Sistemụ Endoscopy Bichannel V-ụdị (VBE)

endoscopic lumbar fusion nke nwere ụdị V nwere akụkụ abụọ (VBE-LIF transforminal)

Nkwadebe na nhazi tupu ịwa ahụ: Tupu ịwa ahụ, anyị kwesịrị iji nlezianya jụọ akụkọ ahụike nke onye ọrịa, nyocha anụ ahụ na nyocha enyemaka iji dokwuo anya nyocha onye ọrịa, ma wepụ ihe mgbochi ndị dị mkpa tupu ị tụlee n'ụzọ ziri ezi ịhọrọ ịwa ahụ VBE. Tupu ịwa ahụ, a ga-eji nlezianya gụọ ụzarị X-ray iji nyochaa ntụgharị vertebral, scoliosis, hyperplasia nkwonkwo, na ọnụnọ ma ọ bụ enweghị nke vertebrae na-akwaga na ọkpụkpụ azụ ndị ọzọ. Ekwesịrị ịhụ ịdị elu nke oghere intervertebral, nha na ịdị elu nke oghere intervertebral, na obere nkwonkwo nke oghere intervertebral na-arịa ọrịa kwesịrị ịhụ site na redio ndị dị n'akụkụ, na 3D morphology nke foramen na lumbar spine nwere ike ịhụ site na nrụzigharị 3D. nke CT, na spine lumbar kwesịrị iji nlezianya nyochaa ya site na lumbar spine magnetik resonance sagittal na transverse scans, iji hụ na ọnụnọ ma ọ bụ na-anọghị nke mgbọrọgwụ mgbọrọgwụ degeneration nke akụkụ a na-arụ ọrụ, na ịghọta nhazi mgbọrọgwụ akwara. Anyị na-enyocha nke ọma lumbar MRI sagittal na transverse scans iji hụ ma mgbọrọgwụ akwara dị na mpaghara a na-arụ ọrụ nwere ọdịiche ọ bụla, iji ghọta usoro mgbọrọgwụ akwara, na ịhazi ụzọ ịwa ahụ na nlezianya iji zere mmebi akwara. Dị ka ụzọ ịwa ahụ a na-eme atụmatụ si dị, a na-atụ anya paracentesis na akụkụ nke ntanye na ihe nkiri resonance nke lumbar. N'ozuzu, anya paracentesis nke lumbar VBE bụ 6 ruo 9 cm, na cephalad ka ukwuu, otú ahụ ka anya nke paracentesis dị ntakịrị, na akụkụ mgbatị ahụ na-adịkarị 30 ° ruo 45 °.

Ọnọdụ anụ ahụ na akara mbepụ: onye ọrịa na-anabata ọnọdụ dị mfe, a kwụsịtụrụ afọ, ụlọ ọgwụ ndị nwere ọnọdụ ahụ nwere ike iji nleba anya neurophysiological iji gosipụta ọnọdụ ahụ nke kposara pedicle na ọnọdụ nke mbepụ endoscopic dual-channel. ihe nchọta elu ahụ. Na-ekpochapụ mgbe niile ma gbasaa akwa nhicha ahụ, n'ihi na endoscopy dual-channel chọrọ ụzọ abụọ nke ịsacha mmiri, mmiri na-agbanye mmiri ka ukwuu, ọ dị mkpa ịkwadebe ihe dị ka 3000 ml nke mmiri na-ekpo ọkụ, na n'otu oge ahụ iji kpoo mmiri na-ekpo ọkụ, iji zere ịba ụba nke ukwuu. mmiri na-emetụta ọnọdụ okpomọkụ nke onye ọrịa, iji akpa mmiri arthroscopic na-anakọta mmiri mmiri mmiri, ọnọdụ nke igwe X-ray C-arm na ọnọdụ nke ihe ngosi ihe ngosi echere tupu oge eruo, iji kwado ọrụ ịwa ahụ na fluoroscopy, ka zere mmezigharị ugboro ugboro oge ịwa ahụ na-egbu oge.

Ndokwa nke guidewire maka screws pedicle percutaneous: N'ozuzu, a na-ebu ụzọ tinye ntuziaka maka akụkụ a ga-edozi ya na skru pedicle percutaneous n'okpuru fluoroscopy, mana enwere ike ime ya na mbụ endoscopically.

Agbanyeghị, ọ ga-ekwe omume ịme njikọ endoscopic nke na-esote pedicle screw guidewire ntinye na ndozi.

Ntunye agịga: agịga pịrị apị na nke nwere atụ dị ka akụkụ nke ngwa a nwere ike họrọ dịka mmasị dọkịta na-awa ahụ si dị. Ụzọ mgbapu kacha mma dị n'akụkụ nsọtụ elu nke ahụ vertebral dị ala, na nso n'akụkụ mpụta nke calcaneus n'ihe dịka 45°. Ọdịiche dị elu na nke dị n'akụkụ na-eme ka ọ merụọ mgbọrọgwụ mpụta ahụ, ebe ngbanwe nke etiti na-ebute mmerụ ahụ akpa ogologo na mgbọrọgwụ ije. Ya mere, a ga-eme atụmatụ nhazi nke ụzọ tupu ịwa ahụ site na iji nlezianya gụọ data onyonyo na

Kpebie ụzọ mgbapu kacha mma.

