成人脊柱変形矯正手術の胸椎-腸骨固定術において術中残存するcoronal malalignmentに対してkickstand rod techniqueで追加矯正を行なった3例
はじめに：kickstand rod technique（KRT）はLenkeらが発案した，胸椎-腸骨矯正固定の術中・術後に残存するcoronal malalignment（CM）に対する矯正手技である．今回，腰椎変性後側弯症の術中に，通常の矯正操作後になお残存するCMに対して，KRTにて追加矯正した3例を経験したので報告する．症例：それぞれ73，68，74歳女性で，術前のC7 plumblineとcenter sacral vertical line（C7PL-CSVL）は65，20，33 mmであった．いずれも前方でlateral interbody fusion（LIF）（L2/3-4/...
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| Published in | Journal of Spine Research Vol. 14; no. 2; pp. 93 - 100 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本脊椎脊髄病学会
20.02.2023
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1884-7137 2435-1563 |
| DOI | 10.34371/jspineres.2022-0022 |
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| Abstract | はじめに：kickstand rod technique（KRT）はLenkeらが発案した，胸椎-腸骨矯正固定の術中・術後に残存するcoronal malalignment（CM）に対する矯正手技である．今回，腰椎変性後側弯症の術中に，通常の矯正操作後になお残存するCMに対して，KRTにて追加矯正した3例を経験したので報告する．症例：それぞれ73，68，74歳女性で，術前のC7 plumblineとcenter sacral vertical line（C7PL-CSVL）は65，20，33 mmであった．いずれも前方でlateral interbody fusion（LIF）（L2/3-4/5，L2/3-4/5，L1/2-5/6）を行い，二期的に後方固定（第9胸椎-腸骨）を行った．LIFを施行しなかった下位腰椎-仙椎には後方椎体間固定を行った．通常の矯正操作後の術中X線像でCMの残存を認めたため，KRTで追加矯正した．術後最初の立位X線像でC7PL-CSVLは11，13，18 mmであった．結語：術中に残存するCMに対し，KRTによって追加矯正を行なった3例を経験した．KRTは簡便かつ有用な手技である． |
|---|---|
| AbstractList | はじめに：kickstand rod technique（KRT）はLenkeらが発案した，胸椎-腸骨矯正固定の術中・術後に残存するcoronal malalignment（CM）に対する矯正手技である．今回，腰椎変性後側弯症の術中に，通常の矯正操作後になお残存するCMに対して，KRTにて追加矯正した3例を経験したので報告する．症例：それぞれ73，68，74歳女性で，術前のC7 plumblineとcenter sacral vertical line（C7PL-CSVL）は65，20，33 mmであった．いずれも前方でlateral interbody fusion（LIF）（L2/3-4/5，L2/3-4/5，L1/2-5/6）を行い，二期的に後方固定（第9胸椎-腸骨）を行った．LIFを施行しなかった下位腰椎-仙椎には後方椎体間固定を行った．通常の矯正操作後の術中X線像でCMの残存を認めたため，KRTで追加矯正した．術後最初の立位X線像でC7PL-CSVLは11，13，18 mmであった．結語：術中に残存するCMに対し，KRTによって追加矯正を行なった3例を経験した．KRTは簡便かつ有用な手技である． |
| Author | 谷田, 司明 |
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| References | 4) Ploumis A, Simpson AK, Cha TD, et al: Coronal Spinal Balance in Adult Spine Deformity Patients With Long Spinal Fusions: A Minimum 2- to 5-Year Follow-up Study. J Spinal Disord Tech. 2015; 28 (9): 341-347 8) Buell TJ, Christiansen PA, Nguyen JH, et al: Coronal Correction Using Kickstand Rods for Adult Thoracolumbar/Lumbar Scoliosis: Case Series With Analysis of Early Outcomes and Complications. Oper Neurosurg (Hagerstown). 2020; 19 (4): 403-413 5) Bao H, Yan P, Qiu Y, et al: Coronal imbalance in degenerative lumbar scoliosis: prevalence and influence on surgical decision-making for spine osteotomy. Bone Jt J. 2016; 98-B: 1227-1233 3) Obeid I, Berjano P, Lamartina C, et al: Classification of coronal imbalance in adult scoliosis and spine deformity: a treatment-oriented guideline. European Spine Journal. 2019; 28: 94-113 7) Tanaka N, Ebata S, Oda K, et al: Predictors and Clinical Importance of Postoperative Coronal Malalignment After Surgery to Correct Adult Spinal Deformity. Clin Spine Surg. 2020; 33 (7): E337-E341 6) Glassman SD, Berven S, Bridwell K, et al: Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine (Phila Pa 1976). 