Enqubweni ye-TLIF noma ye-PLIF, udokotela ohlinzayo usebenza ephasishi elingamasentimitha ambalwa ububanzi, impande yenzwa ephumayo ihlezi khona kanye emaphethelweni omzila osebenzayo. Awukho umugqa oqondile wokubona ukuze uqinisekise indawo yekheji - udokotela ohlinzayo ufunda i-C-arm, ngokuphindaphindiwe, ethemba ukuthi lokho okubonisa ku-fluoroscopy monitor kubonisa ngokunembile lapho ikheji lihlezi khona ngokuhlobene nesikhala se-disc kanye nezakhi ze-neural ezizungezile.
Lesi yisikhathi lapho ikhwalithi yokufakelwa inyamalala ngemuva noma ibe isikhungo sokunakwa ngazo zonke izizathu ezingalungile. Uma izimpawu ze-tantalum zingaqondani kahle, zihlezi kahle, noma zingahambisani ukusuka ekhejini ukuya kwelinye, udokotela ohlinzayo kufanele amise, adubule kabusha, aqondise kabusha, futhi aqagele okwesibili ukubekwa obekufanele kuthathe imizuzwana. Konke ukudubula okungeziwe kwe-fluoro ukuchayeka kakhudlwana emisebeni yeqembu NOMA kanye nesikhathi esengeziwe ngaphansi kokulaliswa kwezinzwa esigulini. Futhi uma umsabalalisi kunguye onikeze lelo kheji, i-fallout ayilona nje ibhokisi elibuyisiwe lezimila - udokotela ohlinzayo ongeke abambe ucingo olulandelayo.
Okubonakale KuMonitor
Lesi isithombe somunye wodokotela abahlinzayo abasabalalisi esithunyelwe ngokuqondile sisuka kwa-OR, phakathi nenqubo, ngaphandle kokucelwa sona.
Isithombe se-Intraoperative C-arm sithunyelwe udokotela ohlinzayo wokusabalalisa ngesikhathi senqubo ye-TLIF. Imininingwane yokuhlonza ihlelelwe ubumfihlo besiguli nomhlinzeki.
Umbuthano oluhlaza osesithombeni akusona owethu - udokotela ohlinzayo wazidweba ngokwakhe ngaphambi kokuthumela isithombe, ukuze akhombe ngqo lokho ayefuna sikubone: izintambo zomaka we-tantalum ekhejini, zixazululwe ngokucacile ngokumelene nomzimba we-vertebral, ngohlaka olubukhali, olungacacile ngaphansi kwe-fluoroscopy.
Umlayezo wakhe kamuva waba mfushane: 'Ikheji lakho elixhunywe ethangeni liyamangalisa.'
Lokho akulona ikhasimende elinesizotha. Funda ngokumelene nesithombe asithumele, kuwukubhekwa komtholampilo okukhethekile. Udokotela ohlinzayo omaphakathi akathathi isithombe semonitha futhi azungelezele imininingwane ngaphandle kwalapho leyo mininingwane ibalulekile kulokho abekwenza ngaleso sikhathi. Akushoyo empeleni ukuthi: umaka wejiyomethri uvele lapho kufanele khona, ngaphandle kokudideka mayelana nokuma kwekheji, futhi ukufakwa kudlule ngaphandle komjikelezo wokudayisa nokubheka ukuthi ikheji elimakwa kabi limcindezela.
Yilelo iphuzu lonke le-radiopacity elenziwe ngendlela efanele. Ayizimemezeli. Kusho ukuthi udokotela ohlinzayo akakaze acabange ngokufakelwa - ngesiguli kuphela.
Kungani Lokhu Kunzima Ukwenza Kunokuba Kubukeka
Abasabalalisi abangakachithi isikhathi esitezi sefekthri kwesinye isikhathi bacabanga ukuthi omaka be-tantalum bayimininingwane emincane - izintambo ezimbalwa ezicindezelwe ku- I-PEEK cage , yenziwe. Empeleni, lesi ngesinye sezinyathelo ezithambekele ekuhlulekeni ekukhiqizeni amakheji e-interbody, ngenxa yezizathu ezimbili ezihlukene.
