Hyun Seung-Jae, Jung Jong-Myung
Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
J Korean Neurosurg Soc. 2018 Nov;61(6):661-668. doi: 10.3340/jkns.2018.0150. Epub 2018 Oct 30.
Among the spinal disorders, the treatment approach for spinal deformities has been discussed least among department of neurosurgery. But nowadays, more and more neurosurgeons are interested in spinal deformities as well as complex spinal disorders and are doing not a few surgeries for these kinds of disease. Nevertheless, it is mandatory to understand the course of spinal deformity, principles of treatment, and surgical outcomes and complications. Understanding of the biology, biomechanics and metallurgy of the spine and instrumentation are also required for successful spinal deformity surgery. We need senior mentors and good surgical and neurophysiologic monitoring team. Knowledge of spinal deformity may be augmented with spine fellowships and surgical experience. Step by step training such as basic knowledge, orthopedic as well as neurosurgical disciplines and surgical skills would be mandatory. Neurosurgeons can have several advantages for spinal deformity surgeries. By high-level technical ability of the spinal cord handling to preserve neurological function and familiarity with microscopic surgery, better synergistic effect could be expected. A fundamental understanding of pediatric spinal deformity and growing spine should be needed for spinal deformity surgery.
在脊柱疾病中,神经外科对脊柱畸形的治疗方法讨论得最少。但如今,越来越多的神经外科医生对脊柱畸形以及复杂的脊柱疾病感兴趣,并针对这类疾病开展了不少手术。然而,了解脊柱畸形的病程、治疗原则、手术效果及并发症是很有必要的。成功进行脊柱畸形手术还需要了解脊柱的生物学、生物力学、金属材料学以及内固定器械。我们需要资深导师以及优秀的手术和神经生理监测团队。通过脊柱专科进修和手术经验可以增加对脊柱畸形的了解。逐步进行基础知识、骨科及神经外科相关学科以及手术技能等方面的培训是必不可少的。神经外科医生在脊柱畸形手术方面有诸多优势。凭借处理脊髓以保留神经功能的高水平技术能力以及对显微手术的熟悉程度,可以期待更好的协同效果。脊柱畸形手术需要对小儿脊柱畸形和生长中的脊柱有基本的了解。