2005; 30: 682-688 1) Makhni MC, Cerpa M, Lin JD, et al: The "Kickstand Rod" technique for correction of coronal imbalance in patients with adult spinal deformity: theory and technical considerations. J Spine Surg. 2018; 4 (4): 798-802 9) Redaelli A, Langella F, Dziubak M, et al: Useful and innovative methods for the treatment of postoperative coronal malalignment in adult scoliosis: the "kickstand rod" and "tie rod" procedures. Eur Spine J. 2020; 29 (4): 849-859 2) Makhni MC, Zhang Y, Park PJ, et al: The "kickstand rod" technique for correction of coronal imbalance in patients with adult spinal deformity: initial case series. J Neurosurg Spine. 2020; 32: 415-422 |
| References_xml | – reference: 7) Tanaka N, Ebata S, Oda K, et al: Predictors and Clinical Importance of Postoperative Coronal Malalignment After Surgery to Correct Adult Spinal Deformity. Clin Spine Surg. 2020; 33 (7): E337-E341 – reference: 3) Obeid I, Berjano P, Lamartina C, et al: Classification of coronal imbalance in adult scoliosis and spine deformity: a treatment-oriented guideline. European Spine Journal. 2019; 28: 94-113 – reference: 5) Bao H, Yan P, Qiu Y, et al: Coronal imbalance in degenerative lumbar scoliosis: prevalence and influence on surgical decision-making for spine osteotomy. Bone Jt J. 2016; 98-B: 1227-1233 – reference: 2) Makhni MC, Zhang Y, Park PJ, et al: The "kickstand rod" technique for correction of coronal imbalance in patients with adult spinal deformity: initial case series. J Neurosurg Spine. 2020; 32: 415-422 – reference: 9) Redaelli A, Langella F, Dziubak M, et al: Useful and innovative methods for the treatment of postoperative coronal malalignment in adult scoliosis: the "kickstand rod" and "tie rod" procedures. Eur Spine J. 2020; 29 (4): 849-859 – reference: 4) Ploumis A, Simpson AK, Cha TD, et al: Coronal Spinal Balance in Adult Spine Deformity Patients With Long Spinal Fusions: A Minimum 2- to 5-Year Follow-up Study. J Spinal Disord Tech. 2015; 28 (9): 341-347 – reference: 6) Glassman SD, Berven S, Bridwell K, et al: Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine (Phila Pa 1976). 2005; 30: 682-688 – reference: 1) Makhni MC, Cerpa M, Lin JD, et al: The "Kickstand Rod" technique for correction of coronal imbalance in patients with adult spinal deformity: theory and technical considerations. J Spine Surg. 2018; 4 (4): 798-802 – reference: 8) Buell TJ, Christiansen PA, Nguyen JH, et al: Coronal Correction Using Kickstand Rods for Adult Thoracolumbar/Lumbar Scoliosis: Case Series With Analysis of Early Outcomes and Complications. Oper Neurosurg (Hagerstown). 2020; 19 (4): 403-413 |
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| Title | 成人脊柱変形矯正手術の胸椎-腸骨固定術において術中残存するcoronal malalignmentに対してkickstand rod techniqueで追加矯正を行なった3例 |
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