臨床整形外科50巻6号

2015年06月発行

臨床経験

術前の後方すべりは開窓術後に生じるヘルニアの危険因子である

著者： 武中章太¹ 立石耕介¹ 細野昇¹ 向井克容¹ 冨士武史¹

所属機関： ¹JCHO大阪病院整形外科

ページ範囲：P.569 - P.577

　腰部脊柱管狭窄症に対する開窓術後(髄核摘出術，固定術併用を除く)，新たに椎間板ヘルニアを発症する危険因子を検討した．開窓術施行381例のうち，18例(ヘルニア群)が2年以内に椎間板ヘルニアによる急性下肢痛を呈し，対照群90例と比較した．ヘルニア群で有意に術前の後方すべりがあり(p＜0.001)，腰椎前弯角が小さかった(p＝0.044)．術前の後方すべり率とヘルニア発症をROC曲線で解析すると，カットオフ値は後方すべり率7％であった．7％以上の後方すべりを有する例では同一高位に椎間板ヘルニアを生じるリスクが高いことが示された．

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