Hasegawa Kazuhiro, Homma Takao
Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Japan.
J Neurosurg. 2003 Jul;99(1 Suppl):125-31. doi: 10.3171/spi.2003.99.1.0125.
Surgery for degenerative lumbar kyphoscoliosis (DLKS) is very challenging because the curve has become rigid due to circumferential osteoarthritic changes. Therefore, a standard procedure involving correction and fusion after decompression of the nerves has not yet been established. The authors have been searching for an effective procedure that provides adequate decompression and three-dimensional (3D) correction for symptomatic DLKS. In this report they describe a new 3D correction and fusion technique involving multilevel posterior lumbar interbody fusion. They analyze the results obtained in the first 23 cases and discuss the advantages and disadvantages of the procedure. The correction effect was excellent, and compared with other instrumentation-assisted procedures, this surgery is not remarkably invasive. Although the procedure is limited in achieving normal sagittal alignment and the acceleration rate of adjacent-disc degeneration remains relatively high, it is an option for the rigid deformity characterized by DLKS.
退行性腰椎后凸侧弯（DLKS）的手术极具挑战性，因为由于周向骨关节炎改变，脊柱侧弯已变得僵硬。因此，尚未确立一种在神经减压后进行矫正和融合的标准手术方法。作者一直在寻找一种有效的手术方法，为有症状的DLKS提供充分减压和三维（3D）矫正。在本报告中，他们描述了一种涉及多节段腰椎椎间融合的新型3D矫正和融合技术。他们分析了前23例患者的手术结果，并讨论了该手术方法的优缺点。矫正效果极佳，与其他器械辅助手术相比，该手术的侵袭性并不显著。尽管该手术在实现正常矢状位对线方面存在局限性，且相邻椎间盘退变的加速率仍然相对较高，但它是DLKS所致僵硬畸形的一种选择。
