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 QOL MISt MISt 2 MISS VOICE vol. 4
SRE RT total en-block spondylectomy TES 1)2) instrumentation TES 2005 screw MISt 3-11) screwmist 4. ( RT ).. Contamination,. MISt.. rod. RT MISt SINS 12) ( 1) RT SINS 12) 1 SINS SINS Compornent Score Location Junctional (Occiput-C2, C7-T2, T11-L5, L5-S1) 3 Mobile spine (C3-6, L2-4) 2 Semirigid (T3-10) 1 Rigid (S2-5) 0 Pain Yes 3 Occasional pain but not mechanical 1 Pain-free lesion 0 Bone lesion Lytic 2 Mixed (lytic/blastic) 1 Blastic 0 Radiographic spinal alignment Subluxation/translation present 4 De novo deformity (kyphosis/scoliosis) 2 Normal alignment 0 Vertebral body collapse 50% collapse 3 50% collapse 2 No collapse with 50% body involved 1 None of the above 0 Posterolateral involvement of spinal elements Bilateral 3 Unilateral 1 None of the above 0 A score of 0 to 6 denotes stability, 7 to 12 denotes indeterminate (possibly impending) instability, and 13 to 18 denotes instability. vol. 4 MISS VOICE 3
Tip #.1 MISt 1 long fusion MRI CT screw screw screw mini-open 2 3 X 4 5 6 finger navigation BKP tapping screw 7 screw extender switchback technique 8 9 screw head screw 4 MISS VOICE vol. 4
1 PPS(Percutaneous Pedicle Screw) MIS Screw SAILong Fusion Screw OPEN Screw 2 X vol. 4 MISS VOICE 5
Tip #.1 2014 4 2016 721 MISt12 9 64 41 79 5SRE 16 6.5 1 21 7 QOL 7 PS Performance Status ADL 13 RT RT 2 16 5 64 (41 79 ) 65 (57 76 ) 8 8 4 1 7.4 (1 21 ) 2.4 (2 4 ) score 8.4 8 score 5.7 6.2 score 3.9 5.4 SINS score 10.3 10.8 192 161 132g 136g 6.9 6.2 4.2 2.2 7 0 Performance Status 3.4 2.5 Frankel E 7/16 5/5 6 MISS VOICE vol. 4
1 63 1 T7-8 C7-T3 C3-L2 MIS-PLF mini-open PS PPS PPS T7-8 6 30 210g2RT 4 3 vol. 4 MISS VOICE 7
2 41 L3 L1-5 MIS-PLF 1 52 10g RT 18 screw RT L3 4 8 MISS VOICE vol. 4
3 76 T6-12 MIS-PLF 1 55 50g 2 RT 5 MISt MISt ADL QOL MISt 1) Tomita K, et al. : Total en block spondylectomy for solitary spinal metastasis. Int Orthop, 18: 291-298, 1994. 2),. :., 55: 1113-1118, 2012. 3),. :. J MIOS, 68:27-34, 2013. 4),. :. J MIOS, 68:49-59, 2013. 5),. : Minimally Invasive spine Stabilization: MISt. J MIOS, 68: 61-67,2013. 6),. : (MISt)., 55: 1095-1101, 2012. 7),. :. Journal of Spine Research, 2-4: 872-875, 2011. 8). : MISt - -. Modern Physician., 31-9: 1091-1094, 2011. 9),. : MISt. J.Spine Res., 1: 1475-1480, 2010. 10),. : MIS-TLIF., 24-6: 623-627, 2011. 11). : MISt. J MIOS, 68:77-83, 2013. 12) Fisher CG,et al. : A novel classification system for spinal instability in neoplastic disease. SPINE, 35:1221-1229, 2010. vol. 4 MISS VOICE 9
Theme #.2 M I S t Minimally Invasive Spine Stabilization minimally invasive spine stabilization(mist) MISS VOiCE ~ 4 MISt 1) MISt AO/OTA1 2) scoring system load sharing classification 3) Thoracolumbar Injury Classification System(TLICS) 1 4) 1-a AO/OTA typea 1-b AO/OTA typeb 10 MISS VOICE vol. 4
1-c AO/OTA typec 1 TLICS 1 2 / 3 4 0 1 3 2 3 0 / 2 3 TLICS 54 TLICS 3 Vaccaro 2 5) 1 above one-below one AO/OTA A3.3 Load sharing classification8 DCO phase4 expandable cage 2 / / vol. 4 MISS VOICE 11
Tip #.2 MISt MISt MISt open surgery 1) cross link fusion posture reductionmist DCO(damage control orthopaedic) MISt MISt ligamentotaxis DCO (Damage Control Orthopaedic) Damage Control DCO 4 phase ICU 2phase MISt DCO 12 MISS VOICE vol. 4
MISt 4 X X X X X ( 2) CT X 2 3 cross link 2 3 vol. 4 MISS VOICE 13
Tip #.2 12 14 Injury Severity Score ISS 34.3(17 59) 12494ml open surgery 24 27 ISS 20.9 10 38 124530ml MISt ISS MISt 83%7.9 94% 0.4 67%12 MISt 90% 0.3 MISt MISt 4 8 60 60 GCS12 T10,L1,L2 T12 (AO/OTA C3) TAE 4 7 12 MISt DePuy Synthes VIPER2 X-tab (T9-L3) 16065g MISt 3 CT1 14 MISS VOICE vol. 4
4 CT 5 6CT 7 CT 8 1 Jiang XZ, et al. Comparison of a paraspinal approach with a percutaneous approach in the treatment of thoracolumbar burst fractures with posterior ligamentous complex injury: a prospective randomized controlled trial: J Int Med Res. 2012;40(4)p1343-56. 2) AO Spine Manual, Thieme Publishers 3) McCormack T, et al. The load sharing classification of spine fractures: Spine 1994;19,p1741 4. 4) Joon Y. Lee1,et al. Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma: Orthop Sci 2005;10,p671 675 5) Alexander R. Vaccaro,et al. A New Classification of Thoracolumbar Injuries. The Importance of Injury Morphology, the Integrity of the Posterior Ligamentous Complex, and Neurologic Status: Spine 2005;30(20), p2325 2333 vol. 4 MISS VOICE 15
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 101-0065 東京都千代田区西神田 3 丁目 5 番 2 号 T. 03 4411 6125 depuysynthes.jp 販売 : VIPER2 スパインシス 番号 : 22400BZX00042000 販売 : VIPER2 セ 番号 : 13B1X00204DS0052 販売 : Viper イド イ ー 番号 : 223ADBZX00029000 販売 : VIPER3D セ 番号 : 13B1X00204DS0058 J&J K.K. 2014 DSSJ135M-01-201410-NK