Multisegmental Spinal Instrumentation of the Degenerated Lumbar Spine.

概要

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From 1987 to 1994, forty-three patients with degenerative lumbar canal stenosis, degenerative spinal deformity, degenerative spondylolisthesis, or degenerative multiple lumbar disc diseases were operated upon using multisegmental spinal instrumentation. We have used several kinds of instrumentation for these diseases, and since 1991 have mainly used the Isola spinal system. Seventeen cases had complications from using this instrumentation. Six of twelve cases with less improvement in their clinical JOA score were those complicated cases. Thirty-seven cases acquired bony union and there were six cases of non-union. Among the non-union cases, there was only one case of posterior lumbar interbody fusion (PLIF). Therefore we recognized the need for PLIF to be performed in the area of maximun degereration. We measured sagittal and coronal alignment between the instrumentation area and spinal balance using the Isola system. Although sagittal alignment showed a loss of correction postoperatively, coronal alignment and spinal balance were maintained. We discuss the indications, the purpose and matters that require attention when using multisegmental spinal instrumentation.
西日本整形・災害外科学会の論文