Posterior Instrumentation Surgery for Lumbar Degenerative Kyphosis.

概要

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10 females with vertebral fracture and kyphosis deformity due to osteoporosis were retrospectively studied following operative treatment. Their average age was 68 years (46 to 77 years) at the time of operation. The average follow-up was 10 months. All patients had neurological disorder (4: thoracic myelopathy, 5: cauda equina syndrome, 1: myelopathy and cauda eguina syndrome) while 6 had non-ambulatory paraparesis. They were treated by posterior instrumentation and spinal fusion, and an additional anterior decompression followed by A-W glass ceramic strut graft in 5 with spinal canal encroachment of fracture fragments. Urinary disturbance in 6 patients disappeared, intermittent claudication in 3 disappeared (2) or improved (1), and low back pain in 10 disappeared (4) or improved (6). The 6 non-ambulatory cases were able to walk with support except for a rheumatoid arthritis patient. Instrumentation was useful in relieving back pain with early mobilization. The correction rate of kyphosis was, however, 50% for insufficiently balanced spine, showing no correlation with the improvement of clinical symptoms. Use of hooks instead of screws for secure anchorage in the bone, supplemental spinal osteotomy for greater correction, and more precise instrumentation for well-balanced spine are required.
西日本整形・災害外科学会の論文