Idizayini entsha ye-R&D

MIS | Ukuthuthukiswa Kwezobuchwepheshe - Izinzuzo Zezobuchwepheshe - Imiphumela Yangemva Kokuhlinzwa | czmeditech

I-Minimally Invasive Spine System (MIS) iwubuchwepheshe besimanje obuvumela ukwelashwa okunembayo ngokusebenzisa imicu emincane yezimo ezifana nama-herniated disc kanye ne-spinal stenosis.

Imininingwane yomklamo omusha

Izinzuzo ezihlaselayo kancane

Ukuhlukumezeka okuncishisiwe

Idizayini encane yokusika:

Ukusika okujwayelekile kungu-1-2 cm kuphela, kunciphisa ukukhumuzeka kwemisipha kanye nokulimala kwezicubu ezithambile.

Ubuchwepheshe bokubeka ngokunemba:

Ukunemba okuthuthukisiwe kokufakwa kokufakwayo ngokuzulazula kwangaphakathi kokuhlinzwa (isb. O-arm, 3D-C-arm) noma usizo lwerobhothi (isb. Mazor X, Globus Medical).

Ukopha okuncishisiwe kwangaphakathi kokuhlinzwa:

ubuchwepheshe obuncane bokufinyelela obungenamandla bunciphisa ubungozi bokulimala kwemithambo, ikakhulukazi ezigulini esezikhulile noma ezigula kakhulu.

Ukululama ngokushesha ngemva kokuhlinzwa

Ukuhlala isikhashana esibhedlela:

iziguli eziningi zidedelwa emahoreni angu-24-48 ngemva kokuhlinzwa, uma kuqhathaniswa nezinsuku ezingu-3-5 zokuhlinzwa okuvulekile kwendabuko.

Ukuhamba kwangaphambi kwesikhathi:

Ubuhlungu obuncane nokuvikelwa kwemisipha okungcono kuvumela iziguli ukuthi zibuyele emisebenzini yazo yansuku zonke ngokushesha.

Ukwenza ngcono kwe-Biomechanical

Izinhlelo zokusebenza ezintsha:

isb ama-alloys e-titanium aphrintiwe angu-3D, i-PEEK (i-polyether ether ketone) izinto zokufeza i-modulus yokunwebeka eduze naleyo yamathambo nokunciphisa ukufihla ingcindezi.

Amasistimu wokuzinzisa anamandla:

ezinye izimila (isb. I-Dynesys, i-Coflex) igcina ukuhamba komgogodla futhi inciphisa ingozi yokuwohloka kwengxenye eseduze.

Izinkomba ezinwetshiwe

Ukumboza izinhlobonhlobo zezifo zomgogodla ezifana nesifo se-disc degenerative, i-lumbar spinal stenosis, i-spondylolisthesis emnene kanye nokuphuka kwama-vertebral.

临床案列

Okulandelayo yizimo zocwaningo ezimele eminyakeni yakamuva:

1. Isilingo esilawulwa ngokungahleliwe se-lumbar spine fusion (TLIF)

Idizayini yokufunda:

i-RCT ezoba ngama-multicenter (2022) iqhathanisa i-MIS-TLIF (ihlasela kancane) ne-TLIF evulekile.

Usayizi wesampula:

Iziguli ze-120 ezine-single-segment degenerative lumbar spine disease.

Imiphumela:

Isikhathi sokuhlinzwa:

isikhathi eside kancane eqenjini le-MIS (kusho amaminithi angu-150 vs. 130 amaminithi), kodwa ngo-60% ukopha okuncane (<100 ml vs. 250 ml).

Ubuhlungu be-Postoperative:

Ukuncishiswa kwe-50% kumaphuzu we-VAS Iviki le-1 ngemuva kokuhlinzwa eqenjini le-MIS, akukho mehluko obalulekile phakathi kwamaqembu amabili ngemuva kwezinyanga ze-3.

Izinga le-Fusion:

Unyaka ongu-1 we-CT wangemva kokuhlinzwa ubonise> izinga lokuhlanganisa ama-90% kuwo womabili amaqembu.

Izinkinga:

Izinga lokutheleleka ngu-2% eqenjini le-MIS vs. 8% eqenjini elivulekile.

2. Ucwaningo lokulandelela lwesikhathi eside lohlelo lokuzinzisa oluguqukayo (Coflex)

Idizayini yokufunda:

Ucwaningo lokulandela lweminyaka engu-5 lwaseYurophu (2021) luhlola ukufakwa kwe-Coflex yokwelapha i-lumbar spinal stenosis.

Usayizi wesampula:

Iziguli ezingama-80.

UMPHUMELA:

Ukuthuthukiswa komsebenzi:

i-ODI (inkomba yokungasebenzi kahle) yehle isuka kumaphuzu angama-45 ekuqaleni yaya kumaphoyinti angama-20 ngeminyaka emi-5.

UKWEHLWA KWESIQEPHU SAMAKHELWANE:

Iziguli ezingu-12% kuphela ezaba nezinkinga zezingxenye eziseduze, eziphansi kakhulu kunokuhlanganiswa okuvamile (~30%).

Izinga lokusebenza kabusha:

isilinganiso seminyaka engu-5 sokusebenza kabusha esingu-8%, ikakhulukazi ngenxa yokuxega kwesigxivizo (4%) noma ukuvela kabusha kwezimpawu.

3. Ucwaningo lwezindawo eziningi zokufakwa kwe-MIS okusizwa ngamarobhothi

Idizayini yokufunda:

ucwaningo lwe-retrospective olwanyatheliswa ngo-2023 ukuze luhlaziye imiphumela yokubeka isikulufu se-MIS ngosizo lwerobhothi ye-Mazor.

Usayizi wesampula:

Izikulufo ezingama-500 (umgogodla we-thoracolumbar).

Imiphumela:

Ukunemba:

U-98.6% wezindawo eziku-screw ubenelisayo (u-Gertzbein-Robbins ufaka ibanga A/B).

Izinkinga:

izinga lokulimala kwezimpande zemizwa engu-0.4% uma kuqhathaniswa no-3-5% wokubekwa kwesandla samahhala.

Ukuze uthole ulwazi olwengeziwe lomkhiqizo nemininingwane, sicela usithinte!