Maphunziro a kuphatikizika kwa msana | Mitundu ya khola la interbody ndi zida
Makhola amtundu wa interbody ndi zida zomwe zimayikidwa pakati pa matupi oyandikana ndi vertebral panthawi yosankhidwa ya kuphatikizika kwa msana. Amapangidwa kuti azisunga malo okonzeka a disc, kupereka chithandizo chokhazikika komanso kutengera zida za mafupa pomwe kuphatikizika kukukula. Mtundu wa khola, kukula, zakuthupi ndi kukonza njira zimasankhidwa kwa wodwala wina, njira ya opaleshoni ndi dongosolo lovomerezeka la chipangizo.
Kodi Interbody Fusion Cage N'chiyani?
Khola la interbody fusion ndi chipangizo cha msana chomwe chimayikidwa mu intervertebral space pambuyo poti dokotala wa opaleshoni amachotsa zonse kapena gawo la diski yowonongeka panthawi yokonzekera kusakanikirana. Tanthauzo la FDA limaphatikizapo zida zopangidwa kuchokera ku zinthu monga titaniyamu ndi ma polima ndikuyika mu khomo lachiberekero kapena lumbosacral intervertebral space.
Khola si chimbale cholowa m'malo chomwe chimapangidwira kuti chiziyenda bwino. Udindo wake umalumikizidwa ndi kuphatikizika: umathandizira gawo lothandizidwa pomwe fupa latsopano limakula pakati pa vertebrae yoyandikana. Mapangidwe ambiri amaphatikizapo kutsegulira kwamkati kapena chipinda cholumikizira mafupa ndi zinthu zakunja zomwe zimapangidwira kuti zigwirizane ndi ma vertebral endplates.
XC Medico imapanga mapangidwe ake omwe amapezeka mkati mwake magulu azinthu zamtundu wa interbody . Masamba azinthu ndizothandiza pakumvetsetsa zamitundu, koma zisonyezo, zotsutsana, zofunika kukonza ndi njira ya opaleshoni ziyenera kutsimikiziridwa kuchokera pazomwe zidalembedwa pano.
Momwe Spinal Cages Imathandizira Kutalika kwa Disc, Kuyanjanitsa ndi Fusion
Kusiyanitsa kofunikira: kuwonongeka kwa mitsempha kumachitika kudzera mu opaleshoni. Khola lingathandize kusunga diski kapena kutalika kwa foraminal muzopangidwe zosankhidwa, koma siziyenera kufotokozedwa ngati kuchiritsa paokha kupsinjika kwa mitsempha kapena kutsimikizira kupweteka.
Mitundu ya Interbody Cages ndi Njira Yopangira Opaleshoni
Ma khola a interbody amagawidwa m'magulu a msana ndi njira yomwe imagwiritsidwa ntchito pofikira malo a disk. Mawu achidule amafotokoza ndondomekoyi, osati mawonekedwe a implant. Chida chololedwa kugwiritsa ntchito njira imodzi sichiyenera kuganiziridwa kuti ndi yoyenera kwa china.
Kuti mumve zambiri za momwe makola amalumikizirana ndi zomangira za pedicle, mbale za khomo lachiberekero ndi zida zomwe zimayandikira, onaninso XC Medico's. implant msana ndi zida machitidwe.
