Oxhumana naye wokuthengwa kwempahla esibhedlela uyafona futhi akubuze ukuthi uphethe isistimu yesikulufu ye-pedicle engenelele kancane. Njengamanje usabalalisa amasistimu e-fusion avulekile - I-SecuFix noma i-ValuFix-type-screw screw constructs - futhi bebethengisa kahle. Manje uyazibuza ukuthi ingabe ukungeza ulayini we-MIS kuwufanele yini ukutshalwa kwezimali, noma ingabe kuwukuphazamiseka kwesigaba somkhiqizo osesivele sisebenza.
Lokhu kuvela ngaphezu kwalokho abasabalalisi abakulindele. Okuthandwa ngudokotela ohlinzayo kuyashintsha ezimakethe eziningi, kodwa hhayi ngokufanayo, futhi hhayi kuzo zonke izinqubo. Ngaphambi kokwengeza ama-SKU, kuyasiza ukuqonda ukuthi yini ngempela ehlukile - ngokomtholampilo nangokohwebo - phakathi kwalezi zindlela ezimbili.
Yini 'MIS' Eshintsha Empeleni Egunjini Lokusebenza
Igama lisetshenziswa ngokukhululeka, ngakho-ke kufanelekile ukunemba. Isistimu ye-MIS pedicle screw yeqiniso ayiyona nje inguqulo encane yesistimu evulekile. Umehluko oyinhloko uwukuthi:
- Ukufakwa kwesikulufa se-Percutaneous — izikulufu zingena ngesikhumba esincane esiqondiswa i-fluoroscopy, esikhundleni sokuvezwa okukodwa okuvulekile okunomsipha ohoxisiwe.
- Izinti zethebhu ezigobe ngaphambili noma zokunciphisa - induku idluliswa ngohlelo lombhoshongo okheniwe kunokuba ibekwe ngqo endaweni evulekile, yingakho izinhlelo ze-MIS rod zivame ukugoba ngaphambili.
- Izikulufu ezikheniwe, ezifenestrated - izikulufu ezingenalutho zivumela ukufakwa okusekelwe kumhlahlandlela futhi ngezinye izikhathi nokwengezwa kukasimende ethanjeni le-osteoporotic
- I-Tubular retractor noma i-extension tower instrumentation — lena isethi yensimbi eyenza ukubekwa kwe-percutaneous kwenzeke, futhi ingxenye abasabalalisi abavame ukuyibukela phansi ngokwezindleko nobunkimbinkimbi.
Vula amasistimu weqa konke lokhu. Udokotela ohlinzayo unombono oqondile, izitholi ezijwayelekile ze-pedicle kanye nompompi, kanye nenduku eqondile noma ekhonjisiwe kancane encishiswa endaweni yayo. Ukuhamba komsebenzi okusungulwe kakhudlwana okunejika lokufunda elingashoni.
I-Clinical Trade-offs Odokotela Abahlinzayo Empeleni Bayakunakekela
Abasabalalisi akudingeki babe odokotela abahlinzayo bomgogodla, kodwa ukuqonda ukuthi yini eqhuba ukukhetha kodokotela abahlinzayo kukusiza ukuba ube nengxoxo ethembekile nokuthengwa kwempahla kanye nabasebenzi NOMA.
Izindlela ze-MIS ngokuvamile zinciphisa ukulahleka kwegazi, ukuhlukumezeka kwemisipha, kanye nobude besibhedlela kubantu abafanelekayo - ngokuvamile izimo eziwohlokayo zezinga le-1-2 ngaphandle kokukhubazeka okuphawulekayo. Lokho kuyinzuzo yangempela yomtholampilo futhi yingakho isidingo sikhona.
Kepha i-MIS ayincono emhlabeni wonke. Ukwakhiwa kwamaleveli amaningi, ukuhlinzwa kokubuyekeza, ukulungiswa kokukhubazeka okuphawulekayo, nezimo ezidinga ukucindezelwa okubanzi kusavame ukuvulwa, ngenxa yokuthi ukubuka ngeso lengqondo nokufinyelela kungaphezu kosayizi wokusikwa kulezo zimo. Udokotela ohlinzayo owenza umsebenzi wokukhubazeka oyinkimbinkimbi angase angabi namsebenzi wohlelo lwesikulufu se-MIS. Udokotela ohlinzayo owenza isifo esiwohlokayo kakhulu esikhungweni sokuhlinza sosuku olufanayo angase asebenzise cishe lutho olunye.
Lena into yokuqala okufanele uyithole ngaphambi kokuba wenze i-inventory: isizinda sakho sodokotela ohlinzayo sisebenza kuphi ngempela? Ukwengeza ulayini we-MIS ukuze kuhlinzekwe icala elilodwa likadokotela ohlinzayo onezinga eli-1 ngezikhathi ezithile kuyisinqumo esihluke kakhulu kunokwengeza ngoba odokotela abahlinzayo abathathu esibhedlela sakho esinevolumu ephezulu bayakucela masonto onke.
