臨床整形外科52巻1号

2017年01月発行

論述

関節リウマチ患者のPLIF後には疾患活動性に関係なく固定隣接椎間障害が高率に発生する

著者： 藤原啓恭¹ 小田剛紀¹ 牧野孝洋² 森口悠¹ 米延策雄³ 海渡貴司²

所属機関： ¹国立病院機構大阪南医療センター整形外科 ²大阪大学大学院医学系研究科器官制御外科学（整形外科） ³滋慶医療科学大学院大学

ページ範囲：P.39 - P.48

背景：関節リウマチ(RA)患者の疾患活動性が後方経路腰椎椎体間固定術(PLIF)後の固定隣接椎間障害(ASD)発生率に影響を与えるかを検討した．

対象と方法：2椎間以下のPLIFを施行し，2年間の経過観察が可能であった90例(RA患者22例，非RA患者68例)を対象とし，臨床・画像成績を調査した．RA患者は画像上ASD発生の有無により副分類し，術前の患者背景を比較検討した．

結果：画像上ASD発生率はRA患者30％(12/40椎間)，非RA患者9％(11/121椎間)と有意差を認めた(P＜0.05)．画像上ASD発生の有無でRA群の患者背景に有意差を認めなかった．

まとめ：RA患者では疾患活動性制御に関わらずASDが高率に発生した．

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