Pedicle Screws rau Spinal Fusion

Pedicle screws yog cov cuab yeej tseem ceeb siv los tswj kev ruaj ntseg ntawm tus txha caj qaum thaum lub sij hawm fusion surgeries, nrog rau ob qho tib si lub ncauj tsev menyuam fusion thiab fusion ntawm lumbar cov txheej txheem. Cov ntsia hlau no ua lub luag haujlwm tseem ceeb hauv kev ua kom tus txha nraub qaum ruaj ntseg, uas yog qhov tseem ceeb rau kev ua tiav cov txiaj ntsig zoo ntawm kev phais. Niaj hnub nimno pedicle screws muaj txiaj ntsig zoo thiab muaj kev ntseeg siab los ntawm cov kws phais neeg siv rau hauv ob lub caj dab thiab sab nraub qaum.

Xaiv lub tuam txhab muaj koob npe zoo li XC Medico xyuas kom koj nkag tau mus rau ntau yam kev nyab xeeb thiab txhim khu kev qha pedicle screws. Lawv cov khoom yog tsim los ntawm cov ntaub ntawv muaj zog thiab cov qauv tsim tshwj xeeb, uas pab txo qis cov teeb meem thiab txhim kho cov neeg mob kev nyab xeeb thaum lub sij hawm fusion ntawm ncauj tsev menyuam thiab fusion ntawm lumbar phais.

Nrog XC Medico cov kws tshaj lij, koj tuaj yeem ua tiav cov nqi txuag thiab cov txiaj ntsig zoo hauv kev phais txha caj qaum, txawm tias ua haujlwm ntawm ncauj tsev menyuam lossis fusion ntawm cov txheej txheem lumbar.

Ntsiab Cai

• Pedicle screws muab kev txhawb nqa tseem ceeb thaum lub sij hawm phais txha caj qaum. Lawv pab ua kom tus txha nraub qaum tsis tu ncua thiab pab nws zoo.

• Xaiv cov pedicle zoo los ntawm cov tuam txhab ntseeg siab xws li XC Medico tuaj yeem txo cov teeb meem thiab ua rau cov neeg mob muaj kev nyab xeeb dua.

• Muab pedicle screws nyob rau hauv qhov chaw yog qhov tseem ceeb heev rau cov txiaj ntsig zoo. Siv cov cuab yeej zoo li 3D qauv tuaj yeem pab cov kws kho mob kom paub meej dua.

• Cov neeg mob tuaj yeem kho sai dua thiab hnov ​​​​mob tsawg dua nrog pedicle screws dua li cov txheej txheem phais laus.

• Tham nrog koj tus kws kho mob txog koj qhov teeb meem ntawm qaum. Qhov no yuav pab koj paub seb tus txha caj qaum fusion nrog pedicle screws yog qhov zoo tshaj rau koj.

Dab tsi yog Pedicle Screws?

Tsim thiab Ua Haujlwm

Pedicle screws yog cov cog tshwj xeeb uas pab ua kom koj tus txha nraub qaum tsis tu ncua thaum lub sijhawm fusion phais . Lawv yog tsim los ntawm cov hlau muaj zog xws li titanium lossis stainless hlau. Cov hlau no tsis ua mob rau koj lub cev. Txhua tus ntsia hlau muaj cov xov uas tuav mus rau ntawm cov pob txha kom nruj. Cov kws phais tau muab cov ntsia hlau pedicle los ntawm cov pedicles, uas yog cov pob txha me me nyob rau sab nraum qab ntawm txhua tus vertebra. Tom qab cov screws nyob rau hauv qhov chaw, lawv ua haujlwm raws li cov ntsiab lus thauj tog rau nkoj los yog daim hlau.

Qee cov qauv tsim pab ua kom tus txha nraub qaum ruaj khov:

Cov kws phais tuaj yeem xaiv qhov sib txawv ntawm qhov sib txawv thiab cov duab rau txhua tus neeg mob. Qhov no pab kom lawv tau txais txiaj ntsig zoo tshaj plaws rau txhua tus.

