Imfundo yokuhlanganisa umgogodla | Izinhlobo zekheji le-interbody kanye nezinto zokwakha
Amakheji e-Interbody angamadivayisi afakekayo abekwe phakathi kwemizimba yama-vertebral eseduze ngesikhathi sezinqubo ezikhethiwe zokuhlanganisa umgogodla. Zenzelwe ukugcina indawo yediski elungisiwe, inikeze ukwesekwa kwesakhiwo futhi ifake izinto ezixhunywe ngamathambo ngenkathi i-fusion ikhula. Uhlobo lwekheji, usayizi, impahla kanye namasu okulungisa akhethelwa isiguli esithile, indlela yokuhlinzwa kanye nesistimu yedivayisi egunyaziwe.
Iyini I-Interbody Fusion Cage?
I-interbody fusion cage iyisisetshenziswa somgogodla esifakwe endaweni ye-intervertebral ngemva kokuba udokotela ohlinzayo esusa yonke noma ingxenye ye-disc eyonakele ngesikhathi senqubo yokuhlanganisa ehleliwe. Incazelo ye-FDA ihlanganisa amadivaysi enziwe ngezinto ezifana ne-titanium nama-polymers futhi afakwe endaweni yomlomo wesibeletho noma i-lumbosacral intervertebral.
Ikheji aliyona idiski eshintshayo ehloselwe ukulondoloza ukunyakaza okuvamile. Indima yayo ihlotshaniswa nokuhlangana: isekela ingxenye eselashwayo kuyilapho ithambo elisha likhula phakathi kwama-vertebrae aseduze. Imiklamo eminingi ihlanganisa ukuvulwa kwangaphakathi noma igumbi lokuxhunyelelwa kwezinto ezibonakalayo zethambo-graft kanye nezici zangaphandle ezihloselwe ukuxhumana nama-endplates e-vertebral.
I-XC Medico ihlela imiklamo yayo etholakalayo ngaphakathi kwayo izigaba zomkhiqizo we-interbody cage . Amakhasi omkhiqizo awusizo ekuqondeni ububanzi, kodwa izinkomba ezisebenzayo, izingqinamba, izimfuneko zokulungiswa kanye nezindlela zokuhlinzwa kufanele ziqinisekiswe kusukela ekulebulani kwamanje kwedivayisi.
Indlela Amakheji Omgogodla Asekela Ngayo Ukuphakama Kwediski, Ukuqondanisa kanye Ne-Fusion
Ukuhlukaniswa okubalulekile: ukuchithwa kwe-nerve kwenziwa ngenqubo yokuhlinzwa. Ikheji ingasiza ukugcina i-disc noma ukuphakama kwe-foraminal ezakhiweni ezikhethiwe, kodwa akufanele ichazwe njengokwelapha ngokuzimela ukucindezelwa kwezinzwa noma ukuqinisekisa ukukhululeka kobuhlungu.
Izinhlobo zamakheji e-Interbody by Surgical Approach
Amakheji e-Interbody avame ukuhlukaniswa yisifunda somgogodla kanye nendlela esetshenziselwa ukufinyelela isikhala sediski. Izifinyezo zichaza inqubo, hhayi nje isimo sokufakelwa. Umkhiqizo ogunyazwe indlela eyodwa akufanele kuthathwe ngokuthi ulungele enye.
Ukuze uthole umbono obanzi wokuthi amakheji axhuma kanjani nezikulufu ze-pedicle, amapuleti omlomo wesibeletho kanye namathuluzi aqondene ngqo nendlela, buyekeza i-XC Medico's. ukufakelwa komgogodla kanye nezinhlelo zezinsimbi.
