臨床整形外科56巻4号

2021年04月発行

手術手技

低侵襲な内視鏡下椎間孔外腰椎椎体間固定術mELIF

著者： 柴山元英¹ 李光華¹ 伊藤全哉¹ 星尚人¹ 倉石慶太¹ 河合将紀¹ 伊藤不二夫¹

所属機関： ¹あいちせぼね病院

ページ範囲：P.385 - P.392

背景：後側方アプローチで，脊柱管の除圧をしない脊椎内視鏡下椎間孔外腰椎椎体間固定術(microendoscopy-assisted extraforaminal lumbar interbody fusion：mELIF)を開発した．

対象と方法：52例，平均62.5歳．病名はすべり症が多かった．手術は腰椎椎間板外側ヘルニア手術の要領で片側の後側方から椎間板へ達し，脊椎内視鏡下にケージと移植骨を挿入．両側の経皮的椎弓根スクリュー，ロッドで固定する．

結果：平均経過観察24カ月で，臨床成績は大幅に改善した．Macnab評価では優，良が90％以上であった．臨床的な合併症はなかった．

まとめ：mELIFで良好な結果が得られた．L5/S1にも適応でき低侵襲で安全性も高い．

参考文献

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