Mayelana NATHI
Inkampani Changzhou Meditech Technology Co., Ltd., etholakala e-Changzhou Science & Education Town, esifundazweni sase-Jiangsu, igxile kakhulu ekwenzeni izimila nezinsimbi zamathambo.
Ngemuva kweminyaka engaphezu kwe-10 yocwaningo nokuthuthukiswa, Sinochungechunge oluyinhloko lomkhiqizo we-10 futhi luyisistimu yomgogodla, isistimu ye-nail ye-intramedullary, i-trauma plate kanye nesistimu ye-screw, ipuleti lokukhiya kanye nesistimu yesikulufu, uhlelo lwe-CMF, uhlelo lwe-fixator yangaphandle, uhlelo lwamathuluzi wezokwelapha, uhlelo lwezinsimbi zokuhlinza jikelele, uhlelo lwesitsha sokuvala inzalo kanye nesistimu ye-orthopedic yezilwane.
Njengomthengisi wemishini yezokwelapha enolwazi olungaphezu kweminyaka eyishumi, futhi enezitifiketi ze-CE ne-ISO, imikhiqizo yethu ithunyelwe emazweni amaningi afana ne-USA, Germany, Argentina, Chile, Mexico, India,Thailand, Malaysia, Turkey, Egypt, South Africa, Ivory Coast, njll.
Emthethweni 'wekhwalithi kuqala, isevisi kuqala, i-R&D kuqala, ukuqamba okusha kuqala', inkampani yethu izuza idumela elihle kakhulu ekhaya naphesheya. Le nkampani ithatha iziguli ezizuzayo njengomgomo wayo waphakade futhi yenza imizamo engapheli empilweni yabantu.
Ukuhlinzwa Umgogodla
Kunezinhlobo eziningi zokuhlinza umgogodla, ikakhulukazi ezihlasela kancane futhi ezivulekile. Amanye ama-lumbar fractures, i-disc herniation, isifo sofuba somgogodla, i-scoliosis ingelashwa ngokuhlinzwa. Ukuhlinzwa okuhlaselayo okuncane ikakhulukazi kuhlanganisa: i-vertebroplasty, i-radiofrequency ablation, ukususwa kwe-nucleus pulposus endoscopic, i-percutaneous pedicle screw rod fixation yangaphakathi, njll. Ukuhlinzwa okuvulekile ikakhulukazi kuhlanganisa ukunciphisa okuvulekile nokulungiswa kwangaphakathi, i-laminectomy, ukuwohloka okuvulekile nokulungiswa kwangaphakathi, njll. Futhi sizokwethula lokhu ngakunye ngakunye:
A. I-Spondylosis yomlomo wesibeletho
Ukuze kusetshenziswe i-cervical disc herniation, i-cervical spondylotic myelopathy, kanye ne-ossification ye-posterior longitudinal ligament yomgogodla womlomo wesibeletho, ezinye izibhedlela noma odokotela benza ukuhlinzwa kwangaphambili noma ukuhlinzwa ngemuva. Eqinisweni, kunezinhlobo eziningi zokuhlinzwa ongakhetha kuzo. Abantu banokuhlangenwe nakho okuningi okuphumelelayo kulezi zinhlobo zokuhlinzwa, ezingasetshenziswa ngokunengqondo ngokuvumelana nezimo ezihlukahlukene, ngaphandle kwanoma yibuphi ubuchwepheshe, izimo, nemibono emincane, futhi zinikeze ukudlala okugcwele ezinzuzweni ezifanele zezinhlobo ezahlukene zokuhlinzwa. Nge-spondylosis yomlomo wesibeletho eyinkimbinkimbi, ukuchithwa nokulungiswa ngokusebenzisa izindlela zombili zangaphambili nangemuva kunganciphisa kakhulu isikhathi sokulaliswa esibhedlela, futhi umphumela wokunciphisa okuphelele ungcono.
I-decompression yangaphambili yomlomo wesibeletho kanye nokuhlanganiswa ne-bone graft kanye nokulungiswa kwangaphakathi:
Isebenza ku-spondylosis yomlomo wesibeletho nge-protrusion ye-intervertebral discand izingxenye zokucindezela okufushane (izikhala ze-1-3) zezitshalo ze-spur. Inenzuzo yokukhishwa okuqondile kwesilonda, okuyinto elula futhi elula. Kuwukuhlinzwa okuvamile kanye nendlela eyisisekelo yokwelapha i-spondylosis yomlomo wesibeletho.