| Ikheji noma indlela | yokufinyelela Okujwayelekile | Ukucatshangelwa komklamo ojwayelekile | Izici zesistimu okufanele ziqinisekiswe |
|---|---|---|---|
| Ikheji yesibeletho / ACDF | Indlela yomlomo wesibeletho yangaphambili | Izinyathelo eziqinile, ubude bomlomo wesibeletho nama-engeli, igumbi lokuxhunyelelwa kanye nezimpawu zezithombe. | Kungakhathaliseki ukuthi ipuleti langaphambili elihlukile noma ukulungiswa okuhlanganisiwe kuyadingeka noma kugunyaziwe. |
| Isikhwama se-TLIF | Indlela ye-Transforaminal lumbar | Iphrofayili yokufaka, umkhondo wezinyawo, umumo wokugcina, uxhumano lwesifaki nezinketho ze-lordotic. | Amathuluzi avuliwe noma ahlasela kancane kanye nokulungisa okungemuva okungeziwe. |
| Igumbi le-PLIF | Indlela ye-lumbar yangemuva | Ukufinyelela ngemuva, inombolo yekheji nendawo njengoba kucaciswe uhlelo oluthile. | Izivivinyo, izifaki, amathuluzi wokuxhunyelelwa kanye nokuhambisana kokulungiswa kwangemuva. |
| Igumbi le-ALIF | Indlela ye-lumbar yangaphambili | Izinyathelo ezinkulu, ubude kanye nobubanzi be-lordosis, ukwakheka okuzimele noma okungeziwe. | Amathuluzi okusondela, izikulufu zokulungisa noma amapuleti nokulebula okuqondene nomkhiqizo. |
| Ikheji le-LLIF / OLIF | I-Lateral noma i-oblique lumbar approach | Unyawo olubanzi, iphrofayili yokufakwa kwezinhlangothi kanye nezinsimbi eziqondene ngqo nendlela. | I-Neuromonitoring, isistimu yokufinyelela kanye nezidingo zokulungisa ezengeziwe njengoba kusebenza. |
Amakheji e-Cervical Interbody e-ACDF
Amakheji e-Cervical interbody asetshenziswa ku-discectomy yangaphambili yomlomo wesibeletho kanye nezinqubo zokuhlanganisa. Imiklamo ingasetshenziswa ngepuleti yomlomo wesibeletho yangaphambili ehlukile noma ingase ihlanganise izici zokulungisa, kuye ngesistimu egunyaziwe. Buyekeza i-XC Medico's Izixazululo ze-ACDF zokuhlanganiswa komlomo wesibeletho zokubuka konke kwesistimu yomkhiqizo.
I-TLIF kanye ne-PLIF Cages for Posterior Lumbar Fusion
I-TLIF ne-PLIF zombili zifinyelela isikhala se-lumbar disc kusuka emizileni esekelwe ngemuva, kodwa umhubhe wokusebenza, i-cage geometry, indlela yokufaka kanye nokucushwa kwekheji kungahluka. Akulungile ukusho ukuthi yonke inqubo ye-interbody isebenzisa amakheji amabili. Ukuze uthole isibonelo senhlangano yesistimu eqondene nenqubo, bona Izinhlelo zekheji ze-TLIF kanye ne-MIS-TLIF.
I-ALIF kanye ne-Lateral Lumbar Cages
Amakheji e-ALIF afakwa ngendlela ye-lumbar yangaphambili. Izindlela ze-Lateral ne-oblique zisebenzisa amaphasishi okufinyelela ahlukene namathuluzi akhethekile. Le mindeni yekheji ivamise ukuhlinzeka ngezinyathelo nezinketho ze-lordotic eziklanywe eduze komzila wabo wokufinyelela. I isistimu yekheji ezimele yodwa ye-ALIF PEEK ibonisa ukucushwa okuhlanganisiwe kwekheji nesikulufu; ukucaciswa kwayo akufanele kube okujwayelekile kuwo wonke amadivaysi e-ALIF.
I-Static vs Expandable Interbody Cages
Amakheji amile anobukhulu obunqunywe kusengaphambili. Amakheji anwebekayo afakwa ekucushweni okuhlangene futhi alungiswa ngaphakathi kwebanga lawo eligunyaziwe ngemva kokubekwa. Ukunwetshwa akusho ngokuzenzakalelayo imiphumela engcono yomtholampilo. Ukumakhenikha kwedivayisi, imikhawulo yokunweba, ukuthintana kwe-endplate, imigomo yokuqondanisa, ukulungisa nobufakazi obutholakalayo konke kufanele kucatshangelwe.