Lapho Umehluko Wezindleko Zangempela Uvela Khona - Futhi Akukona Ukufakelwa
Nakhu okubamba abasabalalisi bengaqaphile: izindleko zokufakelwa kweyunithi ngayinye phakathi kwe-MIS namasistimu ezikulufi ezivulekile ze-pedicle azihlukile kakhulu. Umehluko wezindleko usezinsimbini.
Uhlelo lwe-MIS ludinga imibhoshongo enwetshiwe, izintambo zokuqondisa, ompompi abafakwe amathini, izidluli ze-percutaneous rod, futhi ngokuvamile nethreyi yensimbi ehambisana ne-fluoroscopy ehlukile ohlelweni oluvulekile. Awungezi nje ama-SKU okufakelwa - wengeza isethi yensimbi egcwele enomjikelezo wayo wokuvala inzalo, ukuphathwa kwethreyi layo, kanye nezindleko zayo ezinkulu uma uhlinzeka ngamathuluzi omthwalo ezibhedlela.
Kumsabalalisi osevele esebenzisa i-inventory ye-open-system, lokhu kusho:
- Ithreyi yensimbi ehlukile ezolandelwa, inzalo, futhi inakekele (noma ihlinzekwe njengamasethi omboleki)
- Isikhathi sokuqeqeshwa esengeziwe sabasebenzi baNOMA ekuhlanganiseni kombhoshongo kanye nokuhamba komsebenzi nge-percutaneous
- Imali engase ibe khona ngaphambili uma uxhasa ngezimali amasethi ezikhathi zesivivinyo sasesibhedlela
- Inzuzo encane yecala ngalinye uma unethreyi elilodwa le-MIS elimboza ama-akhawunti amaningi
Kungakho abanye abasabalalisi abengeza imigqa ye-MIS bagcina bephoxekile ngemajini - hhayi ngoba amanani okufakwayo amabi, kodwa ngenxa yokuthi babukeza kancane ukuhlelwa kwethuluzi.
I-Side-by-side: Yini Eshintsha I-Business
| Factor |
Open Fusion System |
MIS Pedicle Screw System |
| Kudingeka amathreyi wezinsimbi |
1 ugqoko ojwayelekile |
1-2 amathreyi kanye namasethi ombhoshongo/guidewire |
| Ijika lokufunda ngodokotela ohlinzayo |
Okuncane kodokotela abahlinza umgogodla abanolwazi |
Okunenjongo - ngokuvamile amacala angu-15-20 ngaphambi kwenduduzo |
| Ukuncika kwe-Fluoroscopy |
Isetshenziswa, kodwa kancane ngokuqhubekayo |
Iseduze nokuqhubekayo phakathi nokubekwa kwesikulufu |
| I-Ideal case complexity |
Amazinga amaningi, ukukhubazeka, ukubuyekezwa |
Izinga eli-1-2 liyawohloka, ukukhubazeka okuphansi |
| Isidingo sempahla yemali yesibhedlela |
I-standard OR fluoro suite |
Okufanayo, kodwa kuvame ukubhangqwa ne-O-arm noma ukuzulazula ezikhungweni zevolumu ephezulu |
| Ukutshalwa kwezimali kokuqeqeshwa kwabasabalalisi |
Phansi - iningi labameli seliyazi kakade |
Amarep aphezulu - adinga ukuhlanganiswa kombhoshongo kanye nokushelela kokusekelwa kwamacala |
Imbuyiselo Ayihlali Ivuza I-MIS Ngendlela Odokotela Abahlinzayo Abayilindele
Lokhu kufanelekile ukuphakanyiswa ngokuqondile noxhumana nabo basesibhedlela ngaphambi kokuba uzibophezele emugqeni womkhiqizo, ngoba kuyehluka kakhulu ngokwemakethe. Kwamanye amazwe nezinhlelo zabakhokhi, i-DRG noma inkokhelo ehlanganisiwe yekesi elihlanganisiwe iyafana noma ivuliwe noma i-MIS — isibhedlela sikhokhelwa inani elifanayo, kodwa icala le-MIS lingadinga okulahlwayo eqolo (imibhoshongo yokwandisa, izintambo zokuqondisa) kanye nezindleko zokuzulazula ngokunokwenzeka. Lokho kucindezela umkhawulo wesibhedlela nakuba umphumela wesiguli uvame ukuba ngcono.
Ezimakethe lapho abahlinzeki bomshwalense abazimele noma iziguli ezizikhokhelayo zikhokha inkokhelo yendlela yokwenza kancane, izibhedlela zinezisusa ezicacile zezezimali zokwamukela i-MIS. Ezimakethe ezinembuyiselo eyizinqwaba eziyisicaba, ukutholwa kuqhutshwa cishe ngokuphelele ngokuthandwa ngudokotela ohlinzayo kanye NOMA ukusebenza kahle, hhayi umkhawulo wesibhedlela.
