Japanese

Title	腰部脊柱管狭窄症手術例における骨粗鬆症の有病率と治療状況の検討
Subtitle	原著
Authors	河合慈, 加藤仁志, 横川文彬, 田中由貴, 清水貴樹, 有藤賢明, 石野雄士, 南保和宏, 出村諭
Authors (kana)
Organization	金沢大学大学院整形外科
Journal	Journal of Spine Research
Volume	16
Number	6
Page	849-854
Year/Month	2025 /
Article	原著
Publisher	日本脊椎脊髄病学会
Abstract	「要旨」 「はじめに」: 超高齢社会の我が国では, 脊椎手術を受ける患者も高齢化している. 近年, 術後合併症予防の観点から, 術前の骨粗鬆症評価と介入が重要視されているが, 評価と介入は十分とは言い難い. 本研究では, 腰部脊柱管狭窄症(LSS)症例の骨粗鬆症有病率と治療状況を調査し課題を検討した. 「対象と方法」: 2016年1月から2023年12月における当院のLSS手術例のうち, 2椎間以内の除圧術または単椎間固定術を施行した145例を対象とした. 術前に腰椎・大腿骨DEXA法で骨密度を測定し, 全脊柱レントゲンで既存椎体骨折の有無を評価し, 本邦ガイドラインに基づき骨粗鬆症診断を行い, 有病率を算出した. さらに術前後の骨粗鬆症の治療状況を男女間で比較した. 「結果」: 骨粗鬆症有病率は全体21.4%, 男性14.6%, 女性28.5%であり腰椎DEXA≦70%の症例は2.1%のみであった. 男性では術前・術後とも治療介入率が低かった. 「結語」: LSS患者は骨粗鬆症の有病率が一般コホートより高く, 腰椎変性により腰椎DEXA法単独では, 過小評価をする可能性がある. また男性例では治療が不十分であり, 積極的な介入が求められる.
Practice	臨床医学：外科系
Keywords	骨粗鬆症, 腰部脊柱管狭窄症, 腰椎変性, Osteoporosis, Lumbar spinal stenosis, Lumbar degeneration

English

Title	Prevalence of osteoporosis and treatment status in surgical cases of lumbar spinal stenosis
Subtitle	Original Article
Authors	Megumu Kawai, Satoshi Kato, Noriaki Yokogawa, Yuki Tanaka, Takaki Shimizu, Takaaki Uto, Yuji Ishino, Kazuhiro Nanpo, Satoru Demura
Authors (kana)
Organization	Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University
Journal	Journal of Spine Research
Volume	16
Number	6
Page	849-854
Year/Month	2025 /
Article	Original article
Publisher	The Japanese Society for Spine Surgery and Related Research
Abstract	[Abstract] [Introduction]: In Japan, now a super-aging society, the proportion of elderly patients undergoing spinal surgery continues to increase. Reduced bone density has been reported to be a risk factor for postoperative complications such as screw loosening and intervertebral cage subsidence. Recently, preoperative osteoporosis screening and treatment have been emphasized to prevent postoperative complications in spinal fusion surgeries. However, the intervention and screening are often insufficient. This study investigated the prevalence of osteoporosis and the current treatment status in patients with lumbar spinal stenosis (LSS) undergoing surgeries. It also examined the problems of osteoporosis treatment in patients with LSS. [Methods]: A total of 145 patients who underwent decompression of up to two levels or single-level fusion for LSS at our institution during the period from January 2016 to December 2023 were included. Preoperative bone density was measured using dual-energy X-ray absorptiometry (DEXA) of the lumbar spine and proximal femur. Existing vertebral fractures were examined by whole-spine X-ray. Osteoporosis was diagnosed according to the Japanese guidelines. The prevalence of osteoporosis was examined. Preoperative and postoperative treatment statuses were compared between male and female patients. [Results]: Overall, 21.4% of the patients were diagnosed with osteoporosis (14.6% in men, 28.5% in women). Only 2.1% of patients had a lumbar DEXA value <-70%. Only a few patients were diagnosed with osteoporosis by lumbar DEXA. The rate of osteoporosis treatment intervention remained low in men both before and after surgery. [Conclusions]: Patients with LSS had a higher prevalence of osteoporosis than the general population. In particular, male patients had insufficient treatment, indicating a need for more proactive management of osteoporosis in this population. In addition, the diagnosis of osteoporosis was difficult using only lumbar DEXA in this population due to degeneration.
Practice	Clinical surgery
Keywords	Osteoporosis, Lumbar spinal stenosis, Lumbar degeneration

• 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。