Nigute wasuzuma uruganda rwa TLIF na PLIF mu Bushinwa

Abagabuzi bagereranya abatanga cage batanga isoko bakunda kureba urwego rwa PEEK nigiciro kuri buri gice, hanyuma bakeka ko ibisigaye bihinduka. Ntabwo aribyo. A. TLIF cyangwa Akazu ka PLIF nigikoresho gito, cya geometrike igoye kubona ibintu byinshi icyarimwe - ikirenge, uburebure, inguni ya lordotic, uburyo bwo kumenyo amenyo, ingano yidirishya ryinjizwamo, interineti yinjira, hamwe no gushyira ibimenyetso - kandi kubona kimwe muribi kibi kigaragara muri OR, ntabwo kiri kurupapuro rwihariye.

Nuburyo bufatika bwo gusuzuma uruganda rukora TLIF / PLIF rushingiye ku Bushinwa rwashize ibikoresho no kugereranya ibiciro abagurisha benshi batangirana.

Akazu Ntabwo ari PEEK gusa

Biroroshye gutekereza ku kato ka interbody nkigice kimeze nka PEEK cyangwa titanium hamwe nu mwobo waciwemo. Mubikorwa, buri gipimo nicyemezo cyo gushushanya hamwe ningaruka zamavuriro:

• Ikirenge - gito cyane kandi akazu gashobora kwibasirwa na vertebral endplate; binini cyane kandi ntabwo bizicara neza binyuze muri koridor ya TLIF nta gusubira inyuma cyane

• Uburebure - bukenera intera ihagije mubyongeweho bito (akenshi intambwe 1mm) kugirango ugarure uburebure bwa disiki utarinze kurangaza igice

• Inguni ya Lordotic - kasho iringaniye ntisubiza guhuza sagittal; uruganda rutanga inguni imwe gusa murwego rwubunini bwarwo ntabwo rwose rutanga sisitemu ikoreshwa kuri anatomy zitandukanye

• Kurangiza amenyo - igishushanyo mbonera kirwanya kwimuka nyuma yo gushyirwa; uburebure bwinyo nu mfuruka bigira ingaruka kumurongo wambere no koroshya gukuraho mugihe cyisubiramo

• Idirishya rya Graft - ahantu hafunguye ibikoresho byamagufwa; ubuso buto cyane hamwe nubuso bwubuso burahungabana, binini cyane nuburinganire bwuburinganire bwakazu ubwabwo buragabanuka

• Imigaragarire yimbere - burya akazu kafunga igikoresho cyo gushiramo mugihe cyo gushyira

• Ibimenyetso bya radiopaque - mubisanzwe pin ya tantalum, ikoreshwa mukwemeza ikibanza cyerekezo hamwe nicyerekezo munsi ya fluoroscopi kuva PEEK ubwayo ari radiolucent

Uruganda rushobora kuvuga muri ibi bipimo byumwihariko - ntabwo 'dutanga ubunini bwinshi ' - ni umuntu wumva neza ibyo bakora aho gukora gusa gahunda ya CNC kurwanya igishushanyo undi muntu yatanze.

PEEK na Titanium: Ibyo Kugereranya Mubyukuri

Abatanga ibicuruzwa bakunze kubaza ibikoresho aribyo 'byiza. ' Ntabwo arikibazo gifite igisubizo kimwe - biterwa nibyifuzo byo kubaga, urwego rwihariye rwahujwe, hamwe nibisabwa byerekana amashusho - ubwo rero uburyo bwingirakamaro ni ukugereranya ibyo uwabikoze ashobora kwandika kuri buri kintu aho guhitamo uruhande.

• Inyandiko y'ibikoresho - kuri PEEK, ibi bivuze kwemeza urwego rwubuvuzi PEEK idafite ingufu za karubone (karuboni-fibre PEEK irakomeye ariko itwikiriye amashusho, ifite akamaro ko gusuzuma fusion nyuma yo gutangira); kuri titanium, ibi bivuze urwego rwihariye rwa alloy kandi niba rukomeye cyangwa 3D-icapuwe neza

• Ibiranga amashusho - PEEK ni radiolucent, ituma abaganga babaga basuzuma iterambere rya fusion kumashusho yo gukurikirana nta kasho itapfukirana kureba; titanium ni radiopaque, bamwe mubaganga babaga bahitamo kwemeza ikibanza ariko gishobora gutuma gusuzuma imikurire yamagufwa binyuze mu kato bigoye

