脊椎是人體的軀幹，主要用於支撐身體重量、提供全身功能性活動及保護脊
髓神經組織。然而不正確的身體姿勢或過度使用則可能會造成脊椎產生莫大磨損
進而使之產生受傷退化、椎間盤軟骨突出抑或脊椎骨移位滑脫等情況。但傳統手
術有傷口大、流血量多、術後疼痛感大，且部分手術後需進行復健等缺點，以致
大部分患有脊椎相關疾病之病患均對於脊椎手術相當排斥，所幸拜科技日新月異
之賜，現今醫療技術突飛猛進已發展出微創手術，其優點不僅是大幅改善傳統手
術的缺陷，更是精準提高病灶切除之準確性、避免破壞鄰近組織及減少術後復原
之疼痛情形。
綜觀國內高雄地區號稱俱微創手術中心之醫療院所的組成，大致可分為兩大
類，即是以骨科專長或為神經外科專長的醫師或醫師群，仍尚無以脊椎骨科加上
神經外科之微創手術中心運作模式。爰此，本研究論文即應用設計科學研究法並
配合使用SWOT 分析，以探討義大癌治療醫院如何有效整合脊椎骨科及神經外科
醫師群，進而成立「脊椎神經重建微創中心」並提供全方位專業、先進且完善的
手術前、手術中及手術後醫療照顧服務團隊之經營策略。
依據義大癌治療醫院脊椎神經重建微創中心，所統計之修正型Macnab 標準
病患滿意度成果可知，義大癌治療醫院脊椎神經重建微創中心除了以SO 策略為
經營主軸外，更因軟硬體等相關配套措施配置得宜，使義大癌治療醫院脊椎神經
重建微創中心之經營成效有明顯獲得豐碩反饋的成果。尤其是在脊椎神經重建微
創中心，眾多專精於脊椎骨科及神經外科的醫師付出耕耘之下，終打造出俱備國
際級優異醫術的好口碑，為脊椎神經重建微創中心在南台灣樹立起指標性醫學中
心的金字招牌!

The human spine functionally supports the body axis and transmits the weight of
the trunk to the lower limbs. It surrounds and protects the spinal cord and provides
attachment for the ribs, and ligaments and muscles of the neck and back to allow
physiologic mobility and activities of daily living. The importance of the spinal cord is
the column of nerve fibers responsible for sending and receiving messages from the
brain, runs through the spinal canal. It is through the spinal cord and its branching
nerves that the brain influences the rest of the body, controlling movement and organ
function. The improper body posture or overuse may cause great wear to the spine. In
turn, it causes the injury, further degeneration, herniated intervertebral disc, or even
spondylolisthesis, and so on. However, the traditional methods of spinal surgery
sometimes will result in a big wound, massive blood lost, intractable postoperative
pain, the need of rehabilitation after surgery, and some undesired complications.
Therefore, most patients with spine related diseases are quite repulsive to spinal
surgery. Nowadays, minimally invasive spinal surgery is increasing with the current
rapid development of medical technology. The advantages is not only to significantly
improve the traditional ways of surgery, but also improve the accuracy of the lesion
resection, avoid destroying the adjacent tissue, and reduce the pain after surgery. The
composition of the medical institute, which is known as the minimally invasive spinal
surgery center in Kaohsiung, can be divided into two major groups, the surgeons of
orthopedic spine or neurosurgery. Until now, there is no institute successful integrating
these two groups.
The main issue of this study is the application of design science and combination
of business model and SWOT analysis, to evaluate how effectively integrating the
surgeons of orthopedic spine or neurosurgery in one institute for patient oriented
medical care and treatment. A minimally invasive spine and nerve reconstruction
center is therefore set up in E-Da Cancer Hospital, which aims to provide both
comprehensive and professional examination, diagnosis, surgery, and rehabilitation,
either preoperatively, during operation, or postoperatively. We also discuss the
competitive advantages and business strategies of this center in E-Da Cancer Hospital.
Based on the modified Macnab criteria, more than 80% patients (a total of 150
patients since official open on 26 May 2017) satisfied with the surgical results of the
minimally invasive spine and nerve reconstruction center in E-Da Cancer hospital. It
could be a successful business strategies with superior competitive advantages to
integrate both the surgeons of orthopedic spine or neurosurgery in one institute for
patient oriented medical care and treatment.

誌謝 ............................................................................................................................... i
摘要 .............................................................................................................................. ii
第一章 緒論 .................................................................................................................. 10
第一節 研究背景與動機 .................................................................................................. 10
第二節 研究目的與範圍 .................................................................................................. 11
第二章 文獻探討..............................................................................................................12
第一節 脊椎神經重建及微創手術發展現況 .........................................................................12
第二節 國內脊椎神經重建微創中心現況 .............................................................................26
第三節 經營策略 ............................................................................................................. 29
第四節 SWOT 分析.......................................................................................................... 37
第三章 研究方法.............................................................................................................. 39
第一節 研究方法 ............................................................................................................. 39
第二節 研究流程 ............................................................................................................. 39
第四章 設計與發展 .......................................................................................................... 41
第一節 義大醫療個案 ....................................................................................................... 41
第二節 義大脊椎神經重建微創中心特色 ............................................................................. 44
第三節 義大脊椎神經重建微創中心SWOT 分析 .................................................................. 53
第四節 義大脊椎神經重建微創手術中心經營策略說明.......................................................... 62
第五節 義大脊椎神經重建微創中心商業模式圖分析 ............................................................. 65
第五章 展示與評估解決方案 ............................................................................................. 67
第一節 義大脊椎神經重建微創中心經營成果 ...................................................................... 67
第二節 評估解決方案 .......................................................................................................69
第六章 結論與建議 ......................................................................................................... 72
第一節 研究成果 ............................................................................................................. 72
第二節 研究貢獻 ............................................................................................................. 74
第三節 建議 .................................................................................................................... 76
參考文獻 ........................................................................................................................ 77

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