Surgical management of minimally invasive anterior lumbar interbody fusion with stand-alone interbody cage for L4-5 degenerative disorders: clinical and radiographic findings.

• 資料種別: 博士論文
• タイトル: Surgical management of minimally invasive anterior lumbar interbody fusion with stand-alone interbody cage for L4-5 degenerative disorders: clinical and radiographic findings.
• 著者・編者: Hironaka, Yasuo; Morimoto, Tetsuya; Motoyama, Yasushi; Park, Young-Su; Nakase, Hiroyuki
• 著者標目: Hironaka, Yasuo; Morimoto, Tetsuya; Motoyama, Yasushi; Park, Young-Su; Nakase, Hiroyuki
• 出版事項: 日本脳神経外科学会
• 出版年月日等: 2013
• 出版年（W3CDTF）: 2013
• 並列タイトル等: 第4-5腰椎変性疾患に対する椎間cageのみでの低侵襲前方固定術(mini-ALIF)の臨床成績と放射線学的検討
• タイトル（掲載誌）: Neurologia medico-chirurgica
• 巻号年月日等（掲載誌）: 53 12
• 掲載巻: 53
• 掲載号: 12
• 掲載ページ: 861-869
• ISSN（掲載誌）: ISSN : 0470-8105
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2014-05-28
• 報告番号: 乙第1338号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: anterior lumbar interbody fusion; circumferential fusion; degenerative lumbar spinal disorder; minimally invasive therapy
• 対象利用者: 一般
• 一般注記: type:Thesis; Surgical treatment for degenerative spinal disorders is controversial, although lumbar fusion is considered an acceptable option for disabling lower back pain. Patients underwent instrumented minimally invasive anterior lumbar interbody fusion (mini-ALIF) using a retroperitoneal approach except for requiring multilevel fusions, severe spinal canal stenosis, high-grade spondylolisthesis, and a adjacent segments disorders. We retrospectively reviewed the clinical records and radiographs of 142 patients who received mini-ALIF for L4-5 degenerative lumbar disorders between 1998 and 2010. We compared preoperative and postoperative clinical data and radiographic measurements, including the modified Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score for back and leg pain, disc height (DH), whole lumbar lordosis (WL), and vertebral wedge angle (WA). The mean follow-up period was 76 months. The solid fusion rate was 90.1% (128/142 patients). The average length of hospital stay was 6.9 days (range, 3-21 days). The mean blood loss was 63.7 ml (range, 10-456 ml). The mean operation time was 155.5 min (range, 96-280 min). The postoperative JOA and VAS scores for back and leg pain were improved compared with the preoperative scores. Radiological analysis showed significant postoperative improvements in DH, WL, and WA, and the functional and radiographical outcomes improved significantly after 2 years. The 2.8% complication rate included cases of wound infection, liquorrhea, vertebral body fractures, and a misplaced cage that required revision. Mini-ALIF was found to be associated with improved clinical results and radiographic findings for L4-5 disorders. A retroperitoneal approach might therefore be a valuable treatment option.; 博士（医学）・乙第1338号・平成26年5月28日; Copyright © 日本脳神経外科学会 | The Japan Neurosurgical Society / 学会誌名（Neurologia medico-chirurgica）とJ-STAGEからの出典である; identifier:Neurologia medico-chirurgica Vol.53 No.12 p.861-869; identifier:04708105; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/2722; identifier:Neurologia medico-chirurgica, 53(12): 861-869
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.2176/nmc.oa2012-0379
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

目次

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/2722/1/01%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/2722/2/02%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/2722/6/03%e6%9c%ac%e6%96%87.pdf fulltext