臨床整形外科46巻3号

2011年03月発行

臨床経験

後方進入腰椎椎体間固定術を安全に行うための手法：椎間関節全切除―従来法との合併症比較

著者： 三輪俊格¹ 細野昇¹ 向井克容¹ 海渡貴司² 武中章太¹ 冨士武史¹

所属機関： ¹大阪厚生年金病院整形外科 ²独立行政法人国立病院機構大阪南医療センター整形外科

ページ範囲：P.229 - P.234

　背景：後方進入腰椎椎体間固定術(PLIF)において椎間関節を全切除すると外側の操作空間を広く取ることができ，神経根の術中牽引も少なくできる．

　方法：この手法により周術期神経合併症が減少したかどうかを検討した．

　結果：46例の変性すべり症において全合併症は11例(24％)，神経合併症は9例(20％)であった．重度の筋力低下例や麻痺が後遺した症例はなくすべて一過性であった．

　まとめ：椎間関節を部分的に残して行っていた以前のPLIFと比較すると神経合併症は少なく，椎間関節全切除は特別な器具を必要とせずに神経合併症を減らす有用な方法であることが示唆された．

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