特発性側弯症に対するin situ contouring techniqueによる手術の成績

Clinical Results of Surgical Treatment of Idiopathic Scoliosis by an In Situ Contouring Technique

　国内3施設においてin situ contouring techniqueを用いて行われた特発性側弯症に対する矯正手術の成績を調査した．対象は平均年齢16.1歳の15例で，カーブパターンはKing type Ⅰが3例，type Ⅱが3例，type Ⅲが6例，type Ⅴが3例であった．矯正率は上位胸椎，胸椎主弯曲，腰椎カーブでそれぞれ21.6％，54.2％ならびに52.7％であった．本法の施行に際しては，フックやスクリューの的確で調和的な設置ならびにロッドベンディング手技に習熟しておく必要がある．矯正後の左肩上がりや固定隣接椎間での局所後弯の発生にも注意が必要である．

　The clinical results of corrective surgery for idiopathic scoliosis by the in situ contouring technique at three institutions in Japan were reviewed. Fifteen patients, average age 16.1 years, 2 with a King type Ⅰcurve, 4 with a type Ⅱcurve, 6 with a type Ⅲcurve, and 3 with a type Ⅴcurve, were the subjects of the review. The mean correction rate of the upper thoracic curve, lower thoracic curve, and lumbar curve was 21.6％, 54.2％, and 52.7％ respectively. Use of this technique requires proper and harmonic setting of pedicle screws and pedicle hooks. Surgeons should also be familiar with the rod-bending maneuver. Care should be taken to prevent the development of shoulder imbalance during surgery and to prevent adjacent local kyphosis in the thoracolumbar area after surgery.