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Anterior cervical discectomy with decompression and implant fusion (ACDF) is one of the most commonly used surgical methods for the treatment of spinal cord-type and nerve root-type cervical spondylosis, cervical spine trauma and other disorders, and it has the advantages of initial stabilisation, high fusion rate, restoration of normal anterior convexity, and the absence of external fixation, etc. The Ebizibu ebitera okubeerawo oluvannyuma lw’okulongoosebwa nga obuzibu mu kumira, okuvunda kw’ebitundu ebiriraanyewo, okusannyalala kw’obusimu obuddamu okuyingira mu nnyindo, okukulukuta kw’amazzi g’obwongo, okukulukuta kw’omusaayi, okukwatibwa, n’okukendeera kw’okuteekebwa kw’omugongo ogw’omu maaso n’ebirala.Okutwalira awamu okubeerawo kw’ebizibu oluvannyuma lw’okulongoosebwa kuli ku 8%.
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Mu kwanukula ebizibu ebyo waggulu, abasomesa buli kiseera bakola ku kulongoosa mu by’ekikugu, okumenyawo endowooza, n’okulongoosa ebitundu by’omubiri (prosthesis optimisation). Ekyuma ekiyunga omugongo gw’omumwa gwa nnabaana (Zero-Trace), ekikwata mu bujjuvu mu kifo ekiri wakati w’omugongo era kikendeeza bulungi obulabe bw’okusannyalala oluvannyuma lw’okulongoosebwa n’okukendeera kw’ekitundu ekiriraanyewo, kikkiriziddwa nnyo.
Ebizibu ebiva mu kulongoosebwa ebikwatagana n’ebitundu by’omubiri eby’omubiri (prostheses) byogerwako wansi ——
1.Okukaayana ku oba okusalako oba obutasalako ekinywa ky’omugongo ekikutte .
Ekifaananyi 1 Ekifaananyi ekiraga ensengekera y’omusuwa gw’omugongo, ogw’omugongo, n’omugongo n’ebikoola by’obusimu.
omu. Enkolagana wakati w’obukulu bw’ekitundu ky’omubiri (articular eminence) bw’omusuwa gw’omugongo (concha) n’omusuwa gw’omugongo.
b. Mu kitabo, empenda ey’omu makkati ey’obukulu bw’omugongo eggyibwamu, era empenda ey’ebbali ekuumibwa mu ngeri esaanidde okwewala okwonooneka kw’omusuwa gw’omugongo.
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Ekifaananyi 2 Ekifaananyi ekiraga okunyigirizibwa kw’ebikoola by’obusimu n’okukendeeza ku buzito nga tusaasaanya ebiyungo bya koniki ebiyitibwa hyperplastic conical joints.
omu. Okukula kw’amagumba n’okuvunda kw’omugongo kw’ennyondo za kontuuni bikendeeza ku kitundu eky’omusalaba eky’omutawaana ogw’omu lubuto (intervertebral foramina), bwe kityo ne kinyiga ebikoola by’obusimu.
b. Intervertebral fusion device/implant esobola okuggulawo ekifo ekiri wakati w’omugongo okugaziya ekitundu ky’omugongo gw’omugongo n’okukwatagana n’okunyigirizibwa kw’ekikolo ky’obusimu, ate mu kiseera kye kimu, ne kiddamu okunyweza omugongo.
Obwetaavu bw’okulongoosa omugongo gw’omumwa gwa nnabaana mu maaso okuggyawo ekinywa ky’omugongo gw’enkoba kibadde kya ggumba ly’okukaayana okuva lwe kyatandikibwawo obukodyo .