| Khola kapena njira | Njira yolowera mokhazikika | Zomwe zimaganiziridwa ndi kapangidwe | kake Zoyenera kutsimikizira |
|---|---|---|---|
| Khola la Cervical / ACDF | Anterior khomo lachiberekero njira | Mapazi ang'onoang'ono, kutalika kwa khomo lachiberekero ndi ngodya, chipinda cha graft ndi zolembera zojambula. | Kaya mbale yosiyana yapambuyo kapena kukhazikika kophatikizika kumafunika kapena kuloledwa. |
| Mtengo wa TLIF | Njira ya Transforaminal lumbar | Mbiri yoyika, chopondapo, mawonekedwe omaliza, kulumikizana kwa olowetsa ndi zosankha za lordotic. | Zida zotsegula kapena zowononga pang'ono ndi kukonzanso kumbuyo kwapambuyo. |
| Chithunzi cha PLIF | Njira ya posterior lumbar | Kufikira kumbuyo, nambala ya khola ndi malo monga momwe zafotokozedwera ndi dongosolo linalake. | Mayesero, olowetsa, zida zomezanitsa ndi kuyanjana kwapambuyo. |
| ALIF khola | Njira ya anterior lumbar | Mapazi akuluakulu, kutalika ndi ma lordosis, mawonekedwe oyimira kapena owonjezera. | Zida zoyandikira, zomangira zomangira kapena mbale ndi zilembo zamtundu wina. |
| Khola la LLIF / OLIF | Njira yam'mbali kapena oblique lumbar | Mapazi otambalala, mbiri yoyikira m'mbali ndi zida zapadera. | Neuromonitoring, njira yofikira ndi zofunikira zowonjezera zowonjezera monga zikuyenera. |
Khola la Cervical Interbody la ACDF
Makola amtundu wa chiberekero amagwiritsidwa ntchito posankha anterior cervical discectomy ndi njira zophatikizira. Mapangidwe angagwiritsidwe ntchito ndi mbale yosiyana yapakhomo lachiberekero kapena angaphatikizepo zokonzekera, malingana ndi dongosolo lovomerezeka. Onaninso za XC Medico ACDF njira zophatikizira khomo lachiberekero pakuwunika kwadongosolo lazinthu.
TLIF ndi PLIF Cages for Posterior Lumbar Fusion
TLIF ndi PLIF onse amapeza malo a lumbar disc kuchokera kumayendedwe apambuyo, koma njira yogwiritsira ntchito, khola la geometry, njira yoyikamo ndi kukonzanso khola kungakhale kosiyana. Ndizolakwika kunena kuti njira iliyonse yolumikizana ndi anthu imagwiritsa ntchito makola awiri. Chitsanzo cha dongosolo la ndondomeko yeniyeni, onani TLIF ndi MIS-TLIF khola machitidwe.
ALIF ndi Lateral Lumbar Cages
Makhola a ALIF amalowetsedwa kudzera munjira yakutsogolo ya lumbar. Njira zam'mbali ndi zokhotakhota zimagwiritsa ntchito makonde osiyanasiyana olowera ndi zida zapadera. Mabanja a kholawa nthawi zambiri amapereka mapazi ndi zosankha za lordotic zomwe zimapangidwa mozungulira njira yawo yolowera. The njira yoyimilira yokha ya ALIF PEEK khola ikuwonetsa kasinthidwe ka khola-ndi-screw; mafotokozedwe ake sayenera kusinthidwa ku chipangizo chilichonse cha ALIF.
Static vs Expandable Interbody Cages
Malo osasunthika ali ndi miyeso yodziwiratu. Makhola okulirakulira amayikidwa mu kachulukidwe kakang'ono ndikusinthidwa mkati mwaovomerezeka atayikidwa. Kukula sikungotanthauza zotsatira zabwino zachipatala. Zimango za chipangizo, malire okulitsa, kulumikizana ndi ma endplate, zolinga zofananira, kukonza ndi umboni womwe ulipo ziyenera kuganiziridwa.
