Iimpazamo zesigulane sotyando kunye nesayithi zinzulu kwaye zinokuthintelwa. Ngokutsho kweKomishoni eHlangeneyo yokuVunywa kweMibutho yezeMpilo, iimpazamo ezinjalo zingenziwa ukuya kuthi ga kwi-41% yotyando lwamathambo / lwabantwana. Ngokuhlinzwa komqolo, impazamo yendawo yotyando iyenzeka xa icandelo le-vertebral okanye i-lateralization ingalunganga. Ngaphandle kokungaphumeleli ukujongana neempawu zesigulane kunye ne-pathology, iimpazamo zecandelo zingakhokelela kwiingxaki ezintsha zonyango ezifana nokukhawuleza kwe-disc degeneration okanye ukungazinzi komgogodla kwezinye iindawo ezingabonakaliyo okanye eziqhelekileyo.
Kukwakho nemiba esemthethweni enxulumene neempazamo zamacandelo kuqhaqho lomnqonqo, kwaye uluntu, iiarhente zikarhulumente, izibhedlele, kunye nemibutho yoogqirha abanazo ukunyamezela iimpazamo ezinjalo. Utyando oluninzi lomgogodla, olufana ne-discectomy, i-fusion, i-laminectomy decompression, kunye ne-kyphoplasty, lwenziwa ngokusetyenziswa kwendlela yangasemva, kwaye ukubeka ngokufanelekileyo kubalulekile. Nangona iteknoloji ye-imaging yangoku, iimpazamo zecandelo zisenzeka, kunye namazinga eziganeko ukusuka kwi-0.032% ukuya kwi-15% echazwe kwiincwadi. Akukho sigqibo malunga nokuba yeyiphi indlela yokwenziwa kwendawo echanekileyo kakhulu.
Abaphengululi beSebe le-Orthopedic Surgery kwiNtaba yeSinayi yeSikole sezoNyango, eU.SA, baqhube uphando lwemibuzo ye-intanethi ebonisa ukuba uninzi lwabagqirha botyando basebenzise iindlela ezimbalwa kuphela zendawo, kwaye ukucaciswa kwezizathu eziqhelekileyo zephutha kunokusebenza ukunciphisa iimpazamo zecandelo lotyando, kwinqaku elipapashwe ngoMeyi 2014 kwi-Spine J. Uphononongo lwenziwe kusetyenziswa i-questionnaire ethunyelwe nge-imeyile. Uphononongo lwenziwe kusetyenziswa ikhonkco le-imeyile kwi-questionnaire ethunyelwe kumalungu e-North American Spine Society (kubandakanywa noogqirha bamathambo kunye ne-neurosurgeons). Uluhlu lwemibuzo lwathunyelwa kube kanye kuphela, njengoko kunconyiwe nguMbutho waseMntla waseMelika. I-totali yama-2338 oogqirha bayifumene, i-532 yavula ikhonkco, kwaye i-173 (i-7.4% izinga lokuphendula) yagqiba i-questionnaire. Amashumi asixhenxe anesibini ekhulwini abazalisi babengoogqirha bamathambo, i-28% yayingama-neurosurgeons, kwaye i-73% yayingamagqirha omqolo ekuqeqesheni.
I-questionnaire iqulethwe yimibuzo ye-8 (umzobo 1) equka iindlela ezisetyenziswa ngokuqhelekileyo zendawo (zombini iimpawu ze-anatomical kunye ne-imaging localization), iziganeko zeempazamo zecandelo lotyando, kunye nobudlelwane phakathi kweendlela zendawo kunye neempazamo zecandelo. Uluhlu lwemibuzo alukhange luvavanywe okanye luqinisekiswe. Uluhlu lwemibuzo luvumela ukhetho lweempendulo ezininzi.
Umfanekiso 1 Imibuzo esibhozo kwikhweshine. Iziphumo zibonise ukuba i-fluoroscopy ye-intraoperative yayiyeyona ndlela isetyenziswa ngokuqhelekileyo kwindawo yokuhlinzwa kwe-thoracic kunye ne-lumbar spine (89% kunye ne-86%, ngokulandelanayo), ilandelwa yi-radiographs (54% kunye ne-58%, ngokulandelanayo). Oogqirha abangama-76 bakhetha ukusebenzisa indibaniselwano yeendlela zombini zokwabiwa kwendawo. Iinkqubo ze-spinous kunye ne-pedicles ezihambelanayo zizinto eziqhelekileyo ezisetyenziselwa ukuhlinzwa kwe-thoracic kunye ne-lumbar spine (67% kunye ne-59%), elandelwa yinkqubo ye-spinous (49% kunye ne-52%) (umzobo 2). I-68% yoogqirha bavuma ukuba baye benza iimpazamo zendawo zendawo ekusebenzeni kwabo, ezinye zazo zalungiswa ngokungahambi kakuhle (umzobo 3).
Umzobo 2 Ukwenziwa komfanekiso kunye neendlela zokwenziwa kwendawo eziphawulweyo ze-anatomical ezisetyenzisiweyo.
Umzobo 3 Ugqirha kunye nokulungiswa kwe-intraoperative yeempazamo zecandelo lotyando.
Ngeempazamo zendawo, i-56% yala magqirha asebenzisa i-radiographs yangaphambili kunye ne-44% isebenzisa i-intraoperative fluoroscopy. Izizathu eziqhelekileyo zeempazamo zokubeka indawo yangaphambili kwakungaphumeleli ukujonga indawo yesalathiso eyaziwayo (umzekelo, i-sacral spine ayizange ifakwe kwi-MRI), ukuhluka kwe-anatomical (i-lumbar displaced vertebrae okanye i-13-root ribs), kunye nokungaqondakali kwecandelo ngenxa yesigulane somzimba wesigulane. imeko (umboniso we-X-reyi onganeno kakhulu). Izizathu eziqhelekileyo zeempazamo zokubeka i-intraoperative zibandakanya unxibelelwano olunganelanga kunye ne-fluoroscopist, ukungaphumeleli kokubuyisela emva kokumiswa (ukunyakaza kwenaliti yokumisa emva kwe-fluoroscopy), kunye namanqaku okubhekisela okungalunganga ngexesha lokubeka (i-lumbar 3/4 ukusuka kwiimbambo phantsi) (Umfanekiso 4).
Umzobo we-4 Izizathu zeempazamo zangaphambili kunye ne-intraoperative localization.
Ezi ziphumo zingentla zibonisa ukuba nangona kukho iindlela ezininzi zendawo, uninzi lwabagqirha basebenzisa ezimbalwa zazo. Nangona iimpazamo zecandelo lotyando zinqabile, ngokufanelekileyo azikho. Akukho ndlela isemgangathweni yokuphelisa ezi mpazamo; nangona kunjalo, ukuthatha ixesha lokwenza indawo kunye nokuchonga izizathu eziqhelekileyo zokubeka iimpazamo kunokunceda ukunciphisa iziganeko zeempazamo zecandelo lotyando kwi-thoracolumbar spine.
Ixesha lokuposa: Jul-24-2024
