Imfundo yokudibanisa umqolo | Iintlobo ze-Interbody yekheji kunye nemathiriyeli
Iikheji ze-Interbody zizixhobo ezifakelwayo ezibekwe phakathi kwemizimba ye-vertebral ekufutshane ngexesha leenkqubo ezikhethiweyo zokudibanisa umgogodla. Zenzelwe ukugcina indawo yediski elungiselelwe, ukubonelela ngenkxaso yesakhiwo kunye nokuhlalisa i-bone-graft material ngelixa i-fusion ikhula. Uhlobo lwe-Cage, ubungakanani, izinto eziphathekayo kunye nesicwangciso sokulungiswa sikhethwa kwisigulane esithile, indlela yokuhlinzwa kunye nenkqubo yesixhobo esigunyazisiweyo.
Yintoni i-Interbody Fusion Cage?
I-cage ye-interbody fusion iyisixhobo esifakwe kwi-spinal space efakwe kwi-intervertebral space emva kokuba ugqirha okhupha yonke into okanye inxalenye yediski eyonakalisiweyo ngexesha lokucwangciswa kwenkqubo yokudibanisa. Inkcazo ye-FDA ibandakanya izixhobo ezenziwe kwizinto ezifana ne-titanium kunye neepolymers kwaye zifakwe kwi-intervertebral space yomlomo wesibeleko okanye i-lumbosacral.
Ikheji ayisiyiyo idiski yokutshintsha ejolise ukugcina ukunyakaza okuqhelekileyo. Indima yayo inxulunyaniswa nokudibanisa: ixhasa icandelo eliphathwayo ngelixa ithambo elitsha likhula phakathi kwe-vertebrae ekufutshane. Uyilo oluninzi lubandakanya ukuvulwa kwangaphakathi okanye igumbi lokuxutywa kwezinto eziphathekayo zethambo kunye neempawu zangaphandle ezijoliswe ukusebenzisana ne-vertebral endplates.
I-XC Medico iququzelela uyilo olukhoyo ngaphakathi kwayo Iindidi zemveliso ye-interbody cage . Amaphepha emveliso aluncedo ekuqondeni uluhlu, kodwa izalathisi ezisebenzayo, ukuchasana, iimfuno zokulungisa kunye nobuchule botyando kufuneka buqinisekiswe ukusuka kwilebhile yesixhobo sangoku.
Indlela i-Spinal Cages ixhasa ngayo ubude be-Disc, ukulungelelanisa kunye ne-Fusion
Ukwahlula okubalulekileyo: ukuchithwa kwe-nerve kwenziwa ngenkqubo yokuhlinzwa. I-cage inokunceda ukugcina i-disc okanye ukuphakama kwe-foraminal kwizakhiwo ezikhethiweyo, kodwa akufanele kuchazwe njengokuzimela ngokuzimeleyo ukunyanzeliswa kwe-nerve okanye ukuqinisekisa ukukhululeka kweentlungu.
Iindidi ze-Interbody Cages nge-Surgery Approach
Iikheji ze-Interbody zivame ukuhlukaniswa ngummandla womgogodla kunye nendlela esetyenziselwa ukufikelela kwi-disc space. Izifinyezo zichaza inkqubo, hayi nje imilo yokufakelwa. Imveliso egunyazisiweyo yendlela enye akufuneki icingelwe ukuba ifanelekile kwenye.
Ngombono obanzi wendlela iikheji ezinxibelelana ngayo nezikrufu ze-pedicle, iipleyiti zomlomo wesibeleko kunye nezixhobo ezikhethekileyo, jonga kwakhona i-XC Medico's. ukufakelwa komqolo kunye neenkqubo zesixhobo.