Ngaphambi kokuphonsa izinsimbi ze-MIS esibhedlela, kufanelekile ukuqonda ukuthi imakethe yakho iwela kuluphi uhlangothi lwalowo mugqa. Umsabalalisi othatha i-MIS ngokuzenzakalelayo inketho yezomnotho ekhethwa yisibhedlela angathola impendulo ebandayo ngokungalindelekile ethimbeni lokuphatha izinto ezigxile ezindlekweni zekesi ngalinye.
Indlela Ephakathi: I-Hybrid Adoption
Abasabalalisi abaningi abengeza ngempumelelo i-MIS abalithathi indawo yesistimu yabo evulekile — basebenzisa kokubili, futhi bavumela ukukhethwa kwamacala kunqume ukuthi iyiphi esetshenziswayo. Lokhu kuvame ukuba yindlela odokotela abahlinzayo ngokwabo abasebenza ngayo: I-MIS yamacala aqondile weleveli 1-2, avulekele noma yini eyinkimbinkimbi.
Empeleni, lokhu kusho:
- Gcina isistimu yakho ekhona evulekile ye-rod-screw njengomugqa wekhathalogi oyinhloko wamakesi ayinkimbinkimbi
- Engeza izinsimbi ze-MIS kuphela uma unodokotela ohlinzayo oyedwa noma ababili abanesidingo sangempela, esiphindelelayo - hhayi intshisekelo eqagelwayo
- Xoxisana ngemibandela yethreyi yensimbi (umthwalo uma uqhathaniswa nokuthenga) ngokucophelela, njengoba kulapho imajini ye-MIS yenziwa khona ngempela noma ilahleka khona.
- Isikhathi sokuqeqeshwa sangempela sebhajethi - sabathengisi bakho njengabasebenzi be-OR - njengoba ukusekelwa kwecala le-MIS kudinga ukuba khona okwengeziwe ngesikhathi sokutholwa kusenesikhathi.
Abakhiqizi abahlinzeka ngazo zombili izinhlelo ezivulekile (ezifana nokwakhiwa kwe-rod-screw efana ne-SecuFix noma i-ValuFix-type platforms) kanye nolayini we-MIS ohambisanayo - onamathuluzi aklanyelwe ukwabelana nge-screw geometry kanye nobubanzi benduku kukho kokubili - kwenza lolu shintsho lube lula kakhulu kunokufakwa kwe-juggling kusuka kubahlinzeki ababili abangahlobene. Ukucaciswa kwesikulufu esihambelanayo kanye nezinduku kusho ukuthi i-inventory yakho ayihlukani ibe amasistimu amabili angasebenzisani, futhi ithimba lakho labadayisi kufanele lifunde isixhumi esibonakalayo somshayeli wesikulufa esisodwa esikhundleni sokubili.
Imibuzo Efanele Ukubuzwa Ngaphambi Kokwenza I-Inventory
- Bangaki odokotela abahlinzayo kuma-akhawunti ami amanje abacela i-MIS ngenkuthalo, uma kuqhathaniswa nokuthi bangaki abayishilo lapho bedlula?
- Ingakanani iphesenti levolumu yecala labo elingashintsha ngokweqiniso liye ku-MIS - ingabe u-10% wamacala noma u-60%?
- Ngingalithola yini ithreyi lensimbi yomthwalo kumkhiqizi isikhathi sokuhlola ngaphambi kokuthenga ngokuqondile?
- Ingabe isistimu yesikulufu ye-MIS yabelana ngejiyomethri nesistimu yami evulekile ekhona, noma ingabe lezi zimpahla ezimbili ezihlukene ngokuphelele okufanele ziphathwe?
- Ngabe ukuqeqeshwa komkhiqizi nokusekelwa kwecala kubonakala kanjani kumacala okuqala ayi-10-15?
Uma ungakwazi ukuthola izimpendulo ezikhululekile zemibuzo emibili yokuqala, ngokuvamile kungcono ukulinda. Ukwengeza umugqa womkhiqizo osuselwe engxoxweni eyodwa kadokotela ohlinzayo, ngaphandle kokuhlola ukuthi lokho kuhumushela kumthamo wangempela, kungenye yezindlela ezivame kakhulu abasabalalisi abagcina benohlu lwamagama olungasetshenzisiwe behlezi ethreyini eshalofini.
Kwabasabalalisi abahlola izinketho ze-MIS pedicle screw eduze nekhathalogi yabo ekhona yomgogodla, ukubuyekezwa okuhambisanayo I-MIS Spinal Fixation Systems ehlanganisa kokubili ukwakhiwa okuvuliwe kanye ne-MIS ingenza lesi sinqumo sibe lula - ikakhulukazi lapho i-screw geometry kanye nokucaciswa kwenduku kwabelwana kuyo yomibili imigqa yomkhiqizo esikhundleni sokudinga uhlu lwempahla oluhluke ngokuphelele.
