アブストラクト
| Title | 頚椎疾患 (2) : 頚椎OPLLに対する治療戦略 |
|---|---|
| Subtitle | 特集 : 脊椎の外科基本手技 II. 各論 |
| Authors | 辻崇* |
| Authors (kana) | つじたかし |
| Organization | *東京医療センター, 脊椎脊髄センター長 |
| Journal | MB Orthopaedics |
| Volume | 34 |
| Number | 10 |
| Page | 81-85 |
| Year/Month | 2021 / 10 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | 「Abstract」頚椎OPLLの治療には椎弓形成術が広く用いられ, その長期成績も安定しているが, 脊柱管の拡大による間接除圧を目指す椎弓形成術には限界も存在し, すべてのOPLL患者に適した術式とはいえず, 前方除圧固定もしくは後方除圧固定を選択すべき症例も少なからず存在する. 骨化占拠率とアライメントを簡便に評価できるK-lineは治療法に直結する非常に有用な指標であるが, 動的因子や術後後弯の予測の評価ができていない欠点があった. 近年では屈曲位K-lineおよび伸展位K-lineの有用性(いわゆるdynamic K-line)やバランス不良を評価するK-line tiltの概念も報告され, 動的因子や後弯リスクの評価も可能となってきている. 椎弓形成術で予後不良が予測される場合, 前方除圧固定もしくは後方除圧固定の適応となるが, 改善率や術後愁訴に加えて, 手術手技, 周術期管理や合併症を加味すると一長一短があり, 患者背景に加えて術者の技量施設の対応能力も加味したうえで術式を選択することが現実的である. |
| Practice | 臨床医学：外科系 |
| Keywords | 椎弓形成術(laminoplasty), 前方除圧固定(anterior decompression and fusion), 後方除圧固定(posterior decompression and fusion) |
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参考文献
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残りの9件を表示する
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