Gufata vis imbere y'inzira y'ibumba bigumana imikorere yo kuzenguruka ya C1-2 kandi byagaragaye ko mu nyandiko hari igipimo cyo guhuza hagati ya 88% na 100%.
Mu 2014, Markus R n'abandi basohoye inyigisho ku buryo bwo kubaga bwo gufata vis imbere ku mvune z'amenyo mu kinyamakuru The Journal of Bone & Joint Surgery (Am). Iyi nkuru isobanura mu buryo burambuye ingingo z'ingenzi z'uburyo bwo kubaga, gukurikirana nyuma yo kubagwa, ibimenyetso n'uburyo bwo kwirinda mu ntambwe esheshatu.
Iyi ngingo ishimangira ko imvune zo mu bwoko bwa II gusa ari zo zishobora kuyobora screw imbere kandi ko gufunga screw imwe ifite ubugari ari byo byiza.
Intambwe ya 1: Gushyira umurwayi mu mwanya we mu gihe cyo kubagwa
1. Hagomba gufatwa ifoto nziza ya radiyo ipima imbere n'inyuma kugira ngo igaragare ku muntu ukoresha.
2. Umurwayi agomba kuguma afunguye umunwa mu gihe cyo kubagwa.
3. Ivuniko rigomba guhindurwa uko bishoboka kose mbere yo gutangira kubagwa.
4. Uruti rw'umugongo rugomba kwaguka cyane uko bishoboka kose kugira ngo hagaragare neza ishingiro ry'imikorere y'uturemangingo.
5. Niba umugongo w’umura udashoboka – urugero, mu kuvunika kw’umugongo ukabije hamwe no kwimuka kw’inyuma y’igice cy’inyuma cy’inzira y’inyuma – hashobora kwitabwaho guhindura umutwe w’umurwayi mu cyerekezo gitandukanye n’igihimba cye.
6. Kura umutwe w'umurwayi mu mwanya uhamye uko bishoboka kose. Abanditsi bakoresha umutwe wa Mayfield (ugaragara ku Ishusho ya 1 na 2).
Intambwe ya 2: Uburyo bwo kubaga
Uburyo busanzwe bwo kubaga bukoreshwa kugira ngo hagaragazwe urwego rw'imbere rw'imitsi hatabayeho kwangiza imiterere y'umubiri.
Intambwe ya 3: Aho winjirira hifashishijwe screw
Aho kwinjira ni heza cyane ku ruhande rw'imbere rw'inyuma rw'umubiri w'umugongo wa C2. Kubwibyo, impande z'imbere za disiki ya C2-C3 zigomba kugaragara. (nk'uko bigaragara ku mashusho ya 3 na 4 hepfo) Ishusho ya 3
Umwambi w'umukara uri ku Ishusho ya 4 ugaragaza ko umugongo wa C2 w'imbere ureberwa neza mu gihe cyo gusoma filime ya CT yo mu gice cy'imbere mbere yo kubagwa kandi ugomba gukoreshwa nk'ikimenyetso cy'imiterere y'umubiri kugira ngo hamenyekane aho urushinge rushyirwa mu gihe cyo kubagwa.
2. Emeza aho winjirira ukoresheje uburyo bwa fluoroscope bugaragara imbere n'inyuma y'umugongo w'inkondo y'umura. 3.
3. Kanda urushinge hagati y'inkombe y'imbere y'igice cyo hejuru cya C3 n'aho C2 yinjirira kugira ngo ubone aho screw yinjirira hakwiriye.
Intambwe ya 4: Gushyira screw
1. Urushinge rwa GROB rufite umurambararo wa mm 1.8 rubanza gushyirwaho nk'umuyobozi, urushinge rukerekeza inyuma gato y'umutwe w'agace k'umunwa. Nyuma yaho, hashyirwaho vis ifite umurambararo wa mm 3.5 cyangwa mm 4. Urushinge rugomba guhora rushyirwa ku ruhande rw'umunwa buhoro buhoro munsi y'igenzura rya fluoroscope imbere no ku ruhande.
2. Shyira umuyoboro w'ububobere mu cyerekezo cy'agapira k'ubuyobozi munsi y'ubugenzuzi bwa fluoroscopic hanyuma ukomeze buhoro buhoro kugeza igihe winjiriye mu cyavunitse. Umuyoboro w'ububobere ntugomba kwinjira mu gice cy'imbere cy'umutwe w'inyuma kugira ngo agapira k'ubuyobozi katavamo umuyoboro w'ububobere.
