Neurological Surgery 脳神経外科34巻3号

2006年03月発行

解剖を中心とした脳神経手術手技

腰椎変性疾患に対するアプローチ

著者： 上村和也¹ 松村明¹

所属機関： ¹筑波大学大学院人間総合科学研究科機能制御医学専攻 脳神経機能制御医学（脳神経外科学）

ページ範囲：P.255 - P.265

Ⅰ．は じ め に

　変形性腰椎症は，加齢に伴い現れる腰椎の変性所見である．このうち症候性になったものが治療対象となる．変形性腰椎症の術式の根幹になるのは神経組織の十分な減圧と安定性の保持であることはいうまでもないが，たとえインストルメンテーションにしろ特殊な減圧手技にしろ，基本は神経根および硬膜囊の減圧である．治療対象になりうる腰椎変性疾患は大まかに3つに分類される．つまり，①腰椎椎間板ヘルニア，②腰椎脊柱管狭窄症，③不安定腰椎病変，である．この3つの病態は互いに併存することが稀でなく，それぞれの圧迫要因を取り除くために同一手技の応用が可能である．ここでは，減圧に際して注意すべき腰椎の解剖学的特性を概説する．

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