Kubaga umurwayi no kwibeshya kurubuga birakomeye kandi birashobora kwirindwa. Nk’uko byatangajwe na Komisiyo ihuriweho no kwemeza amashyirahamwe yita ku buzima, amakosa nk'aya arashobora gukorwa kugeza kuri 41% yo kubaga amagufwa / abana. Kubaga umugongo, ikosa ryo kubaga bibaho mugihe igice cyurugingo cyangwa kuruhande bitari byo. Usibye kunanirwa gukemura ibimenyetso byumurwayi na patologiya, amakosa yibice arashobora gukurura ibibazo bishya byubuvuzi nko kwihuta kwangirika kwa disiki cyangwa guhungabana kwumugongo mubindi bice bidafite ibimenyetso cyangwa bisanzwe.
Hariho kandi ibibazo byemewe n'amategeko bifitanye isano namakosa yibice byo kubaga umugongo, kandi abaturage, ibigo bya leta, ibitaro, na societe yabaganga ntibihanganira na gato ayo makosa. Kubaga umugongo byinshi, nka discectomy, fusion, laminectomy decompression, na kyphoplasty, bikorwa hakoreshejwe inzira yinyuma, kandi guhagarara neza ni ngombwa. Nubwo ubu buryo bwo gukoresha amashusho yerekana amashusho, amakosa yibice aracyagaragara, aho ibipimo byanduye biva kuri 0.032% kugeza 15% byavuzwe mubitabo. Nta mwanzuro wuburyo bwo kwimenyekanisha neza.
Intiti zo mu ishami ry’ubuvuzi bw’amagufwa ku ishuri ry’ubuvuzi rya Mount Sinai, muri Amerika, zakoze ubushakashatsi ku bibazo byabajijwe ku rubuga rwa interineti zerekana ko umubare munini w’abaganga b’umugongo bakoresha uburyo buke bwo kwimenyekanisha, kandi ko gusobanura impamvu zisanzwe zitera amakosa bishobora kuba ingirakamaro muri kugabanya amakosa yo kubaga igice, mu kiganiro cyasohotse muri Gicurasi 2014 muri Spine J. Ubushakashatsi bwakozwe hakoreshejwe ikibazo cyanditse kuri imeri. Ubushakashatsi bwakozwe hifashishijwe imiyoboro ya imeri ku kibazo cyohererejwe abanyamuryango ba Sosiyete yo muri Amerika y'Amajyaruguru ya rugongo (harimo n'abaganga babaga amagufwa na neurosurgueons). Ikibazo cyoherejwe rimwe gusa, nkuko byasabwe na Sosiyete y'Abanyamerika y'Amajyaruguru. Abaganga 2338 barayakiriye, 532 bafungura umurongo, naho 173 (7.4% yo gusubiza) barangije kubaza. 72% by'abayirangije ni abaganga babaga amagufwa, 28% ni abaganga babaga, naho 73% bari abaganga b'umugongo mu mahugurwa.
Ikibazo cyari kigizwe nibibazo 8 byose (Igishusho 1) gikubiyemo uburyo bukoreshwa cyane muburyo bwo kwimenyekanisha (haba ibimenyetso byerekana ibimenyetso ndetse no kwerekana amashusho), kuba habaye amakosa yo kubaga igice, hamwe no guhuza uburyo bwo kwimenyekanisha hamwe namakosa yibice. Ikibazo nticyageragejwe cyangwa cyemejwe. Ikibazo cyemerera guhitamo ibisubizo byinshi.
Igishushanyo 1 Ibibazo umunani bivuye kubibazo. Ibisubizo byerekanye ko fluoroscopi intraoperative aribwo buryo bwakoreshwaga cyane muburyo bwo kubaga umugongo winyuma ya thoracic na lumbar (89% na 86%), hagakurikiraho amaradiyo (54% na 58%). Abaganga 76 bahisemo gukoresha uburyo bwombi muburyo bwaho. Inzira zizunguruka hamwe na pedicles bihuye nibyo byakoreshwaga cyane mu kwerekana ibimenyetso bya anatomic byo kubaga umugongo wa thoracic na lumbar (67% na 59%), bikurikirwa no kuzunguruka (49% na 52%) (Ishusho 2). 68% by'abaganga bemeje ko bakoze amakosa yo mu bice bimwe na bimwe mu myitozo yabo, bamwe muri bo bakosowe mu buryo budasanzwe (Ishusho 3).
Igishushanyo cya 2 Kwerekana amashusho na anatomiki yerekana ibimenyetso byaho byakoreshejwe.
Igishushanyo cya 3 Muganga no gukosora gukosora amakosa yo kubaga igice.
Ku makosa yo kwimenyekanisha, 56% by'abaganga bakoresheje radiyo mbere yo gutangira na 44% bakoresheje fluoroscopi intraoperative. Impamvu zisanzwe zitera amakosa yibibanza mbere yo gutangira kwari ukunanirwa kwiyumvisha ahantu hazwi (urugero, urutirigongo rwigitereko ntirwashyizwe muri MRI), itandukaniro rya anatomique (vertebrae yimuwe yimitsi cyangwa imbavu zumuzi 13), hamwe nibisobanuro bidasobanutse bitewe numubiri wumurwayi. imiterere (suboptimal X-ray yerekana). Impamvu zikunze gutera amakosa yimyanya ndangagitsina harimo itumanaho ridahagije hamwe na fluoroscopiste, kunanirwa kwimurwa nyuma yo guhagarara (kugenda urushinge ruhagaze nyuma ya fluoroscopi), hamwe nibisobanuro bitari byo mugihe uhagaze (lumbar 3/4 uhereye kumbavu hasi) (Ishusho 4).
Igishushanyo cya 4 Impamvu zo kwibeshya no gutangira ibikorwa.
Ibisubizo byavuzwe haruguru byerekana ko nubwo hariho uburyo bwinshi bwo kwimenyekanisha, umubare munini wabaganga babaga bakoresha bike muri byo. Nubwo amakosa yo kubaga yibice adasanzwe, nibyiza ko adahari. Nta buryo busanzwe bwo gukuraho aya makosa; icyakora, gufata umwanya wo gukora imyanya no kumenya impamvu zisanzwe zitera amakosa yo guhagarara birashobora gufasha kugabanya umubare wamakosa yo kubaga igice cyo kubaga umugongo wa thoracolumbar.
Igihe cyo kohereza: Nyakanga-24-2024