Ennyonyola esooka ey’okukendeeza ku buzito bw’omumwa gwa nnabaana mu maaso n’okuteekebwa mu mubiri n’okunyweza okw’omunda yaweebwa Robinson ne Smith mu 1955 mwe yannyonnyodde enkola eno nti teyeetaaga kuggyawo osteophyte ya leptokyphotic joint osteophyte. Cloward, omulala eyatandikawo ACDF, yakikkaatiriza nti okunyigirizibwa kwonna kulina okuggyibwawo, era nti okuggyawo obutereevu hyperplastic leptokyphosis kyali kyetaagisa nnyo okukendeeza ku buzito, ate Robinson n’addamu nti leptokyphosis eyinza okuddamu okusalibwawo ng’okutebenkera kw’omugongo kwateekebwawo era nga empalirizo z’ebyuma ezitali za bulijjo bwe zibula, era nti bino instabilitis bwe byali bisuubirwa okubeera ebikwatagana n’okutondebwa kw’okutondebwa kw’okutondebwa kw’okutondebwa.
Abakuumaddembe bagamba nti ekiyungo kya Hook kiyamba ebitundu 48% ku 60% ku ntegeka ya buli kitundu era kiwa obutebenkevu obusinga obunene mu ludda olw’emabega olw’omugongo gw’omumwa gwa nnabaana, era nti omutindo gw’okukendeera kw’omumwa gwa nnabaana ogw’omutindo gukendeera ekitundu eky’emabega eky’ekiyungo ky’ekiyungo n’ekitundu eky’omu maaso n’ekitundu eky’omu maaso (in reality) kibeera mu kitundu ekisinga okubeera ekinywevu (in reality) nga kibeera mu kitundu ekisinga okubeera eky’omu maaso n’ekitundu eky’omu maaso (in reality) nga kibeera mu kitundu ekisinga okubeera ekinywevu (in reality) nga kibeera mu kitundu ekisinga okubeera eky’omu maaso n’eky’omu maaso (in reality) nga kibeera mu kitundu ekisinga okubeera eky’omu maaso (hook joint) n’ekitundu eky’omu maaso (interality) nga kibeera mu kitundu ekisinga okubeera ekinywevu (interality) nga kibeera mu kitundu (hook joint). Okusengula ekifo ky’okuteekebwamu kikendeeza ku buwanguzi bw’okuyungibwa.
Singa ebiva mu bujjanjabi ebyenkanankana bisobola okutuukibwako awatali kusala ku kiyungo ky’omugongo gw’enkoba, okukuuma ekinywa ky’omugongo gw’enkoba mu ndowooza kuyinza okuwa embeera esinga okutuukirawo ku miwendo egy’okuyungibwa egy’oku ntikko. Okugatta ku ekyo, okukuuma ekinywa ky’omugongo gw’enkoba kiyamba okukendeeza ku mikisa gy’okulongoosebwa oluvannyuma lw’okulongoosebwa, era kibadde kimanyiddwa nti ekitundu ky’ekiyungo ky’omugongo gw’enkoba bwe kinaasalwako ebitundu ebisukka mu 38%, omuwendo gw’okuyungibwa kw’okuyunga wakati w’omubiri gujja kweyongera nnyo.
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Endowooza y'abasukkulumye ku balala .
Okusinziira ku ssomero ly’endowooza erya resection, mu nsengekera y’omubiri, ekisenge eky’emabega eky’ekiwanga kya leptospondylar kye kisenge eky’omu maaso eky’omukutu gw’ebikoola by’obusimu, era ekisigaddewo eky’amagumba okuva mu leptospondylar joint hyperplasia kiyinza okuvaako omugongo ogw’omugongo ogw’omugongo.
Mu nkola y’obujjanjabi eriwo kati, okukendeeza ku buzito (decompression) olw’okusalako obulwadde bwa leptokyphosis kikyawanirirwa mu balwadde abalina okunyigirizibwa okw’amaanyi okw’obulwadde bwa leptokyphotic joint hyperplasia, okusobola okumalawo okunyigirizibwa kw’obusimu oba omusuwa gw’omugongo amangu ddala nga bwe kisoboka.
