腰椎椎間板ヘルニアと腰部脊柱管狭窄症における後方除圧術後のしびれ遺残率

Postoperative Residual Numbness in Lumbar Disc Herniation and Lumbar Spinal Canal Stenosis

　腰椎椎間板ヘルニアと脊柱管狭窄症の100例ずつで，術後しびれ遺残率とそれに影響する因子を検討した．前者では，術前84％にしびれが存在し，術後1，3，6カ月，1年では32％，27％，26％，26％に残存した．しびれ遺残と手術時年齢が関連し，神経組織の回復力の問題が考えられた．後者では，術前89％にしびれが存在し，術後1，3，6カ月，1年では44％，40％，42％，45％に残存した．しびれ遺残と罹病期間や術前JOAスコア，術前筋力が関連し，神経組織の不可逆的変化の有無が影響していると思われた．

　I investigated the incidence of post-operative residual numbness and the factors which influenced that with lumbar disc herniation and lumbar spinal canal stenosis. In lumbar disc herniation, there were 84％ of patients who complained of numbness preoperatively. The incidence of residual numbness was 26％ in patients one year after the operation. The factor that influenced residual numbness was the age of the patient at operation. In lumbar spinal canal stenosis, there were 89％ of patients who complained of numbness preoperatively. The incidence of residual numbness was 45％ in patients 1 year after the operation. The factors that influenced residual numbness were the pre-operative JOA score, muscle weakness and the duration of symptoms. It is speculated that the power of recovery of neural tissues is important when considering residual numbness in lumbar disc herniation, and for lumbar spinal canal stenosis the existence of irreversible change is important.