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成人脊柱畸形的微创手术与未来

Minimally Invasive Surgery in Adult Spinal Deformity and the Future.

作者信息

Gandhi Shashank V, Farber S Harrison, Giraldo Juan P, Shaffrey Christopher, Uribe Juan S

机构信息

Texas Back Institute, Plano, TX, USA.

Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.

出版信息

Global Spine J. 2025 Jul;15(3_suppl):172S-189S. doi: 10.1177/21925682241282277. Epub 2025 Jul 9.

Abstract

Study DesignNarrative review.ObjectivesThe purpose of this literature review is to evaluate various MIS techniques, assesses their roles in ASD when compared to traditional open surgery, and highlight potential future directions in minimally invasive spine surgery. Correction of spinal malalignment and decompression of neural elements through surgical intervention in adult spinal deformity (ASD) has demonstrated significant improvements in health-related quality of life (HRQOL) metrics. Historically, open surgery has been the primary approach to ensure sufficient decompression and alignment in ASD patients. However, advancements in MIS techniques, equipment, and extensive experience in managing degenerative pathologies have enabled effective corrections using less invasive methods.MethodsAn extensive review of MIS and open techniques for ASD was conducted.ResultsThis review evaluates various MIS techniques, assesses their roles in ASD when compared to traditional open surgery, and highlights potential future directions in minimally invasive spine surgery.ConclusionsThe evaluation of various minimally invasive surgery (MIS) techniques in treating adult spinal deformity (ASD) compared to traditional open surgery reveals significant advantages. MIS has progressed from initially treating simple degenerative pathologies to effectively addressing complex ASD cases. This evolution underscores the increasing role of MIS in ASD treatment. Over the past two decades, there has been a noticeable shift towards the mainstream adoption of MIS techniques, reflecting their growing prevalence and acceptance within the medical community. Looking ahead, ongoing advancements and innovations in minimally invasive spine surgery suggest exciting potential future directions for improving outcomes in ASD patients and expanding the application of MIS in spine deformity correction.

摘要

研究设计

叙述性综述。

目的

本文献综述的目的是评估各种微创技术,将其与传统开放手术相比,评估它们在成人脊柱畸形(ASD)中的作用,并突出微创脊柱手术未来的潜在发展方向。通过手术干预矫正成人脊柱畸形(ASD)中的脊柱排列不齐和对神经结构进行减压,已在与健康相关的生活质量(HRQOL)指标方面显示出显著改善。从历史上看,开放手术一直是确保ASD患者充分减压和矫正的主要方法。然而,微创技术、设备的进步以及在处理退行性病变方面的丰富经验,使得能够采用侵入性较小的方法进行有效的矫正。

方法

对ASD的微创和开放技术进行了广泛的综述。

结果

本综述评估了各种微创技术,将其与传统开放手术相比,评估它们在ASD中的作用,并突出微创脊柱手术未来的潜在发展方向。

结论

与传统开放手术相比,对各种治疗成人脊柱畸形(ASD)的微创手术(MIS)技术的评估显示出显著优势。MIS已从最初治疗简单的退行性病变发展到有效处理复杂的ASD病例。这一演变凸显了MIS在ASD治疗中日益重要的作用。在过去二十年中,明显出现了向主流采用MIS技术的转变,这反映了它们在医学界的日益普及和接受。展望未来,微创脊柱手术的持续进步和创新为改善ASD患者的治疗效果以及扩大MIS在脊柱畸形矫正中的应用暗示了令人兴奋的潜在未来发展方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/035a/12254568/89258bcb441f/10.1177_21925682241282277-fig1.jpg

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