PEEK vs Titanium Interbody Cages
PEEK ndi titaniyamu amagwiritsidwa ntchito kwambiri pazida zophatikizira ma interbody, koma palibenso wapamwamba kwambiri. Zinthu zakuthupi zimagwirizana ndi khola la geometry, kapangidwe kapamwamba, kukonzekera kwa endplate, zinthu za odwala komanso kukonza kwathunthu. Zotsatsa zamalonda siziyenera kulowetsedwa m'malo mwa umboni wokhudzana ndi chipangizocho.
| Zida kapena mapangidwe | Mawonekedwe azithunzi | Zolingaliridwa pamakina ndi pamwamba | Mafunso oti mutsimikizire |
|---|---|---|---|
| PEEK | Thupi la khola la radiolucent; zolembera za radiopaque nthawi zambiri zimagwiritsidwa ntchito kuwonetsa malo. | Ma polima amasiyana ndi zitsulo; geometry ndi kupanga ndondomeko zimakhalabe zofunika. | Mafotokozedwe a kalasi yachipatala, kamangidwe ka chikhomo, makulidwe, pamwamba, kuyesa ndi kulemba. |
| Titaniyamu alloy yolimba | Ma radiopaque ndipo amatha kupanga zojambula zongoyerekeza kutengera chipangizo ndi machitidwe. | Mphamvu yapamwamba; modulus ndi mawonekedwe apamwamba amasiyana ndi PEEK. | Mafotokozedwe a alloy, njira yopangira, mawonekedwe apamwamba komanso umboni wamakina. |
| Titaniyamu yopangidwa ndi porous kapena kuwonjezera | Radiopaque; mawonekedwe amatengera geometry ndi zojambula. | Zomangamanga za porous zimabweretsa kupanga, kuyeretsa ndi kutsimikizira. | Mafotokozedwe a porosity, kutsimikizira ndondomeko, ukhondo ndi umboni wothandizira. |
| PEEK yokhala ndi titaniyamu | Imasunga thupi la polima la radiolucent lomwe lili ndi gawo lapamwamba la radiopaque. | Kumatira kumamatira, kuphimba, tinthu tating'onoting'ono ndi mawonekedwe amafunikira kuwongolera. | Njira yokutira, kutsimikizira, kuyang'anira, kuyeretsa ndi umboni wokhudzana ndi malonda. |
Chifukwa Chake Cage Material Simatsimikizira Zotsatira Zokha
Magulu a XC Medico amapezeka pamapangidwe a khomo lachiberekero ndi lumbar polima mkati mwake PEEK khomo lachiberekero ndi lumbar cage range . Tsimikizirani giredi yeniyeni yazinthu, chikhomo cha radiopaque, mkhalidwe wosabala kapena wosabala ndi chilolezo chamsika pamtundu uliwonse.
Osalemba 'MRI safe' kuchokera kuzinthu zokha: chitetezo cha MR kapena kuyanjana kuyenera kutsimikiziridwa kuchokera pa chipangizo chathunthu ndi zilembo zake zamakono, osatengera mawu okhudza PEEK kapena titaniyamu.
Kodi Interbody Cages Amagwiritsidwa Ntchito Bwanji Opaleshoni ya Spinal Fusion?
Zambiri zimasiyana kwambiri pakati pa khomo lachiberekero, kumbuyo kwa lumbar, transforaminal, anterior and lateral njira. Zotsatirazi ndizotsatira zamaphunziro apamwamba osati malangizo a opaleshoni.
Kuchotsa Chimbale, Kukonzekera kwa Endplate ndi Kuyika Cage
Zofunikira pakugwiritsa ntchito akatswiri: kuphatikiza kwa interbody ndikofunikira mwaukadaulo. A FDA amalimbikitsa kuti zipangizozi zikhazikitsidwe ndi madokotala odziwa bwino opaleshoni a msana omwe ali ndi maphunziro apadera pa chipangizocho. Odwala ayenera kukambirana za ubwino wa ndondomeko, njira zina ndi zoopsa ndi dokotala wawo wowachiritsa.
Ndi Mikhalidwe Yotani Ingathandizidwe ndi Interbody Fusion?
Kuphatikizika kwa ma interbody kungaonedwe ngati gawo la chithandizo chamankhwala osankhidwa a msana pamene katswiri wophunzitsidwa atsimikiza kuti kusakanikirana kuli koyenera. Chizindikirocho chimadalira dera la msana, zizindikiro, kujambula, kusakhazikika, chithandizo cham'mbuyo, zifukwa za odwala ndi kulembedwa kovomerezeka kwa chipangizo chosankhidwa.
