腰椎化膿性椎間関節炎手術後に回旋すべり変形を生じた1例

Rotation and Translation Deformity of the Lumbar Spine after Surgery for Bilateral Septic Arthritis of Lumbar Facet Joints. Case Report

　われわれは腰椎化膿性椎間関節炎手術後に回旋すべり変形に発展した1例を経験したので報告する．症例は75歳の男性で発熱と腰下肢痛により発症した．MRIにおいて椎体と椎間板には病変はみられなかったが，L3/4高位の両側椎間関節が異常輝度変化を呈するとともに，著しく腫大し硬膜管を圧迫していた．病巣掻爬・洗浄術を施行後，床上安静と抗生物質療法により感染は鎮静化した．以後，体幹装具を装着させて経過観察していたが，徐々に椎間関節機能の破綻による不安定性が進行し，腰椎回旋すべり変形に発展したため脊柱固定術の追加を余儀なくされた．

　We report a case of rotation and translation deformity of the lumbar spine after surgery for bilateral septic arthritis of lumbar facet joints. A 75-year-old man complained of a high-grade fever, low back pain, and sciatica. MR images showed severe bilateral swelling of the facet joints at the L3/4 level with abnormal signal intensity and severe constriction of the dural sac. There were no abnormal findings in the other vertebral bodies or in the intervertebral discs. Antibiotic therapy followed by surgical debridement was effective, and his symptoms resolved completely. However, the bilateral loss of function of the facet joints resulted in a rotation and translation deformity of the lumbar spine, and spinal fusion was necessary in a second-stage operation.