Lub luag haujlwm hauv Spinal Fusion

Pedicle screws yog ib qho tseem ceeb hauv kev sib txuas ntawm tus txha caj qaum vim tias lawv nres lub vertebrae los ntawm kev txav mus los. Thaum lub sij hawm kev phais mob txha caj qaum, cov ntsia hlau thiab cov pas nrig ua ib qho tawv nqaij uas tuav cov pob txha ua ke. Qhov no cia cov pob txha tshiab loj hlob ntawm cov vertebrae, uas yog lub hom phiaj tseem ceeb.

Kev tshawb fawb qhia pedicle screws txwv kev txav mus los thiab txo qis kev ntxhov siab ntawm tus txha caj qaum. Nws yog ib qho tseem ceeb heev kom muab cov screws nyob rau hauv qhov chaw. Yog tias cov ntsia hlau tsis raug muab tso zoo, kev rov qab tuaj yeem siv sijhawm ntev dua thiab kev sib xyaw ua ke yuav tsis ua haujlwm zoo. Cov kws phais mob ua haujlwm hnyav los muab txhua qhov ntsia hlau rau hauv qhov chaw zoo tshaj plaws kom tau txais txiaj ntsig zoo.

Lub zog ntawm pedicle screws nyob ntawm seb cov pob txha muaj zog npaum li cas. Yog tias tus neeg mob muaj cov pob txha tsis muaj zog, cov kws phais yuav siv cov ntsia hlau ntev dua los yog muab tso rau hauv cov pob txha tuab kom txhawb nqa zoo dua. Kev npaj ua tib zoo pab ua kom tus txha caj qaum ua haujlwm thiab pab koj kho sai dua.

Pedicle Screws hauv Cervical thiab Lumbar Fusion

Pedicle screws tseem ceeb heev rau ob qho tib si lub ncauj tsev menyuam fusion thiab fusion ntawm lumbar phais. Cov cuab yeej no pab ua kom koj tus txha nraub qaum muaj zog thiab khov kho. Tej zaum koj yuav xav tau lawv yog tias koj tau phais ntawm koj lub caj dab lossis sab nraub qaum. Cov kws phais siv cov ntsia hlau pedicle vim lawv ua rau tus txha nraub qaum ruaj khov. Qhov no yuav pab koj cov pob txha zoo ua ke. XC Medico ua cov ntsia hlau pedicle uas ua haujlwm hauv ntau qhov chaw ntawm tus txha nraub qaum. Qhov no ua rau koj thiab koj tus kws kho mob xaiv ntau txoj kev kho mob.

Cervical Fusion Applications

Cervical fusion siv pedicle screws kom lub caj dab khov kho. Tej zaum koj yuav xav tau qhov kev phais no yog tias koj tawg pob txha, qog nqaij hlav, lossis muaj teeb meem disc hauv koj lub caj dab. Muab pedicle screws nyob rau hauv lub caj dab yuav siv sij hawm ceev faj npaj. Cov kws phais siv cov cuab yeej tshwj xeeb thiab cov duab los tso cov ntsia hlau rau hauv qhov chaw.

Tswv yim: Cov neeg mob cov lus qhia thiab 3D qauv pab cov kws kho mob muab pedicle screws nyob rau hauv lub caj dab kom raug.

Nov yog qee yam zoo txog kev siv pedicle screws hauv ncauj tsev menyuam fusion:

• Cov kws kho mob tuaj yeem tso cov ntsia hlau kom raug nrog cov neeg mob cov lus qhia.

• Pedicle screws tuav zoo dua thiab ua kom lub caj dab ruaj khov dua li lwm cov ntsia hlau.

• Lub caij nyoog ntawm cov teeb meem loj los ntawm qhov tsis raug ntsia hlau tso yog tsawg, ntawm 0 thiab 6%.

• Xav tau lwm qhov kev phais tsis yog ntau, tsuas yog li 1.0-2.4%.

• 3D templates pab cov kws kho mob kom raug thiab txo cov teeb meem.

• Pedicle screws muab lub caj dab muaj zog txhawb nqa, yog li lawv yog qhov kev xaiv sab saum toj rau cov teeb meem hauv caj dab.

Cov lus hauv qab no qhia qee tus lej tseem ceeb rau lub ncauj tsev menyuam fusion nrog pedicle screws :

XC Medico ua pedicle screws hauv ntau qhov ntau thiab tsawg. Qhov no pab cov kws kho mob xaiv qhov zoo tshaj plaws rau koj lub caj dab. Cov ntaub ntawv muaj zog thiab ua tib zoo tsim pab kom koj tus txha nraub qaum kom zoo thaum koj kho.

