顕微鏡視下腰椎椎間板ヘルニア摘出術とLove法によるヘルニア摘出術の手術成績―同一術者による前向き研究

Comparison of the Outcome of Treatment of Lumbar Disc Herniation by the Love Method and by Microsurgery. Prospective Study of Procedures Performed by the Same Spinal Surgeon

　腰椎椎間板ヘルニアに対し，Love法とキャスパー法の手術成績を同一術者による前向き研究で比較検討した．両手術方法において，術後使用した鎮痛剤，術前後のJOAスコア，術後の下肢痛のVASに有意差はなかった．手術時間，出血量，入院日数，術後の腰痛のVASにおいて統計上有意差がみられたが，いずれも大きな差ではなく，臨床的に違いはないものと考えられた．腰椎椎間板ヘルニアに対するヘルニア摘出術に関しては術者が習熟していれば，Love法でもキャスパー法でもどちらでも良いと考えられた．

　The outcome of treatment of lumbar disc herniation by means of the Love method and the Caspar method performed by the same surgeon was compared in a prospective study. There were no significant differences between the two procedures in frequency of postoperative analgesic use, change between pre-and post-operative JOA scores, or postoperative visual analogne score (VAS) pain scores for melosalgia. Statistically significant differences were observed in operation time, blood loss, length of stay, and postoperative VAS scores for lumbar pain, but the differences were not large, and may not have been significant clinically. Hence, both the Love and Caspar methods are appropriate herniotomy procedures for lumbar disc herniation, if the surgeon has mastered them.