臨床整形外科54巻5号

2019年05月発行

臨床経験

内視鏡下除圧手術は腰椎固定術後の隣接椎間障害に対する低侵襲治療オプションとなる

著者： 村田鎮優¹ 中川幸洋² 南出晃人¹ 岩﨑博¹ 山田宏¹

所属機関： ¹和歌山県立医科大学整形外科学講座 ²和歌山県立医科大学附属病院紀北分院脊椎ケアセンター

ページ範囲：P.517 - P.523

背景：腰椎固定術後の隣接椎間障害(ASD)に対する低侵襲除圧術の妥当性を検討した．

方法：圧迫性神経障害が主症状である腰椎固定術後ASDに対して内視鏡下除圧手術を行った17症例を対象とし，術前，術後の腰下肢痛，日本整形外科学会腰痛疾患治療成績判定基準(JOAスコア)，合併症について調査した．

結果：腰痛・下肢痛VASは術後有意に改善し，JOA改善率は43％で，17例中14例(82.4％)でfair以上(改善率≧25％)の治療効果を得た．17例中3例(17.6％)に追加固定術が必要となった．

まとめ：内視鏡下除圧手術は，圧迫性神経障害が主症状である腰椎固定術後ASDに対する低侵襲治療オプションとなる．

参考文献

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