Kapangidwe katsopano ka R&D

MIS | Kukwezera Ukadaulo - Ubwino Waukadaulo - Zotsatira Zapambuyo Pantchito | czmeditech

The Minimally Invasive Spine System (MIS) ndiukadaulo wamakono womwe umathandizira chithandizo cholondola kudzera m'madontho ang'onoang'ono azinthu monga ma disc a herniated ndi spinal stenosis.

Tsatanetsatane wa mapangidwe atsopano

Ubwino wocheperako

Zowonongeka zochepa

Kapangidwe kakang'ono:

Mawonekedwe odziwika ndi 1-2 cm okha, amachepetsa kuvula kwa minofu ndi kuwonongeka kwa minofu yofewa.

Ukadaulo woyikira mwatsatanetsatane:

Kuwongolera kolondola kwa kuyika kwa implant ndi kuyenda kwa intraoperative (monga O-arm, 3D-C-arm) kapena thandizo la roboti (monga Mazor X, Globus Medical).

Kuchepa kwa magazi m'thupi:

ukadaulo wofikira pang'ono umachepetsa chiopsezo cha kuvulala kwa mitsempha, makamaka kwa okalamba kapena odwala omwe ali ndi comorbid.

Kuchira msanga pambuyo pa opaleshoni

Chipatala chachifupi:

Odwala ambiri amatulutsidwa patatha maola 24-48 atachitidwa opaleshoni, poyerekeza ndi masiku 3-5 a opaleshoni yachikhalidwe.

Kusuntha koyambirira:

Kupweteka kochepa komanso chitetezo chabwino cha minofu chimalola odwala kubwerera kuntchito zawo za tsiku ndi tsiku mofulumira.

Kukhathamiritsa kwa biomechanical

Ntchito zatsopano:

mwachitsanzo 3D yosindikizidwa titaniyamu aloyi, PEEK (polyether etha ketone) zipangizo kukwaniritsa modulus ya elasticity pafupi ndi fupa ndi kuchepetsa nkhawa masking.

Makina okhazikika okhazikika:

ma implants ena (monga Dynesys, Coflex) amateteza kusuntha kwa msana ndikuchepetsa chiopsezo cha kuwonongeka kwa gawo loyandikana nalo.

Zizindikiro zowonjezera

Kuphimba matenda osiyanasiyana a msana monga matenda osokoneza bongo, lumbar spinal stenosis, mild spondylolisthesis ndi vertebral fractures.

临床案列

Zotsatirazi ndi zochitika zoimira kafukufuku m'zaka zaposachedwa:

1. Kuyesedwa kosasinthika kwa lumbar spine fusion (TLIF)

Kapangidwe ka maphunziro:

oyembekezera multicenter RCT (2022) kuyerekeza MIS-TLIF (yowononga pang'ono) ndi TLIF yotseguka.

Kukula kwachitsanzo:

Odwala 120 omwe ali ndi gawo limodzi losasinthika la lumbar msana matenda.

Zotsatira:

Nthawi ya Opaleshoni:

motalika pang'ono mu gulu la MIS (kutanthauza 150 min vs. 130 min), koma 60% kuchepa kwa magazi (<100 ml vs. 250 ml).

Ululu pambuyo pa opaleshoni:

Kuchepetsa kwa 50% mu masewera a VAS 1 sabata pambuyo pa gulu la MIS, palibe kusiyana kwakukulu pakati pa magulu awiriwa pambuyo pa miyezi 3.

Fusion rate:

1 chaka cha postoperative CT chinasonyeza> 90% mlingo wa fusion m'magulu onsewa.

Zovuta:

Chiwerengero cha matenda 2% mu gulu la MIS vs. 8% mu gulu lotseguka.

2. Kafukufuku wotsatizana kwa nthawi yayitali wa dynamic stabilization system (Coflex)

Kapangidwe ka maphunziro:

Kafukufuku wotsatira wazaka 5 ku Europe (2021) akuwunika kukhazikitsidwa kwa Coflex pochiza lumbar spinal stenosis.

Kukula kwachitsanzo:

80 odwala.

Zotsatira:

Kusintha kwa magwiridwe antchito:

ODI (chilolezo chosokonekera) chinatsika kuchokera ku mfundo za 45 poyambira kufika pa mfundo 20 pa zaka 5.

KUSINTHA KWA CHIGAWO CHONSE:

Odwala 12% okha ndi omwe adakumana ndi mavuto oyandikana nawo, otsika kwambiri kuposa maphatikizidwe wamba (~ 30%).

Mlingo woyambiranso:

kuchuluka kwa 5-year reoperation rate 8%, makamaka chifukwa cha implant kumasula (4%) kapena kuyambiranso kwazizindikiro.

3. Kafukufuku wambiri wa ma implants othandizidwa ndi roboti a MIS

Kapangidwe ka maphunziro:

kafukufuku wobwereza womwe adasindikizidwa mu 2023 kuti aunike zotsatira za MIS screw placement ndi thandizo la robotic la Mazor.

Kukula kwachitsanzo:

500 screw placements (thoracolumbar spine).

Zotsatira:

Kulondola:

98.6% ya ma screw positions anali okhutiritsa (Gertzbein-Robbins grading A/B).

Zovuta:

minyewa muzu kuvulala mlingo 0.4% poyerekeza 3-5% kwa ochiritsira freehand makhazikitsidwe.

Kuti mudziwe zambiri zamalonda ndi zambiri, chonde titumizireni!