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Anterior cervical discectomy with decompression and implant fusion (ACDF) hi spinal cord-type leh nerve root-type cervical spondylosis, cervical spine trauma leh natna dang enkawlna atana surgical method hman tlanglawn ber pakhat a ni a, initial stabilisation, fusion rate sang, normal anterior convexity siamthat leh external awm lohna te a thatna a nei bawk fixation, etc. Operation hnua hman tlanglawn tak complications te chu ei harsa, a kianga segment te degeneration, laryngeal reentrant nerve paralysis, cerebrospinal fluid leakage, haematoma, infection, leh intervertebral implant subsidence etc. Postoperative complication awm zawng zawng hi 8% vel a ni.
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A chunga harsatna awmte chhanna atan hian zirna lama mithiamte chuan technical lama hmasawnna, conceptual breakthroughs, leh prosthesis optimisation te an thawk chhunzawm zel a ni. Self-stabilising cervical spine fusion device (zero-trace) hi intervertebral space-ah a awm kim vek a, postoperative dysphagia leh adjacent segment degeneration hlauhawmna a tiziaawm thei hle a, hei hi pawm a ni nasa hle.
Prosthesis nena inzawm postoperative complications te chu a hnuaia mi ang hian tarlan a ni ——
1.Hooked vertebral joint resect tur nge resect loh tur chungchangah inhnialna a awm
Fig. 1 Conotruncus, vertebral artery, leh spinal cord leh nerve roots te structure schematic diagram.
ani. Concha articular eminence leh vertebral artery inzawmna.
b. Lehkhabuah hian articular eminence medial edge chu lakchhuah a ni a, vertebral artery tihchhiat loh nan lateral edge chu a remchan dan anga vawnhim a ni.
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Fig. 2 Hyperplastic conical joint te theh darh a nerve root compression leh decompression te schematic diagram.
ani. Conical joints-a ruh lian leh ruhro (spinal degeneration) hian intervertebral foramina cross-sectional area a ti tlem a, chu chuan nerve roots a ti compress a ni.
b. Intervertebral fusion device/implant hian intervertebral space a hawng thei a, intervertebral foramen area a tizau thei a, nerve root compression a tawk thei bawk a, chutih rual chuan spine stability chu a remodel thei bawk.
Hook vertebral joint lakchhuah nan anterior cervical spine surgery neih a ngai tih hi he technique hman tan tirh atang khan bone of contention a ni
Anterior cervical decompression leh implant fusion with internal fixation chungchang sawifiahna hmasa ber chu Robinson leh Smith te chuan kum 1955 khan an pe a, chutah chuan he procedure hi leptokyphotic joint osteophyte lakchhuah ngai lo niin a sawi. ACDF dintu dang Cloward chuan compression zawng zawng tihbo vek tur a nih thu a sawi uar hle a, decompression atan hyperplastic leptokyphosis direct removal chu a pawimawh thu a sawi a, Robinson chuan leptokyphosis chu spine stability a awm chuan leh abnormal mechanical forces a bo chuan resorbed theih a ni tih a chhang a, heng instabilities te hi the formation nen a inzawm nia ngaih a nih thu a sawi bawk leptokyphosis natna (leptokyphosis) a ni.
Preservationist-te chuan hook joint hian segment tinte stability 48% atanga 60% a thawhpui a, cervical spine hnunglam aspect-ah stability nasa ber a pe a, standard cervical foraminotomy decompression hian hook joint hnunglam leh neuraxial canal hmalam aspect a decompress a, a nihna takah chuan joint-a stable ber a ni, an ti paih chhuah, leh instability bakah displacement te pawh a awm bawk of the implant position chuan fusion hlawhtlinna a ti tlem a ni.
Hook vertebral joint resection tel lovin clinical outcome inang lo tak tak hmuh theih a nih chuan, hook vertebral joint humhalh hian theoretically chuan fusion rates sang zawk neih theihna tur setting dik ber a pe thei ang. Chu bakah, hook vertebral joint humhalh hian postoperative vertebral subluxation chance a tihtlem phah a, hook vertebral joint area chu 38% aia tam resect a nih chuan interbody fusion subluxation rate chu nasa takin a sang dawn tih hriat a ni bawk.
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Excisionist ngaihdan a ni
Resection school of thought ang chuan anatomically chuan leptospondylar joint hnunglam bang hi nerve root canal hmalam bang a ni a, leptospondylar joint hyperplasia atanga ruh awmte hian intervertebral foraminal stenosis a thlen thei a ni.
Tuna clinical practice-ah chuan leptokyphotic joint hyperplasia compression na tak nei damlote tan leptokyphosis excision hmanga decompression tih hi an la rawt a, hei hi nerve emaw vertebral artery emaw compression tihziaawmna tur a ni.
A pum puiin, inhnialna a awm fo a, mahse damlo dinhmun a zirin hook spondylolisthesis humhalh, a then humhalh emaw, a pum puia paih vek emaw duhthlanna chu clinical practice hrang hrangah chuan inremna a lo ni ta a ni. Mahse, individualized treatment strategy chuan prosthesis lian tham tak chu a phut nasa hle thung.
