腰部脊柱管狭窄症に対する片側進入拡大開窓及び両側椎間関節内側切除及び椎間孔開放術

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Purpose : Commonly used techniques of lumbar decompression that include bilateral takedown of paraspinal musculature and aggressive bony resection can result in significant iatrogenic sequelae. Bilateral fenestration through a unilateral approach for lumbar spinal canal stenosis has been reported as a minimally invasive procedure. In addition to this method, we have performed contralateral facetectomy and foraminotomy. In this study, we describe and analyze this technique that affords excellent decompression while minimizing damage to surrounding tissues. Materials and Methods : Between 2000 and 2002, 30 patients with lumbar spinal canal stenosis were surgically treated at our hospital. The 12 women and 18 men had a mean age of 60.4 years (range, 29-75yr). Mean duration of symptoms prior to surgery was 28.6 months (range, 3-120 months). Spinal canal stenosis was shown at a single interlaminar space in all patients who were suffering from cauda equina syndrome with bilateral root pain at the stenosis level. We performed bilateral fenestration, facetectomy and foraminotomy using unilateral approach. Results : The technique affords excellent decompression while minimizing destruction to tissues not directly involved in the pathologic process. Functional outcome scores increased remarkably and 93.3% of patients reported high satisfaction rates. Conclusions : This method is a minimally invasive technique that appears to provide excellent functional outcomes. In particular, the contralateral facet joint is preserved very well since only lower part of the superior articular process is resected.
2003-07-31

腰部脊柱管狭窄症に対する片側進入拡大開窓及び両側椎間関節内側切除及び椎間孔開放術

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