I-PEEK vs Titanium Interbody Cages
I-PEEK ne-titanium zisetshenziswa kakhulu kumishini yokuhlanganisa i-interbody, kodwa akukho okudlula yonke indawo. Izakhiwo zezinto ezibonakalayo zisebenzisana nejometri yekheji, ukwakheka kwendawo, ukulungiswa kwe-endplate, izici zesiguli kanye nokwakhiwa okuphelele kokulungisa. Izimangalo zokumaketha akufanele zithathelwe indawo ubufakazi obuqondene nedivayisi.
| Impahla noma idizayini | Izici zokufanekisa | Ukucatshangelwa kwemishini nengaphezulu | Imibuzo okufanele iqinisekiswe |
|---|---|---|---|
| I-PEEK | Umzimba wekheji okhanyayo; Omaka be-radiopaque bavame ukusetshenziselwa ukukhombisa indawo. | Izakhiwo ze-polymer zihlukile ezinsimbi; i-geometry kanye nenqubo yokukhiqiza ihlala ibalulekile. | Ukucaciswa kwebanga lezokwelapha, idizayini yomaka, ubukhulu, indawo, ukuhlolwa nokulebula. |
| Ingxube ye-titanium eqinile | I-Radiopaque futhi ingase idale i-artifact yokuthwebula kuye ngedivayisi nendlela. | Amandla aphezulu; i-modulus nokuziphatha kwendawo kuyahluka ku-PEEK. | Ukucaciswa kwe-alloy, umzila wokukhiqiza, isimo esiphezulu kanye nobufakazi bemishini. |
| I-titanium enezimbotshana noma eyenziwe ngokungeziwe | I-Radiopaque; ukubona ngeso kuncike kwijometri nezimo ze-imaging. | I-Porous Architecture yethula ukukhiqiza, ukuhlanza nokuqinisekisa ukucatshangelwa. | Ukucaciswa kwe-Porosity, ukuqinisekiswa kwenqubo, ukuhlanzeka kanye nobufakazi bokusebenza obusekelayo. |
| I-PEEK ehlanganiswe ne-Titanium | Igcina umzimba we-polymer ekhanyayo enengxenye yendawo ye-radiopaque. | Ukunamathela kokumboza, ukumbozwa, izinhlayiya nokuziphatha kwesixhumi esibonakalayo kudinga ukulawula. | Inqubo yokumboza, ukuqinisekiswa, ukuhlolwa, ukuhlanzwa kanye nobufakazi obuqondene nomkhiqizo. |
Kungani I-Cage Material Inganqumi Imiphumela Yodwa
Amaqembu e-XC Medico atholakala ngemiklamo ye-polymer yomlomo wesibeletho ne-lumbar ngaphakathi kwayo I-PEEK yekheji yomlomo wesibeletho kanye ne-lumbar cage . Qinisekisa izinga lempahla eliqondile, umaka we-radiopaque, isimo esiyinyumba noma esingeyona inyumba kanye nokugunyazwa kwemakethe kwemodeli ngayinye.
Ungabhali 'i-MRI ephephile' ngento yodwa: Ukuphepha noma ukusebenzisana kwe-MR kufanele kunqunywe kusistimu yedivayisi ephelele kanye nokulebula kwayo kwamanje, okungathathwa kusitatimende esijwayelekile mayelana ne-PEEK noma i-titanium.
Asetshenziswa Kanjani Amakheji E-Interbody Ekuhlinzweni Kwe-Spinal Fusion?
Imininingwane ihluka kakhulu phakathi komlomo wesibeletho, i-lumbar yangemuva, i-transforaminal, yangaphambili kanye ne-lateral. Okulandelayo ukulandelana kwezemfundo okusezingeni eliphezulu kunomyalelo wokuhlinza.
Ukususwa Kwediski, Ukulungiswa Kweplate Lokugcina kanye Nokufakwa Kwekheji
Imfuneko yokusetshenziswa kochwepheshe: ukuhlanganiswa kwe-interbody kufuna ukuhlinzwa ngobuchwepheshe. I-FDA incoma ukuthi lezi zinsimbi zifakwe kuphela odokotela abahlinzayo abanolwazi ngokuqeqeshwa okukhethekile kudivayisi. Iziguli kufanele zixoxe ngezinzuzo eziqondene nenqubo ethile, ezinye izindlela kanye nezingozi nodokotela wazo ohlinzayo.
Yiziphi Izimo Ezingase Zelashwe Nge-Interbody Fusion?
Ukuhlanganiswa kwe-interbody kungase kubhekwe njengengxenye yokwelashwa kwezimo ezikhethiwe zomgogodla lapho uchwepheshe oqeqeshiwe enquma ukuthi ukuhlanganisa kufanelekile. Isibonakaliso sincike esifundeni somgogodla, izimpawu, izithombe, ukungazinzi, ukwelashwa kwangaphambilini, izici zesiguli kanye nokulebula okugunyaziwe kwedivayisi ekhethiwe.
