手術に至った骨粗鬆症性椎体偽関節の初期治療

Initial Treatment in Surgically Treated Cases of Osteoporotic Spinal Pseudarthrosis

　骨粗鬆症性椎体偽関節に対して手術を行った45症例を対象に，圧迫骨折の初期治療と手術侵襲を含めた成績を検討した．約半数で初期治療に外固定が行われていなかった．受傷形態は非外傷が約半数を占めていた．手術侵襲は大きく，また合併症の発生率も高かった．偽関節の発生を低減させる適切な初期治療の確立が急務である．

　We analyzed 45 cases of spinal pseudarthrosis that had been treated surgically to identify initial treatment for osteoporotic spinal compression fractures and the clinical results of the surgeries.　Primary external fixation was had not been performed in almost half of the cases.　The fractures had occurred in the absence of major trauma in half of the patients.　Although better walking ability was obtained, surgical affection was greater and complications were more common in the cases in which operation was performed.　An appropriate initial strategy to prevent spinal pseudarthrosis should be devised.