胸腰椎破裂骨折に対する経皮的椎弓根スクリュー挿入システムSextant®を用いたtemporary fixation without fusion法による低侵襲手術の治療経験

An Introduction of Temporary Fixation without Fusion Method for Thoracolumbar Burst Fractures as a New Minimally Invasive Surgical Technique with Combination of Sextant and Vertebroplasty

　われわれはAO分類typeAの胸腰椎破裂骨折に対し，temporary fixation without fusionの概念に基づき，経皮的椎弓根スクリュー挿入(Sextant)と椎体形成術(vertebroplasty)を用いた低侵襲手術による脊椎固定術を行った．本法は術後早期の離床，通院加療への移行を可能とし，骨癒合後の運動制限・遺残腰痛も認めなかった．経過観察中，内固定材料の破損はなく，矯正損失も許容範囲内であった．また，抜釘を行うことによりmobile segmentを温存しうる点で，脊椎破裂骨折の治療として理想的と考えられた．

　Temporary posterior fixation by using the Sextant system and vertebroplasty without fusion was performed as minimally invasive surgery to theat AO type A thoracolumbar burst fractures.

　Patients were able to begin bedside walking rehabilitation one week after surgery and they discharged from hospital four or five weeks after surgery.　There was no limitation of range of motion in the spine and no low back pain after bone union.　There was no instrumentation failure and little loss of correction in the spine after bone union.　This method was concluded to be ideal as a treatment for thoracolumbar burst fractures, because the mobile segment is preserved after removing the instruments.