3. Pima uburebure bw'urushundura rw'ubudodo rukenewe hanyuma urwemeze ukoresheje CT ipima mbere yo kubagwa kugira ngo wirinde amakosa. Menya ko urushundura rw'ubudodo rugomba kwinjira mu igufwa rya cortical ku mpera y'inzira y'ubudodo (kugira ngo byorohereze intambwe ikurikira yo gukanda impera z'amagufwa).
Mu manza nyinshi z'abanditsi, hakoreshejwe screw imwe y'ubusamo mu gushyiraho, nk'uko bigaragara ku Ishusho ya 5, iri hagati mu gice cyo hasi cy'inzira y'ubusamo ireba cephalad, aho umutwe w'ubusamo winjira gusa mu igufwa ry'inyuma ry'inzira y'ubusamo ku mpera y'inzira y'ubusamo. Kuki screw imwe isabwa? Abanditsi banzuye ko byagorana kubona aho kwinjira hakwiye mu gice cyo hasi cy'inzira y'ubusamo iyo screw ebyiri zitandukanye zishyizwe kuri mm 5 uvuye hagati ya C2.
Ishusho ya 5 igaragaza uruziga rw'ubudodo ruri hagati mu gice cyo hasi cy'inzira y'ubudodo rureba cephalad, aho umutwe w'uruziga winjira mu gice cyo hasi cy'igufwa inyuma gato y'intambwe y'inzira y'ubudodo.
Ariko uretse umutekano, ese vis ebyiri zongerera ubushobozi bwo kugumana ubuzima nyuma yo kubagwa?
Ubushakashatsi bwakozwe mu biyomekeniki bwasohotse mu 2012 mu kinyamakuru Clinical Orthopaedics and Related Research cyanditswe na Gang Feng n'abandi bo muri Royal College of Surgeons of the United Kingdom bwagaragaje ko screw imwe n'ama screw abiri bitanga urwego rumwe rwo guhagarara neza mu gufata neza amagufwa y'uturemangingo. Kubwibyo, screw imwe irahagije.
4. Iyo aho imvune n'udupira tw'icyitegererezo biherereye byemejwe, hashyirwaho utupira tw'ubudodo bukwiye. Aho utupira n'udupira biherereye bigomba kugaragara hifashishijwe fluoroscopy.
5. Hagomba kwitonderwa ko igikoresho cyo gukurura kidakoresha ingirangingo zoroshye zikikije iyo ukora kimwe mu bikorwa byavuzwe haruguru. 6. Kanda inzingo kugira ngo ushyire igitutu ku mwanya wavunitse.
Intambwe ya 5: Gufunga igikomere
1. Sukura aho bakorewe ubuvuzi nyuma yo kurangiza gushyira vis.
2. Guhagarika burundu amaraso ni ingenzi kugira ngo bigabanye ingorane nyuma yo kubagwa nko gukanda amaraso mu muhogo.
3. Imitsi ya cervical latissimus dorsi iciwe igomba gufungwa neza bitabaye ibyo ubwiza bw'inkovu nyuma yo kubagwa buzagabanuka.
4. Gufunga burundu ibice byimbitse si ngombwa.
5. Gukuraho ibikomere si amahitamo asabwa (abanditsi akenshi ntibashyiraho imiyoboro nyuma yo kubagwa).
6. Gusunika uruhu imbere y'uruhu ni byiza kugira ngo bigabanye ingaruka ku isura y'umurwayi.
Intambwe ya 6: Gukurikirana
1. Abarwayi bagomba gukomeza kwambara igitambaro gikomeye cyo mu ijosi mu gihe cy'ibyumweru 6 nyuma yo kubagwa, keretse iyo ubuvuzi bw'abaforomo bubibasaba, kandi bagomba gusuzumwa buri gihe hakoreshejwe amashusho nyuma yo kubagwa.
2. Isuzuma risanzwe rya radiyo y'umugongo w'inkondo y'umura (anteroposterior) n'iy'inyuma (lateral radiographs) ry'umugongo w'inkondo y'umura rigomba gusuzumwa nyuma y'ibyumweru 2, 6, na 12, ndetse no nyuma y'amezi 6 na 12. Isuzuma rya CT ryakozwe nyuma y'ibyumweru 12.
Igihe cyo kohereza: Ukuboza-07-2023
