Impinduramatwara Nkuru muri Pinhole Ntoya - Byuzuye Amashusho Yumugongo Endoscopi

Vuba aha, Dr. Cong Yu, Umuyobozi wungirije w’umuganga w’ishami ry’amagufwa mu bitaro bikuru bikuru by’iburasirazuba, yakoreye Bwana Zong "kubaga umugongo endoskopi". Kubaga byibasiye cyane byafashaga Bwana Zong, wari urwaye indwara y'uruti rw'umugongo, gukira vuba no gusubira ku kazi nyuma gato yo kubagwa.

Ntabwo nigeze ntekereza ko ingaruka zo kubaga zizaba nziza. Numvaga byoroshye kugabanya ihungabana ry'imitsi mu gihe cyo kubagwa, "ibi bikaba byavuzwe na Bwana Zong w'imyaka 56 yishimye.

Bivugwa ko Bwana Zong yari afite ibimenyetso byo kubabara umugongo no ku kuguru mu myaka 5 ishize. Nyuma yo gusura abaganga bazwi ahantu hatandukanye, abahanga bahurije hamwe bamusaba kumuvura. Kubera gutinya kubagwa, ubuzima bwa Bwana Zong bwadindijwe inshuro nyinshi. Amezi atatu ashize, ububabare bwo mu mugongo bwongeye kwiyongera, buherekejwe n'ububabare butihanganirwa mu gihimba cyo hepfo cy'ibumoso. Ntiyashoboye kugenda kandi ntashobora gusinzira mubabaro nubwo yaryamye, ntibyakwihanganirwa. Yongeye kwivuriza mu bitaro byinshi, yizeye ko azavurwa bitagoranye ibimenyetso bye bitamworoheye. Amaherezo, yaje ku ivuriro ry’inzobere mu kubaga umugongo kwa Dr. Congyu, inzobere mu magufa mu bitaro bikuru by’iburasirazuba bikuru kugira ngo avurwe. Nyuma yo kwakira umurwayi, Dr. Cong Yu yasesenguye ibimenyetso bya Bwana Zong, ibimenyetso, hamwe n’amakuru yerekana amashusho, maze asuzuma indwara ya disiki yo mu mutwe hamwe na stenosis. Ashingiye ku miterere ya Bwana Zong n'ubushake bwe bwo kuvurwa, yinjiye mu karere ka orthopedie 23.

Nyuma yo kwemererwa, isuzuma ry'umubiri ryerekanye ko Bwana Zong yari afite ubwuzu mu gace ka paraspinal kuva L5 kugeza kuri S1, akaba afite imbogamizi zikomeye mu kugenda no mu mitsi yo hepfo. Ikizamini cyo kuzamura amaguru mbere yo gutangira cyari 20 ° gusa, kandi imbaraga z'imitsi y'amano y'ibumoso nazo zagize ingaruka.

Ku bijyanye n'imiterere ya Bwana Zong, Umuyobozi Cong Yu yasesenguye ko nucleus pulposus izwi cyane hamwe no gukwirakwiza osteophyte igabanya imitsi yo mu muyoboro w’umugongo, bikavamo ibimenyetso nko kubabara umugongo no ku kuguru, kunanirwa, no kugabanuka kw’ingingo zo hasi. Gusa mugukuraho kwikuramo imitsi gusa dushobora kwirinda ko kwiyongera kwangirika kwimitsi no gutanga ibisabwa kugirango imikorere yimitsi ikire. Niba uburyo bwa gakondo bwo kubaga bwakoreshejwe, birakenewe kuvanaho imitsi ya parasipine, kandi kubagwa ni binini, hamwe no kuva amaraso menshi mu nda ndetse nigihe kinini cyo gukira nyuma yo kubagwa.

Nyuma yo gutumanaho bihagije no kwitegura mbere yo gutangira, Dr. Cong Yu yarangije neza kubaga munsi ya anesthesi yaho akoresheje "Byuzuye Visualization Spinal Endoscopy Technology (Ndabona)". Mu gihe cyo kubagwa, Bwana Zong yashoboraga kubona neza ububabare bwazanywe no gukuraho nucleus pulposus isohoka. Igihe cyo kubagwa cyari kigufi, gutemwa byari milimetero 7 gusa, kandi nta mazi yabaga nyuma yo kubagwa. Yashoboye kuzenguruka ku munsi wa kabiri nyuma yo kubagwa, twavuga ko ari "pinhole ntoya ikemura ikibazo gikomeye".

