1. 脊柱変形を有する成人患者の骨微細構造から骨質を詳細に検討し, 脊椎矯正固定術に伴い発生する固定隣接脊椎の骨折の頻度と骨質の関係を調査した。また, 得られた骨微細構造から有限要素モデルを作成し, 力学的解析から手術における最適固定脊椎高位を検討した。
2. 脊柱変形を有する成人患者の立位における床反力と下肢および脊柱起立筋の表面筋電図における筋活動を検討することで, 立位および動作時の高齢者の最適な脊椎バランスを明らかにし, 手術における脊椎の必要とされる最適な脊椎矯正角度を患者ごとに検討した。
The relationship between gait pattern, spinal alignment and the level of upper instrumented vertebra (UIV) in surgically treated patients with adult spinal deformity (ASD) has not been fully documented. Our study aimed to assess the effect of UIV level for the gait pattern and spinal alignment in ASD. Both UT and LT groups achieved similar improvement of gait ability and pattern after surgery. Additional studies will be needed to further define the effect of UIV for the activity of daily living such as fast walking, stepping the stairs, or standing from the chair in ASDs. Additionally, the patients with ASD had an asymmetric gait pattern and impaired gait ability compared with healthy volunteers. Gait ability correlated significantly with the GL, spinopelvic alignment, lower extremity joint ROM, and lean volume. The surgical correction of spinopelvic alignment and exercises to build muscle strength may improve the gait pattern and ability in patients with ASD.
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