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

• Material Type: 博士論文
• Title: Surgical management of minimally invasive anterior lumbar interbody fusion with stand-alone interbody cage for L4-5 degenerative disorders: clinical and radiographic findings.
• Author/Editor: Hironaka, Yasuo; Morimoto, Tetsuya; Motoyama, Yasushi; Park, Young-Su; Nakase, Hiroyuki
• Author Heading: Hironaka, Yasuo; Morimoto, Tetsuya; Motoyama, Yasushi; Park, Young-Su; Nakase, Hiroyuki
• Publication, Distribution, etc.: 日本脳神経外科学会
• Publication Date: 2013
• Publication Date (W3CDTF): 2013
• Alternative Title: 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
• Periodical title: Neurologia medico-chirurgica
• No. or year of volume/issue: 53 12
• Volume: 53
• Issue: 12
• Pages: 861-869
• ISSN (Periodical Title): ISSN : 0470-8105
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2014-05-28
• Dissertation Number: 乙第1338号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: anterior lumbar interbody fusion; circumferential fusion; degenerative lumbar spinal disorder; minimally invasive therapy
• Target Audience: 一般
• Note (General): 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
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.2176/nmc.oa2012-0379
• Data Provider (Database): 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
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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