骨粗鬆症性椎体骨折後偽関節・遅発性神経麻痺に対する手術方針

Surgical Strategy for Pseudoarthrosis and Delayed Nerve Palsy after Osteoporotic Vertebral Fracture

Point

・骨粗鬆症性椎体骨折は，保存的治療で多くの症例は改善する．

・偽関節，遅発性神経麻痺による疼痛，神経障害にて日常生活強度が障害される場合，手術を必要とする．

・手術に関しては，手術体位で矯正可能な動態圧迫と脊柱変形による神経圧迫の状態を評価し，前方支柱再建，後方固定の方法を選択しておのおのの症例にふさわしい治療を検討する．

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　Osteoporotic vertebral fractures are among the most common fractures associated with osteoporosis. Approximately 80% of cases heal by fusion in the natural process without the need for surgery, and if we include the so-called “incidental vertebral body fractures,” which are discovered by chance during radiography, the frequency of prolongation of back pain due to pseudoarthrosis or delayed-onset neurological deficits is low. However, the prognosis of osteoporotic vertebral fractures is affected by the number of fractured vertebrae. In patients who become bedridden because of prolonged pain due to pseudoarthrosis or delayed neurological deficits, surgical treatment aimed at improving activities of daily living is required from the viewpoint of life prognosis. Here, we describe the indications for surgery and surgical methods for pathologies that require surgical treatment after osteoporotic vertebral fractures.