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
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
DOIinfo:doi/10.2176/nmc.oa2012-0379
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