I-posterior decompression yomlomo wesibeletho kanye ne-laminoplasty:
Isebenza ku-spondylosis yomlomo wesibeletho ngenombolo kanye nengxenye ye-intervertebral disc compression kanye ne-spinal canal stenosis, kanye nokucindezela okunzima kwangaphambili (i-ossification ye-posterior longitudinal ligament, intervertebral disc). Kungokwe-decompression engaqondile, enenzuzo yokulondoloza umsebenzi wokunyakaza komlomo wesibeletho futhi iphephile ngokuqhathaniswa.
I-Artificial cervical disc replacement:
Isebenza ezigulini ezingaphansi kweminyaka engu-60 ubudala ezinesigaba esifushane sokucindezelwa kwe-intervertebral disc yangaphakathi. Ngenkathi i-decompressing futhi ikhulula ukucindezelwa komgogodla, igcina umsebenzi womgogodla womlomo wesibeletho, inciphisa amathuba okusheshisa ukuwohloka kwezingxenye eziseduze, ukuze iziguli zikwazi ukuhamba ngaphambi kokuhlinzwa futhi umsebenzi useduze nesimo somzimba.
Isigaba sokuqala sokuwohloka komlomo wesibeletho sangaphambili nangemuva kanye nokulungiswa
I-Decompression iphelele futhi iphephile, ilungele i-spondylosis yomlomo wesibeletho enzima futhi ekhethekile. Ezimweni ze-cervical spondylotic myelopathy enohlobo lwe-clamp noma ingxenye ende ye-spinal stenosis kanye nokucindezelwa okukhulu kwangaphambili, kunemikhawulo ethile ekuhlinzeni kwangaphambili noma ngemuva kuphela. Sithatha indawo ejwayele ukuhlinzwa ngemuva, bese sithatha indawo yokulala ukuze sihlinzwe ngaphambili, kanye nesigaba sokuqala sokuwohloka kwangaphambili nangemuva.
Izinzuzo : Ngemva kokuwohloka kwe-posterior, intambo yomgogodla womlomo wesibeletho ingakhukhuleka ngemuva, isikhala esiphambi komgogodla wesibeletho siyanda, futhi ukucindezela emgodini womgogodla kuyancipha, ukunciphisa ingozi yokuhlinzwa kwangaphambili. Ngesikhathi esifanayo, ukucindezelwa kwamazwe amabili kuyakhululwa, ukuchithwa kuphelile, umphumela usobala, futhi kuyasiza ekubuyiseleni umsebenzi womgogodla; kunciphisa ubuhlungu beziguli futhi kulula ukuba iziguli zamukele. Igwema ukungalungi kokulaliswa esibhedlela kabili, ukuhlinzwa kwesibili, inkambo ende yezifo, futhi yonga izindleko zokulaliswa esibhedlela.
I-posterior cervical foraminal decompression kanye ne-discectomy
Uma kuqhathaniswa nendlela yangaphambili, i-posterior cervical foraminal decompression ayidingi i-bone graft fusion futhi ayilahlekelwa ububanzi bokunyakaza komgogodla womlomo wesibeletho. I-posterolateral cervical disc herniation nucleus pulposus ukususwa ngokusebenzisa indlela yangemuva yenziwa ngaphansi kombono oqondile futhi kulula, ngakho iphephile futhi inokwethenjelwa. Izinkomba: i-posterolateral cervical disc herniation, i-single level intervertebral foramen stenosis, i-multi-level intervertebral foramen stenosis ngaphandle kwe-central stenosis yomgogodla womgogodla, kanye nezimpawu zezimpande eziqhubekayo ngemva kwe-discectomy yangaphambili kanye nokuhlanganiswa.
Ukuhlinzwa kwesifo sentamo engenhla
Ukulimala kanye nezifo zomgogodla ophezulu womlomo wesibeletho kungabangela ukungasebenzi kahle komgogodla. Ngenxa yesakhiwo esiyinkimbinkimbi se-anatomical, izibhedlela eziningi azikwazi ukuzelapha. Isibonelo, i-atlantoaxial fracture kanye ne-dislocation, i-atlanto occipital malformation, kanye ne-rheumatoid engenhla ye-spondylopathy yomlomo wesibeletho, ukukhululwa kwangaphambili kanye nokulungiswa kwangemuva kungasetshenziswa ukunciphisa ukukhishwa, ukukhulula ukucindezelwa komgogodla, nokusindisa izimpilo.