Kuvura byibuze indwara zifata uruti rwumugongo mu ishami ryamagufwa ryibitaro bikuru byiburasirazuba bikuru ni ibintu byumwuga. Tekinike yibasiwe cyane nka intervertebral foramen endoscopy, UBE, na MisTLIF zagiye zikorwa buri gihe, zifatanije nisuzuma ryihariye ryimiterere yumurwayi, kugirango batange ubundi buryo bwo kuvura kubaga. Tuzakomeza kandi gukoresha tekinoroji yibasiwe cyane kugirango dutange serivisi nziza zubuvuzi, ziteye imbere, kandi zinoze kubaturage muri rusange.

Kubyerekeranye na Visualisation Yuzuye ya Spinal Endoscopy Ikoranabuhanga (Ndabona Ikoranabuhanga)

Kubaga umugongo byibuze (MISS) bivuga tekinoroji nuburyo bwo gusuzuma no kuvura indwara zumugongo hakoreshejwe uburyo budasanzwe bwo kubaga no gukoresha ibikoresho byihariye byo kubaga, ibikoresho, cyangwa uburyo. Yagaragaye hamwe no gukoresha tekinoroji yubuvuzi yateye imbere, tekinoloji yubuhanga ikomeje kwigaragaza, kandi tekinike yibasiye cyane iratangaje. Hano hari igikoresho gikomeye muri arsenal nini ya MISS, ni percutaneous endoscopic lumbar discectomy (PELD), mu magambo ahinnye nka endoscope intervertebral foramen.

Ishuri gakondo rya intervertebral foramen endoscopy tekinoloji yateye imbere kuva mubitekerezo byo gutabara, bityo rero inzira yo gushyira imiyoboro ya pucure hamwe no gushiraho imiyoboro ihanitse ishingiye cyane kuri X-ray fluoroscopi kugirango isobanure neza umwanya uriho, bikaba bitoroshye kandi bigira ingaruka zikomeye kubarwayi no kubaga hakoreshejwe imirasire ya X.

Kandi Ndabona ikoranabuhanga, rizwi kandi nka tekinoroji yuzuye ya spinal endoscopique, ituma umuntu ashobora kubona mu buryo butaziguye imiterere ya foramen ihuza imiterere ya endoskopi, bikagabanya cyane umubare wibitekerezo ndetse bikagera no kuri 1-2. Ikiranga iryo koranabuhanga ni ihinduka rya filozofiya yo kubaga: gukoresha kubaga endoskopique nk'uburyo bwo kubaga, kugera kuri endoskopi nziza yo kubaga. Kureka ibibi bya gakondo ya intervertebral foramen endoscopic intervention kubaga bisaba fluoroscopi inshuro nyinshi.

Muri rusange, ibyiza byo kureba neza tekinoroji ya spinal endoscopique (Ndabona ikoranabuhanga) nibi bikurikira:

1. Kugabanya cyane X-ray fluoroscopi mugihe cyo kubagwa, kugabanya igihe cyo kubaga, kunoza umutekano wo kubaga, no kurinda abarwayi nabaganga;

2. Anesteziya yaho irashobora gukoreshwa, iroroshye, hamwe no kubagwa munsi ya santimetero 1 no kuva amaraso make. Irashobora kwibasirwa cyane kandi ntisaba amazi nyuma yo kubagwa. Ku munsi wa kabiri nyuma yo kubagwa, umurwayi arashobora kugenda no gusohoka, kugabanya ibitaro no kwemerera umurwayi gusubira mu buzima no gukora vuba;

3. Yabitse ibice byo mu ruti rw'umugongo; Kutangiza ingingo zo mu gihimba, kwirinda ihungabana nyuma yo kubagwa ibice bijyanye no kubaga;

4. Iri koranabuhanga ritanga amahirwe yo kuvura abarwayi benshi badashobora kwihanganira kubagwa kumugaragaro cyangwa anesteziya rusange (abarwayi bageze mu zabukuru, abafite uburwayi bukomeye bwibanze);

5. Igiciro gito, igiciro gito, kuzigama cyane amafaranga yubwishingizi bwubuvuzi.