Fusion ntawm Lumbar Spine

Fusion ntawm lumbar phais siv pedicle screws los txhawb koj sab nraub qaum. Tej zaum koj yuav xav tau qhov kev phais no yog tias koj muaj lub pob txha tawg, txha nraub qaum, lossis pob txha tawg. Thaum lub sij hawm lumbar fusion, tus kws kho mob muab pedicle screws saum toj thiab hauv qab ntawm qhov chaw uas yuav tsum tau kho. Ib tug pas nrig txuas cov screws thiab ua kom cov pob txha tseem. Qhov no cia cov pob txha graft kho thiab koom cov pob txha ua ke.

Pedicle screws tau ua rau kev phais txha caj qaum zoo dua rau ntau tus neeg. Koj tuaj yeem cia siab tias cov ntsia hlau no muab kev txhawb nqa muaj zog thiab pab koj tus txha nraub qaum kho ncaj. Cov kws kho mob siv cov duab los xyuas seb cov ntsia hlau nyob qhov twg thiab tsis txhob muaj teeb meem. Funnel Technique pab cov kws kho mob muab cov ntsia hlau rau hauv kev nyab xeeb thiab yooj yim.

Tej zaum koj yuav xav tias yuav ua li cas tom qab koj tus txha nraub qaum kho. Yog tias cov ntsia hlau lossis cov pas nrig thab koj, koj tus kws kho mob tuaj yeem coj lawv tawm tom qab cov pob txha koom nrog. XC Medico muaj ntau hom pedicle screws rau lumbar fusion, txawm rau kev phais me me. Cov khoom no pab cov kws kho mob xaiv cov ntsia hlau zoo rau koj.

Pedicle screws rau txha nraub qaum fusion muab sijhawm zoo rau koj kom muaj zog, khov kho tom qab phais. Ua tib zoo muab cov ntsia hlau tso thiab cov txheej txheem fusion tshiab pab txo qhov kev pheej hmoo ntawm teeb meem. Nrog XC Medico tsom rau qhov zoo, koj tuaj yeem ntseeg tau tias cov ntsia hlau hauv koj qhov kev phais muaj kev nyab xeeb thiab ua haujlwm zoo.

Cov txiaj ntsig thiab kev pheej hmoo ntawm Pedicle Screws

Clinical Zoo

Pedicle screws pab koj tus txha nraub qaum kom muaj zog thaum kev phais fusion. Cov ntsia hlau thiab cov pas nrig no muab kev txhawb nqa zoo rau koj cov pob txha. Qhov kev txhawb nqa no pab koj cov pob txha zoo ua ke. Nws kuj ua rau koj tus txha nraub qaum tsis tu ncua. Cov kws kho mob nyiam pedicle screws vim lawv ua haujlwm zoo dua li qub. Cov lus hauv qab no qhia txog cov txiaj ntsig tseem ceeb:

Tej zaum koj yuav tau zoo dua sai dua vim tias cov ntsia hlau no tso cai rau koj mus ua ntej. Ntau tus neeg xav tias mob tsawg dua thiab rov qab mus rau lub neej zoo sai sai. Cov kev tshawb fawb pom tias pedicle screws pab cov pob txha koom nrog zoo. Fusion tus nqi yog tshaj 90% nrog cov screws. Txoj kev qub tsis ua hauj lwm zoo li. Kev phais tsawg dua kuj pab koj kho sai dua thiab siv sijhawm tsawg dua hauv tsev kho mob.

XC Medico muaj ntau hom kev kho vajtse rau qaum fusion . Koj tuaj yeem xaiv los ntawm ntau qhov sib txawv thiab cov duab. Qhov no pab cov kws kho mob xaiv cov ntsia hlau zoo tshaj plaws rau koj. Cov ntaub ntawv muaj zog thiab cov qauv tsim ntse ua rau cov khoom no muaj kev nyab xeeb. Lawv ua haujlwm zoo rau ntau hom kev sib txuas ntawm qaum.

