下垂足を呈した腰椎椎間板ヘルニアの検討

Study of Drop Foot Due to Lumbar Disc Herniation

　下垂足を呈した腰椎椎間板ヘルニアの病態と臨床成績を検討した．前けい骨筋筋力が徒手筋力テスト3以下であった12例を対象とした．男性7例，女性5例，平均年齢は45歳であった．9例には手術を，3例には保存的治療をそれぞれ行った．術中所見ではsequestrationタイプによる複数根障害例が多かった．手術は概ね良好な成績であったが成績不良例も存在した．保存的に経過をみた3例ではいずれも良好な筋力の回復がみられた．

　This study investigated mechanisms and clinical results of drop foot due to lumbar disc herniation. Twelve cases scoring between 0 and 3 on manual muscle testing (MMT) for tibialis anterior muscles were included in this study. There were 7 men and 5 women, and the patients' average age was 45 years. We performed surgery on 9 cases and applied conservative treatment to 3 cases respectively. The intraoperative findings showed that double nerve roots were affected by sequestration-type herniation in most of our cases. Excellent results were obtained in most of cases although not all treated operatively and in all conservatively treated cases.