成人脊柱変形—基本事項と手術手技

Basics and Surgical Techniques for Adult Spinal Deformity

Point

・成人脊柱変形は加齢により脊柱変形（側彎，後彎，後側彎）を来して，起立障害，歩行障害など，ADL障害を来す病態である．

・脊柱骨盤パラメーターを計測することで，重症度判定，矯正手術のプランニングができる．

・低侵襲変形矯正固定術（cMIS）は側方進入椎体間固定術と後方経皮的椎弓根スクリューを用いた矯正固定術から成り立っている．

・変形矯正固定術の合併症には周術期合併症とインプラント関連合併症があり，十分な対策をとる必要がある．

＊本論文中、［Video］マークのある図につきましては、関連する動画を見ることができます（公開期間：2028年2月まで）。

　Adult spinal deformity（ASD）is a condition in which the spinopelvic alignment changes owing to age-related degeneration, making it difficult to maintain a standing position. The goal of surgery for ASD is to correct the spine and obtain normal alignment. Here, we discuss the pathophysiology of ASD, spinopelvic alignment, surgical methods, and complications. Circumferential minimally invasive surgery for ASD comprises an anterior approach using lateral lumbar interbody fusion and a posterior approach using percutaneous pedicle screws．Complications include perioperative and implant-related complications, both of which can be serious. Computer-assisted devices are useful for avoiding these complications. Circumferential minimally invasive surgery requires various spine surgery techniques, most of which are performed daily. Circumferential minimally invasive surgery can be achieved by gaining a solid understanding of the theory and improving the accuracies of the basic procedures.