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(2)FESS

外側陥凹部狭窄症に対するTFアプローチ全内視鏡下除圧術

著者： 木島和也¹

所属機関： ¹兵庫医科大学整形外科

ページ範囲：P.1141 - P.1145

トランスフォラミナールアプローチによる全内視鏡下外側陥凹部除圧術は，局所麻酔下に8mmの皮膚切開，筋間アプローチで手術を行うため背筋への侵襲も最小限に抑えることができ，最小侵襲脊椎手術といえる．手術を行うには正確な椎間板穿刺，椎間孔部の解剖の理解，ドリルによる上関節突起切除が必要である．手術成績は良好な結果が報告されているが，術前に不安定性を要する症例では術後成績が不良であることがわかっている．ラーニングカーブや導入コストの問題はあるが，これらが解消されれば高齢者や全身合併症が多くある患者さんには特にメリットの大きい術式である．

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