• Igishushanyo mbonera - PEEK yoroshye ifite ubuso bwa bioinert budateza imbere amagufwa-gukura; Imiterere ya titanium yuzuye (harimo na 3D yacapishijwe trabecular yubatswe) yashizweho kugirango ishishikarize osseointegration itaziguye hejuru yatewe

• Ibisabwa bya mashini - ibikoresho byombi bigomba kuba byujuje ibipimo ngenderwaho byogusunika kubikoresho, ariko ibishushanyo mbonera byemewe bitandukana no gukomera kubintu

Icyo ushaka kuva mubakora ni inyandiko kumirongo yombi yibintu, ntabwo ikibanza cyo kugurisha icyaricyo cyose kibyara umusaruro mwinshi.

Impamvu Gushyira Ikimenyetso cya Radiopaque Mubyukuri

Kubera ko akazu ka PEEK katagaragara neza kuri fluoroscopi, ibimenyetso bya tantalum byinjijwe mu kato nicyo kintu cyonyine cyo kubaga abaganga bemeza igihe cyagenwe cyerekana icyerekezo ndetse nicyerekezo mugihe cya TLIF cyangwa PLIF - koridor ifite amashusho make cyane. Niba ibyo bimenyetso byicaye bidahuye, cyangwa bimuka mugihe cyo kutagira ingaruka, umuganga ubaga atakaza icyizere mubyo C-ukuboko yerekana.

Twabikurikiranye muburyo burambuye muri Impamvu Radiopacity ifite akamaro muri kasho ya TLIF , harimo nishusho nyayo itagaragara yo kubaga umuganga wohereje yerekana ibimenyetso byerekana mugihe cyukuri. Birakwiye ko usoma kuruhande rwiki gitabo, kuko cyerekana icyo 'cyiza gihagije ' gushyira ibimenyetso mubyukuri bisa na monitor ya fluoroscopi nzima - ntabwo biri mubisabwa gusa.

Cage na Inserter Guhuza

Nukunanirwa nokugabura abumva bumva hafi cyane kurenza ubwiza bwibintu, ariko bitera ibibazo byinshi hagati. Imigaragarire hagati yakazu niyinjizamo igomba gufata mugihe cyisubiramo - mallet ikubita yicaye akazu mumwanya wa disiki - nta kurekura cyangwa kudahuza.

Ibyo kugenzura byumwihariko:

• Uburyo bwo gufunga kwinjiza - urudodo, urufunguzo, cyangwa guterana-bikwiranye - kandi niba bifite umutekano binyuze muburyo bwuzuye

• Icyerekezo cage cyemeza - ushobora kubaga ashobora kumenya inzira akazu kamaze guhura na inserter, cyane cyane muri koridor aho amashusho atagaragara ari make

• Kwihanganira ingaruka - ese guhuza akazu-gushiramo bifata munsi yimbaraga zifatika, cyangwa bisaba gufata neza bidasanzwe bidindiza umuganga ubaga hasi?

• Ibipimo bihoraho - ni interineti yinjizwamo ikozwe mu kato kamwe ko kwihanganira nyuma y’akazu, icyiciro nyuma yicyiciro, cyangwa gikwiye kiratandukanye bihagije kuburyo ibice bimwe byumva birekuye kurusha ibindi.

• Guhuza ibikoresho - ese uwabikoze atanga inserter nkigice cya sisitemu yemewe hamwe nakazu, cyangwa ni igikoresho rusange kiba gihuye hafi

Akazu gahuye na buri kintu gipima ku mpapuro ariko kigatandukana hagati yacyo hagati yacyo ntabwo ari ikintu cyoroshye - ni ikibazo cyahagaritswe n'umwanya wa disiki umaze gutegurwa n'umurwayi munsi ya anesteziya.

Urutonde rwibicuruzwa kuri TLIF na PLIF

Imigaragarire yimashini nubukanishi bimaze kwemezwa, ikibazo gikurikiraho ni ukumenya niba ingano yuwabikoze nubunini buringaniye bikubiyemo ibyo abaganga bawe bakeneye:

• Ibirenge bigororotse hamwe n'ibirenge bigoramye - akazu kagoramye karasanzwe kuri PLIF (gushyira mubihugu byombi) mugihe TLIF ikunze gukoresha igishushanyo kimeze nk'igitoki cyangwa gisa n'impyiko gikwiranye no gushyiramo uruhande rumwe.