I-PEEK-to-Marker Interface
I-Tantalum ne-PEEK azihlangani ngamakhemikhali. Umaka kufanele agcinwe ngokuzibambela mathupha - icindezelwe esiteshini esinembayo esikwazi ukubekezelela izihlalo eziqinile kangangokuthi izihlalo zocingo aziguquki ngaphansi kokulayisha okuphindaphindiwe komshini kokufaka, ukushayisana, neminyaka yokuthwala umthwalo womzimba ngemva kwalokho. Uma isiteshi sisikwa saba nosayizi ngokweqile, umaka angafuduka noma atsheke ngesikhathi sokungqubuzana - okuyimodi yokwehluleka ebonakala njengokugcotshwa noma umaka wesithombe esikabili ku-fluoroscopy, okuphoqa udokotela ohlinzayo ukuthi aphinde adubule futhi aphinde ahlole.
Lena inkinga yemishini ye-CNC ene-eksisi emihlanu, hhayi eyokuhlanganisa ngesandla. Ijiyomethri yeshaneli yomaka kufanele isikwe ukuze ihambisane nobubanzi bentambo evunyelwe kancane, kukheji ngalinye, ngevolumu yokukhiqiza - hhayi nje kumasampuli ifektri ewathumelayo ukuze ahlolwe.
I-Insertion Interface
Abanye abasabalalisi bephoyinti lokuhluleka bazwa mayelana kaningi kakhulu kunokubonakala komaka: uxhumano phakathi kwekheji kanye nethuluzi elifakayo liphuma phakathi nendawo. Uma leso sixhumi esibonakalayo esinentambo noma esinokhiye sinokukhukhuleka okunobukhulu obuncane, isifaki singahlehla noma singahambi kahle ngaphansi kweziteleka eziphindaphindiwe ze-mallet ezidingekayo ukuze kuhlaliswe ikheji - okuyinkinga enkulu kakhulu emhubheni we-TLIF kunasekuhlinzeni okuvulekile, ngenxa yokuthi udokotela ohlinzayo unendawo encane kakhulu yokubuyisela ikheji ngesandla uma ihlukana nesifaki kungazelelwe.
Ukubamba leyo geometry yokusebenzelana ingaguquguquki, ikheji ngemva kwekheji, inqwaba ngemva kwenqwaba, kuwumsebenzi oqondile wokulawula ukubekezelela kwe-CNC kanye nokuhlolwa kobukhulu obungaphakathi kwenqubo — akuyona into engalungiswa ngokupakishwa okungcono noma ishidi leziyalezo elihle.
Kusho Ukuthini Lokhu Empeleni Kumthengisi Ohlola Abahlinzeki
Isizathu sokuthi leli zinga lemininingwane yokukhiqiza libalulekile kumsabalalisi - hhayi kudokotela ohlinzayo kuphela - ukuthi lezi zindlela zokwehluleka azibonisi esithombeni sekhathalogi noma eshidini elicacisiwe. Ikheji elinophawu oluxega kancane noma isixhumi esibonakalayo esifaka umngcele sibukeka sifana nesihle kuze kube yilapho sithinteka esikhaleni sediski lapho udokotela ohlinzayo ebukele i-C-arm. Leso isikhathi esibi kakhulu esingaba khona sokuthola igebe lekhwalithi, futhi yisikhathi esinqumayo ukuthi i-akhawunti yasesibhedlela ihlala nawe yini noma iya koqhudelana naye.
