Nsogbu na ihe ịma aka ndị chere ihu n'ihu ịwa ahụ endoscopic spinal

Oge endoscopy ịwa ahụ malitere na njedebe 1970 site na iwebata teknụzụ endoscopy na-enyere aka na telivishọn. Site na mmepe ngwa ngwa nke usoro mmekpa ahụ dị ntakịrị dị ka arthroscopy, laparoscopy, thoracoscopy, na discoscopy, ugbu a ọ nọchiri anya ịwa ahụ mepere emepe na ọgwụgwọ ịwa ahụ nke ọtụtụ ọrịa. N'ihi usoro ahụ dị iche iche nke anatomical na ịwa ahụ chọrọ nke ọkpụkpụ azụ, obere ịwa ahụ nke azụ azụ azụ na-eche nsogbu ndị ọzọ ihu, nsogbu ịwa ahụ dị ukwuu, na ihe egwu kachasị elu nke ịwa ahụ na nsogbu, nke na-egbochi ma na-egbochi mmepe na ọganihu nke endoscopic anterior spinal ịwa ahụ.

Endoscopic nyere aka n'ihu cervical foramen mbepụ nbibi ịwa ahụ malitere na 1990s. Uru ya abụghị naanị trauma ịwa ahụ pere mpe, kamakwa ichekwa diski intervertebral cervical, si otú a na-echekwa ọrụ moto ya. Ịwa ahụ a nwere mmetụta dị ukwuu n'ịgwọ mgbaàmà radicular nke otu akụkụ nke spine cervical, ma isi mgbagwoju anya nke usoro a bụ mmerụ ahụ nke akwara vertebral n'oge ọgwụgwọ nke nkwonkwo nko vertebral. Jho kwenyere na oghere intervertebral 6-7 cervical, akụkụ dị n'akụkụ nke nkwonkwo vertebra nke hooked, na transverse usoro foramen bụ ebe kachasị mfe iji mee ka ọkpụkpụ vertebral merụọ ahụ. Oghere intervertebral 6-7 cervical dị n'etiti usoro ntụgharị nke cervical 7 na akwara olu ogologo. Iji zere mmerụ ahụ vertebral vertebral, Jho na-atụ aro ịkpụ ogologo olu olu n'ogo nke cervical 6. Iberibe anụ ahụ ga-atụgharị gaa na usoro ntụgharị nke cervical 7, si otú a na-ekpughe akwara vertebral n'okpuru ogologo olu olu; Iji zere mmerụ ahụ nke akwara vertebral na nkwonkwo vertebra a na-agbanye, ihe na-egweri ekwesịghị ịbanye na oghere usoro ntụgharị. Enwere ike idowe akwa cortex ọkpụkpụ n'oge a na-egweri na nkwonkwo vertebra a na-agbanye, mgbe ahụ enwere ike wepụ ọkpụkpụ ahụ na spatula. Mgbe discectomy dị n'ihu na ndị ọrịa nwere mgbaàmà mgbọrọgwụ akwara dị n'otu akụkụ, mgbaàmà mgbọrọgwụ na-emegiderịta onwe ya nwere ike ime n'ihi nkwụsị nke cervical. Naanị ime nkwụsị mgbọrọgwụ akwara enweghị ike ibelata mgbaàmà nke mgbu olu na ndị ọrịa a nke ọma. Njikọ intervertebral dịkwa mkpa iji nọgide na-akwụsi ike nke cervical, ma ọ bụ ntakịrị mkpasu iwe endoscopic fusion na nhazi nke azụ azụ cervical dị n'ihu bụ ihe ịma aka ụlọ ọgwụ na-edozibeghị.

