Memory Alloy Rod Spinal Orthopedics
Treatment of diseases: spinal deformity scoliosis Indication Memory alloy rod spine orthopedics are suitable for: 1, non-surgical treatment is ineffective, spinal deformity continues to increase patients need surgery. Because spinal fusion will hinder the growth of the length of the spine, if the spinal deformity is not serious or non-surgical treatment can control the development of the deformity, the time of surgical fusion should be delayed as far as possible to the mature stage of the spine. However, due to thoracic scoliosis, secondary rib thoracic deformity may have a greater impact on cardiopulmonary function, and the appearance of deformity is obvious. Thoracic deformity is limited by the ribs and surrounding structures, and the effect of surgical orthopedics is poor, so early surgical treatment should be considered. 2. Young patients with obvious scoliosis deformity. In general, the obvious scoliosis refers to the lateral curvature of 40 ° ~ 45 ° before the developmental maturity, and the lateral curvature of the mature period of 50 ° ~ 60 °, and those who continue to develop should be actively treated. Surgical treatment can not be measured only by Cobb angle, other factors must be considered, the patient's age, growth ability and the possibility of scoliosis development. Preoperative preparation The memory alloy rod of the corresponding length should be selected according to the length of the scoliosis over the length of the upper and lower neutral vertebral bodies 1 to 2 knots. The spare memory alloy rod and the anti-rotation card are wrapped in a sterile towel, and after high-pressure steam sterilization, the outer plastic wrap is wrapped and placed in a low-temperature refrigerator for use. Surgical procedure 1. Fixed memory alloy rod Take the memory alloy rod out of the refrigerator for use. A thick Kirschner wire was taken out and bent according to the curvature of the scoliosis. The upper and lower ends of the memory stick are separated, and the two memory alloy rods are respectively bent and formed according to the curvature of the bent K-wire. Then place the memory stick on the lamina (do not reverse the left and right side bars), place the anti-rotation card at the proximal end of the rod, and fix the upper ends of the rods with steel wires to prevent the anti-rotation card from falling off. Then tighten the pairs of wires in order to secure the memory rod to the lamina. After the wire is tightened, the excess wire is cut short and the wire end is flattened. 2, memory alloy rod heating method Dip the gauze pad into hot salt water at 60 °C isotonic saline, wring the gauze pad after soaking (avoid hot salt water flowing into the epidural space), and cover it on the memory alloy rod that has been fixed on the lamina, try to make it close Sticking together. Cover 2 to 3 layers of gauze pads to maintain temperature. During the heating process, the surgeon pushes the torso with a three-point compression method to help the spine orthosis. After 5-6 minutes, the hot saline gauze pad needs to be replaced, and the orthodontic condition of the memory alloy rod is observed until the orthopedic shape is satisfied. 3, bone graft Due to the arc incision in the posterior superior iliac spine, the soft tissue of the posterior iliac spine and the periosteum of the iliac crest were pushed open, and the cancellous ligament was implanted on the lamina of the memory alloy rod. If rib orthopedic surgery is performed at the same time, rib bone strips can also be used for bone grafting. After adequate hemostasis, the soft tissue layers are sutured layer by layer.
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