I-Vertebral Perforator (ithiphu yezindwani ezi-3)

Izindlela ezihlukahlukene zokubhoboza i-extra-arch zisetshenziswe ngempumelelo i-percutaneous vertebroplasty (PVP) kanye ne-percutaneous kyphoplasty (PKP).

I-Percutaneous vertebroplasty (PVP)

I-Percutaneous vertebroplasty (PVP) iyindlela yokwelapha iziguli ezine-vertebral fracture eyodwa noma ngaphezulu yezimpawu ezibangelwa amathambo, i-osteoporosis noma ukuhlukumezeka. Ku-PVP, inaliti ye-bone biopsy ifakwe ku-vertebrae ephukile ngaphansi kwe-anesthesia yendawo esigulini; usimende wethambo owenziwe nge-polymethylmethacrylate (PMMA) ujova ngenaliti, kulandele ukukhululeka ngokushesha kwezimpawu ezinjengobunzima bokuhamba noma ubuhlungu obuphansi emhlane. Inqubo eyodwa ye-PVP idinga amahora angu-2 kuphela wesikhathi sokwelashwa kanye namahora angu-2 okuphumula kombhede ngemuva kokuhlinzwa; ingenziwa ngokusikwa kwesikhumba esingu-5 mm ukuze kufakwe inaliti ngayinye ye-biopsy yethambo, inezinga eliphansi lezehlakalo ezimbi kakhulu, ingenziwa ngaphandle kokulungiswa okukhethekile kwangaphambi kokuhlinzwa noma ukunakekelwa okujulile kwangemva kokuhlinzwa, futhi okuwukuphela kokuphikisana okuphelele ukutheleleka okungalawuleki nokuthambekela ukopha. iziguli esezikhulile ezingaphezu kweminyaka engama-90 ubudala ezinemiphumela eqinisekisiwe.

I-Percutaneous kyphoplasty (PKP)

I-Percutaneous kyphoplasty (PKP) okwamanje iyindlela yokwelapha ephumelelayo futhi esetshenziswa kabanzi ye-osteoporotic vertebral compression fractures (OVCF), ngokuvamile eyenziwa ngaphansi kwe-anesthesia yendawo futhi ibekezelelwa kahle iziguli. Ucwaningo lwakuqala lubonise imiphumela ethembisayo yomtholampilo mayelana nokukhululeka kobuhlungu ngokushesha kanye nomsebenzi othuthukisiwe, ikakhulukazi kubantu asebekhulile. Nokho, kusenenani eliphezulu kakhulu leziguli ezinganelisekile ngemiphumela yangemva kokuhlinzwa. Ngokuqondene nalezi ziguli, zikhononda ngokungagculisi noma akukho ushintsho ekunciphiseni ubuhlungu babo noma ubuhlungu obukhulu nakakhulu, obungase bubonise ukucindezela okuqhubekayo noma ukuhlukana okuphindaphindiwe ku-vertebrae ephathwayo. Ucwaningo lwangaphambili luye lwabonisa ukuthi i-intravertebral vacuum clefting (IVC) ku-OCCF eyingozi akuyona into engavamile futhi ibhekwa njengento ebalulekile engozini yobuhlungu obuqhubekayo bokubuyela emuva kanye nokuwa okukhulu kwe-vertebral, okungase kube isizathu esiyinhloko semiphumela engagculisi ngemva kwe-PKP.

Iyini i-balloon kyphoplasty?

I-Balloon kyphoplasty iyinqubo ehlasela kancane eklanyelwe ukulungisa ukuphuka kwe-vertebral compression fractures (VCF) ngokunciphisa nokusimamisa ukuphuka. Iphatha i-pathological vertebral fractures ebangelwa i-osteoporosis, umdlavuza noma izilonda ezimbi.

Isebenza kanjani i-Balloon Osteoplasty

Ukudala isikhala sebhaluni

Udokotela ohlinzayo uzokwenza indlela eya ku-vertebra ephukile esebenzisa ithuluzi elingenalutho. Ibhaluni elincane libe seliqondiswa ngethuluzi liye ethanjeni.

Ukufutha ibhaluni

Uma selisendaweni, ibhaluni livuthelwa umoya kancane ukuze liphakamise kancane ithambo eligoqekile libe endaweni yalo evamile.

Ukukhipha ibhaluni

Lapho ithambo lisendaweni efanele, udokotela ohlinzayo uyalikhipha umoya bese elikhipha ibhaluni. Lokhu kushiya igebe—noma umgodi—ngaphakathi komzimba womgogodla.

Ukugcwalisa i-vertebral void

Ukuze ithambo lingaphindeli futhi, isikhala sigcwaliswa ngosimende wamathambo.

Ukwakha abalingisi bangaphakathi

Uma usumisiwe, usimende wenza i-cast ngaphakathi komzimba we-vertebral ezinzisa ithambo. Ukuze uvikele ngokugcwele ithambo, inqubo ngezinye izikhathi yenziwa ezinhlangothini zombili zomzimba we-vertebral.