Nkà na ụzụ thoracoscopy nke oge a malitere na mmalite 1990s, na site na mmepe ya na-aga n'ihu, ọ jiri nwayọọ nwayọọ mechaa ọgwụgwọ dịka lobectomy, thymectomy, pericardial na ọrịa pleural. Ka ọ dị ugbu a, a na-etinye nkà na ụzụ thoracoscopic na ọgwụgwọ nke vertebral lesion biopsy, abscess drainage and spinal lesion clearance, intervertebral disc nucleus pulposectomy for thoracic disc herniation, nkwụghachi azụ na ntinye nke ime maka ọkpụkpụ vertebral thoracic, yana mgbazi ma ọ bụ loosening scoliosis. na ndozi nke nrụrụ kyphosis. Achọpụtala ịdị irè ya na nchekwa ya n'ọtụtụ ebe. Otú ọ dị, e jiri ya tụnyere ịwa ahụ oghe obi nke ọdịnala, thoracoscopic minimally invasive anterior spinal ịwa ahụ ọ bụghị nanị na-enwe otu nsogbu nke nsogbu ịwa ahụ, kamakwa ọ na-enwe ogologo oge ịwa ahụ, ihe isi ike ịwa ahụ, na nnukwu ihe egwu ịwa ahụ. Dickman et al. rụrụ 15 thoracoscopic ịwa ahụ na 14 ọrịa na thoracic disc herniation, na-akpata 3 ikpe nke atelectasis, 2 ikpe nke intercostal neuralgia, 1 ikpe nke screw loosening chọrọ iwepụ, 1 ikpe nke fọdụrụ intervertebral diski chọrọ ịwa ahụ nke abụọ, na 1 ikpe nke cerebrospinal fluid leaka. na nsogbu ndị ọzọ. McAfee et al. A na-akọ na ọnụọgụ ọbara ọgbụgba na-arụ ọrụ mgbe ịwa ahụ thoracoscopic pere mpe na-emerụ ahụ bụ 2%, ihe omume atelectasis bụ 5%, ihe omume intercostal neuralgia bụ 6%, yana enwekwara nsogbu siri ike dị ka mmerụ ahụ akwara azụ, chylothorax, mmerụ ahụ akwara septal, na mmerụ ahụ akụkụ ahụ ndị ọzọ. L ü Guohua et al. kọrọ na nsogbu nke ịwa ahụ thoracoscopic azụ azụ azụ gụnyere:; N'ihi ọbara ọgbụgba kpatara mmerụ ahụ azygous, ntụgharị na ịwa ahụ imeghe maka ntọhapụ bụ 2.6%, mmerụ ahụ nku ume bụ 5.2%, chylothorax bụ 2.6%, atelectasis mpaghara bụ 5.2%, exudative pleurisy bụ 5.2%, oge igbapu obi>awa 36, Mpịakọta mmiri> 200ml bụ 10.5%, nkụchi obi mgbidi keyhole ọnụọgụ ma ọ bụ mgbu bụ 2.6%. A na-akọwa n'ụzọ doro anya na n'oge mmalite nke ịwa ahụ thoracoscopic scoliosis na-emeghe, ihe mgbagwoju anya dị elu karịa ịwa ahụ omenala. Site na nchịkọta nke nkà na ahụmahụ na ọrụ ahụ, a ga-ebelata nsogbu nke nsogbu. Watanabe et al. nyochara ndị ọrịa 52 na-aga ịwa ahụ thoracoscopic na laparoscopic spinal, yana nnukwu nsogbu nke 42.3%. Ọnụ ọgụgụ dị elu nke nsogbu na ihe ize ndụ ịwa ahụ na-egbochi mmepe nke ịwa ahụ thoracoscopic anterior thoracic. N'ihi nke a, ọtụtụ ndị ọkà mmụta na-akwado ma na-ewere obere mbepụ n'ihu ịwa ahụ thoracic na-enyere aka thoracoscopic, nke ọ bụghị nanị na-eme ka ịwa ahụ dị mfe, kamakwa na-ebelata oge ịwa ahụ.