• Uburebure buringaniye - mubisanzwe 8-14mm muri 1mm yiyongera kubikorwa bya lumbar, bitwikiriye intera yuburebure bwa disiki yahuye nayo

• Amahitamo ya Lordotic - byibuze bisanzwe hamwe na hyperlordotic ihitamo (mubisanzwe 0 °, 6 °, no hejuru kubice bisaba gukosorwa cyane)

• Ubugari bwikirenge nuburebure - itandukaniro rihagije kugirango rihuze ubunini bwumubiri wurugingo rutarinze guhatira ubunini bumwe

• Guhuza TLIF / PLIF / MIS - niba urubuga rumwe rukora rukora muburyo bwuguruye kandi bworoshye, cyangwa niba gushyira MIS bisaba igishushanyo mbonera cyihariye na sisitemu yo gushiramo.

Urwego ruto ruhatira itsinda ryanyu ryo kugurisha kumvikana nabaganga babaga hagati - kubabwira ingano yegeranye ni 'funga bihagije ' aho guhuza nibyo urubanza rusaba.

Ni izihe nyandiko n'ibizamini Abashoramari bagomba gusaba?

Mbere yo gukora ibarura, saba:

• Umugereka wa ISO 13485 - wemeza ko amakarito yo guhuza abantu aringaniye muburyo bwemewe, ntabwo byafashwe murwego rusange rwumugongo

• Icyemezo cyibikoresho - PEEK resin lot icyemezo cyemeza urwego rwubuvuzi no kutagira imbaraga za karuboni (keretse karuboni-fibre PEEK aribyo byateganijwe); uruganda rwa titanium rwerekana ibipimo bya ASTM bijyanye

• Igenzura ryibipimo - Kugenzura CMM kubirenge, uburebure, hamwe no kwihanganira imiyoboro ya marike, ntabwo igenzurwa ryingingo ya mbere gusa ahubwo ikomeje gukorwa

• Raporo yikizamini cya mashini - igeragezwa rihamye kandi rifite imbaraga zo kwikuramo-shear kuri ASTM F2077 cyangwa bihwanye nibikoresho byabantu

• Ikurikiranwa hamwe nibyiciro - birashobora kuba akazu kihariye uhereye kumasoko yacyo hamwe nibikoresho fatizo nyuma y'ibyoherejwe

Kubagabuzi basubiramo interineti fusion cage amahitamo kubatanga ibicuruzwa, ugereranije iyi nyandiko nukuri interbody fusion cage ibisobanuro na PEEK cage ibicuruzwa kumurongo kuruhande nuburyo bwizewe bwo gusuzuma kuruta kugereranya ibyifuzo byo kwamamaza.

Ibarura, MOQ, na OEM Inkunga

Ikariso ya interbody itwara matrix yagutse - ibirenge byinshi, uburebure bwinshi, impande nyinshi za Lordotic - bivuze ko ibarura ryabacuruzi rigomba gutwikira ubutaka bwinshi kugirango wirinde guhamagarira ibitaro ubunini butari ku gipangu. Sisitemu isanzwe ya cage sisitemu ikomeza kubarwa cyane, hamwe no koherezwa mububiko mubisanzwe muminsi 3 yakazi, bigabanye itandukaniro ryikinyuranyo kinini biba ikibazo cyingengabihe.

Inkunga ya OEM kuri sisitemu ya cage mubisanzwe ikubiyemo gupakira no kuranga ibicuruzwa, iboneza rya kataloge ku isoko, hamwe n'inkunga yinyandiko yo kwiyandikisha - ibi birihuta kubishyira mubikorwa. Akazu gashya rwose ka geometrie cyangwa ikirenge, bitandukanye, bisaba kwemeza igishushanyo mbonera no kuvugurura imashini mbere yo kohereza, kandi iyo ngengabihe igomba kumenyeshwa neza aho gutwikirwa hejuru.

Isuzuma ryanyuma ryabatanga isoko

Ibibazo byo gutanga ibyemezo no gukora ibihano hano bikurikiza ibitekerezo bimwe bikubiye muburyo bwagutse tureba Ubushinwa n’uruganda rukora umugongo muri Amerika - ibitandukanya utanga isoko yizewe n’ingaruka zishobora kwandikwa kugenzura inzira, ntabwo aho uruganda ruba rwicaye ku ikarita.