OLIF Hybrid PF 2012 OLIF 1, 2 OLIF OLIF OLIF Open Hybrid Rigidity, Single stage Two-stage MIS 1, 2 MIS Sagittal Adjusting Screw SAS + LONGITUDE II Dir

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1 OLIF Hybrid PF CLYDESDALE Spinal System CAPSTONE PTC Spinal System Gary K. Michelson, M.D.

2 OLIF Hybrid PF 2012 OLIF 1, 2 OLIF OLIF OLIF Open Hybrid Rigidity, Single stage Two-stage MIS 1, 2 MIS Sagittal Adjusting Screw SAS + LONGITUDE II Direct lordotic correction Open MIS cantilever Hybrid PF OLIF Hybrid PF Our Surgical Options for Anterior and Posterior Approach in ASD from 2012 Anterior Multiple OLIF Corpectomy Anterior Osteotomy All with OLIF retractor Posterior Percutaneous PF -Pure MISt Hybrid PF -Partially open for Th or Lumbosacral area Full Open PF -Often w/ Osteotomy Single or Two-stage Surgery according to Curve Severity and Spinal Imbalance 1 OLIF25 Direct lordotic correction Sagittal Adjusting Screw SAS LONGITUDE II 1 1

3 1. OLIF 3.5cm L1/2 L4/5 4 OLIF O-arm StealthStation S7 C-arm OLIF 2 Reference frame OLIF Navigated shaver CLYDESDALE L3/4, 4/5 12mm 4 OLIF 100ml 2 2. Sagittal Adjusting Screw SAS +LONGITUDE II Hybrid PF mm Modified CBT mcbt 3 4 CBT Anterior load-sharing mcbt Hybrid PF Open L1 L4 mcbt 3 L5,S1 mcbt S2 Alar Iliac Screw SAI Open 18 CAPSTONE CONTROL L5/S1 TLIF 3 Cephalad Caudal 2

4 Extender 4 Extender Direct lordotic correction 5 Extender Extender SAI Approximation Extender Cantilever engage OLIF Open Ponte osteotomy Open Hybrid PF 6 Cephalad Caudal

5 症例提示症例1 69歳女性変性側弯症立位保持障害を伴う高度腰痛下肢痛しびれを呈していた術前LL14度であったが Global balanceは比較的保たれていた一期的なL1-5 OLIF, Hybrid PF L1-S2 を行った総手術時間342分総出血150ml LL52度と良好な矯正が得られた 4

6 症例提示症例2 78歳女性冠状面バランス異常を伴う変性側弯症 CVA 123mm, SVA 136mm, LL26度であった二期的なL1-5 OLIFとT10-S2 Hybrid PFを行った総手術時間426分総出血225ml LL62度で良好な冠状面矢状面矯正が低侵襲に得られた症例3 77歳女性成人後側弯症立位保持障害を伴う高度腰痛とGERDを呈していた SVA202mm, LL19度であった二期的なL1-4 OLIFとT6-S2 Hybrid PF w/ L5/S1 Ponte osteotomyを行った総手術時間536分総出血235ml 良好な体幹バランスの矯正と前弯形成が得られた LL58度 5

7 OLIF Spinal imbalance 5 GERD cc cc Cobb 29 9 CVA SVA 28mm 110mm 13mm 50mm pullout PJ K DJK 5 OLIF 2 MMT JOABPEQ 60 LL SAS OLIF MISt Hybrid PF Global imbalance 1 2nd stage Global balance MIS Hybrid OLIF L5/S1OLIF OLIF51 Device 1. Kotani Y, Gonchar I, et al, Clinical results of first Japanese experience in combined OLIF and posterior MIS approach for adult spinal deformities. Society of Minimally Invasive Spine Surgery SMISS, Global Forum 2014, Miami, FL, USA 2.. OLIF MIS J Spine Research 6, 383, CBT 100 PS J Spine Research 6, 633, Kotani Y, Gonchar I, Hamasaki M, Fujita R, Fukaya H, Masuko T. Experience of 160 Consecutive Spine Reconstructions using Modified Cortical Bone Trajectory mcbt screws vs Traditional Pedicle Screws. SMISS 2015 Global Forum, Las Vegas, USA, Nov 6-7,

8 27B1X KM TEL FAX 札幌 TEL FAX 仙台 TEL FAX 埼玉 TEL FAX 東京 TEL FAX 横浜 TEL FAX 名古屋 TEL FAX 金沢 TEL FAX 京都 TEL FAX 大阪 TEL FAX 岡山 TEL FAX 福岡 TEL FAX : CLYDESDALE 22300BZX CDH SOLERA LONGITUDE 22600BZX CAPSTONE CONTROL : BZX : 22600BZX O-arm : 224ABBZX Nav : 13B1X00261S00001 : 223ACBZX MLITHYBWP16J 2016 Medtronic Sofamor Danek USA, Inc. All Rights Reserved. MO#### GD No.1 M

MISS Voice 4 MISt QOL (PPS) MISt MISt MISS Voice Theme #.1 Minimally Invasive Spine Stabilization: MISt 2005 MISt ADL QOL MISt MIS

Vol.4 MISt (Minimally Invasive Spine Stabilization: MISt ) MISt MISS Voice 4 MISt QOL (PPS) MISt MISt http://mist.umin.jp MISS Voice Theme #.1 Minimally Invasive Spine Stabilization: MISt 2005 MISt ADL