Nhau - Vhura-Door Posterior Cervical Laminyoplasty maitiro

Keypoint

1. Iyo isipolar elecTrick banga rinodonha fascia uye rinobva ratete pasi pepamba, teerera kuchengetedza runyararo

2. Teerera TKuwedzera zvishoma nezvishoma kwekuvhurwa kwemusuwo seyese, zvidiki zvidiki spatulas zvinogona kushandiswa kuvhura chikamu chimwe chete chevatertebral.

3. Kana OpeninG regai risina kujairika, kuruma kubva kuLigamentum Flavum rinogona kutungamira kuhukura kubva kuVeuslect plexus.

Vhura-pamusuwo posterior cervical spine yekuvhiya yakatanga kugadzirwa neJapan nyanzvi muma1970s. Kunyangwe zvave zvichivandudzwa kakawanda, kushanda kwekuvhiya kwekuvhiya kuchiri kuwanda kana kuderera kwakafanana uye kwakafanana nekuita kwemusuwo wekushanda kwemusuwo, uye ndeimwe yeiyo cleval cervical spoury yekuvhiya kwespine.

1.open-gonhi rekudenga cervical laminoplasty

Chinyorwa ichi chinobva kuDhipatimendi reKuswerengera kweNunivhesiti yeMiami yeMiami

Murwere akaiswa munharaunda yeMalone, iwo musoro wacho waishandiswa kudhonza mupfudzi wemurwere uye ipapo ganda raizosvitswa kubva kuFascia, uye tsandanyama dzakange dzibve pasi pepamba banga, uye kuchengetedzwa kwemabatiro ezvinyorwa kwakaratidzirwa, uye lignament of the sphenoidal mudzi haafanire kuganhurirwa kuitira kuti udzivise kutendeka kweiyo cervical vertebrae; iyo yepamusoro uye yakaderera kuratidzwa kwakagadzirwa. Iyo yepamusoro uye yakaderera kuratidzwa kwazosvika chikamu chepazasi cheC2 vertebral ndiro uye chikamu chepamusoro cheT1 vertebral Plate Maitiro ezvipenga akarumwa neanotora forceps kugadzirira kusamiswa kwepfupa.

Tevere C3-C7 musuwo wekuvhurwa, sezvakaratidzwa mumufananidzo uri pamusoro, mudenga rekuvhura remukova rakanga riri munzvimbo yemasuwo. Musoro wekunaka musoro wekunwisa musoro wakashandiswa pakuvhurwa kwesuo.

Mushure mekugeda kuburikidza neCortex bilaterally, iyo yakazaruka yemusuwo inoda kucheneswa neyekuputika. Inoshandiswa kuvhura imwe vertebral ndiro diki usati wavhura imwe, wobva wavhura suo, uye nenzira iyi, inogona kudzivirirwa kuti udzivise kupwanyika kwakazara kudivi remasimbe kusvika pakukwira zvakanyanya.

Panofanirwa kuve nekuvapo kushoma kwekumanikidza kushushikana panzvimbo iyo bhuroka rakaiswa pasina kudiwa kwekiriniki

2.Open-gonhi cervical expansle laminoplasty

Ichi chinyorwa, kubva kuDhipatimendi reNeurosurger

Zvikamu zvekuvhiya zvaive zvangoita chete C3-7 kufambisa kwekutumira kwekufamba kweiyo musana; Sphenoidal midzi ligaments yakachengetedzwa kuti ifambise kugadzikana kwechibereko; Iyo yekufananidza musoro yekugaya dhiraivha yakashandiswa kuvhura musuwo kuti uderedze kukuvara kwetambo yemuzongoza; Uye mapapfupa emapfupa akaiswa paC3, 5, uye 7 kutsigira kuvhurwa kwemusuwo.

Cherechedzo Cherechedzo: A, kuratidzwa kweiyo Lamina kubva pasi peC2 kusvika kumusoro kweT1. b, kudhiraivha kweiyo inotevera groove neyechikamu chakazara kune rimwe divi uye chikamu chestio kune rumwe rutivi. c, kukwidziridzwa kweiyo lamina kubva kuC3 kusvika C7 sechimwe chinhu. d, kuiswa kweiyo allograph bone spacer.

Cherechedzo Chinyorwa: Intraoperative View mushure mekudhirowa maburi mune yakazotevera marovha yeC3, C5, uye C7 (a) uye mushure mekuiswa kweiyo allograft mbabvu (b).

Nekudaro, iyo pfuma yayo yemahombekombe, mukuwedzera kune allogeneic pfupa (fig. A), iri vertebral autogenies bighta yakagadzirwa nePolylactic acid, sezvakaratidzwa pazasi (bc fig.), Iyo ishoma kuChina. Panyaya yehupamhi yemusuwo kuvhurika, iyo yakakodzera upamhi inoonekwa se10-15 mm, iyo yakasiana zvishoma kubva ku8-16 mm pamusoro.

Paunenge uchiita imwe yekuvhurwa kwesuo yeiyo vertebral ndiro, kuruma kubva pane iyo nzvimbo yekuvhurika kwemusuwo kunogona kukonzera kubuda ropa, iwe unogona kushandura bilectrocoagation yekumisa kubuda ropa kana glatin chipanje kumisa kubuda ropa.

3.cervical laminoplasty

Kuwedzera pakutsigira bhuroka pamusuwo pekuvhurwa, dzimwe nzira dzekugadzira nhabvu dzakatsanangurwa dzinotsanangurwa mune ino nyaya, iyo nzira yekugadzirisa microplates, iyo inowanzo shandiswa mukuita kwekiriniki uye inopa tsika yakachengeteka.