N'ọgwụgwụ 1980s, mbụ laparoscopic cholecystectomy mere DuBois et al. na France wetara mmepe mgbanwe na teknụzụ laparoscopic. Ka ọ dị ugbu a, a na-ejikarị ịwa ahụ ọkpụkpụ laparoscopic eme ihe maka iwepụ diski intervertebral lumbar ala na ịwa ahụ intervertebral fusion (ALIF). Ọ bụ ezie na laparoscopic ALIF nwere ike ibelata mmebi anụ ahụ nke ọma, ịwa ahụ ALIF nke abdominal chọrọ nguzobe nke pneumoperitoneum, nke nwere ike ime ka ihe isi ike na ikuku ventilashion na ikuku ikuku mgbe ị na-agbanye ma na-edozi ọnọdụ nke afọ n'oge ịwa ahụ laparoscopic, na-akpata isi ala na ụkwụ dị elu. Tụkwasị na nke ahụ, nsogbu nke ịwa ahụ n'ihu lumbar interbody fusion na-agụnye hernia abdominal mpụga, mmerụ ahụ akụkụ ahụ abdominal, mmebi nke nnukwu arịa ọbara, akwara akwara na venous embolism, iatrogenic spinal nerve mmerụ, retrograde ejaculation, na ngwá ọrụ rupture. Okwu nke retrograde ejaculation mgbe ịwa ahụ lumbar fusion na-adọta mmasị ndị mmadụ. Nke a bụ n'ihi mmerụ ahụ nke akwara plexus nke na-abanye n'ime ala ala nke dị n'ihu n'ihu ọkpụkpụ lumbar dị ala n'oge ọrụ ahụ. Regan et al. kọrọ na omume nke retrograde ejaculation na 215 ikpe nke laparoscopic ala lumbar interbody BAK fusion bụ 5.1%. Dabere na akụkọ US FDA na-enyocha iji LT-CAGE na njikọ njikọta nke laparoscopic, ihe ruru 16.2% nke ndị ọrịa na-awa ahụ nwoke na-enweta ejaculation retrograde, nke nwere nnukwu nsogbu ndị a ma e jiri ya tụnyere ịwa ahụ mepere emepe. Newton et al. kwenyere na nsogbu nke ịwa ahụ thoracoscopic n'ihu ọkpụkpụ azụ yiri nke a na-eme ka ịwa ahụ obi na-emeghe, ma ụda mmiri mmiri nke ịwa ahụ thoracoscopic mgbe ọ gasịrị dị elu nke ukwuu karịa nke ịwa ahụ oghe. N'iburu oke ọrụ siri ike na ihe ize ndụ nke ịwa ahụ nke lumbar interbody fusion, yana nnukwu nsogbu nke ịwa ahụ, laparoscopic na-enyere aka obere mbepụ azụ azụ ịwa ahụ ọ bụghị nanị na ọ nwere obere trauma na ọ dị mfe ịrụ ọrụ, kamakwa ọ nwere obere oge ọrụ na obere nsogbu nke nsogbu. Ọ bụ ntụzịaka maka mmepe n'ọdịniihu nke ịwa ahụ n'ihu lumbar pere mpe.