Izinzuzo eziyinhloko ze-balloon kyphoplasty zihlanganisa:

• Isikhathi esifushane sokuhlinzwa; inqubo ngokuvamile ithatha cishe isigamu sehora ngalinye izinga lomgogodla.

  
  

• Inqubo ye-kyphoplasty ngokuvamile ingenziwa nge-anesthesia yendawo. Kodwa-ke, ezinye iziguli, kuye ngempilo yazo evamile kanye nobukhulu bokuphuka komgogodla zingadinga i-anesthesia ejwayelekile.

  
  

• Iziguli ziyakwazi ukuhamba futhi zibuyele emisebenzini yazo evamile ngemva kokuhlinzwa.

  
  

• I-Kyphoplasty ingenziwa esikhungweni sokuhlinza i-ambulatory (ASC), esibhedlela, noma esikhungweni sokuhlinza umgogodla wesiguli.

  
  

• Iziguli eziningi zikhishwa ekhaya ngosuku olufanayo nenqubo yazo ye-kyphoplasty. Ukulala esibhedlela ubusuku bonke kungase kunconywe kwezinye iziguli kuye ngezinto eziningi, njengezinkinga zezokwelapha ezihlala zikhona (isb., izingozi zenhliziyo nemithambo yegazi).

Ubude Bokuhlala Nokubuyisela

Udokotela wakho uzokunikeza imiyalelo ethile yangemva kokuhlinzwa, kodwa ngokuvamile, uzochitha cishe ihora ekamelweni lokutakula ngemva kwenqubo. Lapho, umhlengikazi uqapha ngenkuthalo izimpawu zakho ezibalulekile, ezihlanganisa ubuhlungu beqolo.

Iziguli eziningi zikhishwa e-ASC noma esibhedlela kungakapheli amahora angama-24 ngemuva kwenqubo ye-balloon kyphoplasty. Ekulandeleni kwakho isikhathi sokuhlinzwa, udokotela wakho uzohlola inqubekelaphambili yakho yokululama ukuze anqume ukuthi kufanele ukhawulele yini imisebenzi ethile (isb, ukuphakamisa). Iziguli eziningi zibika ukuthuthukiswa okuphawulekayo ebuhlungu, ukuhamba kanye nekhono lokwenza imisebenzi yansuku zonke-ngakho ungase ungadingi ukwenza noma yiziphi izinguquko ezingeni lakho lomsebenzi womzimba.

I-Kyphoplasty Balloon Vertebral Perforator: Ukwelashwa Okuphumelelayo Kokuphuka Kwama-Vertebral Compression

Isingeniso

I-Vertebral compression fractures (VCFs) iyisimo esivamile, ikakhulukazi kubantu asebekhulile, futhi ngokuvamile ihlotshaniswa ne-osteoporosis. Ukwelashwa kwendabuko kwama-VCF kufaka phakathi ukuphathwa ngendlela elandelanayo, njengemithi yezinhlungu nokubhuqa, noma ukungenelela kokuhlinzwa okufana nokuhlanganisa umgogodla. Nokho, lezi zindlela zokwelapha zingase zibe nokusebenza okulinganiselwe noma ziholele kwezinye izinkinga. I-Kyphoplasty balloon vertebral perforator (KBP) iyindlela yokwelapha ehlasela kancane, ephumelelayo yama-VCF eguqule ukuphathwa kwalesi simo. Kulesi sihloko, sizohlola indlela, izinkomba, izinzuzo, kanye nezingozi ezihlobene ne-KBP.

I-Anatomy kanye ne-Mechanism ye-VCFs

Ama-VCF ayenzeka lapho umzimba we-vertebral uwa ngenxa yesakhiwo samathambo esibuthakathaka, ngokuvamile esibangelwa ukukhumuzeka kwamathambo noma ukuhlukumezeka. Umzimba we-vertebral uyingxenye emaphakathi ye-vertebra, futhi yakhiwe ithambo elikhansela elizungezwe ungqimba oluncane lwethambo le-cortical. Lapho umzimba we-vertebral uwela, kungabangela ubuhlungu obukhulu nokukhubazeka.

Izinkomba ze-Kyphoplasty Balloon Vertebral Perforator

I-KBP ikhonjiswe ekwelapheni ama-VCF abuhlungu ahlulekile ukuphendula ekuphathweni okuvamile, noma ezimeni lapho ukuhlinzwa kungeyona inketho efanelekile. Inqubo ngokuvamile ibekezelelwa kahle futhi inengozi ephansi yezinkinga.

I-Kyphoplasty Balloon Vertebral Perforator Procedure

I-KBP ihilela ukusetshenziswa kwe-catheter yebhaluni encane efakwe emzimbeni we-vertebral odilikile ngaphansi kokuqondisa kwe-fluoroscopic. Ibhaluni libe selivuthwa ukuze libuyisele ukuphakama komzimba we-vertebral futhi lidale umgodi. Uma umgodi udaliwe, usimende wamathambo ujojowe ukuze uzinzise umzimba we-vertebral futhi uvimbele ukuwa okuqhubekayo.