| Ikheji okanye indlela | yofikelelo ngokubanzi Imiba | yoyilo eqhelekileyo | Imiba yenkqubo yokuqinisekisa |
|---|---|---|---|
| Ikheji yesibeleko / ACDF | Indlela yomlomo wesibeleko yangaphambili | Unyawo olubambeneyo, ubude bomlomo wesibeleko kunye nee-engile, igumbi loxhulumaniso kunye neziphawuli zokucinga. | Ingaba iplate yangaphambili eyahlukileyo okanye ukulungiswa okudibeneyo kuyafuneka okanye kugunyaziswe. |
| Ikheji ye-TLIF | Indlela ye-Transforaminal lumbar | Iprofayili yokufaka, unyawo, ukuqhelaniswa kokugqibela, uqhagamshelo lofakelo kunye nokhetho lwe-lordotic. | Izixhobo ezivulekileyo okanye ezingephi kunye nokulungiswa kwangasemva okongeziweyo. |
| Ikheji ye-PLIF | Indlela ye-lumbar yangasemva | Ukufikelela ngasemva, inombolo yekheji kunye nendawo njengoko kuchaziwe yinkqubo ethile. | Izilingo, abafakeli, izixhobo zokuxhunyelelwa kunye nokuhambelana kokulungiswa kwangasemva. |
| Ikheji ye-ALIF | Indlela ye-lumbar yangaphambili | Imizila emikhulu yeenyawo, ubude kunye noluhlu lwe-lordosis, i-standalone okanye i-supplement fixation design. | Izixhobo zokusondela, izikrufu zokulungisa okanye iipleyiti kunye nokuleyibhelishwa kwemveliso ethile. |
| Ikheji ye-LLIF / OLIF | I-Lateral okanye i-oblique lumbar approach | Unyawo olubanzi, iprofayili yofakelo olusecaleni kunye nesixhobo sokujonga ngqo. | I-Neuromonitoring, inkqubo yokufikelela kunye neemfuno zokulungisa ezongezelelweyo njengoko kusebenza. |
Iikheji ze-Cervical Interbody Cages ze-ACDF
Iikheji ze-Cervical interbody zisetyenziselwa kwi-discectomy yangaphambili yomlomo wesibeleko kunye neenkqubo zokudibanisa. Uyilo lunokusetyenziswa kunye neplate yangaphambili yomlomo wesibeleko eyahlukileyo okanye inokubandakanya iimpawu zokulungisa, kuxhomekeke kwinkqubo egunyazisiweyo. Phonononga XC Medico's Izisombululo ze-ACDF zokuhlanganiswa komlomo wesibeleko kumboniso wenkqubo yemveliso.
I-TLIF kunye ne-PLIF Cages for Posterior Lumbar Fusion
I-TLIF kunye ne-PLIF zombini zifikelela kwi-lumbar disc space ukusuka kwiindlela ezisekelwe emva, kodwa i-corridor yokusebenza, i-geometry ye-cage, indlela yokufaka kunye nokucwangciswa kwe-cage inokwahluka. Akuchanekanga ukuchaza ukuba inkqubo nganye ye-interbody isebenzisa iikheji ezimbini. Ngomzekelo wombutho wenkqubo ethile, bona i I-TLIF kunye ne-MIS-TLIF iinkqubo zekheji.
I-ALIF kunye neLateral Lumbar Cages
Iikheji ze-ALIF zifakwe ngendlela ye-lumbar yangaphambili. Iindlela ze-lateral kunye ne-oblique zisebenzisa iipaseji ezahlukeneyo zokufikelela kunye nezixhobo ezikhethekileyo. Ezi ntsapho zekheji zihlala zibonelela ngeenyawo kunye nokhetho lwe-lordotic oluyilwe malunga nendlela yabo yokufikelela. I inkqubo yekheji ezimeleyo ye-ALIF PEEK ibonisa uqwalaselo oludityanisiweyo lwekheji kunye ne-screw; iinkcukacha zayo akufuneki zenziwe ngokubanzi kuzo zonke izixhobo ze-ALIF.
I-Static vs I-Interbody Cages Eyandiswayo
Iikheji ezimileyo zinemilinganiso emiselwe kwangaphambili. Iikheji ezinokwandiswa zifakwe kwi-compact configuration kwaye zilungelelaniswe ngaphakathi koluhlu olugunyazisiweyo emva kokubekwa. Ukwandiswa akuthethi ngokuzenzekelayo iziphumo ezingcono zeklinikhi. Ubuchwephesha besixhobo, imida yokwandiswa, uqhagamshelwano lwe-endplate, iinjongo zokulungelelanisa, ukulungiswa kunye nobungqina obukhoyo kufuneka zonke ziqwalaselwe.