- isifo se-disc degenerative ngaphansi kwencazelo kanye nemibandela eshiwo ekulebeni kwedivayisi;
- amacala akhethiwe we-spondylolisthesis noma ukungazinzi komgogodla;
- ukulungiswa okuthile kokukhubazeka okudinga ukwakhiwa kabusha nokuhlanganiswa;
- i-pseudoarthrosis noma ukuhlinzwa okubukeziwe ezimweni ezikhethiwe;
- ezinye izimo ezimbozwe ngokukhethekile uhlelo lukadokotela ohlinzayo kanye nezinkomba zedivayisi.
Ikheji ye-interbody ayifanele wonke umuntu onobuhlungu beqolo noma bentamo. Ukwelashwa okungahlinzeki, ukucindezelwa ngaphandle kokuhlanganiswa noma enye inqubo ingase icatshangelwe kuye ngokuthi ukuxilongwa. Leli khasi alikwazi ukunquma ukuthi isiguli sidinga ukuhlinzwa.
Izinzuzo Ezingaba Khona kanye Nezingozi Ze-Interbody Cages
Imigomo ehlosiwe yokwakhiwa kwe-interbody ingabandakanya ukugcina isikhala sediski esilungisiwe, ukusekela ukulungiswa kwesigaba, ukuthwala umthwalo kanye nokuhlinzeka ngendawo yokuhlanganisa amathambo. Lezi yizinhloso zokuklama nezinqubo, hhayi imiphumela yesiguli eqinisekisiwe.
Imvamisa yobungozi ayikwazi ukufingqwa ngephesenti elilodwa elijwayelekile kuwo wonke amakheji nezinqubo. Imiphumela iyahlukahluka ngedivayisi, indlela yokwenza, inani lamazinga, ukulungiswa, ukuxhunyelelwa, impilo yesiguli, idizayini yocwaningo kanye nokulandelela. Ngenxa yalesi sizathu, ukuqhathanisa okungasekelwe kwe-ALIF, TLIF ne-PLIF kwesilinganiso sokuhlanganisa kusuka esihlokweni sangaphambilini akufanele kushicilelwe kabusha.
Odokotela Abahlinzayo Balikhetha Kanjani Ikheji Ye-Interbody?
Ukukhetha idivayisi- futhi kuncike esigulini. Izinto zingase zihlanganise izinga lomgogodla, indlela yokusondela, ubukhulu be-disc-space, i-endplate anatomy, ukuqondanisa okufunayo, ikhwalithi yamathambo, i-cage footprint, ukuphakama, i-angle ye-lordotic, impahla, ivolumu yokuxhunyelelwa, izimpawu ze-imaging, indlela yokufaka kanye nokulungiswa okungeziwe.
Ikheji kufanele futhi ihambisane nezivivinyo zayo, isifaki, izinsimbi zokuxhunyelelwa nanoma yikuphi ukulungiswa okuhlanganisiwe noma okungeziwe. Ithuluzi elibukeka ngendlela efanayo elivela kwenye isistimu akufanele kuthathwe ngokuthi liyasebenzisana. Izibhedlela nabasabalalisi kufanele bahlole izimila kanye nesethi yezinsimbi ezifanayo kanye nemiyalelo yamanje yokusetshenziswa.
Amagama anomthwalo wemfanelo: alikho 'ikheji elingcono kakhulu le-interbody.' Inketho efanelekile ikhethwa udokotela ohlinzayo olapha emishinini egunyaziwe ngokuya ngezidingo zesiguli, inqubo ehleliwe kanye nokulebula okuqondene nomkhiqizo othile.
I-Interbody Cage Systems Yezibhedlela Nabasabalalisi
Abathengi abangochwepheshe badinga okungaphezu kohlu lwezinto zekheji. Linganisa ukuthi ingabe ubude, umkhondo kanye ne-lordosis matrix iyahambisana nesidingo senqubo yendawo; ukuthi izivivinyo nezifakeli ziqediwe; kanye nokuthi ukugunyazwa komkhiqizo, ukulebula, ukulandeleka, ukupakishwa, ukuvala inzalo kanye nokwesekwa kwangemuva kokumakethwa kuyatholakala yini ezweni oya kulo.