I-B.Lumbar disc herniation, i-lumbar spinal stenosis, i-lumbar spondylolisthesis, i-discogenic low back pain
Ukuhlanganiswa kwe-Intervertebral akudingi ukususwa kwamathambo e-pelvic nge-lumbar spinal stenosis noma i-spondylolisthesis ye-lumbar ebangelwa izizathu ezihlukahlukene. Inhloso yokuqala yokuhlinzwa ukuwohloza imizwa. Uma umgogodla ungaqiniseki, ukuhlangana komgogodla kunqunywa ngokwezinga lokungazinzi kanye ne-spondylolisthesis. I-posterolateral spinal bone graft (PLF) noma i-interbody bone graft (PLIF) ikhethwa ngokuya ngokuthi ifanele yini ukulungiswa kwangaphakathi kwesikulufu se-pedicle. Ku-PLIF, yonke i-vertebral arch ekhishiwe kanye ne-inferior articular process complex (i-incision median) isetshenziswa njenge-interbody bone graft fast, engatholi nje kuphela into engcono kakhulu yokuxhunyelelwa kwethambo, kodwa futhi igweme ukuthatha ithambo kusuka ku-pelvis noma ukuthenga i-interbody fusion cage, eqeda izinkinga zokususwa kwamathambo futhi kunciphisa kakhulu izindleko zokusebenza.
Ngokwezinhlobo ezahlukene ze-pathological, i-fenestration ye-nucleus pulposus, i-laminectomy kanye ne-discectomy (ngezinye izikhathi nge-bone graft fusion kanye nokulungiswa kwangaphakathi) kanye nokufakwa esikhundleni se-disc yokufakelwa.
Ukuwohloka komsele womgogodla kanye nezimpande zezinzwa kungenzeka. Ezigulini ezinokungazinzi komgogodla, ukulungiswa okunamandla noma ukulungiswa kwe-fusion kufanele kwenziwe ngokukhetha, ukuze iziguli zikwazi ukufeza umgomo wokwelashwa ngezindleko ezincane futhi zithole imiphumela eyanelisayo.
I-1) Ukulungiswa okunamandla kwe-lumbar spine - akugcini nje ukuzinzisa umgogodla, kodwa futhi kugcina umsebenzi wokunyakaza kwe-lumbar. Izinzuzo zayo zihlanganisa: (1) inganciphisa kakhulu ingcindezi ye-intervertebral disc futhi ivimbele ukuwohloka kwe-intervertebral disc; (2)Ukuxhuma okunwebekayo kugcina futhi kubuyisela ibhalansi yezinhlangothi ezintathu zesegimenti enyakazayo.
2) Ukuhlinzwa okungenavaza okuncane kokuwohloka komgogodla okugciniwe ubuqotho bemisipha - indlela yokuhlinzwa ethuthukisiwe eyethulwe phesheya. Ngemva kokuthuthukiswa okuqhubekayo, ukuhlinzwa kune-incision encane, ayihlikihli imisipha, igcina ukuma kwemigqa nama-vertebrae, futhi ukucindezeleka ngaphansi kwengilazi yokukhulisa kanye ne-microscope kunokwethenjelwa ngokugcwele, akulimazi ukuzinza komgogodla, futhi kunempendulo elula ngemva kokuhlinzwa. Iziguli zingahamba ngosuku lwesibili, futhi ziphume esibhedlela ngemva kwezinsuku ezingu-5-7.
I-Lumbar spondylolisthesis
Kuyinkomba engcono kakhulu ye-decompression kanye nokunciphisa, i-bone graft fusion, nokulungiswa kwangaphakathi kwe-pedicle. Futhi kuwuhlobo oluvame kakhulu lokuhlinza kusetshenziswa i-titanium plate fixation. Ukusebenza kunzima futhi kukhulu ngezinga. Isizathu noma isigaba sokuqala se-spondylolisthesis, i-lumbar spondylolysis, kulula kakhulu ukubhekana nayo ngesikhathi.
