脊髄の整合に対する開口骨解剖の影響
Tetsuro Shimada1, Akira Maeyama1, Tetsuro Ishimatsu1
1Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, Fukuoka, JPN.
Cureus
|September 2, 2025
まとめ
オープン・ケイジ・ハイ・ティビア・オステオトミー (OWHTO) は,膝の整合性を改善し,腰骨の整合性に良い影響を及ぼし,腰骨の傾斜と腰骨発症の不一致を軽減します. この手術は 下肢と脊髄の両方に 効果があります
科学分野:
- 整形外科
- バイオメカニクス
- 放射線科
背景:
- 膝の折り合いは前頭部姿勢と骨盤の逆転と関連しており,膝の症状を悪化させる可能性があります.
- 膝と脊髄の整合には双方向的な関係があり,膝関節炎の手術に関する調査が必要である.
研究 の 目的:
- 中部部部関節症の患者における脊椎骨盤上部骨折 (OWHTO) の効果を評価する.
主な方法:
- 膝関節炎のためにOWHTOを受けた34人の患者の遡及分析.
- 下肢の整合 (機械的軸,mMPTA,mLDFA,JLCA,PTS) と脊椎骨盤のパラメータ (骨盤の傾き,サクラルの傾き,骨盤の発生率,胸部キフォシス,腰部ロードシス,PI- LL不一致) の放射線評価は,手術前と手術後1年です.
- クリニカルアウトカムは,膝の怪我と骨関節炎アウトカムスコア (KOOS) を用いて評価された.
主要な成果:
- OWHTOは,骨盤の傾き (p = 0. 003) と骨盤の発生率と腰部主体の不一致 (p = 0. 044) を有意に減少させ,脊椎骨盤のサギタルアライメントの改善を示した.
- 術後の脊椎骨盤の調整の変化とKOOSスコアとの間に有意な相関は観察されなかった.
結論:
- OWHTOは,下肢の整列を効果的に修正し,特に腰骨盤の傾きとPI-LL不一致を減少させ,腰骨盤の整列に好影響を及ぼしています.
- 下肢の負荷分布が改善され,膝の整合が改善される.
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