難治脊椎感染症に対する大網移植

Pedicled Greater Omentum Graft for Intractable Pyogenic Spondylitis

　難治脊椎感染症3例に対して，病巣掻爬，骨移植に加えて大網移植を行い，治癒を得た．有茎大網を用いることで，死腔が充塡されるだけでなく，周囲組織からの豊富な血流を得ることができる．その結果，浸出液の吸収，浮腫の改善，感染への抵抗性の増強などの効果が得られる．さらに骨の血行再建により，早期のリモデリングも期待される．有茎大網移植は，難治脊椎感染症の治療法として有効な手段である．

　This report describes the use of a pedicled greater omentum graft to treat intractable pyogenic spondylitis. Three patients were treated by anterior curettage and omentum grafting, and healing was successful in all three cases. The advantage of using the greater omentum is that it not only fills the dead space, but provides an abundant blood supply to the surrounding tissue, which results in absorption of effusion fluid and improvement of edema, an increase in the blood concentration of antibiotics, and early revascularization of the bone. These three cases demonstrate that pedicled greater omentum grafting is an effective method managing of intractable pyogenic spondylitis.