Muaj peev xwm txaus ntshai thiab kev tswj hwm

Pedicle screws tuaj yeem muaj qee qhov kev pheej hmoo, zoo li lwm yam khoom siv kho mob. Cov teeb meem feem ntau yog kis kab mob, xoob screws, thiab xav tau kev phais ntxiv. Qee zaum, cov cement siv nrog cov ntsia hlau tuaj yeem xau thiab ua rau muaj teeb meem. Cov kab mob sib sib zog nqus tsis tshua muaj tab sis yuav xav tau kev phais ntxiv. Loose screws tshwm sim ntau dua yog cov pob txha tsis muaj zog.

Cov kws kho mob tuaj yeem txo cov kev pheej hmoo no nrog kev npaj zoo thiab ceev faj txog kev phais. Lawv siv cov cuab yeej tshwj xeeb thiab cov duab los coj cov ntsia hlau tso. Navigation systems pab muab cov ntsia hlau rau hauv qhov chaw zoo. Kev kho cov pob txha tsis muaj zog ua ntej kev phais pab ib yam nkaus. Cov kws kho mob yuav siv cov braces lossis tshuaj los pab koj kho. Yog tias muaj teeb meem tshwm sim, cov kws kho mob tuaj yeem kho nws nrog kev phais ntau dua lossis lwm yam kev kho mob.

Nco tseg: Xaiv cov khoom zoo zoo li cov los ntawm XC Medico tuaj yeem pab txo qis kev pheej hmoo. Cov khoom kho mob zoo thiab ceev ceev muab tso rau hauv cov ntsia hlau pab koj kho kom zoo dua thiab muaj teeb meem tsawg dua.

Kev phais thiab kev rov qab los

Txheej txheem txheej txheem

Tej zaum koj yuav xav tias muaj dab tsi tshwm sim thaum lub sijhawm spinal fusion nrog pedicle screws. Cov kws phais neeg ua raws cov kauj ruam kom koj muaj kev nyab xeeb thiab pab koj tus txha nraub qaum. Ua ntej, kws kho mob siv cov duab los npaj qhov chaw txiav. Lawv txiav me me los pib qhov kev phais. Ib rab koob Jamshidi pab nrhiav qhov chaw zoo rau cov ntsia hlau. Cov koob nkag mus rau hauv cov pob txha ntawm lub kaum sab xis. Tom qab ntawd, ib txoj hlua nyias hu ua K-wire coj cov ntsia hlau. Cov kws phais tau muab cov ntsia hlau hla cov hlau rau hauv cov pob txha. Cov pas nrig txuas cov ntsia hlau los ua kom muaj zog hauv koj lub cev.

Ntau tus kws kho mob siv cov txheej txheem minimally invasive tam sim no. Cov txheej txheem no siv cov txiav me me thiab cov cuab yeej tshwj xeeb. Koj poob ntshav tsawg dua thiab kho sai dua. XC Medico muaj ntau cov ntsia hlau thiab pas nrig rau cov txheej txheem tshiab no. Cov lus hauv qab no qhia qee cov tswv yim thiab lawv cov txiaj ntsig:

Tswv yim: Nug koj tus kws kho mob yog tias koj tuaj yeem muaj kev phais mob me me. Cov hau kev no yuav pab tau koj rov qab mus rau lub neej zoo sai dua.

Kev kho mob thiab kev kho mob tom qab

Tom qab tus txha caj qaum fusion, rov qab tshwm sim hauv cov kauj ruam. Cov neeg feem coob pib ua haujlwm lub teeb hauv 4 mus rau 6 lub lis piam. Kev rov zoo tag nrho tuaj yeem siv sijhawm 3 txog 6 lub hlis. Thawj rau lub lis piam, so thiab tsis txhob nqa tej yam hnyav. Kev kho lub cev pab koj txav thiab muaj zog. Los ntawm peb lub hlis, koj yuav hnov ​​​​mob tsawg dua thiab txav mus zoo dua. Pob txha fusion txuas ntxiv mus txog ib xyoos.

Nov yog qee cov lus qhia los pab koj kho:

• Tsis txhob nqa tej yam hnyav.

• Tsis txhob ua kis las xws li ntaus pob.

• Tsis txhob twist lossis khoov koj nraub qaum.

• Nyob deb ntawm kev haus luam yeeb thiab cawv ntau dhau.