Ntọala nke ọwa na-arụ ọrụ: Ozugbo ọnọdụ nke agịga nkwụsị na-eju afọ, a na-eji tube dilatation kwekọrọ na ya mee ihe na-eme ka ọkpụkpụ na-aga n'ihu. Mgbe emechara mgbasawanye, a na-etinye ọwa na-arụ ọrụ nke nwere isi ihe ntinye ya na agịga nkwụsị iji ruo ebe dị mma. Mgbe ahụ, a na-awụnye ihe ngosi okirikiri nkịtị n'ime nkwonkwo synovial articular site n'ime ọwa n'okpuru ọhụụ kpọmkwem ma ọ bụ fluoroscopy. Ozugbo nkwọ okirikiri ahụ erutela ebe nchekwa dị omimi, a na-ewepụ ihe mgbochi ọkpụkpụ ma debe ya maka ịdo ọkpụkpụ.

Ọgwụgwọ oghere intervertebral: Mgbe e wepụrụ ihe mgbochi ọkpụkpụ site na okirikiri okirikiri na ngwa ngwa egbe, enwere ike iru oghere intervertebral ozugbo, a na-ewepụ pulposus nucleus na nucleus pulposus forceps, ihe na-agbasa oghere intervertebral na-agbasa nzọụkwụ site na nzọụkwụ, na intervertebral A na-eji oghere reamer na spatula eme ihe na njedebe ruo mgbe ha na-agbapụta ma chebe ya nke ọma. Nhazi ugbu a nke ngwá ọrụ microscopic VEB bụ nke dị omimi, na ntinye miri emi n'ime oghere intervertebral adịghị agafe 40 mm, nke na-eme ka arịa ọbara na akụkụ ahụ dị n'ihu na vertebral ahụ adịghị emerụ ahụ.

Njikọ aka nke ọkpụkpụ: Mgbe e mezichara oghere intervertebral nke ọma, a na-etinye oghere ọkpụkpụ n'ime oghere intervertebral maka ịdo ọkpụkpụ. Ọkpụkpụ intervertebral kwesịrị ijide n'aka na ọnụ ọgụgụ nke ọkpụkpụ a na-adọdo zuru ezu, na mgbe mgbe, ọkpụkpụ autogenous nke a na-emegharị nke articular eminence enweghị oke ọkpụkpụ dị mkpa maka njikọta, ya mere ọ dị mkpa ịkụnye ọkpụkpụ allogeneic zuru ezu ma ọ bụ ọkpụkpụ artificial dị ka a. ihe ngbanwe, ma ọ bụ iji ihe ndị na-akwalite ọkpụkpụ ọkpụkpụ, dị ka BMP, iji hụ na ọkpụkpụ a nyadoro anya na-enweta njikọ.

Ịkụnye ngwaọrụ ngwakọta: Mgbe ọkpụkpụ ọkpụkpụ, a na-akụnye ngwaọrụ ahụ. Site na ịnweta VBE dual, enwere ike ịme usoro ntinye nke njikọ n'okpuru nlekota endoscopic. Ngwa ngwakọta a na-eji ugbu a dị na nha nke edobere yana nke nkwado. Ngwa ngwakọta nke nkwado nkwado na-adị mfe ịkụnye endoscopically n'ihi nha ha pere mpe ma nwee ike ịkwado ya mgbe etinyere ngwaọrụ ahụ n'ebe.

Ipsilateral and contralateral decompression: A na-atụkarị aro ka a rụchaa nhụsianya mgbe etinyechara ngwakọta, nke enwere ike ime ya ozugbo site na iji ngwa igwe ejikọtara ọnụ na-enweghị dochie trocar ọwa abụọ na-arụ ọrụ. Ọ bụrụ na echiche ahụ adịghị anya nke ọma n'ihi ọbara ọgbụgba, wdg, enwere ike dochie oghere intervertebral a na-ahụkarị iji mee nkwụsịtụ na iwepụ diski; Ọ bụrụ na a ka nwere diski herniated ma ọ bụ stenotic n'akụkụ akụkụ ahụ, enwere ike iji oghere intervertebral a na-emekarị n'akụkụ akụkụ ahụ maka ịda mbà n'obi, mwepụ nke nucleus pulposus, na mwepụ nke nucleus pulposus. Enwere ike iwepụ Nucleus pulposus n'akụkụ akụkụ ahụ ma ọ bụrụ na a ka nwere diski herniation ma ọ bụ stenosis, na akụkụ abụọ ahụ nwere ike ịrụ ọrụ site na ndị ọrụ abụọ n'otu oge, nke na-adịghị eme ka oge ọrụ ahụ dịkwuo elu.

Ndozi screw percutaneous: Mgbe emechara ngwakọta na mgbakasị ahụ, a na-eme ndozi pedicle pedicle. Mgbe fluoroscopy na nkwenye gasịrị, a na-agbanye skru nke percutaneous n'akụkụ ụzọ ntuziaka etinyere ma mechie mbepụ ahụ.