腰椎変性すべり症に対する interbody fusion cage を用いた posterior lumbar rigid fixation の適応と手術手技

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The lumbar interbody fusion cage has been newly developed for PLIF. The benefits are easy handing, good disc space holding and early mobilization for the patient. The materials used to make the titanium, or carbonfiber or ceramic. Each material has its merits and demerits. For example, carbonfiber is evaluated highly for fusion, but when it is used, it is difficult to check the migration of lumbar X-P. We use the SDIC and CCD because of good fixation provided for the lumbar spine by this system. We report the result of the SDIC system with CCD (rigid fixation) in this paper. 30 cases of patients with spondylolisthesis were operated on in our institute. Patient age distribution was 38-70 (mean 57.9) y. o. and gender was male, 15 cases; female, 15 cases. Follow up term was 4-57 (mean 35) months. We also measured the FACET SAGITTAL ANGLE by CT to check the indication for the instrumentation. Facet sagittal angle was significantly small in degenerative spondylolisthesis patients compared to the control group. All patients experienced relief of radicular pain of the foot and intermittent claudication but complaints of lower-back pain continued for 2-5 months postoperatively. The results were evaluated using the JOA disability scale and neurological signs showed an 82.5% improvement. No serious complication was observed except in one patient who fell on the floor and fractured the L5 pedicle. He recovered after reoperation to fix the lumbar from L3, 4 to S1. It is reported that the interbody fusion cage by itself is enough to stabilize the lumbar spine, but we observed some cases of kyphosis post operatively when only cage fixation was used. As the follow-up term has not been long enough to evaluate properly the effect of this manipulation, it is important to carefully select which instrumentation system we should use.
日本脊髄外科学会の論文
1998-03-30

腰椎変性すべり症に対する interbody fusion cage を用いた posterior lumbar rigid fixation の適応と手術手技

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