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MIS | Hoʻonui ʻenehana - Nā Pōmaikaʻi ʻenehana - Nā hopena ma hope o ka hana | czmeditech

ʻO ka Minimally Invasive Spine System (MIS) kahi ʻenehana hou e hiki ai i ka mālama pololei ʻana ma o nā ʻoki liʻiliʻi no nā kūlana e like me nā herniated discs a me spinal stenosis.

Nā kikoʻī hoʻolālā hou

Nā pōmaikaʻi invasive liʻiliʻi

Hoʻemi i ka ʻeha

Hoʻolālā ʻoki liʻiliʻi:

ʻO nā ʻoki maʻamau he 1-2 knm wale nō, e hōʻemi ana i ka wehe ʻana o ka ʻiʻo a me ka pōʻino o ke kino palupalu.

ʻenehana hoʻonohonoho pololei:

Hoʻomaikaʻi i ka pololei o ka hoʻokomo ʻana i ka implant me ka hoʻokele intraoperative (eg O-arm, 3D-C-arm) a i ʻole kōkua robotic (e laʻa me Mazor X, Globus Medical).

Hoʻemi i ke koko intraoperative:

ʻO ka ʻenehana hoʻohana liʻiliʻi e hōʻemi i ka hopena o ka hōʻeha vascular, ʻoi aku ka nui o nā poʻe maʻi maʻi a i ʻole nā ​​​​maʻi maʻi.

ʻOi aku ka wikiwiki ma hope o ka hoʻihoʻi ʻana

Noho i ka haukapila pōkole:

ʻO ka hapa nui o nā maʻi i hoʻokuʻu ʻia i nā hola 24-48 ma hope o ke kaʻina hana, i hoʻohālikelike ʻia me 3-5 mau lā no ke kaʻina wehe kuʻuna.

Ka neʻe mua ʻana:

ʻO ka liʻiliʻi o ka ʻeha a me ka pale ʻoi aku ka maikaʻi o ka ʻiʻo e hiki ai i nā maʻi ke hoʻi wikiwiki i kā lākou mau hana i kēlā me kēia lā.

ʻO ka loiloi biomechanical

Nā noi mea hou:

e laʻa me 3D i paʻi ʻia nā mea hao titanium, PEEK (polyether ether ketone) mea e loaʻa ai kahi modulus o ka elasticity kokoke i ko ka iwi a e hoʻemi i ka huna ʻana i ke kaumaha.

Pūnaehana hoʻokūpaʻa ikaika:

ʻO kekahi mau implants (e laʻa me Dynesys, Coflex) mālama i ka neʻe ʻana o ka spinal a hoʻemi i ka pilikia o ka degeneration ʻāpana pili.

Nā hōʻailona hoʻonui

Ka uhi ʻana i kahi ākea o nā maʻi maʻi spinal e like me ka maʻi degenerative disc, lumbar spinal stenosis, mild spondylolisthesis a me vertebral fractures.

临床案列

Eia nā hihia noiʻi hōʻike i nā makahiki i hala iho nei:

1. Hoʻokolo ʻia ka hoʻāʻo ʻia ʻana o ka hui ʻana o ka spine lumbar (TLIF)

Hoʻolālā haʻawina:

multicenter RCT (2022) e hoʻohālikelike ana i ka MIS-TLIF (ka liʻiliʻi invasive) me ka TLIF hāmama.

Laʻana nui:

ʻO nā maʻi 120 me ka maʻi maʻi maʻi degenerative lumbar spine hoʻokahi.

Nā hualoaʻa:

ʻO ka manawa ʻoki:

ʻoi aku ka lōʻihi ma ka hui MIS (mean 150 min vs. 130 min), akā 60% emi ke koko (<100 ml vs. 250 ml).

ʻEha ma hope o ka hana ʻana:

ʻO 50% ka ho'ēmiʻana i nā helu VAS 1 pule ma hope o ka hana ma ka hui MIS,ʻaʻohe mea nui ma waena o nā huiʻelua ma hope o 3 mahina.

Laki hui 'ana:

1 makahiki postoperative CT hōʻike> 90% fusion rate ma nā pūʻulu ʻelua.

Nā pilikia:

ʻO ka nui o ka maʻi maʻi 2% ma ka hui MIS vs. 8% ma ka hui ākea.

2. Hoʻopaʻa haʻawina lōʻihi o ka ʻōnaehana hoʻoikaika ikaika (Coflex)

Hoʻolālā haʻawina:

ʻO ka hoʻopaʻa ʻana o ka European 5-year follow-up (2021) e loiloi ana i ka implantation Coflex no ka mālama ʻana i ka stenosis spinal lumbar.

Laʻana nui:

80 mau maʻi.

KA HUA:

Hoʻomaikaʻi hana:

ua emi iho ka ODI (dysfunction index) mai 45 mau helu ma ka papa kuhikuhi a hiki i 20 mau helu ma 5 makahiki.

KA HOʻOLOHE ʻana o ka ʻāpana pili:

ʻO 12% wale nō o nā maʻi i hoʻomohala i nā pilikia ʻāpana pili, ʻoi aku ka haʻahaʻa ma mua o ka fusion maʻamau (~ 30%).

Laki hana hou:

kumulative 5-makahiki reoperation rate o 8%, ma muli o ka implant loosening (4%) a i ʻole hōʻailona hōʻailona.

3. Hoʻopaʻa haʻawina multicenter o nā implants MIS i kōkua ʻia e robot

Hoʻolālā haʻawina:

ʻO ka noiʻi retrospective i paʻi ʻia ma 2023 e nānā i nā hopena o ka MIS screw placement me ke kōkua robotic Mazor.

Laʻana nui:

500 mau hoʻokomo ʻana (thoracolumbar spine).

Nā hualoaʻa:

pololei:

Ua ʻoluʻolu ka 98.6% o nā kūlana screw (Gertzbein-Robbins grading A/B).

Nā pilikia:

He 0.4% ka nui o ka eha o ke aʻa aʻa i ka 3-5% no ka hoʻokomo lima lima maʻamau.

No ka ʻike hou aku a me nā kikoʻī, e ʻoluʻolu e kelepona mai iā mākou!