PEEK vs Titanium Interbody Cages
I-PEEK kunye ne-titanium zisetyenziswa kakhulu kwizixhobo zokudityaniswa kwe-interbody, kodwa azikho ziphezulu. Iimpawu zezinto eziphathekayo zisebenzisana nejometri ye-cage, isakhiwo somphezulu, ukulungiswa kwe-endplate, izinto zesigulane kunye nokwakhiwa kokulungiswa okupheleleyo. Amabango okuthengisa akufuneki afakwe endaweni yobungqina obuthe ngqo kwisixhobo.
| Imatheriyali okanye uyilo | Iimpawu zokubonisa | Iingcamango zoomatshini kunye nomphezulu | Imibuzo yokuqinisekisa |
|---|---|---|---|
| PEEK | Umzimba wekheji we-radiolucent; Iimpawu zeradiopaque ziqhele ukusetyenziswa ukubonisa indawo. | Iimpawu zePolymer zihluke kwiintsimbi; ijometri kunye nenkqubo yokuvelisa ihlala ibalulekile. | Ukucaciswa komgangatho wezonyango, uyilo lomakishi, imilinganiselo, umphezulu, uvavanyo kunye nokuleyibheli. |
| I-alloy ye-titanium eqinile | I-Radiopaque kwaye isenokwenza umfanekiso we-artifact ngokuxhomekeke kwisixhobo kunye nendlela. | Amandla aphezulu; imodyuli kunye nokuziphatha komphezulu kwahlukile kwi-PEEK. | Ukucaciswa kwe-alloy, indlela yokuvelisa, imeko ephezulu kunye nobungqina bomatshini. |
| I-Porous okanye i-titanium eyenziwe ngokungeziweyo | I-Radiopaque; ukubonwa kuxhomekeke kwijometri kunye neemeko zokucinga. | Uyilo lwePorous lwazisa ukuveliswa, ukucocwa kunye nokuqwalaselwa kokuqinisekisa. | Ukucaciswa kwe-Porosity, ukuqinisekiswa kwenkqubo, ukucoceka kunye nobungqina bokusebenza obuxhasayo. |
| I-PEEK ene-Titanium | Igcina umzimba we-polymer ene-radiolucent kunye necandelo lomphezulu we-radiopaque. | Ukunamathela kwi-coating, ukugubungela, amaqhekeza kunye nokuziphatha kojongano kufuna ulawulo. | Inkqubo yokugquma, ukuqinisekiswa, ukuhlolwa, ukucocwa kunye nobungqina obuthe ngqo kwimveliso. |
Kutheni iMathiriyeli yeCage ingazimiseli ziziphumo zodwa
Amaqela e-XC Medico afumaneka kuyilo lomlomo wesibeleko kunye ne-lumbar polymer ngaphakathi kwayo Uluhlu lwe-PEEK yomlomo wesibeleko kunye ne-lumbar cage . Qinisekisa ibakala lemathiriyeli echanekileyo, imarker radiopaque, imeko echuliweyo okanye engeyontsholongwane kunye nogunyaziso lwentengiso lwemodeli nganye.
Musa ukubhala 'i-MRI ekhuselekileyo' kwizinto zodwa: Ukhuseleko lwe-MR okanye ukuhambelana kufuneka kugqitywe kwisixokelelwano esipheleleyo sesixhobo kunye nokuleyibheli kwayo kwangoku, akuthatyathelwanga kwingxelo jikelele malunga ne-PEEK okanye i-titanium.
Zisetyenziswa njani iikheji ze-Interbody kuTyando lweSpinal Fusion?
Iinkcukacha zihluka kakhulu phakathi komlomo wesibeleko, i-lumbar yangasemva, i-transforaminal, yangaphambili kunye neendlela ezisecaleni. Oku kulandelayo lulandelelwano lwemfundo olukwinqanaba eliphezulu kunomyalelo wotyando.
Ukususwa kweDisc, ukulungiswa kwe-Endplate kunye nokufakwa kweCage
Imfuneko yokusetyenziswa kobuchwephesha: ukudityaniswa kwe-interbody kufuna utyando ngokobuchwepheshe. I-FDA incoma ukuba ezi zixhobo zifakwe kuphela ngabachwephesha abanamava kunye noqeqesho oluthile kwisixhobo. Izigulana kufuneka zixoxe ngezibonelelo ezingqamene nenkqubo, iindlela ezizezinye kunye neengozi kunye nogqirha wabo wotyando.
Zeziphi iimeko ezinokunyangwa nge-Interbody Fusion?
