腰椎固定術—確実な骨癒合を得るためのコツは？

Lumbar Interbody Fusion:How to Achieve Reliable Bone Fusion?

Point

・腰椎椎体間固定術は，椎体間に移植した骨が骨癒合することによって達成される．

・良好な骨癒合を得るには，骨折治癒のメカニズムを知ることが重要である．

・椎弓根スクリューや椎体間ケージが椎体間の初期固定力を高めるために使用されているが，本質は椎体間の骨癒合術である．

　The goal of surgery for degenerative spine disease is to decompress nerves; however, extensive spinal decompression may compromise spinal stability. Therefore, spinal fusion surgery is performed to immediately stabilize such anatomical disruption during a short hospital stay and to allow quick recuperation. Recently, implants such as pedicle screws and intervertebral cages have been regularly used in lumbar fusion surgery. These implants are used to reconstruct the functional unit of the failed spine, correcting any deformity if necessary and maintaining its fixation until complete bone fusion. In other words, the essence of spinal fusion surgery is not the placement of implants but the induction of bone fusion. Therefore, each case requires a carefully developed surgical plan to achieve sufficient bone fusion for spinal stabilization.

　In this article, we describe the mechanism and the surgical technique for achieving reliable interbody fusion.