臨床整形外科52巻3号

2017年03月発行

臨床経験

MRIにおける体位による腸管・腎臓移動—低侵襲側方進入椎体間固定術を安全に行うために

著者： 岩﨑博¹ 山田宏¹ 橋爪洋¹ 南出晃人¹ 中川幸洋¹ 筒井俊二¹ 髙見正成¹ 中尾慎一¹ 吉田宗人¹

所属機関： ¹和歌山県立医科大学整形外科学教室

ページ範囲：P.285 - P.290

背景：腰椎各椎間での体位変化による腸管および腎臓位置移動に関する報告はみられない．

対象と方法：XLIF^®(eXtreme Lateral Interbody Fusion)を行った連続する49症例を対象とし，術前に撮影した仰臥位・左側臥位・右側臥位におけるMRIを用いて後ろ向きに調査した．

結果：L4/5高位では左側臥位で上行結腸が26.5％，右側臥位では下行結腸が18.4％の症例でXLIF^®アプローチの経路に存在する．

まとめ：XLIF^®では，側臥位で撮影したMRI画像を用いた腸管・腎臓位置の術前評価が重要である．

参考文献

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)における術中神経モニタリングの有用性．J MIOS 2015；76：61-8．

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の合併症と対策．J MIOS　2016；79：67-75．