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当科で施行した単椎間monoportal PLIFの手術成績を調査した.%slipは術前22.9±7.6%が術後1年で13.7±7.5%,disc angleは術前4.5±7.5°が術後1年で7.2±4.7°に改善した.手術時間は214±25分,術中出血量は143±96mlであり,麻痺悪化1例と偽関節の1例に再手術を施行した.JOAスコアは術前14.5±4.9点が術後1年で25.5±3.0点に改善し,改善率は76%であった.術後1年の時点で45例中33例にcage前方の移植骨の連続性が認められ骨癒合と判定した.Cageの沈下は2例,4.4%に認められた.片側より椎体間固定を行うmonoportal PLIFは硬膜外血管,神経組織に対し低侵襲であり,従来のPLIFに比べ遜色ない成績が得られた.
We evaluated the operative outcomes of single-level monoportal PLIF (posterior lumbar interbody fusion) performed at our hospital. The percentage of slippage (%slip) of the upper vertebra before operation was 22.5±7.6%;this value decreased to 13.7±7.5% after one postoperative year. The preoperative disc angle was 4.5±7.5 degrees;this value improved to 7.2±4.7 degrees after one postoperative year. The operation time was 214±25 minutes, and the intraoperative blood loss was 143±96 ml. Reoperation was performed in one case with neurological deterioration and one case with pseudoarthrosis. The JOA (Japanese Orthopaedic Association) score improved from 14.5±4.9 points preoperatively to 25.5±3.0 points one year postoperatively, and the average percentage of improvement was 76%. Thirty-three out of 45 cases were judged to have complete bony fusion based on the appearance of a solid bony mass in front of cages on X-ray images. The subsidence of cage was recognized in 3 cases (6.7%). Monoportal PLIF in less invasive with regard to the vessels and nerves and can attain an operative outcome similar to that of PLIF.
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