Ọ bụ ezie na ọganihu na nkà mmụta ihe ndị dị ndụ nwere ike ịkwalite ịdị irè nke ngwakọta, a ka nwere mmejọ ụfọdụ, dị ka obere njem na nrụgide na-abawanye na akụkụ ndị dị n'akụkụ. N'ihi ihe ndị a, ngbanwe nke diski intervertebral ugbu a bụ ọganihu kacha agba ume. Ọ bụ ezie na imepụta diski intervertebral artificial bụ nke dabara kpamkpam na njirimara dị iche iche nke diski intervertebral eke siri ike, ọ bara uru n'ezie maka ahụ mmadụ. Ọ nwere ike ibelata isi iyi nke ọrịa, belata nkwụsi ike nke diski intervertebral degenerative kpatara, weghachi ikesa oke nrụgide sitere n'okike, ma weghachi njirimara mmegharị azụ azụ. Na tiori, ngbanwe diski artificial nwere ike dochie ịwa ahụ njikọ, na-enye mmegharị ahụ physiological nke ọkpụkpụ azụ na igbu oge mmebi nke akụkụ ndị dị n'akụkụ. A na-eme mgbanwe mbụ nke diski lumbar na 1996, bụ nke dochie anya diski na-egbu mgbu. Ugbu a, enwere ụdị diski intervertebral artificial dị iche iche dị. Ihe ndị dị na ya gụnyere ígwè ma ọ bụ eriri na-agbanwe. N'oge na-adịbeghị anya, enwere diski intervertebral artificial nke nwere akwa polyethylene dị n'ime na peptides dị n'èzí, bụ nke a na-ekpuchi ya na plasma. Otú ọ dị, ọnụ ọgụgụ ihe ịga nke ọma nke ngwakọta ekwenyebeghị nke ọma. Na mgbakwunye, akwụkwọ na-egosi na nhọrọ ikpe, ọdịdị, nha, na ọnọdụ diski intervertebral artificial dị oké mkpa maka ọgwụgwọ ọgwụgwọ. Akụkọ ndị gara aga lekwasịrị anya na ịwa ahụ mepere emepe maka ngbanwe diski intervertebral, yana usoro endoscopic ugbu a nwekwara ike iji dochie diski artificial laparoscopic. N'oge na-adịbeghị anya, Prodisc na-emepụta ọgbọ nke abụọ nke intervertebral disc prostheses, nke nwere ike iguzogide ihe niile dị na lumbar ma e wezụga maka mmegharị axial. Ha dị ntakịrị ntakịrị karịa diski intervertebral nkịtị, mana enwere ike ịtinye ya site na laparoscopy nke azụ ma ọ bụ obere mbepụ site na usoro retroperitoneal.

Site na ọganihu na-aga n'ihu nke nkà na ụzụ ịwa ahụ ọkpụkpụ nke oge a na ntinye nke biomaterials na ngwá ọrụ ọhụrụ na-eme ihe na-agwọ ọrịa, a na-eji ịwa ahụ dị n'azụ dochie ọtụtụ ịwa ahụ azụ azụ. A na-eji nwayọọ nwayọọ na-arụcha ịwa ahụ ọkpụkpụ azụ ndị bụ isi nke na-achọ ụzọ ihu na azụ site na ịwa ahụ nke otu nkeji. N'ihi usoro ahụ dị mgbagwoju anya, nhụjuanya ịwa ahụ dị ịrịba ama, na nnukwu nsogbu nke ịwa ahụ na nso nso nke ọkpụkpụ azụ, yana njedebe ịwa ahụ na ihe ize ndụ ndị metụtara endoscopic anterior spinal ịwa ahụ, n'ime afọ ndị na-adịbeghị anya, endoscopic anterior spinal ịwa ahụ nwere. jiri nwayọọ nwayọọ dochie ya site na ịwa ahụ nke azụ ma ọ bụ azụ azụ, azụ na azụ azụ azụ azụ na-enyere aka site na endoscopy. N'ọdịnihu, ịwa ahụ azụ azụ azụ n'okpuru laparoscopy ga-ejikarị eme ihe maka ịwa ahụ azụ azụ na azụ azụ na-enyere aka site na laparoscopy. Ọ bụghị nanị na nke a na-eme ka àgwà ndị dị ntakịrị na-emerụ ahụ nke usoro ịwa ahụ endoscopic, ma na-ezerekwa ihe ndọghachi azụ nke ịwa ahụ afọ dị mgbagwoju anya, ogologo oge ịwa ahụ, na nnukwu nsogbu nke nsogbu. Site na mmepe na digitization nke teknụzụ laparoscopic akụkụ atọ, nguzobe nke ụlọ ọrụ nwere ọgụgụ isi na ngwakọ, a ga-enwe mmepe ka ukwuu na teknụzụ ịwa ahụ akwara dị ntakịrị n'ọdịnihu.