I-1) I-spondylolysis ye-Lumbar ingase ibangelwe ukuphuka kokukhathala kwengxenye ye-lumbar spine (isthmus, amalunga amancane) ngenxa yokuzivocavoca okuphindaphindiwe. Uma ingapholi, ukuze kuvinjelwe i-spondylolisthesis ye-lumbar, ikakhulukazi uma izimpawu zisobala, i-bone graft ingasetshenziswa ukulungisa i-isthmus, izikulufu ezimbili kanye nekhebula le-titanium, elilula futhi eliphephile.
I-2) I-spondylolisthesis ye-Lumbar yaphathwa ngokunciphisa okuvulekile okuhlinzwa, i-intervertebral bone graft fusion (PLIF), kanye nokulungiswa kwangaphakathi kwe-pedicle. Inhloso yokuqala yokuhlinzwa ukuwohloza imizwa. Lapho i-PLIF ibheka i-lumbar fusion cage yenziwa, yonke i-vertebral cage arch kanye ne-inferior articular process complex (i-median incision) isetshenziswa njenge-graft esheshayo ye-bone interbody, engakwazi nje ukuthola i-bone best graft material, kodwa futhi igweme ukuthatha ithambo kusuka ku-pelvis noma ukuthenga idivayisi ye-fusion ye-interbody (i-interbody fusion cage), ukunciphisa ukukhishwa kwamathambo, nezindleko ezinkulu.
Ubuhlungu be-Discogenic low back
I-Dynamic lumbar fixation, i-artificial disc replacement kanye ne-interbody fusion (yangaphambili noma ngemuva) kukhethiwe.
C. Ukuphuka komgogodla
Kusukela ekuqhekekeni kwe-vertebra engenhla yomlomo wesibeletho kuya ku-lumbosacral vertebra fracture, i-decompression yangaphambili noma yangemuva kanye nokulungiswa komgogodla kuyamukelwa.
1. I-intraoperative myelography kanye ne-transpedicular decompression
Ekunciphiseni okuvulekile, ukucindezeleka nokulungiswa kwangaphakathi kwe-thoracolumbar burst fracture, umphumela wokunciphisa ungabhekwa ngokuphumelelayo ukuze unciphise ukulimala kwe-iatrogenic.
2. I-kyphoplasty ye-percutaneous encane ehlaselayo yokwelashwa kwe-vertebral compression fractures kubantu asebekhulile
Inalithi eyodwa kuphela kasimende wethambo engajovwa. Ubuchwephesha obungangeneleli ngempela bokuqeda izinhlungu nokuphuma embhedeni ezinsukwini ezi-1-3 ngemuva kokuhlinzwa.
D. Ukuhlinzwa komgogodla okungavamisile
A. Umgomo wokuhlinzwa komgogodla omncane (i-MISS) uwukufinyelela umphumela wokwelashwa kokuhlinzwa okuvamile nokunciphisa ukuhlukumezeka kokuhlinzwa ngangokunokwenzeka, ukuze kuncishiswe izehlakalo zezinkinga, ukopha ngaphandle kokuhlinzwa, ukuhlala esibhedlela, njll., ukuze iziguli zilulame futhi zibuyele ekuphileni okujwayelekile futhi zisebenze ngokushesha ngangokunokwenzeka.
