Moralo o mocha oa R&D

MIS | Ntlafatso ea Theknoloji - Melemo ea Theknoloji - Liphetho tsa Post-operative | czmeditech

The Minimally Invasive Spine System (MIS) ke thekenoloji ea morao-rao e nolofalletsang phekolo e nepahetseng ka mekhoa e menyenyane bakeng sa maemo a kang li-discs tsa herniated le spinal stenosis.

Lintlha tse ncha tsa moralo

Melemo e fokolang haholo

Matšoenyeho a fokolang

Moralo o monyane oa ho seha:

Likarolo tse tloaelehileng ke 1-2 cm feela, ho fokotsa mesifa le tšenyo ea lisele tse bonolo.

Theknoloji ea ho beha maemo ka nepo:

Ho nepahala ho ntlafetseng ha ho kenya li-implant ka ho tsamaea ka har'a opereishene (mohlala, O-arm, 3D-C-arm) kapa thuso ea robotiki (mohlala, Mazor X, Globus Medical).

Ho fokotseha ha mali a tsoang ka har'a opereishene:

thekenoloji e fokolang haholo ea ho fihlella e fokotsa kotsi ea kotsi ea methapo, haholo-holo ho bakuli ba tsofetseng kapa ba nang le bokooa.

Ho hlaphoheloa kapele ka mor'a ho buuoa

Ho lula nakoana sepetlele:

bakuli ba bangata ba lokolloa lihora tse 24-48 ka mor'a ho buuoa, ha ho bapisoa le matsatsi a 3-5 bakeng sa ho buuoa ka tloaelo ho bulehileng.

Ho tsamaea kapele:

Bohloko bo fokolang le tšireletso e ntle ea mesifa e lumella bakuli hore ba khutlele mesebetsing ea bona ea letsatsi le letsatsi ka potlako.

Ntlafatso ea biomechanical

Lisebelisoa tse ncha:

mohlala, li-alloys tsa titanium tse hatisitsoeng tsa 3D, PEEK (polyether ether ketone) lisebelisoa ho finyella modulus ea elasticity e haufi le ea masapo le ho fokotsa khatello ea maikutlo.

Sistimi ea matla ea botsitso:

li-implants tse ling (mohlala, Dynesys, Coflex) li boloka lesapo la mokokotlo le ho fokotsa kotsi ea ho senyeha ha karolo e haufi.

Lipontšo tse atolositsoeng

Ho koahela mefuta e mengata ea li-pathologies tsa mokokotlo tse kang lefu la degenerative disc, lumbar spinal stenosis, spondylolisthesis e bonolo le fractures ea mokokotlo.

临床案列

Tse latelang ke linyeoe tsa lipatlisiso lilemong tsa morao tjena:

1. Teko e laoloang ka mokhoa o sa reroang ea lumbar spine fusion (TLIF)

Moralo oa boithuto:

RCT (2022) e lebelletsoeng ho ba le litsi tse ngata tse bapisa MIS-TLIF (e hlaselang hanyane) le TLIF e bulehileng.

Saese ea mohlala:

Bakuli ba 120 ba nang le lefu la mokokotlo oa mokokotlo oa karolo e le 'ngoe.

Liphetho:

Nako ea ho buuoa:

nako e telele hanyenyane sehlopheng sa MIS (ho bolela 150 min vs. 130 min), empa 60% e fokotsehile ho tsoa mali (<100 ml vs. 250 ml).

Mahlaba a Postoperative:

Ho fokotseha ha 50% ho lintlha tsa VAS 1 beke ka mor'a ho sebetsa sehlopheng sa MIS, ha ho na phapang e khōlō pakeng tsa lihlopha tse peli ka mor'a likhoeli tsa 3.

Sekhahla sa Fusion:

Selemo sa 1 sa postoperative CT se bontšitse> 90% sekhahla sa fusion lihlopheng ka bobeli.

Mathata:

Sekhahla sa tšoaetso 2% sehlopheng sa MIS vs. 8% sehlopheng se bulehileng.

2. Thuto ea nako e telele ea ho latela mokhoa oa ho tsitsisa o matla (Coflex)

Moralo oa boithuto:

Phuputso ea morao-rao ea Europe ea lilemo tse 5 (2021) e hlahlobang ho kenngoa ha Coflex bakeng sa phekolo ea lumbar spinal stenosis.

Saese ea mohlala:

Bakuli ba 80.

SEphetho:

Ntlafatso ea ts'ebetso:

ODI (index ea dysfunction) e fokotsehile ho tloha ho lintlha tse 45 qalong ho ea ho lintlha tse 20 lilemong tse 5.

HO HLAHALA KAROLO EA MOAhisani:

Ke bakuli ba 12% feela ba ileng ba hlahisa mathata a likarolo tse haufi, tse tlase haholo ho feta fusion e tloaelehileng (~ 30%).

Sekhahla sa ts'ebetso:

Keketseho ea lilemo tse 5 tsa ts'ebetso ea 8%, haholoholo ka lebaka la ho lokoloha ho kenngoeng (4%) kapa ho ipheta ka matšoao.

3. Boithuto bo bongata ba li-implants tsa MIS tse thusoang ke liroboto

Moralo oa boithuto:

boithuto ba morao-rao bo phatlalalitsoeng ka 2023 ho sekaseka liphetho tsa ho beoa ha screw ea MIS ka thuso ea robotiki ea Mazor.

Saese ea mohlala:

500 li-screw placements (thoracolumbar spine).

Liphetho:

Nepahalo:

98.6% ea li-screw positions e ne e le tse khotsofatsang (Gertzbein-Robbins o thathamisa A/B).

Mathata:

sekhahla sa ho lemala ha methapo ea kutlo ke 0.4% ha e bapisoa le 3-5% bakeng sa ho beoa ha matsoho ho tloaelehileng.

Bakeng sa tsebo e eketsehileng ea sehlahisoa le lintlha, ka kopo ikopanye le rona!