Okutwaliza awamu, okusika omuguwa bulijjo kubaddewo, naye okulonda okukuuma, okukuuma ekitundu, oba okuggyawo ddala hook spondylolisthesis okusinziira ku mbeera y’omulwadde efuuse okukkaanya mu nkola ez’enjawulo ez’obujjanjabi. Enkola y’obujjanjabi ey’omuntu ku bubwe, wabula, eteeka obwetaavu obw’amaanyi ku bunene bw’ekiwanga.
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Ebintu ebya bulijjo ebisaliddwa ku katale bikoma olw’obwetaavu bw’okusikula mu sikulaapu 4 okusiba, era obugazi bwabyo bwetaaga okuba mm 17.5, nga kino kya sayizi ennene eri bannansi abamu, era emirundi mingi kyetaagisa okuziba ekitundu ky’ekiyungo ky’ekikonde olw’okuteekebwamu okuyungibwa mu kifo eky’omugongo wakati.
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SAGI 2-nail locking zero incision ekendeezeddwa okutuuka ku mm 14.8 mu bugazi, nga etunuulidde ebipimo by’omubiri gw’abantu b’e China, era ewa omukozi eddagala erisingawo eri omuntu mu kulongoosebwa okw’ekiwanga ky’enkoba, okusobozesa okujjanjaba ekinywa ky’enkoba okulondebwa okusinziira ku mbeera y’omulwadde entuufu, ate nga bakakasa okutebenkera okusooka n’okugatta okumala ebbanga eddene.
Oluvannyuma lw’okulongoosebwa omugongo epidural hematoma .
Spinal epidural hematoma (SEH) kizibu ekitali kya bulijjo era eky’amaanyi oluvannyuma lw’enkola y’omumwa gwa nnabaana mu maaso, nga kirimu ebitundu nga 0.1% ku 0.2%.SEH ebaawo mu musuwa omugagga ogw’omusuwa ogw’omu lubuto, ekijja okuvaako omugongo ogw’amaanyi okulemesa okukola kw’omugongo singa okutondebwa kw’omusaayi tekujjanjabibwa mu kiseera. Okulongoosa mu bwangu oluvannyuma lw’okuzuula SEH kiyinza okuyamba okuwona enkola y’obusimu.
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SEH schematic ya ACCF oluvannyuma lw'okulongoosebwa .
Epidural haematomas z’omugongo zisoboka oluvannyuma lwa ACDF ne ACCF zombi, nga ACCF erina obulabe obw’amaanyi obwa haematomas olw’okulumwa okusingawo n’okukulukuta kw’amagumba amangi; Naye, obuzito bw’enkola ya ACDF okutwalira awamu bunene, nga omuwendo gwa SEHs gusingako.
Okuziyiza SEH oluvannyuma lw’enkola y’omumwa gwa nnabaana ey’omu maaso erina okugenda mu maaso mu kiseera kyonna eky’okulongoosebwa:
A. Okukebera nga tebannaba kulongoosa kulina okuggwa, era okubuuza mu bujjuvu kulina okukolebwa oba waliwo endwadde z’okuzimba omusaayi, n’okumanya oba waliwo ebyafaayo by’okunywa sigala okumala ebbanga eddene n’okunywa omwenge; Bwe wabaawo abantu abamira eddagala eriziyiza okuzimba omusaayi, balina okukomya okumira okumala wiiki emu nga tebannaba kulongoosa;
B. Okulongoosa mu kulongoosa mu ngeri ey’okulongoosebwa, haemostasis etali ntuufu olw’akambe k’amasannyalaze agakola amasannyalaze (electrocoagulation knife) kayinza okuvaako okuvaamu omusaayi omupya, kirungi okukozesa amaanyi g’amasannyalaze aga bipolar; Mu nkola y’okusalako omubiri ogw’omugongo ogw’omugongo, amagumba galina okusiigibwa okwewala okukulukuta kw’omusaayi okuyitiridde okuva ku ngulu w’amagumba; okukozesa eddagala eriziyiza omusaayi, gamba ng’okukuba asidi wa tranexamic, n’ebirala, okusobola