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Human Musculoskeletal Biomechanics Part 4

Tham khảo tài liệu 'human musculoskeletal biomechanics part 4', kỹ thuật - công nghệ, cơ khí - chế tạo máy phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Motion Preservation and Shock Absorbing in Cervical and Lumbar Spine A New Device for Anterior Cervical Arthroplasty for Anterior or Posterior Lumbar Arthroplasty 51 Artificial Disc Nomenclature 1. Articulation 2. Material 3. Design Picture 2. Cervical spine study group 2004 2. State of art The surgical approach used until now was anterior arthroplasty. For cervical spine the anterior extrapharingal-presternocleidomastoideo approach is a very tested and safe way in reoperation as well pictures 3 4 . The incidence of cervical intraoperative complications Haematoma dysphagia dysphonia are 6.2 late complications ossification dislocation about 5.2 . In cervical spine it is not difficult to convert if needed even in long follow-ups an arthrtoplasty to fusion. Picture 3. Cervical approach position and skin incisions 52 Human Musculoskeletal Biomechanics PREVERTEBRAL LAYER VERTEBRAL ARTERY C5 ANTERIOR LONGITUDINAL LIGAMENT AND VEIN LONGUS COLLI MUSCLE ANTERIOR SCALENE MUSCLE PHRENIC NERVE SYMPATHETIC TRUNK ESOPHAGUS INVESTING LAYER OF CERVICAL FASCIA VISCERAL LAYER OF CERVICAL FASCIA RECURRENT NERVE STERNOHYOID MUSCLE INTERNAL JUGULAR VEIN COMMON CAROTID ARTERY THYROID fibrous capsule VAGUS NERVE STERNOCLEIDOMASTOID MUSCLE MIDDLE LAYER OF CERVICAL FASCIA Picture 4. Cervical approach surgical way For lumbar spine the anterior trans-peritoneal and retroperitoneal approach most used are less safe more in reoperations because of gross vesselles and and nervous plexis attached to the spine even slight dislocation sometime may causes neurological damages or important vascular bleeding. This needs a long learning curve doing the operations with the collaboration of general or vascular surgeons. The conversion arthroplasty-fusion may be very hard in lumbar spine. The heterotopic ossification with consequent block of the prosthesis and intervertebral fusion increases from 12 to 17.8 perioperative non steroid anti-inflammatory therapy FANS and intraoperative wash-out works out to .