Yingakho futhi okuthi 'ukuhlangabezana nomdwebo' kungafani 'nokusebenza ngokungaguquki.' Umphakeli angakwazi ukushaya i-dimensional spec kusampula yelotho ethunyelwe ukuthi ihlolwe futhi abe nokuhluka kweqoqo-to-batch uma sebesebenzisa ivolumu yokukhiqiza. Okuwukuphela kwendlela yokwazi umehluko ukubuza ukuthi yini ngempela elawula lokho kuvumelana - ukuhlolwa kwe-CMM esenqubweni, ukuqinisekiswa kokubekezelela umaka wesiteshi, nokuhlolwa kwetorque yesixhumi esibonakalayo ngesisekelo samasampuli kuwo wonke ukukhiqizwa, hhayi nje ekuhlolweni kwesihloko sokuqala.
Ukuze abasabalalisi ukuqhathanisa I-TLIF kanye nezinhlelo zekheji ze-PLIF kubo bonke abahlinzeki, lokhu kubalulekile ukukubuza ngokuqondile ngaphambi kokuzibophezela ekuhlanganiseni izinto: yikuphi ukubekezelela okugcinwe esiteshini somaka, futhi liyini izinga lesampula le-QC ku-interface yekheji ukuya ku-inseter ngevolumu yokukhiqiza - hhayi kumayunithi edemo athunyelwe ukuze ahlolwe.
Iqiniso Lezohwebo Ngemuva Kokwethembeka Komtholampilo
Akukho kulokhu okuwumkhiqizo okhethekile owenziwe ukuze kuzuze umsabalalisi oyedwa. Ukulawula ukubekezelelana kuzihlalo zomaka kanye nejometri yesixhumi esibonakalayo esichazwe ngenhla iwumphumela ojwayelekile wolayini wokukhiqiza - inqubo efanayo iqhuba noma ngabe i-oda lingelesethi yokuhlola eyodwa noma inani eliphelele lenkontileka yesibhedlela.
Lokho kuvumelana futhi yikho okwenza ama-oda wevolumu ephansi kanye nezifiso asebenze ngaphandle kokuhwebelana kwekhwalithi. Umsabalalisi ohlola ingxenye yemakethe entsha, noma osebenza nodokotela ohlinzayo ofuna i-footprint ehluke kancane noma i-engeli enkulu yesibalo sesiguli sesifunda, akadingi ukuzibophezela ekusebenzeni okuphelele kokukhiqiza ukuze athole ukunemba okufanayo kokukhiqiza. Ukulungiswa kwekheji le-PLIF/TLIF ngokwezifiso kanye Izinhlelo zelebula yangasese ye-OEM/ODM zisekelwa kusukela kusethi engu-1 ye-MOQ — ebaluleke kakhulu esimweni lapho umsabalalisi engakwazi ukuthethelela ukubamba uhlu lwamagama olujwayelekile kodwa esadinga izimila ezisebenza ngendlela udokotela ohlinzayo okuleso sithombe esichazwe ngayo.
Kumakheji ekhathalogi ajwayelekile, umugqa ofanayo wokukhiqiza ugcina u-90% wokufakwa kwempahla kulo lonke uhla lwesistimu yomgogodla, ngama-oda angaphakathi kwesitoko ngokuvamile athunyelwa phakathi nezinsuku zebhizinisi ezingu-3. Iphuzu akukhona ukuthi ukulethwa okusheshayo nokubekezelelana okuqinile kuyizindawo zokuthengisa ezihlukene - ukuthi zombili zivela emfundweni efanayo yokukhiqiza. Imboni engakwazi ukubekezelela umthamo wevolumu ngokuvamile ayikwazi ukubamba uhlu lwamagama, futhi izinkinga ezimbili zivame ukubonakala ndawonye.
Uma uhlola umhlinzeki wekheji lomgogodla futhi ufuna ukubona imibhalo yangempela yokubekezelela kanye nedatha yesampula ye-QC ngemuva kwezimangalo ezinjengalezi, lokho kuyinto enengqondo okufanele uyicele ngaphambi kokufaka i-oda lokuqala - hhayi ngemuva kokuthi udokotela ohlinzayo ekuthumelele isithombe ebuza ukuthi kungani into ethile ingahlalanga kahle.