Ukuhlinzwa okujwayelekile okuhlasela kancane kuhlanganisa:
Ubuchwepheshe be-Endoscopic
I-endoscopy yomgogodla ibhekisela ekutheni udokotela ohlinzayo, ngaphansi kokuqondiswa kwe-X-ray noma ukuhamba phakathi nokuhlinzwa, usebenzisa amathuluzi okwandisa ama-puncture ukuze abhoboze kusukela esikhumbeni kuya ezilonda zomgogodla, usungula iziteshi ze-endoscopic kanye nokuhlinzwa okuhlinzwa, usebenzisa amanzi njengendlela ephakathi, akhulise futhi abonise imiphumela yangaphakathi nezilonda ku-high-definition display screen ngokusebenzisa isikrini se-endoscopic kadokotela. Izindlela zokuhlinza ezisetshenziswa kakhulu zihlanganisa: i-lateral lumbar foraminal endoscopy, i-posterior lumbar lamina approach endoscopy, kanye nokuhlinzwa kwe-endoscopic yomlomo wesibeletho ngemuva. Uma kuqhathaniswa nokuhlinzwa kwendabuko noma i-microsurgery, inezinzuzo ezilandelayo: (1) Izinkomba ezibanzi, ukopha okuncane nokuhlukumezeka, akukho monakalo esakhiweni esivamile somgogodla, futhi ukusika ngokuvamile kungaphansi kwe-1 cm; (2) Ukusebenza ngaphansi kwe-anesthesia yendawo kungakhethwa, futhi ukuxhumana kwesikhathi sangempela phakathi kodokotela neziguli kuyatholakala ukuze kube lula ukusebenza nokugwema ukulimala kwenzwa ye-intraoperative; (3) Izinkinga ezincane, ukululama ngokushesha, kungaphuma embhedeni ngemva kokuhlinzwa, ukukhishwa ezinsukwini ezingu-1-2, noma ukuhlinzwa ngaphandle; (4) Izinga lokutheleleka eliphansi; (5) Inkinga yesikhathi eside yokuwohloka okusheshayo kwamasegimenti aseduze ekuhlanganiseni kwangaphambi kwesikhathi iyagwenywa. Ukungalungi kuhlanganisa: (1) Kunesilinganiso esithile sokuphinda. Uma ukuphindaphinda kwenzeka, ukusebenza kabusha kuzoba nzima kakhulu futhi kube yingozi ngenxa yokunamathela kwesibazi sokusebenza kokuqala. (2) Kunezinkinga ezithile, njengokucindezelwa kwe-nucleus pulposus eyinsalela, ukulimala kwezimpande ze-dural kanye nezinzwa, ukutheleleka kwesikhala se-intervertebral, ukopha, ukungezwani kwezinzwa zangemva kokuhlinzwa; (3) Izinkomba zokuhlinzwa zilinganiselwe, ikakhulukazi ukwelashwa kwe-intervertebral disc herniation elula. Ukuze uthole i-intervertebral disc herniation eyinkimbinkimbi noma i-stenosis yomgogodla ehlangene, ingelashwa futhi. Uma umphumela ungemuhle, ukuhlinzwa okuvulekile kuyadingeka futhi.
2. Ingxubevange encane kanye nobuchwepheshe bokulungisa bangaphakathi
I-Lumbar fusion kanye nokulungiswa kwangaphakathi kuyindlela eyisisekelo yokuhlinzwa yokwelashwa kwezinkinga ze-lumbar. Ngokusebenzisa izindlela zangaphambili, i-anterolateral, i-lateral, i-posterolateral kanye ne-posterior ye-lumbar spine, i-bone grafting noma i-fusion cage, inqubo ye-facet ehlangene kanye ne-intertransverse ifakwe endaweni ye-intervertebral, ukuze ukuhlanganiswa kwamathambo phakathi kwamalungu e-lumbar kwenzeke, ngaleyo ndlela kusungulwe futhi kugcinwe ukuzinza komgogodla we-lumbar. Ngokombono, ingxenye yokuhlinzwa ngeke iphinde ivele. Izindlela zokuhlanganisa ezihlasela kancane nezindlela zangaphakathi zokulungisa zihlanganisa i-transforaminal lumbar interbody fusion (MIS-TLIF) ne-minimal invasive lateral lumbar interbody fusion (LLIF). I-LLIF iphinde ihlanganise ikheji yokuhlanganisa i-lateral fusion (DLIF) kanye ne-oblique lateral fusion edume kakhulu (OLIF). Ubuchwepheshe bokulungisa obuhlanganisayo obungangeneleli kancane bangaphakathi bungenisa ngokuyinhloko izandisi ezikhethekile nama-tubular retractors ukuze kuncishiswe ukulimala kwezicubu ezithambile futhi kwenze ukubona ngeso okuhle kakhulu kwendawo yokusebenza kube nokwenzeka. Ingakwazi ukusebenzisana nesibonakhulu esisebenzayo noma ingilazi yokukhulisa amandla aphezulu ukuze kwandiswe inkambu yokuhlinza yombono, ukuze kuncishiswe ukusikeka kwesikhumba nokulimala kwezicubu zangaphakathi, futhi yenze ukuhlinzwa komgogodla kuqalise ukwelashwa okuphumelelayo kakhulu ngomonakalo omncane we-iatrogenic. Uma kuqhathaniswa nokuhlinzwa okuvulekile, ubuchwepheshe bokulungiswa kwangaphakathi obuhlanganisiwe obuncane bunemiphumela engcono ngokuhlala esibhedlela, ukulahlekelwa igazi, isikhathi sokululama kanye nesikhathi sokubuyela ekuphileni okuvamile. Ngesikhathi esifanayo, ngokuvamile ingagcina isakhiwo sekholomu yangemuva yomgogodla, ukunciphisa ukulimala kwemisipha, futhi ngaleyo ndlela kunciphise ubuhlungu be-postoperative. I-fusion encane engavamile kanye nobuchwepheshe bokulungisa kwangaphakathi bunezibonakaliso eziningi ezihlukahlukene, kuhlanganise nezifo ezihlukahlukene zomgogodla, i-spinal stenosis, i-disc herniation eyinkimbinkimbi, ukungazinzi, i-scoliosis, njll. Ezigulini ezinezimo ezinzima kakhulu ezingafanelekile i-endoscopy, imisebenzi enjalo kufanele ithathwe kaningi.
