-cut traces siwo bɔ le asi me la seɖoƒe li na le esi wòhiã be woatsɔ gavi 4 ablae hena gavi, eye woƒe kekeme hiã be wòanye milimeta 17.5, si nye lolome gã aɖe na dukɔmevi aɖewo, eye zi geɖe la, ebiana be woaxe kɔsɔkɔsɔa ƒe akpa aɖe hena fusion implantation le akɔta dome teƒea.
![9]( "9")
Woɖe SAGI 2-nail locking zero incision ƒe kekeme dzi kpɔtɔ va ɖo 14.8 mm le eƒe kekeme me, eye wobu Chinatɔwo ƒe ŋutilã ƒe lolome ŋu, eye wònaa dɔwɔla la kpɔa kɔsɔkɔsɔ ƒe ƒunukpeƒea ƒe dɔdamɔnu si sɔ wu le dɔwɔwɔ me, si wɔnɛ be woate ŋu atia kɔsɔkɔsɔ ƒe ƒunukpeƒea ƒe atikewɔwɔ le dɔnɔa ƒe nɔnɔme ŋutɔŋutɔ nu, esime wòkpɔa egbɔ be eli ke le gɔmedzedzea me eye wòwɔa fusion ɣeyiɣi didi.
Dɔwɔwɔ vɔ megbe spinal epidural hematoma
Spinal epidural hematoma (SEH) nye kuxi si mebɔ kura o eye wòsẽna ŋutɔ le ŋgɔgbe vidzidɔ ƒe tete ɖe eŋu megbe, eye wòdzɔna abe 0.1% va ɖo 0.2%.SEH dzɔna le epidural ƒe ʋuka si me kesinɔnuwo le me, si ahe aklã ƒe dɔwɔwɔ ƒe gbɔdzɔgbɔdzɔ sesẽ vɛ ne womewɔ atike na ʋumenugbagbeviɣia ƒe wɔwɔme le ɣeyiɣi nyuitɔ dzi o. Amekoko kpata le SEH ƒe dzesi kpɔkpɔ vɔ megbe ate ŋu akpe ɖe ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋu wòahaya.
![nɔnɔmetata (2) .]( "image (2)")
ACCF ƒe SEH ƒe ɖoɖo si wowɔ le dɔwɔwɔ vɔ megbe
Ʋu ƒe sisi le aklã me ate ŋu adzɔ le ACDF kple ACCF siaa megbe, eye ACCF ate ŋu axɔ ʋu ƒe sisi le nuveviwɔame geɖe wu kple ƒu ƒe akpa siwo le dodom wu ta; ke hã, ACDF ƒe dɔwɔwɔ ƒe agbɔsɔsɔme bliboa lolo wu, eye SEH ƒe xexlẽme si lolo wu dzɔna.
Ele be mɔxexe ɖe SEH nu le ŋgɔgbe vidzidɔa ƒe tete ɖe eŋu megbe nayi edzi le dɔwɔwɔ nɛ ƒe ɣeyiɣia katã me:
A. Ele be woawu dodokpɔ si wowɔ do ŋgɔ na dɔwɔwɔ nɛ nu, eye woabia nya tsitotsito nenye be ʋumenugbagbeviɣidɔ aɖewo li, eye nenye be atamanono kple ahanono ɣeyiɣi didi ƒe ŋutinya aɖe li hã; ne ame aɖewo li siwo le ʋumenugbagbeviɣitikewo zãm la, ele be woadzudzɔ wo nono kwasiɖa ɖeka hafi woawɔ dɔ na wo;
B. Ʋu ƒe sisi nyuie le dɔwɔwɔ me, ʋu ƒe sisi si mede blibo o to electrocoagulation knife dzi ate ŋu ana ʋu yeye nado, wokafui be woazã bipolar electrocoagulation forceps; le vertebral body subtotal resection ƒe ɖoɖoa me la, ele be woatsɔ ƒumeŋuɖui asisi ɖe eŋu be ʋu nagage fũu akpa tso ƒua dzi o; ʋumenugbagbeviɣitikewo zazã, abe tranexamic acid dodo, kple bubuawo ene, be woatsɔ aɖe ʋu si dona le amekoko me dzi akpɔtɔ; mehiã be woadi be woaɖe megbeƒu didi si le akpa si wowɔ dɔ na la ɖa keŋkeŋ o, eye megbeƒu didi sue aɖe takpɔkpɔ le axa eveawo hã ate ŋu akpɔ ŋusẽ si nye decompression; ele be ametia ƒe akpa si woda ɖe teƒea nagblẽ teƒe si sɔ ɖe ɖusime kple miame. Ne wole ametia dam la, ele be woagblẽ teƒe si sɔ ɖe miame kple ɖusime ale be ʋu si dona le lãkusia me nate ŋu asi ayi akɔta ƒe ŋgɔgbe eye wòado to tsi si dona le tsia ƒe nyaƒoɖeamenu manyomanyo me la me;
![10]( "10")
C. Le dɔwɔwɔ nɛ vɔ megbe la, lé ŋku ɖe dzesi veviawo ŋu nyuie; na tsi si le eme la nanɔ blɔ; zã atike siwo tsia ʋumenugbagbeviɣidɔ nu le mɔ si sɔ nu be woaƒo asa na ʋumenugbagbeviɣidɔ; lé ŋku ɖe lãmekawo ƒe dɔwɔwɔ ŋu nyuie; ne nane si mesɔ o li la, kpɔ egbɔ le ɣeyiɣi nyuitɔ dzi.
