Ka Hana Hana: MIS Cement Screw no L3 Compression Fracture

ʻO Vertebral compression fractures (VCFs) i nā poʻe maʻi waena a me nā poʻe ʻelemakule e hōʻike pinepine i kahi paʻakikī ʻelua: ʻo ka pono no ka hoʻihoʻi hou ʻana i ka hale a me ka paʻakikī o ka loaʻa ʻana o ka paʻa paʻa i ka iwi osteoporotic a degenerative paha. Ke noiʻi nei kēia hihia i ka hoʻohana pono ʻana o ka XC Medico MIS 5.5 System Cement Augmented Fenestrated Screw i loko o ke kahua lapaʻau ma Chile.

1. Ka Loiloi Mamua o ka Hana a me na Imi Hana

He wahine 54 makahiki i hōʻike ʻia me ka ʻeha o ke kua hope ma hope o ka hāʻule liʻiliʻi. Ua hōʻike ʻia ka nānā ʻana i ke kino i ka ʻoluʻolu kūloko ma luna o ka spine lumbar a me ke kaohi nui ʻana i ka neʻe.

Kiʻi 1: Hōʻike kiʻi kiʻi pre-operative e hōʻike ana i kahi L3 vertebral body compression fracture (ma kahi o 30% nalowale o ke kiʻekiʻe) a me nā hōʻailona o ka lumbar degeneration.

ʻO ke kiʻi kiʻi mua (Figure 1) i hōʻoia i kahi haʻihaʻi koʻikoʻi L3 e pili ana i ka 30% o ke kiʻekiʻe vertebral. Ua hōʻike pū ka hōʻike i nā loli degenerative lumbar , me ka hyperplasia iwi ma nā ʻaoʻao vertebral a me ka pololei o ka curvature physiological. Ma muli o ka makahiki o ka mea maʻi a me ke ʻano degenerative o ka iwi, ʻo ka hoʻopaʻa ʻana o ka pedicle screw maʻamau i kū i ka pilikia nui o ka 'huki-waho' a i ʻole ka hemo.

2. Ka Papa Hana Hana: No ke aha ka MIS Cement Augmentation?

Ua kohoʻo Dr. Alejandro Silva i kahi hōʻailona Minimally Invasive Surgery (MIS) e hōʻemi i kaʻeha o kaʻiʻo palupalu a me ka wikiwiki o ka ho'ōla. ʻO ka hoʻoholo e hoʻohana i ka XC Medico Cement Augmented Fenestrated Screw i hoʻokumu ʻia ma nā kumu koʻikoʻi ʻelua:

• Hoʻonui ʻia ka heleuma: ʻO ka hoʻolālā fenestrated e hiki ai ke hoʻokō pololei i ka PMMA cement injection, e hana ana i kahi hui 'iwi-cement-screw' e hoʻonui nui i ka ikaika huki i waho o ka iwi degenerative.
• MIS Compatibility: Hoʻonui ʻia ka ʻōnaehana 5.5mm no ka hāʻawi ʻana i ka percutaneous, e hōʻemi ana i ke kahe koko a me ka ʻeha ma hope o ka hana.

3. Hoʻokō Intra-operative a me nā hopena ma hope o ka hana

Hana ʻia ke kaʻina hana ma lalo o ke alakaʻi fluoroscopic. Ua hoʻokomo ʻia nā wili fenestrated XC Medico ma L2 a me L4, e hoʻopili ana i ka vertebra L3 i haki. Ua hoʻokomo pono ʻia ka sima PMMA ma o nā ʻaʻa wiliwili lua, e loaʻa ai ka pilina maikaʻi loa me ka iwi cancellous a puni.

Kiʻi 2: Hōʻike ʻo CT ma hope o ka hana ʻana i nā wili i kahi kūlana kūpono me ka puʻupuʻu sima a puni nā fenestration, e hāʻawi ana i ka paʻa koke.

Kiʻi 3: Hoʻihoʻi hou ʻia ka hoʻonohonoho ʻana o ka spinal. Paʻa ka hoʻoponopono kūloko, a mālama ʻia ke kiʻekiʻe L3.

Ua hōʻoia ka post-operative CT a me DR (Figures 2 & 3) ua hoʻonohonoho pono ʻia ka hoʻoponopono kūloko . Ua mālama ʻia ke kiʻekiʻe o ka vertebral, a ua ʻano like ka laha ʻana o ka sima. Ua hōʻike ka mea maʻi i ka hōʻemi ʻana o 70% i ka ʻeha i loko o 24 mau hola a ua hoʻoneʻe ʻia me ka brace ma ka lua o ka lā post-operative.

4. Ka hopena

ʻO ka hui pū ʻana ma waena o ka ʻike loea o ka hui lapaʻau Chilean a me ka ʻenehana spinal holomua o XC Medico i hopena i kahi hopena lapaʻau maikaʻi loa. ʻO ka MIS 5.5 System Cement Augmented Fenestrated Screw he mea paahana koʻikoʻi ia no nā kauā kuamoʻo e pili ana i nā haʻihaʻi paʻakikī i nā poʻe maʻi me ka maikaʻi o ka iwi.