胸椎脊柱管内占拠性病変に対する顕微鏡下片側進入法

Unilateral Microsurgical Approach to Space-occupying Lesions in the Thoracic Spine

　われわれは，顕微鏡下片側椎弓切除を胸髄腫瘍やくも膜囊腫に対するアプローチとしてだけではなく，他の胸椎脊柱管内占拠性病変（椎間板ヘルニア，後縦靱帯骨化症，黄色靱帯骨化症，硬膜外膿瘍）にも適応を拡大し，24例に施行した．そのうち，脊髄腹側に発生した髄膜腫の1例に，術後一過性に麻痺の悪化を認めた以外は，明らかな神経合併症は認めなかった．髄内腫瘍の1例を除き，病変部は完全に切除され，再発を生じた症例もなかった．本法は胸椎部での低侵襲手術のひとつのオプションとして，今後さらに適応を広げ，普及するものと思われる．

　Unilateral microsurgical hemilaminectomy was used to treat 24 cases of tumor, arachnoid cyst, disk herniation, OPLL, OLF, and extradural abcess of the thoracic spine. The only neurological postoperative complication was temporary paralysis in a patient with a meningioma ventral to the spinal cord. All space-occupying lesions were completely removed except an intramedullary tumor in one patient, and none had recured as of the most recent follow-up examination. This method should be included as an option for less invasive surgery of diseases of the thoracic spine.