Kev ua yuam kev ntawm tus neeg mob thiab qhov chaw phais yog qhov loj heev thiab tuaj yeem tiv thaiv tau. Raws li Pawg Neeg Saib Xyuas Kev Pom Zoo ntawm Cov Koom Haum Kho Mob, cov kev ua yuam kev no tuaj yeem ua rau txog li 41% ntawm kev phais pob txha/poj niam. Rau kev phais pob txha caj qaum, qhov yuam kev ntawm qhov chaw phais tshwm sim thaum ntu vertebral lossis lateralization tsis raug. Ntxiv nrog rau kev tsis daws cov tsos mob thiab kab mob ntawm tus neeg mob, qhov yuam kev segmental tuaj yeem ua rau muaj teeb meem kev kho mob tshiab xws li kev puas tsuaj sai ntawm disc lossis kev tsis ruaj khov ntawm pob txha caj qaum hauv lwm qhov tsis muaj tsos mob lossis cov ntu ib txwm muaj.
Kuj tseem muaj teeb meem kev cai lij choj cuam tshuam nrog kev ua yuam kev segmental hauv kev phais pob txha caj qaum, thiab pej xeem, cov koom haum tsoomfwv, tsev kho mob, thiab cov koom haum ntawm cov kws phais tsis muaj kev zam txim rau cov kev ua yuam kev no. Ntau qhov kev phais pob txha caj qaum, xws li discectomy, fusion, laminectomy decompression, thiab kyphoplasty, yog ua los ntawm kev siv txoj hauv kev posterior, thiab kev tso kom raug yog qhov tseem ceeb. Txawm hais tias muaj cov thev naus laus zis tam sim no, kev ua yuam kev segmental tseem tshwm sim, nrog rau cov nqi tshwm sim ntawm 0.032% txog 15% tau tshaj tawm hauv cov ntaub ntawv. Tsis muaj qhov xaus lus txog txoj kev twg ntawm qhov chaw yog qhov tseeb tshaj plaws.
Cov kws tshawb fawb los ntawm Lub Tsev Haujlwm Saib Xyuas Kev Phais Pob Qij Txha ntawm Mount Sinai Tsev Kawm Ntawv Kho Mob, Tebchaws Meskas, tau ua ib txoj kev tshawb fawb hauv online uas qhia tias feem ntau ntawm cov kws phais pob qij txha tsuas yog siv ob peb txoj hauv kev los ua qhov chaw, thiab kev piav qhia txog cov laj thawj ntawm qhov yuam kev ib txwm muaj tuaj yeem ua tau zoo hauv kev txo cov kev ua yuam kev phais, hauv ib tsab xov xwm luam tawm lub Tsib Hlis 2014 hauv Spine J. Kev tshawb fawb tau ua los ntawm kev siv daim ntawv nug email. Kev tshawb fawb tau ua los ntawm kev siv qhov txuas email mus rau daim ntawv nug xa mus rau cov tswv cuab ntawm North American Spine Society (suav nrog cov kws phais pob qij txha thiab cov kws phais hlwb). Daim ntawv nug tau xa ib zaug xwb, raws li North American Spine Society pom zoo. Tag nrho ntawm 2338 tus kws kho mob tau txais nws, 532 qhib qhov txuas, thiab 173 (7.4% tus nqi teb) ua tiav daim ntawv nug. Xya caum ob feem pua ntawm cov neeg ua tiav yog cov kws phais pob qij txha, 28% yog cov kws phais hlwb, thiab 73% yog cov kws kho pob qij txha uas tau kawm.
Daim ntawv nug muaj tag nrho 8 lo lus nug (Daim Duab 1) uas hais txog cov txheej txheem siv ntau tshaj plaws ntawm kev teeb tsa qhov chaw (ob qho tib si anatomical markings thiab imaging localization), qhov tshwm sim ntawm kev phais mob segmental errors, thiab kev sib raug zoo ntawm cov txheej txheem ntawm kev teeb tsa qhov chaw thiab kev teeb tsa qhov chaw. Daim ntawv nug tsis tau sim lossis lees paub. Daim ntawv nug tso cai rau ntau txoj kev xaiv lus teb.
Daim Duab 1 Yim lo lus nug los ntawm daim ntawv nug. Cov txiaj ntsig tau qhia tias kev siv fluoroscopy thaum lub sijhawm phais yog txoj kev siv ntau tshaj plaws ntawm kev kho qhov chaw rau kev phais mob posterior thoracic thiab lumbar spine (89% thiab 86%, feem), ua raws li kev thaij duab xoo hluav taws xob (54% thiab 58%, feem). 76 tus kws kho mob tau xaiv siv kev sib xyaw ua ke ntawm ob txoj kev rau kev kho qhov chaw. Cov txheej txheem spinous thiab cov pedicles sib xws yog cov cim anatomic feem ntau siv rau kev phais mob thoracic thiab lumbar spine (67% thiab 59%), ua raws li cov txheej txheem spinous (49% thiab 52%) (Daim Duab 2). 68% ntawm cov kws kho mob lees tias lawv tau ua qhov yuam kev segmental localization hauv lawv txoj kev xyaum, qee qhov tau kho thaum lub sijhawm phais (Daim Duab 3).
Daim Duab 2 Siv cov duab thaij thiab cov txheej txheem qhia txog qhov chaw ntawm lub cev.
Daim Duab 3 Kev kho qhov yuam kev ntawm ntu phais mob ntawm kws kho mob thiab thaum phais.
Rau qhov yuam kev ntawm qhov chaw, 56% ntawm cov kws kho mob no siv cov duab xoo ua ntej phais thiab 44% siv kev siv fluoroscopy thaum phais. Cov laj thawj feem ntau rau qhov yuam kev ua ntej phais yog tsis pom qhov chaw siv tau (piv txwv li, tus txha nqaj qaum sacral tsis suav nrog hauv MRI), kev hloov pauv ntawm lub cev (vertebrae lumbar displaced lossis 13-root ribs), thiab kev tsis meej pem ntawm tus neeg mob lub cev (kev tso saib X-ray tsis zoo). Cov laj thawj feem ntau ntawm qhov yuam kev ua thaum phais suav nrog kev sib txuas lus tsis txaus nrog tus kws kho fluoroscopist, tsis hloov chaw tom qab kho (txav ntawm rab koob kho tom qab fluoroscopy), thiab cov chaw siv tsis raug thaum kho (lumbar 3/4 ntawm cov tav qis) (Daim Duab 4).
Daim Duab 4. Vim li cas ho muaj qhov yuam kev ua ntej thiab thaum phais.
Cov txiaj ntsig saum toj no qhia tau tias txawm hais tias muaj ntau txoj hauv kev los kho qhov chaw, feem ntau ntawm cov kws phais tsuas yog siv ob peb txoj hauv kev xwb. Txawm hais tias qhov yuam kev phais mob tsis tshua muaj, qhov zoo tshaj plaws yog tias lawv tsis muaj. Tsis muaj txoj hauv kev ib txwm los tshem tawm cov yuam kev no; txawm li cas los xij, siv sijhawm los ua qhov chaw thiab txheeb xyuas cov laj thawj ib txwm ntawm qhov yuam kev tuaj yeem pab txo qhov tshwm sim ntawm kev phais mob segmental hauv tus txha nqaj qaum thoracolumbar.
Lub sijhawm tshaj tawm: Lub Xya Hli-24-2024
