臨床整形外科43巻12号

2008年12月発行

総説

腰部脊柱管狭窄と血流

著者： 関口美穂¹ 紺野慎一¹ 菊地臣一¹

所属機関： ¹公立大学法人福島県立医科大学整形外科

ページ範囲：P.1211 - P.1218

　臨床の病態に即した腰部脊柱管狭窄類似モデルを用いて，神経機能と治療効果について検討した．馬尾・神経根の圧迫により，神経内血流は低下し，神経伝導速度が低下する．神経根圧迫では疼痛閾値は低下するが，馬尾圧迫では低下しない．馬尾圧迫により，神経内血管の内皮細胞損傷が惹起され，セロトニンに対する感受性が亢進する．プロスタグランジン，セロトニン受容体拮抗薬，あるいはシロスタゾールの投与により圧迫部の神経内血流が改善する．このことから，各種血流改善薬は，腰部脊柱管狭窄の保存療法の手段の一つとして有効性が期待できる．

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