MISt MISt MIStLIF MISt MIStMISS-VOICE MISt MISt MISS Voice 2 MISS VOICE vol. 6
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1 Vol.6 成人脊柱変形における M ISt手技の応用 脊椎側方アプローチを用いた成人脊柱変形手術の低侵襲化 Reconstruction with spinal lateral approach for adult deformity 金村 徳相 先生 愛知県厚生連江南厚生病院 脊椎脊髄センター 整形外科 成人脊柱変形におけるMISt手技の応用 荒瀧 慎也 先生 香川労災病院 整形外科 田中 雅人 先生 岡山大学病院 整形外科
2 MISt MISt MIStLIF MISt MIStMISS-VOICE MISt MISt MISS Voice 2 MISS VOICE vol. 6
3 Theme #.1 Reconstruction with spinal lateral approach for adult deformity Lateral lumbar interbody fusionlif Lateral access surgery Adult spinal deformity LIF LIF 1,2) LIFMIStLIF ligamentotaxis 3-6) 7-9) Cobb30 113LIF PS PSPPS Cobb30Cobb LIF2L5/S3 5LIF47 L5/SPLIFTLIFLIF 1PontePLIFTLIF LIF 1/ ) vol. 6 MISS VOICE 3
4 Tip # XCobb28 LL28PI-LL-24 SVA 5.3 cmpt 22TPA 22 LIFPPSViper DePuy Synthes L2/3L3/4L4/52 LL49PI-LL -3 SVA4.8cmPT 12TPA 12 1MRI2 3 1 LIF + PPS 3 () X 1X 2MISt LIF PPS 3 L2/3 L3/4 MRI T2 1MRI T2 MRI T2 1MRI T2 4 MISS VOICE vol. 6
5 JOA15GERDLIF2 XTh12L4Cobb55LL 24 Th10-L cm4lifl1/2l4/5 30LL 62Th10-L228 1Th10 Expedium DePuy Synthes S2AISS1 PS Th1012L5/SPLIF 5113LL 77 Th10-L24PT -2TPA5 4LIF2 X XLIFX 1X S2AISS1 PS vol. 6 MISS VOICE 5
6 LIF PSOVCR Ponte PLIFTLIF LIF LIF LIF LIFPSO VCRPonte LIF LIF T-score 2.8 SD X 18 SVA 17.7 cmtpa 67XLIF4 L1/2 L4/52 Th10 L5/S PLIF LL 53 SVA 2.3 cmtpa 18 LIF115 LIF7 6LIF2 7CTLIFL1 L4 X LIFX X CT CT 6 MISS VOICE vol. 6
7 LIF LIF P S O posterior VCR 2015 LIF LIF T-score 2.9 SDTh1112 Th11Th12 Th10-L2 82 PT 30 SVA 2.2cmTPA 24 2 Th4-L12 PT 21SVA 0.5cmTPA 15 L2/3L3/4 LIF X MRI T2 CT X X CT vol. 6 MISS VOICE 7
8 10 h L2/3L3/4 LIF 2 Th X LIFX X LIF LIF33% LIF % LIF10% ) 8 MISS VOICE vol. 6
9 16) 1 LIF CTLIF 12 12CT CTLIF MISt 13LIFPPS MISt LIF 90 PPS 3 L5/SPLIFTLIF LIF PPS 17) 1) Ozgur, B.M., et al.: Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J. 6 (4): , ) Fujibayashi S, Hynes RA, Otsuki B, et al.: Effect of Indirect Neural Decompression Through Oblique Lateral Interbody Fusion (OLIF) for Degenerative Lumbar Disease. Spine (Phila Pa 1976) Nov 11. [Epub ahead of print] 3) Oliveira, L. et al. A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements. Spine. 35(26 Suppl), 2010, S ) Elowitz, EH. et al. Evaluation of indirect decompression of the lumbar spinal canal following minimally invasive lateral transpsoas interbody fusion: radiographic and outcome analysis. Minim Invasive Neurosurg. 54(5-6), 201-6, ) Castellvi, AE. Indirect decompression of lumbar stenosis with transpsoas interbody cages and percutaneous posterior instrumentation. Clin Orthop Relat Res. 472(6), ) (XLIF/OLIF)Surgical Technique ) Berjano, P., et al.: Far lateral approaches (XLIF) in adult scoliosis. Eur Spine J. 22 Suppl 2: S242-53, ) Phillips, F.M., et al.: Adult degenerative scoliosis treated with XLIF: clinical and radiographical results of a prospective multicenter study with 24-month follow-up. Spine. 38: , ) Baghdadi, Y.M., et al.: Sagittal balance and spinopelvic parameters after lateral lumbar interbody fusion for degenerative scoliosis: a case-control study. Spine (Phila Pa 1976). 39(3): E166-73, ),, XLIF57: , ) XLIFOLIFMB Orthopaedics 28(2): ) Robert K. EastlackXLIF Bone Joint Nerve ),,, extreme lateral interbody fusion(xlif) ) Rodgers WB, Gerber EJ, Patterson J : Intraoperative and early postoperative complications in extreme lateral interbody fusion. An analysis of 600 cases. Spine (Phila Pa 1976) 36 : 26 32, ) Uribe JS et al : Visceral, vascular, and wound complications following over 13,000 lateral interbody fusions: a survey study and literature review. Eur Spine J. 24 (Suppl 3): , ) Regev GJ, al : Morphometric analysis of the ventral nerve roots and retroperitoneal vessels with respect to the minimally invasive lateral approach in normal and deformed spines. Spine (Phila Pa 1976). 34(12): , ),,,, MIS-long fusion vol. 6 MISS VOICE 9
