Imbere ya Screw ikosora inzira ya Odontoid irinda imikorere izunguruka ya C1-2 kandi yavuzwe mubitabo kugira ngo ifate igipimo cya 88% kugeza 100%.
Muri 2014, Mar Marwis R et Al yatangaje inyigisho kuri tekinike yo kubaga ya screw yimbere yinjira mu kinyamakuru cyo kubaga amagufwa & AM). Iyi ngingo isobanura ibisobanuro birambuye ingingo zingenzi zubuhanga bwo kubaga, gukurikiranwa nyuma yo gukurikiranwa, ibimenyetso n'ibiringa mu ntambwe esheshatu.
Iyi ngingo ishimangira ko icyuma cyi II gusa cyarushijeho kuyobora inyenyeri yimbere kandi ko screw screw screw ikosora irakunzwe.
Intambwe ya 1: Gushyira ahagaragara umurwayi
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2. Umurwayi agomba kubikwa mumwanya wumunwa mugihe cyo kubagwa.
3. Kuvunika bigomba gusubirwamo bishoboka mbere yo kubagwa.
4. Umugongo w'inkondo y'umura ugomba kuba hypexte ya bishoboka cyane kugirango ubone uburyo bwiza bwo kwerekana ishingiro ryibikorwa bya Odontoid.
5. Niba HYPREXTERING yumugongo wo mumutwe udashoboka - eg, muri hyperextension hamwe no kwimura inyuma ya cephalad yibikorwa byumurwayi - noneho usuzumwa kugirango uhindure umutwe wumurwayi muburyo butandukanye.
6. Kureka umutwe wumurwayi mugihe gihamye gihagije. Abanditsi bakoresha Umutwe wa Mayfield (yerekanwe mu gishushanyo cya 1 na 2).
Intambwe ya 2: Uburyo bwo kubaga
Uburyo busanzwe bwo kubaga bukoreshwa mugushiraho urwego rwa tracheal yimbere rutangiza inzego zose zikomeye anatomicake.
Intambwe ya 3: Kwinjira Kwinjira
Ingingo yinjira neza iherereye kurubuga rwambere rwimbere rwumubiri wa C2. Kubwibyo, inkombe yimbere ya C2-C3 igomba kugaragara. (nkuko bigaragara ku gishushanyo cya 3 na 4 hepfo) Igishushanyo cya 3
Umwambi wumukara mu gishushanyo cya 4 cyerekana ko C2 ya C2 yimbere mu gusoma neza film CT ya Axial CT kandi igomba gukoreshwa nkirangamuntu ya anatomical kugirango igerweho mugihe cyo kubagwa.
2. Emeza ingingo yinjira munsi ya Anteroposition hamwe na fluoscopique yibigo byumugongo. 3.
3. Shyira urushinge hagati yimbere yimbere ya C3 Iherezo ryo hejuru hamwe na C2 byinjira kugirango ubone umwanya winjira.
Intambwe ya 4: Gushyira
1. Nyuma, mm 3,5 cyangwa 4 mm diameter yuzuye sluwrewe. Urushinge rugomba guhora rwateye imbere muri Cephalad munsi ya Anteroposteur hamwe na Fluoscopique.
2. Shira imyitozo ngororamubiri mu cyerekezo cya pin iyobowe munsi ya FLOSTOPCOPIC hanyuma ibe iteye imbere kugeza igihe yinjiye kumeneka. Imyitozo ngororamubiri ntizigomba kwinjira muri cortex yuruhande rwa cephalad ya NotoChord kugirango igikoni gitere kidasohoka hamwe nudutonzi.
3. Gupima uburebure bwa Shorent Hollow isabwa kandi igenzure hamwe no gupima CT mbere yo gukumira amakosa. Menya ko umugeni wabishaka ukenera kwinjizwa mumagufwa corcal ku isonga rya odontoid (kugirango woroshye intambwe ikurikira yo kwikuramo imperuka).
Mu bihe byinshi by'abanditsi, umukubite n'umwe wakoreshejwe mu gukosorwa, nkuko bigaragara ku gishushanyo cya 5, kiboneka mu gishushanyo cya 5, kiri hagati ya Cephalad, hamwe n'isonga rya Screw gusa ryinjira mu magufa ya Cortique inyuma y'igice cya Odontoid. Kuki umugozi umwe wasabwe? Abanditsi banzuye ko byaba bigoye kubona aho byinjira mu nsi yinjira mu buryo bwa Odontoid niba imigozi ibiri itandukanye yagombaga gushyirwaho Mm 5 kuva hagati ya C2.
Igishushanyo 5 cyerekana ko ari incuro zisuka hagati yigituba cya Odontoid gihura na Cephalad, hamwe nisonga rya screw gusa ryinjira mu magufwa inyuma yicyiciro cya Odontoid.
Ariko usibye ibintu byumutekano, kora imigozi ibiri yongera gushikama?
Ubushakashatsi bwibinyabuzima bwasohotse muri 2012 muri orthopedical clinical orthopedics hamwe nubushakashatsi bujyanye na Gang Feng et al. Mu mashuri ya cyami abaganga b'ubwami bwerekanye ko imirongo imwe n'amashusho abiri atanga urwego rumwe rwo gukonja mu rwego rwo gukosora ibipimo bya Odontoid. Kubwibyo, inkubi y'umuntu umwe irahagije.
4. Iyo umwanya wo kuvunika hamwe nibipano biyobora byemejwe, imigozi ikwiye yashyizwe. Umwanya wimigozi n'amapine bigomba kubahirizwa munsi ya flushroscopi.
5. Kwitaho bigomba gufatwa kugirango igikoresho gikemuke kitarimo imyenda yoroshye mugihe ikora kimwe mubikorwa byavuzwe haruguru. 6. Koza imigozi kugirango ushyireho igitutu umwanya wo gucika.
Intambwe ya 5: Gufunga ibikomere
1. Funga agace kabaruye nyuma yo kurangiza gushiramo.
2. Haenasiasis nziza ni ngombwa kugirango igabanye ibibazo byamaposita nkibisanzwe bya hematoma bya TRACHEA.
3. Imitsi ya Lastissimus ya Lastissimus ya Dorsi igomba gufungwa muburyo busobanutse cyangwa aestthetike yinkovu yamaposita izahungabana.
4. Gufunga burundu ibice byimbitse ntabwo ari ngombwa.
5. Imiyoboro ya Gukomeretsa ntabwo ari amahitamo asabwa (abanditsi mubisanzwe ntabwo bashiraho imiyoboro ya nyuma).
6. Sutuletmal suture irasabwa kugirango igabanye ingaruka kumiterere yumurwayi.
Intambwe ya 6: Gukurikirana
1. Abarwayi bagomba gukomeza kwambara ibyumweru 6 byihuta byibyumweru 6 bitarenze, keretse niba abashaka kuba babisabye, kandi bagomba gusuzumwa nibibazo byinyuma byamaposita.
2. Radipo zisanzwe na Radio Zisanzwe za Stovocal yumugongo ugomba gusubirwamo kuri 2, 6, hamwe nibyumweru 12 na saa mumezi 6 na 12 nyuma yo kubagwa. CT Scan yakozwe mubyumweru 12 nyuma yo kubagwa.
Igihe cyohereza: Ukuboza-07-2023
