腰部脊柱管狭窄症に対する装具療法の効果と限界

Usefulness and Limitations of Lumbar Orthoses for Symptoms of Lumbar Spinal Canal Stenosis

　抄録：腰部脊柱管狭窄症に対する装具療法の効果と限界について，42例（男性16例，女性26例，年齢：34～87歳，装着期間：3カ月～2年4カ月，平均6カ月）のretrospective studyを行った．使用した装具は，flexion brace（以下FB）と軟性装具（以下D）であり，うち65歳以上の高齢者は18例（FB10例，D8例），65歳未満の若年者は24例（FB14例，D10例）であった．腰痛と下肢症状の程度は，重度2，軽度1，なし0に分類し，歩行能力は間欠跛行出現までの距離または時間を指標として同じく3段階に分類した．総体として見ると，装具療法により腰痛と（p＜0.0001）下肢症状（p＜0.001）は有意に改善したが，歩行能力では有意な改善は得られなかった．これは，今回使用したflexion braceと軟性装具は，間欠跛行の症状を改善するほどには腰椎を制動できないためと推測された．

　The usefulness and limitations of two types lumbar orthoses (Damen corset；D and flexion brace；FB) for lumbar spinal canal stenosis were retrospectively examined in relation to three symptoms and patient age. There were 42 consecutive patients (16 males, 26 females, the patients age：34-87 years old). The duration of orthosis application ranged from 3 months to 2 years 4 months, with an average of 6 months. There were 18 elderly patients over 65 years old (8 D and 10 FB) and 24 younger patients under 65 years old (10 D and 14 FB). Three symptoms of lumbar spinal canal stenosis, that is, low back pain, pain or numbness in the lower extremities, and disability in walking were examined. Each symptom was classified into three scores；2：severe, 1：slight, and 0：none. D and FB were effective for improving low back pain (p＜0.0001) and pain or numbness in the lower extremities (p＜0.001). However, they could not effectively improve disability in walking.