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Market-a zero-cut traces hman tlanglawn tak takte chu locking atan screw 4 screw in a ngai a, an zau zawng chu 17.5 mm a nih a ngai a, hei hi national thenkhat tan chuan a lian hle a, intervertebral space-a fusion implantation atan hook joint chu a then occlusion a ngai fo bawk.
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SAGI 2-nail locking zero incision hi Chinese population anatomical dimensions ngaihtuah chungin a zau zawng 14.8 mm-ah tihhniam a ni a, operator hnenah hook joint chu intraoperative treatment personalized zawk a pe a, hei hian hook joint enkawlna chu damlo dinhmun tak tak a zirin thlan theih a ni a, chutih rualin initial stability leh long-term fusion a tichiang bawk.
Operation hnua spinal epidural hematoma a awm thin
Spinal epidural hematoma (SEH) hi anterior cervical approach hnua harsatna awm lo leh pawi tak a ni a, 0.1% atanga 0.2% vel a ni.SEH hi epidural rich venous plexus-ah a awm a, hei hian hematoma formation hi a hun taka enkawl a nih loh chuan spinal cord functional impairment nasa tak a thlen ang. SEH hmuhchhuah a nih hnua emergency surgery neih hian neurological function a siam that theih nan a pui thei a ni.
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ACCF hmanga operation hnua SEH schematic hmanga siam a ni
ACDF leh ACCF pahnih hnuah hian spinal epidural haematomas hi a awm thei a, ACCF hian trauma nasa zawk leh ruh chunglam oozing tam zawk avangin haematomas vei theihna a sang zawk a mahse, ACDF procedure volume pumpui chu a tam zawk a, SEH tam zawk a awm thung.
Anterior cervical approach hnua SEH venna hi perioperative period chhung zawngin chhunzawm zel tur a ni:
A. Preoperative examination tihfel tur a ni a, coagulation natna a awm em tih te, hun rei tak meizuk leh zu in tawhna history a awm em tih te chipchiar taka zawhfiah tur a ni anticoagulant damdawi ei thin an awm chuan operation hma kar khat chhung chu an ei tawh loh tur a ni;
B. Intraoperative haemostasis uluk tak, electrocoagulation knife hmanga haemostasis tling lo chuan thisen thar a thlen thei a, bipolar electrocoagulation forceps hman a tha Vertebral body subtotal resection kalpui danah hian ruh atanga thisen seepage tam lutuk lo turin bone wax hi hman tur a ni a; intraoperative bleeding tihtlem nan haemostatic damdawi, tranexamic acid injection, etc. ang chi hman Operation segment-a posterior longitudinal ligament resection kimchang zawng a ngai lo va, a sir lehlama posterior longitudinal ligament tlemte humhalh pawh hian decompression effect pawh a thlen thei a Prosthesis dahna hian dinglam leh veilamah hmun a awm tawk tur a ni. Prosthesis dah lai hian veilam leh dinglam lamah hmun remchang dah tur a ni a, chutiang chuan epidural bleeding chu vertebrae hma lamah a luang thei ang a, negative pressure drainage tube hmangin a chhuak thei ang
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C. Operation zawhah chuan vital signs te chu ngun takin en la; Drainage chu a hmin tha hle tur a ni; Thrombosis laka inven nan anticoagulant damdawi chu a remchan dan angin hmang ang che; nervous system hnathawh dan ngun taka enfiah thin; Thil dik lo a awm chuan a hun takah hmachhawn rawh.
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Ram pum huap anatomical dimensions nena inmil tura duan .
1. Hooked vertebral joint enkawlna atan personalized clinical solution a pe.
2. Vertebral body subsidence chance tihtlem .
3. Spinal epidural hematoma vei theihna tihziaawmna .
Variable angle screw design hmanga hnathawh awlsam a ni.
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Screws coronal swing angle -1.5°11.5° a nei a, cephalad swing angle 36°44° a ni a, intraoperative nail dah awlsam zawk nan
Screw insertion atan hmun dang reserve a ngai lo, incision tlem ber chu 2.5cm atanga 2.0cm vel ah tihhniam a ni.
Spinal endoscopic operation concept nena inmil zawk, endo-acdf hriatchhuah.
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CzMedItech chungchang .
Cervical peek cage,2 emaw 4 locking screw) te hi precision orthopedic solutions uluk taka siam a ni a, . CZMedItech hian anterior cervical discectomy decompression leh implant fusion-ah a innghat a, khawvel pum huap vision-in a hruai a, khawvel hmun hrang hranga harsatna khirh tak tak nei damlote tana enkawlna kimchang, awlsam leh man tlawm zawka enkawlna tur ruahmanna siam tura inpe a ni.
Anterior cervical discectomy with decompression and implant fusion (ACDF) hi spinal cord-type leh nerve root-type cervical spondylosis, cervical spine trauma leh natna dang enkawlna atana surgical method hman tlanglawn ber pakhat a ni a, initial stabilisation, fusion rate sang, normal anterior convexity siamthat leh external awm lohna te a thatna a nei bawk fixation, etc. Operation hnua hman tlanglawn tak complications te chu ei harsa, a kianga segment te degeneration, laryngeal reentrant nerve paralysis, cerebrospinal fluid leakage, haematoma, infection, leh intervertebral implant subsidence etc. Postoperative complication awm zawng zawng hi 8% vel a ni.
