臨床整形外科59巻8号

2024年08月発行

特集 脊損患者への投与が始まった脊髄再生医療—脊髄損傷患者に希望が見えるか

脊髄損傷急性期の処置で脊髄再生程度はどう変わるか？—主に外科的立場から

著者： 前田健¹

所属機関： ¹独立行政法人労働者健康安全機構総合せき損センター整形外科

ページ範囲：P.1019 - P.1026

脊髄損傷の急性期には，血圧や血糖を含めた全身状態の管理と，損傷された脊椎/脊髄局所への適切な対応，および早期からのリハビリテーションが極めて重要であり，脊髄の再生医療を論ずる前提となる．外科的立場からすると，骨傷例に対しては受傷後できるだけ早期の局所安定化と脊髄の除圧が重要となる．一方，最も頻度の高い非骨傷性頚髄損傷については，手術適応やその時期に関する質の高いエビデンスが乏しく，強く推奨される対処法が未だ確立していない．脊髄損傷の早い段階ほど神経学的変化が大きな病質の特殊性に鑑み，retrospectiveな論文を評価する際には十分な注意が必要である．

参考文献

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