I Umhlahlandlela ophelele wephothifoliyo wokufakelwa komgogodla uchaza ukuthi amakheji afanelana kanjani nomlomo wesibeletho kanye nezinhlelo zokulungisa i-thoracolumbar. Abathengi abafuna ukukhiqiza okujulile nokuqhathanisa nabahlinzeki bangaqhubeka kokuhlukile Umhlahlandlela womkhiqizi we-interbody fusion cage.
Lokhu kuhlukaniswa kwenziwa ngamabomu: isihloko samanje siphendula umbuzo wolwazi 'ayini amakheji e-interbody?' kuyilapho umhlahlandlela oxhumene ukhuluma ngokuthuthukiswa komkhiqizo, izinto zokwakha, ukukhiqiza kanye nokukhetha kwabahlinzeki.
Imibuzo Evame Ukubuzwa Ngama-Interbody Cages
Ikheji le-interbody lisetshenziselwa ini?
Ikheji ye-interbody isetshenziswa ezinqubweni ezikhethiwe zokuhlanganisa umgogodla ukuze kusekelwe isikhala esilungisiwe phakathi kwemizimba yama-vertebral eseduze futhi ngokuvamile ukuze kufakwe amathambo-graft ngesikhathi ukuhlanganiswa kukhula.
Ingabe i-interbody cage iyidiski yokwenziwa?
Cha. Idiski yokwenziwa ngokuvamile ihloselwe ukulondoloza ukunyakaza. Ikheji yokuhlanganisa i-interbody isetshenziswa njengengxenye yenqubo ehloselwe ukudala ukuhlangana phakathi kwama-vertebrae aseduze.
Yini efakwa ngaphakathi kwekheji lokuxhumana nabantu?
Imiklamo eminingi yekheji ihlanganisa isikhala sezinto ezibonakalayo zethambo-graft. Uhlobo lokuxhunyelelwa kanye nokubekwa kunqunywa udokotela ohlinzayo ngokuya ngenqubo, isiguli kanye nokulebula okusebenzayo komkhiqizo.
Uyini umehluko phakathi kwamakheji e-TLIF, PLIF kanye ne-ALIF?
Amagama ahambisana nezindlela ezahlukene zokuhlinza i-lumbar. Indlela ngayinye ingadinga izinyawo zekheji ezihlukile, iphrofayela yokufaka, umumo kanye nesistimu yezinsimbi. Amagama omkhiqizo ewodwa awaqinisekisi ukushintshashintsha.
Ingabe i-PEEK ingcono kune-titanium yekheji yomgogodla?
Ayikho into engcono emhlabeni jikelele. I-PEEK ne-titanium inezici ezihlukile zokucabanga, ezomshini, ezingaphezulu kanye nezokukhiqiza. Ukukhetha kufanele kucabangele idizayini ephelele yedivayisi, ukusetshenziswa okugunyaziwe, ubufakazi obusekelayo kanye nohlelo lokuhlinzwa.
Ingabe ikheji le-interbody lingasetshenziswa ngaphandle kwezikulufu noma izinduku?
Amanye amasistimu ahlanganisa ukulungisa noma agunyazwe izinhlelo zokusebenza ezizimele zodwa, kuyilapho amanye adinga amapuleti engeziwe, izikulufu noma izinduku. Landela ukulebula kwamanje kanye nezindlela zokuhlinza zedivayisi ngqo.
Yiziphi izingozi eziyinhloko ezihlobene namakheji e-interbody?
Izingozi ezingaba khona zingabandakanya ukuncipha, ukufuduka, ukulahlekelwa ukulungiswa, ukwehluleka kwengxenye, i-pseudoarthrosis, ukutheleleka kanye nokulimala kwemizwa, imithambo noma izicubu. Inqubo kanye nezingozi eziqondene nesiguli kufanele kuxoxwe ngazo nodokotela ohlinzayo owelaphayo.
Izinkomba Zezokwelapha Nezokulawula
- I-US FDA: Isiqondiso Esikhethekile Sokulawula Isigaba II se-Intervertebral Body Fusion Devices
- I-Royal National Orthopedic Hospital: Umhlahlandlela Wesiguli Wokuhlinza I-Low Back Fusion
- I-North American Spine Society: Idizayini ye-Fusion Cage, Izinto zokwakha kanye Nezingubo