3. I-Percutaneous vertebroplasty
Ingowokuhlinzwa okungavamisile, okuhlanganisa i-percutaneous vertebroplasty (PVP) kanye ne-percutaneous balloon kyphoplasty (PKP). Kuwubuchwepheshe ukuthi usimende wethambo lezokwelapha noma ama-biomaterials amathambo okufakelwa ajovwe emzimbeni we-vertebral ogulayo ngokubhoboza isikhumba ukuze kuqinise umzimba we-vertebral. Izifo ezisebenzayo zihlanganisa: 1. I-Osteoporotic vertebral compression fracture, engasebenzi kahle nge-brace noma ukwelashwa kwezidakamizwa; 2. Ama-Benign tumors noma izicubu ezimbi ze-metastatic zomzimba we-vertebral; 3. Ukuphuka komgogodla nge-osteonecrosis noma i-nonnunion ngemva kokuphuka; 4. Ukuphuka kokucindezela okungazinzile noma ukuphuka kwe-vertebral compression fracture; 5. Ukuphuka kokuqhuma ngodonga olungemuva oluqinile lomzimba we-vertebral. Izici zalokhu kusebenza: 1. Ukwelashwa kokungenelela okuncane okungenele ngaphansi kwe-anesthesia yendawo kunesikhathi esifushane sokusebenza, ukusika kungaphakathi kwe-0.5cm, ukopha ku-2-3ml, futhi umphumela we-analgesic ucacile. Inomsebenzi wokudambisa izinhlungu nokwakha kabusha amandla e-biomechanical wethambo ngesikhathi esifanayo. 2. Kubantu asebekhulile kanye neziguli ezibuthakathaka, ingozi yokuhlinzwa incane, futhi izinkinga ezingaba khona ezibangelwa ukungasebenzi kahle ziyagwenywa. 3. Ukubuyiselwa emuva kokuhlinzwa kuyashesha futhi isikhathi sokulaliswa esibhedlela sifushane. 4. Ngenxa yokukhululeka ngesikhathi sobuhlungu, imiphumela emibi kanye nokuncika kwezidakamizwa zokuthatha ama-painkillers kuyagwenywa, futhi izinga lokuphila liyathuthukiswa. 5. Kwehlisa kakhulu isikhathi sokuthi iziguli ziphumule embhedeni zidinga abanakekeli.
4. Irobhothi lisizwa futhi lizulazula ukuhlinzwa komgogodla
Ukuhlinzwa komgogodla kudinga ukuthi odokotela basebenze ngokunemba okuphezulu, futhi amaphutha amancane azoholela emiphumeleni eyinhlekelele. Isibonelo, ngobuchwepheshe bokufaka isikulufa se-lumbar pedicle, ngesikhathi senqubo yokufaka isikulufu, kufanele kuqinisekiswe ukuthi isikulufu sifakwe ngaphakathi kwe-pedicle. Ububanzi be-lumbar pedicle cishe bungama-8mm, futhi izinhlangothi zangaphakathi neziphansi ze-pedicle ziyizakhiwo ezibalulekile zemizwa. Isikulufu sethu singu-6.5 mm, okusho ukuthi uma isikulufu sibhodloza izindonga zangaphakathi nezingaphansi ze-pedicle, kungase kubangele ukulimala okukhulu kwezinzwa. Ngakho-ke, ukunemba nokuphepha kokufakwa kwesikulufa kubaluleke kakhulu. Irobhothi lokuhlinza lamathambo kanye nesistimu yokuzulazula, eqondiswa izithombe ze-3D, ingabeka ngokunembile izikulufi ngokuvumelana nendlela ehleliwe, ngokuzenzakalelayo noma i-semi-automatically screw kuzikulufu ze-pedicle, inciphise umonakalo emisipha ezungezile nezinye izicubu ezithambile, futhi iqinisekise ukunemba nokuphepha kokuhlinzwa. Ngobuchwepheshe be-endoscopic, ukuzulazula okuhlanganisiwe kunganciphisa kakhulu isikhathi sokubhoboza ukusebenza, ukulimala kwezicubu ezithambile kanye nokungaphatheki kahle kweziguli ngesikhathi sokuhlinzwa. Ukusetshenziswa kwerobhothi elisizwayo kanye nokuhlinzwa komgogodla kuzozuzisa kakhulu iziguli ezinezifo zomgogodla.