Izinzuzo ze-Kyphoplasty Balloon Vertebral Perforator

I-KBP inezinzuzo ezimbalwa ngaphezu kokwelashwa kwendabuko kwama-VCF. Okokuqala, kuyinqubo engenele kancane engenziwa ngaphansi kwe-anesthesia yendawo, ukunciphisa izingozi ezihlobene nokubulala izinzwa okuvamile. Okwesibili, kuhlotshaniswa nokuhlala esibhedlela okufushane kanye nesikhathi sokululama ngokushesha uma kuqhathaniswa nokuhlinzwa kwendabuko. Okokugcina, i-KBP inezinga eliphezulu lempumelelo, iziguli eziningi zithola ukukhululeka okukhulu kobuhlungu nokusebenza okuthuthukisiwe kulandela inqubo.

Izingozi Nezinkinga Ze-Kyphoplasty Balloon Vertebral Perforator

Njenganoma iyiphi inqubo yezokwelapha, i-KBP iphethe ubungozi obuthile kanye nezinkinga ezingaba khona. Lokhu kungase kuhlanganise ukutheleleka, ukopha, ukulimala kwezinzwa, ukuvuza kukasimende, noma ukuphuka kokuphuka. Nokho, ingozi yalezi zinkinga iphansi kakhulu, futhi iziguli eziningi ziyibekezelela kahle inqubo.

Ukunakekelwa Kwangemva Kwenqubo Nokuvuselelwa

Ngemuva kwe-KBP, iziguli zivame ukugadwa isikhathi esifushane futhi ngokuvamile zingabuyela ekhaya ngalo lolo suku. Bayalulekwa ukuthi bagweme ukuphakamisa izinto ezinzima kanye nomsebenzi onzima amaviki ambalwa, kodwa bangakwazi ukuqalisa kabusha imisebenzi evamile yansuku zonke phakathi nezinsuku ezimbalwa. Ukwelashwa ngokomzimba kungase futhi kunconywe ukusiza ngokuhlunyeleliswa.

Izikhombisi-ndlela zesikhathi esizayo ze-Kyphoplasty Balloon Vertebral Perforator

I-KBP iyinqubo entsha uma kuqhathaniswa, futhi ucwaningo oluqhubekayo luhlola izinhlelo zayo ezingase zisetshenziswe kanye nokulungiswa. Isibonelo, kukhona ucwaningo oluqhubekayo mayelana nokusetshenziswa kwe-biodegradable bone samente, okunganciphisa ingozi yezinkinga zesikhathi eside ezihlobene nosimende wendabuko.

Isiphetho

I-Kyphoplasty ibhaluni yomgogodla we-vertebral perforator iyindlela encane yokwelapha ephumelelayo yama-VCF abuhlungu eye yaguqula ukuphathwa kwalesi simo. Inqubo ngokuvamile ibekezelelwa kahle futhi inezinga eliphezulu lokuphumelela, neziguli eziningi zithola ukukhululeka okuphawulekayo kobuhlungu kanye nomsebenzi othuthukisiwe olandela inqubo. Nakuba kunezingozi ezithile ezihlobene nenqubo, lezi ngokuvamile ziphansi, futhi iziguli eziningi ziyibekezelela kahle inqubo. Njengoba ucwaningo oluqhubekayo luhlola izicelo ezingase zibe khona kanye nokulungiswa kwe-KBP, le nqubo cishe izoqhubeka nokuba ithuluzi elibalulekile ekuphathweni kwama-VCF.

Imibuzo Evame Ukubuzwa

1. Ingabe i-KBP iyindlela yokwelashwa efanelekile yazo zonke iziguli ezine-VCF?

I-KBP ikhonjiswe ekwelapheni ama-VCF abuhlungu ahlulekile ukuphendula ekuphathweni okuvamile noma ezimeni lapho ukuhlinzwa kungeyona inketho efanelekile. Nokho, akuzona zonke iziguli ezine-VCF ezidinga i-KBP, futhi isinqumo sokwenza inqubo kufanele senziwe ngokubonisana nomhlinzeki wezempilo.

1. Inqubo ye-KBP ithatha isikhathi esingakanani?

Inqubo ye-KBP ivamise ukuthatha cishe ihora elilodwa ukwenza.

1. Ngokushesha ngemva kwenqubo iziguli zingaqala kabusha imisebenzi evamile?

Iziguli zingakwazi ukuqalisa kabusha imisebenzi evamile yansuku zonke phakathi kwezinsuku ezimbalwa ngemva kwenqubo, nakuba ukuphakamisa okusindayo nomsebenzi onzima kufanele kugwenywe amaviki ambalwa.

1. Yiziphi izinkinga ezingaba khona ezihlobene ne-KBP?

Izinkinga ezingaba khona ezihlobene ne-KBP zingase zihlanganise ukutheleleka, ukopha, ukulimala kwezinzwa, ukuvuza kukasimende, noma ukuwohloka kokuphuka. Nokho, ingozi yalezi zinkinga ngokuvamile iphansi.

1. Ingabe i-KBP ikhokhelwa umshwalense?

I-KBP ivamise ukumbozwa umshwalense, nakuba ukuhlinzekwa kungase kuhluke kuye ngohlelo lomshwalense ngamunye wesiguli nezinye izici.