I-interbody fusion inokuthathwa njengenxalenye yonyango kwiimeko ezikhethiweyo zomgogodla xa ingcali eqeqeshiweyo inquma ukuba i-fusion ifanelekile. Isalathiso sixhomekeke kummandla womgogodla, iimpawu, ukucinga, ukungazinzi, unyango lwangaphambili, izinto zesigulane kunye nokubhaliswa okugunyazisiweyo kwesixhobo esikhethiweyo.
- isifo se-disc degenerative phantsi kwenkcazo kunye neemeko ezichazwe kwilebhile yesixhobo;
- iimeko ezikhethiweyo ze-spondylolisthesis okanye ukungazinzi komgogodla;
- ezinye izilungiso zokukhubazeka ezifuna ukwakhiwa ngokutsha kunye nokudibanisa;
- i-pseudoarthrosis okanye utyando oluhlaziyiweyo kwiimeko ezikhethiweyo;
- ezinye iimeko ezigutyungelwa ngokukodwa licebo likagqirha kunye nezalathiso zesixhobo.
Ikheji ye-interbody ayifanelekanga kuye wonke umntu onentlungu yomqolo okanye yentamo. Unyango olungasebenzisi, ukuchithwa ngaphandle kokudibanisa okanye enye inkqubo inokuqwalaselwa ngokuxhomekeke kwisifo. Eli phepha alinakuqinisekisa ukuba isigulane sifuna utyando.
IiNzuzo ezinokuthi zibekho kunye nemingcipheko ye-Interbody Cages
Iinjongo ezijoliswe kwi-interbody construction zingabandakanya ukugcina indawo elungiselelwe i-disc, ukuxhasa ukulungelelaniswa kwecandelo, ukuthwala umthwalo kunye nokubonelela ngendawo yokuxuba amathambo. Ezi zinjongo zoyilo kunye nenkqubo, aziqinisekiswanga iziphumo zesigulane.
Ubuninzi bomngcipheko awunakushwankathelwa ngepesenti enye jikelele kuzo zonke iikheji kunye neenkqubo. Iziphumo ziyahluka ngesixhobo, indlela, inani lamanqanaba, ukulungiswa, ukufakwa, impilo yesigulane, uyilo lokufunda kunye nokulandelela. Ngesi sizathu, uthelekiso olungaxhaswanga lwe-ALIF, TLIF kunye ne-PLIF oludityanisiweyo olusuka kwinqaku elidlulileyo akufuneki luphinde lupapashwe.
Ingaba ooGqirha bakhetha njani i-Interbody Cage?
Ukhetho sisixhobo- kunye nesigulana-ngokuthile. Izinto zingabandakanya inqanaba lomgogodla, indlela, imilinganiselo ye-disc-space, i-endplate anatomy, ukulungelelaniswa okufunwayo, umgangatho wamathambo, i-cage footprint, ukuphakama, i-angle ye-lordotic, izinto eziphathekayo, umthamo we-graft, amakishi emifanekiso, indlela yokufaka kunye nokulungiswa okongeziweyo.
I-cage kufuneka kwakhona ihambelane nezilingo zayo, i-inserter, izixhobo ze-graft kunye naluphi na ukulungiswa okudibeneyo okanye okongeziweyo. Isixhobo esifana neso esisuka kwenye inkqubo akufuneki sicingelwe ukuba siyahambelana. Izibhedlele kunye nabasasazi kufuneka bavavanye ukufakelwa kunye neseti yesixhobo esihambelanayo kunye nemiyalelo yangoku yokusetyenziswa.
Amagama anoxanduva: akukho 'yeyona kheyiji ilungileyo phakathi kwabantu.' Ukhetho olufanelekileyo lukhethwa ngugqirha onyangayo kwizixhobo ezigunyazisiweyo ngokweemfuno zesigulana, inkqubo ecwangcisiweyo kunye nokuleyibhelishwa kwemveliso ethile.
Iinkqubo ze-Interbody Cage kwizibhedlele kunye nabasasazo
Abathengi abachwephesha badinga ngaphezu koluhlu lwezinto zekheji. Vavanya ukuba ngaba ubude, unyawo kunye ne-lordosis matrix iyahambelana nemfuno yenkqubo yendawo; ingaba iimvavanyo kunye nabafakeli zigqityiwe; nokuba ngaba ugunyaziso lwemveliso, iilebhile, ukulandeleka, ukupakishwa, ukuvala inzalo kunye nenkxaso yasemva kokuthengisa ziyafumaneka na kwilizwe ekusingwa kulo.