Ngamafuphi, ubuchwepheshe bomgogodla obungena kancane bungafinyelela inhloso yokwelapha ngokuphepha nangempumelelo ngokunciphisa ukulimala ngangokunokwenzeka. Nakuba ukufeza umphumela ofanayo noma ongcono njengokuhlinzwa komgogodla ovulekile, kunganciphisa ukuhlukumezeka kokuhlinzwa kweziguli, kukhuthaze ukululama kwazo kusenesikhathi, futhi kunciphise i-sequela yokuhlinzwa. Kodwa-ke, ukuhlinzwa komgogodla okungavamisile okuncane akukwazi ukumiselela ngokuphelele ukuhlinzwa komgogodla wendabuko. Uhlelo oluthile lokuhlinza kufanele lunqunywe ngokwesimo sesiguli, ubuchwepheshe bezokwelapha, ukuxhumana phakathi kodokotela neziguli nezinye izici. Ukuqoqwa kokuhlangenwe nakho kokuhlinzwa okuvulekile okuvamile kuyisisekelo sokuhlinzwa okungavamisile kancane. Lapho ukuhlinzwa okungenakuhlasela kancane kuhlangabezana nobunzima, kudinga ukushintshwa ukuze kuvulwe ukuhlinzwa kusenesikhathi ukuze kuqinisekiswe kangcono ukuphepha kweziguli kanye nempumelelo yokuhlinzwa. Okokugcina, kufanele sikhumbuze iziguli ezihlinzayo ukuthi ukugcinwa ngokucophelela nokuzivocavoca kwesayensi emva kokuhlinzwa okuphumelelayo nakho kubaluleke kakhulu, okungakwazi nje ukuthuthukisa ngokuphumelelayo izinga lokuvuselela, kodwa futhi kugweme ukuphindaphinda noma isifo se-vertebral esiseduze.
E. Isimila somgogodla nokuvuvukala
I-Tumor, isifo sofuba kanye nokuvuvukala kwe-suppurative yomlomo wesibeletho, i-thoracic kanye ne-lumbar vertebrae.
F. Isiphetho
1. Ayikho indawo eyimpumputhe ekuhlinzweni komgogodla
Ukuphepha nokuthembeka kuyinjongo yokuqala yokuhlinzwa komgogodla. Ngokuyinhloko ihlola futhi iphathe izifo eziwohlokayo zomgogodla, njenge-cervical spondylotic myelopathy, i-ossification ye-thoracic ligamentum flavum, i-lumbar spinal stenosis, i-disc herniation engxenyeni ngayinye kusukela emgodleni womlomo wesibeletho kuya ku-lumbar spine, kanye ne-ossification ye-posterior ligament longitudi. Ngaphezu kwalokho, iphinde ibhekane nazo zonke izinhlobo zokulimala nezifo ezenzeka emgogodleni, njengokuphuka komgogodla kanye nokuhlukana, ukukhubazeka komgogodla, isimila somgogodla (esiyinhloko kanye ne-metastatic), isifo sofuba somgogodla noma ukutheleleka kwe-suppurative.