Noj zaub mov zoo pab koj kho. Noj cov zaub mov uas muaj calcium thiab vitamin D. Nug koj tus kws kho mob txog cov tshuaj ntxiv yog tias koj xav tau. Kev kho lub cev, thaum koj tus kws kho mob hais tias nws tsis ua li cas, pab koj cov leeg kom muaj zog thiab ua rau koj tus txha nraub qaum hloov tau.

Ntau tus neeg mob xav zoo tom qab kev phais decompression nrog pedicle screws. Feem ntau muaj qhov mob me me lossis tsis muaj mob thiab rov qab mus rau lub neej qub. Daim ntawv qhia hauv qab no qhia tias cov neeg mob xav li cas tom qab kev phais:

Xaiv cov cuab yeej zoo ntawm tus txha caj qaum los ntawm lub tuam txhab ntseeg siab xws li XC Medico tuaj yeem pab koj rov zoo dua thiab xis nyob ntev.

Kev xaiv tus neeg mob

Indications thiab tej yam kev mob

Tej zaum koj yuav xav tsis thoob thaum cov kws kho mob siv pedicle screws rau tus txha caj qaum. Cov kws phais siv qhov kev kho mob no rau ntau qhov teeb meem ntawm qaum. Yog tias koj muaj ib qho ntawm cov no, koj yuav xav tau tus txha nraub qaum nrog pedicle screws:

• Degenerative disc kab mob tuaj yeem ua rau koj lub nraub qaum mob thiab tsis muaj zog.

• Spinal stenosis ua rau qhov chaw hauv koj tus txha nraub qaum me dua thiab ua rau cov hlab ntsha.

• Spondylolisthesis txhais tau hais tias ib lub vertebra swb dua lwm tus.

• Spondylosis ua rau koj tus txha nraub qaum hnav dhau sijhawm.

• Cov pob txha pob txha tawg ua rau cov pob txha hauv koj nraub qaum.

• Scoliosis ua rau koj tus txha nqaj qaum mus rau sab.

• Kyphosis khoov koj tus txha nraub qaum rau pem hauv ntej.

Cov kws kho mob tshawb xyuas koj cov tsos mob, X-rays, thiab MRI scans. Lawv txiav txim siab yog tias cov ntsia hlau pedicle tuaj yeem pab koj txav tau zoo dua thiab tsis tshua mob. Yog tias koj muaj teeb meem taug kev, loog, lossis mob uas yuav tsis nres, qhov kev phais no yuav pab tau koj.

Tswv yim: Yog tias koj tus txha nraub qaum teeb meem ua rau lub neej niaj hnub nyuaj, nug koj tus kws kho mob txog tus txha caj qaum nrog pedicle screws. Qhov kev phais no tuaj yeem pab koj sawv, taug kev, thiab ua tej yam uas koj nyiam dua.

Kev txiav txim siab Factors

Cov kws kho mob xav txog ntau yam ua ntej siv pedicle screws hauv kev phais. Koj txoj kev noj qab haus huv, pob txha muaj zog, thiab hnub nyoog yog qhov tseem ceeb. Txhua tus neeg txawv, yog li koj tus kws kho mob kuaj xyuas koj cov keeb kwm kev kho mob thiab cov txiaj ntsig kuaj. Nov yog qee yam kws kho mob saib:

Koj lub hnub nyoog thiab pob txha zoo tseem ceeb heev. Yog tias koj muaj hnub nyoog tshaj 65 xyoos, koj cov pob txha yuav tsis muaj zog. Osteoporosis ua rau nws nyuaj rau screws nyob rau hauv qhov chaw. Cov kws kho mob tshawb xyuas koj cov pob txha pob txha pob txha pob txha (BMD) ua ntej kev phais. Yog tias koj BMD qis, koj yuav xav tau cov ntsia hlau tshwj xeeb lossis kev txhawb nqa ntxiv.

Lwm yam teeb meem kev noj qab haus huv tseem ceeb heev. Ntshav siab, ntshav qab zib mellitus, thiab haus luam yeeb tuaj yeem ua rau cov pob txha zoo. Yog tias koj noj steroids, koj cov pob txha yuav softer. Cov kws kho mob siv cov qhab nia thiab tshuaj ntsuam xyuas koj cov pob txha lub zog thiab npaj koj txoj kev phais.

• Cov neeg laus yuav xav tau cov ntsia hlau ntev dua los yog tuab dua rau kev txhawb nqa zoo dua.