- degenerative disc matenda pansi pa tanthauzo ndi zikhalidwe zomwe zanenedwa muzolemba za chipangizocho;
- milandu yosankhidwa ya spondylolisthesis kapena kusakhazikika kwa msana;
- zowongolera zina zopunduka zomwe zimafuna kumangidwanso ndi kuphatikizika;
- pseudoarthrosis kapena opaleshoni yokonzanso muzochitika zosankhidwa;
- zina zomwe zimakhudzidwa makamaka ndi dongosolo la dokotalayo ndi zizindikiro za chipangizo.
Khola la interbody siloyenera kwa munthu aliyense amene ali ndi ululu wammbuyo kapena khosi. Chithandizo chopanda opaleshoni, kusokoneza popanda kuphatikizika kapena njira ina ingaganizidwe malinga ndi zomwe zapezeka. Tsambali silingadziwe ngati wodwala akufunika opaleshoni.
Zopindulitsa Zomwe Zingatheke ndi Zowopsa za Interbody Cages
Zolinga zomwe zimapangidwira kumanga kwa interbody zingaphatikizepo kusunga malo okonzeka a disk, kuthandizira kugwirizanitsa magawo, kunyamula katundu ndi kupereka malo opangira mafupa. Izi ndi zolinga zamapangidwe ndi machitidwe, osati zotsatira zotsimikizika za odwala.
Kuchuluka kwachiwopsezo sikungafotokozedwe mwachidule ndi gawo limodzi lapadziko lonse lapansi pamakina ndi njira zonse. Zotsatira zimasiyana ndi chipangizo, njira, kuchuluka kwa milingo, kukonza, kumezanitsa, thanzi la odwala, kapangidwe ka maphunziro ndi kutsata. Pachifukwa ichi, kufananitsa kwa ALIF, TLIF ndi PLIF komwe sikunachirikidwe kuchokera m'nkhani yapitayi sikuyenera kusindikizidwanso.
Kodi Madokotala Ochita Opaleshoni Amasankha Bwanji Khola la Interbody?
Kusankhidwa kumatengera chipangizocho komanso kutengera wodwala. Zinthu zingaphatikizepo msinkhu wa msana, njira, miyeso ya disk-space, endplate anatomy, kulinganiza kofunidwa, khalidwe la fupa, khola la khola, kutalika, lordotic angle, chuma, kulumikiza voliyumu, zolembera zojambula, njira yoyikapo ndi kukonza zowonjezera.
Khola liyeneranso kukhala logwirizana ndi mayesero ake, olowetsa, zida zomezanitsa ndi zina zonse zophatikizika kapena zowonjezera. Chida chofanana chochokera ku dongosolo lina sichiyenera kuganiziridwa kuti n'chogwirizana. Zipatala ndi ogawa ayenera kuwunika ma implants pamodzi ndi zida zofananira ndi malangizo omwe akugwiritsidwa ntchito.
Mawu oyenerera: palibe 'm'khola' imodzi yabwino kwambiri. Njira yoyenera imasankhidwa ndi dokotala wochiza kuchokera ku zipangizo zovomerezeka malinga ndi zosowa za wodwalayo, ndondomeko yomwe yakonzedweratu ndi zolemba za mankhwala.
Interbody Cage Systems kwa Zipatala ndi Ogawa
Akatswiri ogula amafuna zambiri kuposa mndandanda wa khola zipangizo. Onani ngati kutalika, mapazi ndi matrix a lordosis akugwirizana ndi zomwe akufuna; ngati mayesero ndi olowetsa ali athunthu; komanso ngati chilolezo cha malonda, kulemba, kutsatiridwa, kuyika, kutsekereza ndi chithandizo chamsika chilipo kudziko komwe mukupita.