2. Ukuhlinzwa komlomo wesibeletho okungenamkhawulo
Ngokuhlinzwa kwe-cervical spondylotic myelopathy kanye ne-ossification ye-posterior longitudinal ligament yomgogodla womlomo wesibeletho, ezinye izibhedlela noma odokotela benza imisebenzi yangaphambili noma yangemuva kuphela. Eqinisweni, kunezinhlobo eziningana zokusebenza ongakhetha kuzo - ukuwohloka komlomo wesibeletho sangaphambili kanye nokuhlanganiswa kwamathambo nokulungiswa kwangaphakathi, i-laminoplasty yangemuva yomlomo wesibeletho (umnyango owodwa, umnyango ophindwe kabili), kanye nesiteji esisodwa sangaphambili nangemuva kanye nokulungiswa kwangaphakathi. Sinolwazi oluningi oluyimpumelelo kulezi zinhlobo zokusebenza, ezingasetshenziswa ngokunengqondo ngokuvumelana nezimo ezihlukene, Ayinqunyelwe yinoma yibuphi ubuchwepheshe, izimo nemibono emincane, futhi inikeza ukudlala okugcwele ezinzuzweni ezifanele zezindlela ezahlukene.
3. Ukuhlinzwa kwe-Thoracic vertebra kulula futhi kunokwethenjelwa
Ukuze uthole i-ossification ye-thoracic posterior longitudinal ligament, enzima futhi esatshwa izibhedlela eziningi ezinkulu, senze i-segmental posterior decompression. Ezigulini ezinokucindezelwa kwangaphambili (i-ossification yemigqa noma i-protrusion of intervertebral discs), ukuchithwa kwangaphambili komgogodla kwenziwa ngendlela yokuthungatha ukuze kuzuzwe ukucindezeleka okuphelele kwe-360 ° ezungeze umgogodla, okugwema ukucindezelwa kwangaphambili nge-thoracotomy nokunciphisa kakhulu ukuhlukumezeka. Le nqubo ye-360 ° decompression iphinde isetshenziswe ekusebenzeni kokukhubazeka kwemilenze engezansi okubangelwa i-thoracic intervertebral disc prolapse kanye nokuphuka kwe-osteoporotic compression.
4. Ukuhlanganiswa kwe-Intervertebral akudingi ukukhishwa kwethambo le-pelvic
Nge-lumbar spinal stenosis noma i-spondylolisthesis ye-lumbar ebangelwa izizathu ezihlukahlukene, inhloso yokuqala yokusebenza ukuwohloka kwezinzwa. Uma umgogodla ungaqiniseki, ukuhlangana komgogodla kunqunywa ngokwezinga lokungazinzi kanye ne-spondylolisthesis. I-posterolateral spinal bone graft (PLF) noma i-interbody bone graft (PLIF) ikhethwa ngokuya ngokuthi ifanele yini ukulungiswa kwangaphakathi kwesikulufu se-pedicle. Ku-PLIF, yonke i-vertebral arch ekhishiwe kanye ne-inferior articular process complex (i-incision median) isetshenziswa njenge-interbody bone graft fast, engatholi nje kuphela into engcono kakhulu yokuxhunyelelwa kwethambo, kodwa futhi igweme ukuthatha ithambo kusuka ku-pelvis noma ukuthenga i-interbody fusion cage, eqeda izinkinga zokususwa kwamathambo futhi kunciphisa kakhulu izindleko zokusebenza.
Ngoba I-CZMEDITECH , sinomugqa womkhiqizo ophelele kakhulu izimila ukuhlinzwa umgogodla kanye amathuluzi ahambisanayo , imikhiqizo ehlanganisa 5.5mm kanye ne-6.0mm isistimu yesikulufu somgogodla we-spinal pedicle, isistimu yepuleti yomlomo wesibeletho yangaphambili, isistimu yesikulufu somlomo wesibeletho yangemuva, isistimu yepuleti lethoracic yangaphambili, isistimu yepuleti le-thoracolumbar yangaphambili, ikheji ye-titanium mesh, isistimu yokulunguza, ikheji ye-titanium, isistimu ye-screw ye-cervical seplasty esekela i-pedical laminovasive system yabo. Ngaphezu kwalokho, sizibophezele ekuthuthukiseni imikhiqizo emisha ngokuqhubekayo nokwandisa imigqa yemikhiqizo, ukuze sihlangabezane nezidingo zokuhlinzwa zodokotela abaningi neziguli, futhi senze inkampani yethu iqhudelane kakhulu kuwo wonke umkhakha womhlaba wonke wokufakwa kwamathambo nezinsimbi.
