馬尾弛緩の臨床的検討―第3報；手術成績の検討

Outcome of Surgical Treatment for Redundant Nerve Roots of Cauda Equina

　われわれは，腰部脊柱管狭窄症例を対象として，馬尾弛緩を合併している症例と合併していない症例で手術成績に差があるかどうかを，JOAスコアの改善率を用いて検討した．その結果，馬尾弛緩の存在やその形態は，腰部脊柱管狭窄に対する手術成績に有意な影響を及ぼしてはいなかった．馬尾弛緩は，腰部脊柱管狭窄により生じた単なる馬尾の形態学的変化であり，腰部脊柱管狭窄の臨床症状の重症度や手術成績の指標になるとはいえない．

　Clinical analyses were performed to investigate the clinical significance of redundant nerve root of cauda equina (RNR). Seventy-six patients who had undergone surgery for degenerative lumbar spinal canal stenosis were investigated and divided into two groups according to their preoperative myelography results to determine the presence or absence of RNR. RNR was observed in 37 of the 76 patients. Before surgery, no significant differences in the clinical symptoms of the two groups were seen. After surgery, the clinical symptoms significantly improved in both groups, and no significant differences in clinical outcome were seen between the groups. We concluded that RNR is only a morphological change of the cauda equina and does not influence the pre-and post-operative clinical outcomes.