Anterior Screw Kugadziriswa kweOdotoid process inochengetedza basa rekutenderera reC1-2 uye rakataurwa mumabhuku kuti ave nehuwandu hwekufukura 88% kusvika 100%.
Muna 2014, Markus r et al akaburitsa tutorial pane yekuvhiya maitiro eantherior screw gadziriso yekugadzirisa ododonid frace Chinyorwa ichi chinotsanangura zvakadzama pfungwa huru dzehunyanzvi hwekuvhiya, kutevera kwekutevera, zvinoratidza uye kuzvichenjerera pamatanho matanhatu.
Chinyorwa chinosimbisa kuti chete mhando II Fractures inowanzo kuve inotungamira kuendesa kupokana kweChidimbu Screw Screw Screw
Nhanho 1: Intraoperative chinzvimbo chemurwere
1. Optimal anteroposter uye yakazotevera radiographs inofanira kuendeswa kune iyo operator referensi.
2. Murwere anofanirwa kuchengetwa mumamiriro omuromo-pamuromo panguva yekuvhiya.
3. Kupwanya kunofanirwa kuiswa kuiswa zvakanyanya sezvazvinogona kusati kwatanga kuvhiya.
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5. Kana hyprextension yemusana wechibereko hachiitike - egredxtension fraces neyekupedzisira kuguma kweOdoontoid process.
6. Imira musoro wemurwere mune yakagadzikana chinzvimbo sezvinobvira. Vanyori vanoshandisa iyo Mayfield Head chimiro (inoratidzwa muhuwandu 1 ne2).
Nhanho yechipiri: Kuvhiya maitiro
Iyo yakajairwa nzira yekuvhiya inoshandiswa kufumura iyo anterior tracheal layer pasina kukuvadza chero zvinhu zvinokosha zvechinyakare.
Nhanho 3: Screw Kupinda Point
Iyo yakakwana yekupinda point inowanikwa panzvimbo iyo anterior yakaderera maringe eiyo chigadziko cheC2 vertebral muviri. Naizvozvo, mupendero waAnterior weC2-C3 disc inofanira kufumurwa. (sezvakaratidzwa muhuwandu 3 uye 4 pazasi) Mufananidzo 3
Iyo dema museve mumufananidzo 4 inoratidza kuti iyo anterior c2 spine yakanatswa panguva yekuverenga kweiyo yeiyo yeiyo yeAxial CT firimu yekutsvaga iyo yekuisa pfungwa yekusaiswa kwekuvhiya panguva yekuvhiya.
2. Simbisa iyo poindi yekupinda pasi peAnteroposter uye inotevera fluoroscopic maonero echibereko chechibereko. 3.
3. Tsvedza tsono pakati peiyo anterior yepamusoro pamucheto weC3 UPPER ENDPLATE uye C2 yekupinda Point yekutsvaga iyo yakakwana screw yekupinda.
Nhanho 4: Screw Kuiswa
1. A 1.8 mm diameter grob tsono inotanga kuiswa segwara, ine tsono yakatemerwa zvishoma kuseri kwemupendero weiyo notopord. Pashure pacho, a 3.5 mm kana 4 mm diameter Hollow screw yakaiswa. Iyo tsono inofanirwa kugara ichingoita zvishoma nezvishoma cephalad pasi peiyo anteroposter uye yakazotevera fluoroscopic yekutarisa.
2. Isa iyo hold kudhiraivha mune iyo yekufambisa pini yepamhepo pasi peFluoroscopic yekutarisa uye zvishoma nezvishoma inofambira mberi kusvikira yapinda mukati mekupwanya kupwanya. Iyo Hollow Drill haifanire kugeza iyo cortex yeiyo cephalad side of the notochord kuti ipini yekufambisa isinga itsivi nehombodo yekukweva.
3. Kuyera kureba kweiyo inodiwa yehombodo screw uye kuisarudzira iyo chaiyo ct chiyero chekudzivirira zvikanganiso. Ziva kuti ganda rehombodo rinoda kupinda mukati mekoreti yekoreti pane chipenga cheOdoontoid process (kugonesa iyo inotevera nhanho yekupwanya kupatsanuka.
Muzviitiko zvakawanda, screw imwe chete yehasha yakashandiswa kugadziriswa, sezvakaratidzwa mumufananidzo 5, iyo iri pakati pechiitiko cheChedha chete Nei screw imwe ikarumbidza? Vanyori vakagumisa kuti zvingave zvakaoma kuwana nzvimbo yakakodzera yekupinda pachigadziko cheOdoontoid process kana maviri akapatsanurwa screws aifanira kuiswa 5 mm kubva pakati peC2.
Mufananidzo 5 unoratidza gakava rehasha pakati pechiitiko cheOdotoid process procing, ine chipenga chechipfuva chinongopinza cortex cortex yemapfupa ari kumashure kweiyo odotoid process.
Asi kunze kwechinhu chengetedzo, ita maviri masaiti anowedzera kudzora kudzikama?
Chidzidzo che Biomechasical chakabudiswa muna 2012 muJuriniki Clinical Orthopimecs uye Rondedzero Yakabatana neGang Feng Et Al. yeRoyal koreji yekuvhiya yeUnited Kingdom yakaratidza kuti imwe screw uye maviri screws inopa iyo nhanho imwechete yekugadziriswa mukugadziriswa kweOdotoid fractures. Naizvozvo, screw imwe yakakwana.
4. Kana chinzvimbo chevhu uye mapini ekutungamira anosimbiswa, iyo yakakodzera gakava screw yakaiswa. Nzvimbo yezvibodzwa uye mapini inofanira kucherechedzwa pasi peFluoroscopy.
5. Kuchengeta kunofanirwa kutorwa kuti uve nechokwadi chekuti chishandiso chekushamisa hachisanganisire iyo yakapoteredzwa yakapfava matishu kana ichiita chero chipi zvacho chipi zvacho chinoitwa pamusoro. 6. Simbisa zviyero kuti ushandise kumanikidza nzvimbo inokatyamadza.
Nhanho 5: Kuvharwa kwevarungu
1. Flush nzvimbo yekuvhiya mushure mekupedza Screw Kuiswa.
2. Nyatso Haemostasis inokosha kuti ideredze zvinetso zvekumisikidza senge hematoma kumanikidzwa kwe trachea.
3. Iyo yakasarudzika cervical latissimus dorsi tsandanyama inofanira kuvharwa mukugadziriswa kwayo kana aesthetics of the postoperative vanga dzinosanganisirwa.
4. Kuvhara kwakazara kwevakadzika matare hakuna madikanwa.
5. Wakunda madonhwe haisi sarudzo inodiwa (vanyori kazhinji havaise pamba postoperative drins).
6. Intradermal sutures inokurudzirwa kuderedza kukanganisa kwechitarisiko chemurwere.
Nhanho 6: Tevera-up
1. Varwere vanofanirwa kuramba vachipfeka mutsipa wakasarudzika brace kwemavhiki matanhatu pamba, kunze kwekunge vachita mukoti kuchida, uye vanofanirwa kuongororwa nekufungidzira kwekufunga kwekutanga.
2. A CT SCAN yakaitwa pamavhiki gumi nemaviri mushure mekuvhiyiwa.
Kutumira Nguva: Dec-07-2023