I Isikhokelo esipheleleyo sephothifoliyo yokufakelwa komnqonqo sichaza ukuba iikheji zihambelana njani nomlomo wesibeleko kunye ne-thoracolumbar fixation systems. Abathengi abafuna imveliso enzulu kunye nothelekiso lwababoneleli banokuqhubeka ngokwahlukileyo Isikhokelo somenzi we-interbody fusion cage.
Olu lwahlulo lwenziwe ngabom: inqaku langoku liphendula umbuzo wolwazi 'yintoni i-interbody cages?' ngelixa isikhokelo esidityanisiweyo sijongana nophuhliso lwemveliso, imathiriyeli, imveliso kunye nokukhethwa kwababoneleli.
Imibuzo Ebuzwa Rhoqo malunga ne-Interbody Cages
Isetyenziselwa ntoni ikheji yomntu omnye?
Ikheji ye-interbody isetyenziswa kwiinkqubo ezikhethiweyo zokudityaniswa komgogodla ukuxhasa indawo elungisiweyo phakathi kwemizimba ye-vertebral ekufutshane kwaye kaninzi ukulungiselela imathiriyeli yethambo ngelixa i-fusion ikhula.
Ngaba ikheji yomntu omnye yidiski eyenziweyo?
Hayi. Idiski eyenziweyo ngokuqhelekileyo ijolise ekulondolozeni ukunyakaza. Ikheji yokudityaniswa kwe-interbody isetyenziswa njengenxalenye yenkqubo ejoliswe ukudala ukudibanisa phakathi kwe-vertebrae ekufutshane.
Yintoni ebekwe ngaphakathi kwekheji yomntu omnye?
Uyilo oluninzi lwe-cage lubandakanya indawo yokwenza ithambo-graft material. Uhlobo lwe-graft kunye nokubekwa kugqitywe ngugqirha wotyando ngokwenkqubo, isigulane kunye nelebhile yemveliso esebenzayo.
Yintoni umahluko phakathi kwe-TLIF, PLIF kunye ne-ALIF cages?
Amagama ahambelana neendlela ezahlukeneyo zotyando lwe-lumbar. Indlela nganye inokufuna i-cage footprint eyahlukileyo, iprofayili yokufaka, i-orientation kunye nenkqubo yesixhobo. Amagama emveliso yodwa akamiseli ukutshintshiselana.
Ngaba i-PEEK ingcono kune-titanium yekheji yomqolo?
Akukho nanye imathiriyeli engcono jikelele. I-PEEK kunye ne-titanium inemifanekiso eyahlukeneyo, i-mechanical, surface kunye neempawu zokuvelisa. Ukukhetha kufuneka kuthathelwe ingqalelo uyilo olupheleleyo lwesixhobo, ukusetyenziswa okugunyazisiweyo, ubungqina obuxhasayo kunye nesicwangciso sotyando.
Ngaba ikheji yomntu omnye ingasetyenziswa ngaphandle kwezikrufu okanye iintonga?
Ezinye iinkqubo zibandakanya ukulungiswa okanye zigunyazisiweyo kwizicelo ezithile ezizimeleyo, ngelixa ezinye zifuna iipleyiti ezongezelelweyo, izikrufu okanye iintonga. Landela iilebhile zangoku kunye nobuchule botyando kweso sixhobo kanye.
Yeyiphi imingcipheko engundoqo eyayanyaniswa neekheji zokuhlangana kwabantu ababini?
Imingcipheko enokubakho ingabandakanya ukuhla, ukufuduka, ukulahleka kokulungiswa, ukungaphumeleli kwecandelo, i-pseudoarthrosis, ukusuleleka kunye neurological, i-vascular or tissue ukulimala. Inkqubo- kunye nemingcipheko ethile yesigulana kufuneka ixoxwe nogqirha wotyando.
IiReferensi zonyango kunye noLawulo
- I-US FDA: ISikhokelo soLawulo oluKhethekileyo lwe-Intervertebral Body Fusion
- Isibhedlele saseRoyal National Orthopedic: Isikhokelo seSigulane kwi-Low Back Fusion Surgery
- I-North American Spine Society: i-Fusion Cage Design, i-Materials and Coatings
