脊椎instrumentation手術の合併症―予防と対策

The Prevention and a Management of Surgical Complications of Spinal Instrumentation. Summary of the Panel Discussion in 2004

　脊椎instrumentation手術は数多くの利点を持つが，手技には習熟を要し，かつ手術侵襲は大きくなる．未熟な手技や，高齢者や他科疾患を持つ患者への無理な適応で行われれば術後合併症が発生する．パネルディスカッション「脊椎instrumentation手術の合併症―予防と対策」では，6人の演者から，合併症全般について1題，術後感染対策2題，固定術後隣接椎間障害について3題の発表がなされた．いずれもこの分野で経験の豊富な施設と術者からの発表であり，多くの有意義なディスカッションが行われた．

　This is a summary of the panel discussion on the surgical complications of spinal instrumentation held at the 33rd annual meeting of the Japanese Spine Research Society. Six panelists presented their studies on this difficult problem. There was one presentation on the general complications of surgery for spondylolisthesis, two presentations on postoperative infection, and three on changes in adjacent segments after spinal instrumentation and fusion. The fact that surgical indications based on preoperative patient evaluations, including evaluation of co-morbidities, is the key to success was emphasized and discussed. Strategies to prevent and control postoperative infection, including prophylactic and therapeutic chemotherapy, were thoroughly analyzed and discussed. The importance of serious consideration of sagittal alignment to minimize changes in adjacent segments was again emphasized.