腰部脊柱管狭窄症に対する片側進入両側除圧術の除圧椎間数別成績

Clinical Results of Bilateral Decompression through Unilateral Approach for Lumbar Spinal Canal Stenosis

　腰部脊柱管狭窄症に対して同一執刀医が直視下片側進入両側除圧術を行った42例の成績を除圧椎間数別に検討した．平均手術時間ならびに出血量は，それぞれ1椎間で78.8分，44.8g，2椎間で118.7分，150.5g，3椎間で157分，373.0gであった．術前，術後のJOAスコアならびに改善率は1椎間で平均14.1点，25.2点，77.3％，2椎間で11.7点，19.9点，46.8％，さらに3椎間で10.8点，18.6点，40.2％であった．今後多椎間罹患例における術中出血の抑制と，術後成績の向上を図るための対策が必要である．

　We stndied clinical results for 47 patients undergoing bilateral decompression through a unilateral approach with respect to number of levels involved. Average operating time was 78.8min and intra-operative bleeding 44.8g at one level, 118.8min and 150.5g at two levels, and 157min and 373.0g at three levels. The average preoperative JOA score was 14.1 points, postoperative JOA score 25.2 points, and recovery rate 77.3％ at one level；11.7 points, 19.9 points, and 46.8％ at two levels；and 10.8 points, 18.6 points, and 40.2％ at three levels. Intraoperative bleeding should be reduced in multilevel cases. To increase postoperative results in multilevel cases requires that strategy improved.