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転移性胸椎腫瘍に対するsublaminar wiringによる後方固定術23例,24手術の成績を検討した.手術は後方除圧後,上下3椎弓をwireとrodで固定した.特にわれわれはT-saw tubeと糸を利用しwire設置を工夫している.14例が90日以上生存し,麻痺はFrankel AがCに,Frankel Cが1例を除きD以上に改善した.術前疼痛がDenis P4およびP5の例はすべて1段階以上の改善が得られた.平均307日の余命中の約84%の期間で座位が可能で固定効果が持続していた.
We studied the results of 23 cases of posteritor fixation with sublaminar wiring for metastatic thoracic tumor. After posterior decompression, above 3 and below 3 laminae were fixed with wires and rod. A special technique with T-saw tube and thread was useful for passing wires. Fourteen cases survived for more than 90 days. Paraplegia was recovered to Frankel C and D in most cases. Pain was relieved by at least one grade in Denis P4 and P5 group. The mean survival was 307 days. Patients were able to sit and avoid bedridden for 84% period of the remaining life, that showed the usefulness of the surgery.
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