肝臓移植後患者での腰部脊椎固定手術 : 症例報告
スポンサーリンク
概要
- 論文の詳細を見る
Spinal instrumentation after transplantation has not been reported before. We report a case of the posterior lumbar interbody fusion (PLIF) after liver transplantation. A 58-year-old man underwent a cadaveric liver transplantation due to the cirrhosis in 1999. He stopped taking steroid 6 months and Mycophenolate 3 years after the surgery, but he had been taking Cyclosporin and Lamivudine. He could not stand because of the severe low back pain soon after the surgery, but this pain disappeared spontaneously. Nevertheless, not only did low back pain recur but also severe left leg pain appeared. Finally, he could walk only within 100m with a stick. X-photo showed L2 compression fracture and L5 spondylolysis. MRI demonstrated developmental canal stenosis at L3-4 level. He had decreased renal function and diabetes, but his liver function was normal. PLIF with titanium cages at L3-4, L4-5 and L5-6 levels was done in November 2003. Antibiotics were given for two weeks. He recovered from the symptoms completely without any complications. Spinal instrumentation leads to an increase in the rate of successful fusion and to a decrease the period of patient recovery, but can increase the risk of infection. A transplant patient has a risk of infection because of the immunosuppressants used. As stand-alone PLIF with cages decreases the extent of dissection and local tissue damage, it reduces the risk of infection. In addition, fusion often fails in cases of osteoporosis. Patients with end stage liver disease are prone to develop osteopenia and osteoporosis, and additional bone loss occurs with the use of immunosuppressants and steroids. However, bone mineral density (BMD) turns into the restoration within at least 6months after transplantation. Stand-alone PLIF can be done safely only if 6months have passed since the transplantation, BMD is normal and the transplanted organ functions well.
- 日本脊髄外科学会の論文
著者
関連論文
- インターベンション治療における縦型オープンMR装置の初期経験
- 結膜浮腫・結膜充血で発症した非海綿静脈洞部多発性硬膜動静脈瘻
- 老年者の慢性硬膜下血腫 : 統計的観察
- 頭蓋内進展をきたしたOlfactory Neuroblastomaの2例
- PMX小型カラムとCHDF直列施行が有効であった成人敗血症症例(第21回関西地方会抄録)
- D-19 イハラてんかんラット(IER)のpentylenetetrazole誘発痙攣に関与する遺伝子座のquantitative trait loci(QTL)解析
- 後下小脳動脈血栓化巨大動脈瘤の外科的治療
- Cylindrical titanium cageを用いた頸椎前方固定術後1年以上経過症例のレントゲン所見についての検討
- 脳動脈瘤 脳動脈瘤の画像診断--MRA,CTA,3D angiography (インターベンション時代の脳卒中学(改訂第2版)(下)超急性期から再発予防まで) -- (くも膜下出血と脳動脈瘤)
- くも膜下出血 くも膜下出血発症の誘因,環境因子 (インターベンション時代の脳卒中学(改訂第2版)(下)超急性期から再発予防まで) -- (くも膜下出血と脳動脈瘤)