臨床整形外科51巻2号

2016年02月発行

誌上シンポジウム MISの功罪

脊椎手術におけるMISの功罪

著者： 中川幸洋¹

所属機関： ¹和歌山県立医科大学整形外科

ページ範囲：P.123 - P.131

　脊椎外科における低侵襲脊椎手術(MISS)には，脊椎内視鏡の使用やアプローチを工夫した低侵襲脊椎除圧手術と脊椎固定や制動を目的とした低侵襲脊椎制動術(MISt)に大別される．除圧手術におけるMEDをはじめとした脊椎内視鏡の導入，経皮的椎弓根スクリューシステムの導入，XLIF/OLIFによる側方進入椎体間固定術の導入は脊椎外科の低侵襲治療にパラダイムシフトをもたらした．除圧，固定，矯正，制動といった脊椎手術の主要手技のほとんどにMISで対応できるようになっている．しかし，新たな技術の裏には特有の合併症の存在があり，技術的なlearning curveの克服とともに合併症やその予防策を熟知することは必須である．

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