臨床整形外科48巻4号

2013年04月発行

誌上シンポジウム 腰椎変性側弯症の手術―現状と課題

腰椎変性後側弯症に対するPSO（pedicle subtraction osteotomy）による矯正固定術

著者： 豊根知明¹ 志保井柳太郎¹ 男澤朝行¹

所属機関： ¹帝京大学ちば総合医療センター整形外科

ページ範囲：P.341 - P.347

　腰椎が後弯化すると，脊柱の重心は大きく前方へ移動する．片肘をついて反対側の手で洗面や炊事を行う，両手を大腿の前について歩行する，などが後弯に伴う立位バランス障害に特有の症状である．Pedicle subtraction osteotomy(PSO)は，椎体後方を楔状に骨切りすることにより，後弯を矯正して立位バランスを回復させ，歩行障害と一連の症状を劇的に改善させることが可能な手術手技である．腰椎変性後側弯症に対してもasymmetrical PSOにより側弯と後弯を同時に矯正し，立位バランスと臨床症状を改善し得る．この手術法の詳細と成績を詳述する．

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