臨床整形外科58巻9号

2023年09月発行

特集 脊椎内視鏡下手術の進化・深化 各論(1)MED

ヘルニア摘出術(脊柱管内・外側型MED)

著者： 南出晃人¹

所属機関： ¹獨協医科大学日光医療センター整形外科脊椎センター

ページ範囲：P.1089 - P.1095

腰椎椎間板ヘルニアに対する手術療法では，脊椎内視鏡下椎間板摘出術が一般的な手術法になりつつある．その内視鏡下椎間板摘出術は，MED法(microendoscopic discectomy)とFED法(full-endoscopic discectomy)に大別され，それぞれの長所・短所を理解し病態に合わせた術式選択をすることが望ましい．筆者らは，MED法では終板脱出を伴う椎間板ヘルニア例，骨切除を要する脊柱管狭窄に椎間板ヘルニアを合併しているcombined stenosis例，L5/S高位での椎間孔部・椎間孔外ヘルニア(外側ヘルニア)例，FED法では巨大脱出した椎間板ヘルニア例，再発した椎間板ヘルニア例などと，病態に合わせて選択している．

参考文献

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