![详情页8]( "详情页8")
Wotrɔ asi le eŋu be wòawɔ ɖeka kple dukɔa ƒe ŋutilã ƒe wɔwɔme ƒe didimewo
1. Enaa atikewɔƒe ƒe egbɔkpɔnu si sɔ na ame ŋutɔ hena akɔtaƒu si wotsɔ kɔsɔkɔsɔ wɔe la dzi kpɔkpɔ.
2. Ðe mɔnukpɔkpɔ si li be akɔta ƒe ŋutilã naɖiɖi dzi kpɔtɔ
3. Ðe ʋumenugbagbeviɣidɔ si le aklã me ƒe afɔkua dzi kpɔtɔ
Dzogoe si trɔna ƒe ʋuƒo ƒe nɔnɔme hena dɔwɔwɔ bɔbɔe
![8]( "8")
Screws siwo ƒe coronal swing angle nye -1.5°11.5° kple cephalad swing angle si nye 36°44° hena ɖa ɖoɖo bɔbɔe le dɔwɔwɔ me
Mehiã be woadzra teƒe bubu ɖo na gavi dede eme o, woɖea lãɖeɖe suetɔ dzi kpɔtɔna tso 2.5cm va ɖo abe 2.0cm ene.
Woate ŋu atrɔ ɖe nukpɔsusu si nye be woawɔ dɔ le aklã me ŋu wu, si na Endo-ACDF dze sii.
![7]( "7")
Ku ɖe CZMEDITECH ŋu
Cervical Peek Cage(2 alo 4 Locking Screws) nye ƒumeŋutinunya ƒe kuxiwo gbɔ kpɔnu siwo sɔ pɛpɛpɛ siwo wowɔ nyuie to CZMEDITECH ku ɖe anterior cervical discectomy decompression kple implant fusion ŋu eye xexeame katã ƒe ŋutega ʋãe, si tsɔ eɖokui na be yeana atikewɔwɔ ƒe kuxiwo gbɔkpɔnu blibo siwo wɔa dɔ nyuie, siwo sɔ eye womexɔa ga geɖe o na dɔnɔ siwo ƒe gbagbã sesẽwo le xexeame godoo.
Anterior cervical discectomy with decompression and implant fusion (ACDF) nye amekokomɔnu siwo wozãna wu dometɔ ɖeka tsɔ daa aklã ƒe ka ƒomevi kple nerve root-type cervical spondylosis, cervical spine trauma kple dɔléle bubuwo, eye viɖe siwo le eŋue nye be eƒe liƒolili le gɔmedzedzea me, fusion ƒe agbɔsɔsɔ si lolo, ŋgɔgbe ƒe convexity si sɔ gbugbɔgaɖoanyi, kple gotagome ƒe anyimanɔmanɔ fixation, etc. Dɔwɔwɔ vɔ megbe si bɔ kuxiwo abe nu mimi sesẽ, akpa siwo te ɖe wo nɔewo ŋu ƒe gbegblẽ, lãmeka siwo gbugbɔ gena ɖe lãkusi me ƒe lãmetutudɔ, ahɔhɔ̃mekawo ƒe tsi ƒe sisi, ʋu ƒe sisi, dɔlékuiwo, kple akɔta ƒe dɔwɔwɔ vɔ megbe kuxiwo ƒe ɖiɖi kple bubuawo.