• Yog tias koj cov pob txha tsis muaj zog, koj tus kws kho mob yuav siv txoj hauv kev tshwj xeeb los ua kom cov ntsia hlau ruaj khov.

• Koj tus kws kho mob yuav kuaj xyuas koj tus txha nqaj qaum, cov leeg nqaij, thiab kev noj qab haus huv ua ntej kev phais.

Nco tseg: Xaiv txoj cai pedicle ntsia hlau ua haujlwm pab kws kho mob ua tau raws li koj xav tau. XC Medico muaj ntau txoj kev xaiv rau cov neeg mob sib txawv thiab kev phais. Qhov no pab koj tau txais kev saib xyuas zoo tshaj plaws rau koj lub hnub nyoog thiab kev noj qab haus huv.

Yog tias koj xav tau cov txiaj ntsig zoo tshaj plaws, nrog koj tus kws kho mob tham txog koj txoj kev noj qab haus huv thiab tus cwj pwm. Kev npaj zoo thiab cov khoom lag luam zoo ua rau cov leeg txha caj qaum muaj kev nyab xeeb thiab ua haujlwm zoo rau koj.

Pedicle screws pab koj tus txha nraub qaum zoo. Lawv muab sijhawm zoo rau koj kom rov qab muaj zog. Koj tuaj yeem tau txais txiaj ntsig zoo nrog ob qho tib si unilateral thiab ob tog fixation. Cov lus hauv qab no qhia tau hais tias ob hom kev ua haujlwm zoo ib yam rau cov txiaj ntsig nruab nrab thiab mus sij hawm ntev:

Yog tias koj xaiv XC Medico, koj tau txais cov khoom zoo. Koj kuj tau txais kev xa khoom sai thiab cov thev naus laus zis tshiab xws li 5.5 MIS coaxial thiab polyaxial screws. Cov yam ntxwv no pab ua rau kev phais kom nyab xeeb thiab zoo dua. Yog tias koj xav tau kev kho tus txha caj qaum, nrog koj tus kws kho mob tham. Yog tias koj yuav ntau, XC Medico yog qhov kev xaiv zoo. Lawv ua hauj lwm hnyav los pab koj ua tiav.

FAQ

XC Medico pedicle screws siv cov ntaub ntawv dab tsi?

Koj tau txais pedicle screws ua los ntawm cov hlau muaj zog xws li titanium lossis stainless hlau. Cov ntaub ntawv no pab koj lub cev zoo thiab ua kom koj tus txha nraub qaum muaj kev nyab xeeb thaum rov qab los.

Kuv yuav xaiv lub pedicle ntsia hlau zoo li cas rau kuv cov kev xav tau?

Koj yuav tsum saib koj qhov teeb meem ntawm pob txha, pob txha lub zog, thiab hom kev phais. XC Medico muaj ntau qhov ntau thiab tsawg thiab tsim. Koj tus kws kho mob tuaj yeem pab koj xaiv cov ntsia hlau zoo tshaj plaws rau koj qhov xwm txheej.

Pedicle screws puas tuaj yeem siv rau ob qho tib si hauv tsev menyuam thiab lub lumbar fusion?

Yog lawm, koj tuaj yeem siv pedicle screws rau kev phais hauv koj lub caj dab thiab sab nraub qaum. XC Medico tsim cov ntsia hlau rau qhov sib txawv ntawm tus txha nraub qaum, yog li koj muaj kev xaiv rau ntau yam mob.

XC Medico pedicle screws muab cov neeg yuav khoom ntau npaum li cas?

Koj tau txais ntau yam khoom lag luam, xa khoom sai, thiab txhim khu kev qha zoo. Cov neeg yuav khoom ntau tuaj yeem xaiv los ntawm ntau hom ntsia hlau thiab qhov ntau thiab tsawg. Qhov no yuav pab koj ua tau raws li kev xav tau kev phais sib txawv thiab txuag nqi.

Yuav rov qab siv sijhawm ntev npaum li cas tom qab tus txha caj qaum fusion nrog pedicle screws?

Cov neeg feem coob pib ua haujlwm lub teeb hauv 4 mus rau 6 lub lis piam. Kev rov zoo tag nrho yuav siv sijhawm 3 txog 6 lub hlis. Koj tus kws kho mob yuav qhia koj txog txhua kauj ruam los pab koj kho kom zoo.