10 Theme #.2 MISt (Minimally Invasive spine Stabilization : MISt) (adult spinal deformity : ASD)MISt MISt ASD MISt ASDMISt ASD Glassman QOL Lafege QOL ASD Schwab500 Xparameter PI-LL<11SVA<47mmPT<22 pelvic incidence(pi) PImatch (lumbar lordosis : LL) PLIF/ TLIFpontecantilever techniquerod rotation techniquecompression and distractiontranslation YadlaASD 41.2% International Spine Study Group963review major complication7.6%4 5 ASD MISt 10 MISS VOICE vol. 6
11 LIF LIF LIF PSOposterior VCR 2015 LIF LIF <LIF> PLIF/TLIF L5/STLIF/ PLIF PPS PPS LIF PI-LLmismatch25 PPS flexible PPS L5/STLIF/PLIFsemi-open PPScanti-lever technique semi-open SAI screw <PPS> SAIcantilever technique sublaminar wiring ASDMISt LLIF PPS OLIF XLIF OLIFO arm Navigation C arm free vol. 6 MISS VOICE 11
12 C-arm free OLIF Navigation OarmCT Navigation ASDL1/2L4/54L1/2L2/3 L3/4L4/5 NavigationL3/4 Navigation NavigationX NavigationL3/4OLIFL4/5OLIF L1/2L2/3 12 MISS VOICE vol. 6
13 PPS + cantilever technique O armctnavigation (Th10Th12)cantilever techniquesemi-opennavigation3pps L1L4PPSL5S2L5/S TLIFSAI screwsemi-openscrewnavigation semi-open SAI screws1screwset screw cantileverscrewrodsai screw cantilever technique screwl1/2l4/5l5/s TLIFsemi-open Navigation vol. 6 MISS VOICE 13
14 64 64 PT 35PI 55 LL 1 PI-LL=54SVA 139mm LIFL1/2-L4/5LL 33 PI-LL=21PPS LL 57PT3512SVA139mm27mm LIFPPSPI-LL mismatch MISS VOICE vol. 6
15 ASD MISt LIF PI-LL mismatch25pps MISt 6 1/2 L4/5LIFL5/S TLIF proximal junctional kyphosis (PJK) MISLATASDalgorithm 7) MISt MISt MISt Glassman SD, et al : The impact of positive sagittal balance in adult spinal deformity. Spine, 30: , 2005 Lafage V, et al : Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine, 34:E599-E606, 2009 Schwab FJ, et al: Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity : a prospective multicenter analysis. Spine, 38:E803-E812, 2013 Yadla S, et al: Adult scoliosis surgery outcomes: a systematic review. Neurosurg Focus, 28(3): E3, 2010 Mummaneni P, et al, 2011 AANS annual meeting Anand N, et al: Mid-term to long-term clinical and functional outcomes of minimally invasive correction and fusion for adults with scoliosis. Neurosurg forcus, 28(3):E6, 2010 Praveen V, et al: The minimally invasive spinal deformity surgery algorithm: a reproducible rational framework for decision making in minimally invasive spinal deformity surgery. Neurosurg Focus, 36(5): E6, 2014 vol. 6 MISS VOICE 15
16 製造販売元ジョンソン エンド ジョンソン株式会社デピューシンセス ジャパンスパイン事業部 東京都千代田区西神田 3 丁目 5 番 2 号 T depuysynthes.jp 販売 : VIPER2スパインシス 番号 : 22400BZX 販売 : VIPER2セ 番号 : 13B1X00204DS0052 販売 : Viper イド イ ー 番号 : 223ADBZX 販売 : VIPER3Dセ 番号 : 13B1X00204DS0058 販売 : T-PALシス 番号 : 22500BZX 販売 : T-PALセ 番号 : 13B1X00204SS0028 販売 : Expedium Plus スパインシス 番号 : 22500BZX 販売 : Expediumセ 番号 : 13B1X00204DS0026 販売 : CoRoent XL PEEK ージシス 番号 : 22500BZX 製造販売元 : ュー イシ ジャパン株式会社販売 : ススス ーション ーションシス 番号 : 22600BZX 製造販売元 : ド 株式会社 J&J K.K DSSJ306M NK
MISS Voice 4 MISt QOL (PPS) MISt MISt MISS Voice Theme #.1 Minimally Invasive Spine Stabilization: MISt 2005 MISt ADL QOL MISt MIS
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