okukendeeza ku musaayi mu kulongoosebwa; Tekyetaagisa kunoonya kusalako mu bujjuvu omusipi ogw’emabega ogw’ekitundu ekirongooseddwa, era okukuuma omuwendo omutono ogw’omusipi ogw’obuwanvu obw’emabega ku njuyi zombi nakyo kisobola okutuuka ku nkola y’okukendeeza ku buzito; Okuteeka ekitundu ky’omubiri ekiyitibwa prosthesis kulina okulekawo ekifo ekimala ku ludda olwa ddyo ne ku kkono. Bw’oba oteeka ekiwanga, ekifo ekimala kibeere ku ludda olwa kkono ne ddyo olwo okuvaamu omusaayi mu epidural gusobole okukulukuta okutuuka mu maaso g’omugongo ne gufulumizibwa okuyita mu ttanka efulumya puleesa ya negatiivu;
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C. Oluvannyuma lw’okulongoosebwa, weetegereze nnyo obubonero obukulu; Omudumu gukuume nga guweweevu; Kozesa eddagala eriziyiza okuzimba omusaayi mu ngeri entuufu okwewala okuzimba omusaayi; okulondoola ennyo enkola y’obusimu; Bwe wabaawo ekitali kya bulijjo, kikole ku kiseera kino.
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Ekoleddwa okutuukiriza ebipimo by’omubiri gw’eggwanga .
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2. Okukendeeza ku mikisa gy’okukka kw’omubiri gw’omugongo .
3. Okukendeeza ku bulabe bw’okusannyalala kw’omugongo .
Variable angle screw design okusobola okukola obulungi .
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Sikulaapu ezirina enkoona y’okuwuubaala kwa coronal eya -1.5°11.5° ne cephalad swing angle ya 36°44° okusobola okwanguyirwa okuteeka omusumaali mu kulongoosebwa
Tekyetaagisa kutereka kifo kya kwongerako okuyingiza sikulaapu, ekisala ekitono kikendeezebwa okuva ku 2.5cm okutuuka ku nga 2.0cm.
Esinga kukyusibwa n’endowooza y’okukola endoscopic mu mugongo, okutegeera endo-ACDF.
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Ebikwata ku CZMEDITECH .
Cervical peek cage(2 oba 4 locking screws) are precision orthopedic solutions ezikoleddwa n'obwegendereza . CZMeditech yassa essira ku kukendeeza ku buzito bw’omumwa gwa nnabaana mu maaso (anterior cervical discectomy decompression and implant fusion) era nga evugirwa okwolesebwa kw’ensi yonna, nga yeewaddeyo okuwa obujjanjabi obulungi, obulungi era obutasaasaanya ssente nnyingi eri abalwadde abalina okumenya okuzibu okwetoloola ensi yonna.
Anterior cervical discectomy with decompression and implant fusion (ACDF) is one of the most commonly used surgical methods for the treatment of spinal cord-type and nerve root-type cervical spondylosis, cervical spine trauma and other disorders, and it has the advantages of initial stabilisation, high fusion rate, restoration of normal anterior convexity, and the absence of external fixation, etc. The Ebizibu ebitera okubeerawo oluvannyuma lw’okulongoosebwa nga obuzibu mu kumira, okuvunda kw’ebitundu ebiriraanyewo, okusannyalala kw’obusimu obuddamu okuyingira mu nnyindo, okukulukuta kw’amazzi g’obwongo, okukulukuta kw’omusaayi, okukwatibwa, n’okukendeera kw’okuteekebwa kw’omugongo ogw’omu maaso n’ebirala.Okutwalira awamu okubeerawo kw’ebizibu oluvannyuma lw’okulongoosebwa kuli ku 8%.
