頚椎前側方椎体削開術の長期成績

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概要

• 論文の詳細を見る

• A long term follow-up of patients after antero-lateral partial vertebrectomies (ALPV) was performed using patient charts and questionnaires. During the past 15 years, ALPV has been performed on 159 patients with cervical spinal disorders. Among them, 136 patients whose survey was performed more than 1 year ago were selected. 92 were male and 44 were female. Their ages ranged from 41 to 82, and the average age was 63.1. The follow-up period was from 1 to 14 years (the average being 3.8 years). Pathology included spondylosis 119, OPLL 31, canal stenosis 8 and combined lesion 22 cases. Surgical resuts were evaluated using a 5 grade scale (excellent ; E, good ; G, fair ; F, poor ; P and dead ; D). At discharge, group E was 40.2%, G was 51.5%, F was 7.2%, P was 0%, D was 0.7%. At the end of the follow-up period E was 36.9%, G was 35.7%, F was 20.2%, P was 7.1% and dead was 9.8%. None of the deaths were related to the surgery. However, the score obtained from the Neurosurgical Cervical Spinal Scale were essentially consistent. Results of the questionnaire showed that 61.4% of the patients were satisfied, 30.1% were fairly satisfied and only 8.4% were dissatisfied. Dissatisfied cases included 2 cases of surgical failure but most of them were related to the progressive worsening of other lesions such as thoracic, lumbar spinal lesions or peripheral neuropathy. In 2 cases reoperation was performed, one anterior fusion with fibular strut graft for kyphoscoliosis and the other anterior fusion with a mini-plate for a fracture of the lamina and slippage of the vertebral body. In some cases, weakness of the C5 root area was encountered but most of these were resolved in a few months. Radiologically, the bony defects of the vertebral body were observed to become smaller, namely they were replaced by new growth of bone slowly in all cases. Thus, ALPV seems to be a useful surgical procedure for multilevel cervical spinal disorders.

• 日本脊髄外科学会の論文
• 1997-06-16

著者

• 門間 文行

  新庄徳洲会病院脳神経外科

• 中村 宏

  静仁会静内病院脳神経外科

• 小原 進

  八尾徳洲会総合病院 脳神経外科

• 門間 文行

  八尾徳洲会総合病院 脳神経外科

• 岡本 順二

  八尾徳洲会総合病院 脳神経外科

• 大井 政芳

  八尾徳洲会総合病院 脳神経外科

• 中村 宏

  八尾徳洲会病院脳神経外科

• 岡本 順二

  八尾徳洲会病院脳神経外科

• 小原 進

  八尾徳洲会病院脳神経外科

• 大井 政芳

  八尾徳洲会病院脳神経外科

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