The Kalozera wathunthu wa implant implant amafotokoza momwe makola amayenderana ndi khomo lachiberekero ndi thoracolumbar fixation system. Ogula omwe akufuna kupanga mozama komanso kufananitsa kwa ogulitsa akhoza kupitilizabe padera interbody fusion cage wopanga chiwongolero.
Kulekanitsa uku ndi dala: nkhani yapano ikuyankha funso lachidziwitso 'kojekiti zamagulu ndi chiyani?' pomwe buku lolumikizidwa likunena za chitukuko cha zinthu, zida, kupanga ndi kusankha kwa ogulitsa.
Mafunso Ofunsidwa Kawirikawiri Okhudza Interbody Cages
Kodi khola la interbody limagwiritsidwa ntchito chiyani?
Khola la interbody limagwiritsidwa ntchito m'njira zosankhidwa za kuphatikizika kwa msana kuti zithandizire malo okonzeka pakati pa matupi oyandikana ndi vertebral ndipo nthawi zambiri kuti agwirizane ndi zida za mafupa pomwe kuphatikizika kukukula.
Kodi interbody cage ndi disc yopangira?
Ayi. Chimbale chochita kupanga nthawi zambiri chimapangidwa kuti chisungike kuyenda. Khola la interbody fusion limagwiritsidwa ntchito ngati gawo la njira yopangira kuphatikizika pakati pa vertebrae yoyandikana.
Ndi chiyani chomwe chimayikidwa mkati mwa khola la anthu?
Zojambula zambiri za khola zimaphatikizapo malo opangira mafupa. Mtundu wa kumezanitsa ndi kuyika kwake zimatsimikiziridwa ndi dokotalayo molingana ndi ndondomeko, wodwala komanso zolembera zomwe zimagwiritsidwa ntchito.
Kodi pali kusiyana kotani pakati pa TLIF, PLIF ndi ALIF cages?
Mawuwa amafanana ndi njira zosiyanasiyana za opaleshoni ya lumbar. Njira iliyonse ingafunikire chopondapo chosiyana cha khola, mbiri yoyikapo, njira yolowera ndi zida. Mayina azinthu okha sakhazikitsa kusinthana.
Kodi PEEK ili bwino kuposa titaniyamu pa khola la msana?
Palibe chilichonse chomwe chili chabwinoko. PEEK ndi titaniyamu ali ndi malingaliro osiyanasiyana, makina, pamwamba ndi kupanga. Kusankha kuyenera kuganizira kapangidwe kake kachipangizo, kagwiritsidwe ntchito kovomerezeka, umboni wothandizira ndi dongosolo la opaleshoni.
Kodi khola la interbody lingagwiritsidwe ntchito popanda zomangira kapena ndodo?
Machitidwe ena amaphatikizapo kukonza kapena kuloledwa kuti agwiritse ntchito payekha, pamene ena amafunikira mbale zowonjezera, zomangira kapena ndodo. Tsatirani ndondomeko yamakono ndi njira yopangira opaleshoni ya chipangizo chenichenicho.
Ndi zoopsa zotani zomwe zimalumikizidwa ndi ma khola olumikizana ndi anthu?
Zowopsa zomwe zingatheke zingaphatikizepo kutsika, kusamuka, kutayika kwa kukonza, kulephera kwa chigawo, pseudoarthrosis, matenda ndi kuvulala kwa mitsempha, mitsempha kapena minofu. Njira ndi zoopsa zomwe zingakhudzidwe ndi odwala ziyenera kukambidwa ndi dokotala wochiza.
Zolozera Zachipatala ndi Zowongolera
- US FDA: Kalasi Yachiwiri Yotsogola Yapadera Yotsogola kwa Intervertebral Body Fusion Devices
- Chipatala cha Royal National Orthopedic Hospital: Chiwongolero cha Odwala ku Low Back Fusion Surgery
- North American Spine Society: Fusion Cage Design, Zida ndi zokutira
