腰椎椎間孔狭窄に対する経椎間孔的腰椎椎体間固定術（TLIF）の治療成績からみた今後の診断法の検討―椎間孔狭窄スコアの有用性の検討

Diagnostic Method for Lumbar Foraminal Stenosis Based on the Clinical Results of Transforaminal Lumbar Interbody Fusion (TLIF). : Utility of the Foraminal Stenosis Score

　腰椎椎間孔狭窄あるいは中心性狭窄との合併に対して経椎間孔的腰椎椎体間固定術(transforaminal lumbar interbody fusion，TLIF)を施行した73例を調査し，その術中所見，治療成績から今後の椎間孔狭窄の診断法について検討した．実際に術中に明らかな椎間孔狭窄所見を認めなかった症例は25例(34.2％)であった．術前の臨床・画像所見について，術中所見を認めた群と認めなかった群を比較し，多重ロジスティック回帰分析を行った．さらに，そのオッズ比を用いて椎間孔狭窄スコアを作成した．

　In this study we analyzed 73 cases treated by transforaminal lumbar interbody fusion (TLIF) for lumbar foraminal stenosis or central canal stenosis and foraminal stenosis, and based on the perioperative findings and outcome of treatment, we considered the diagnostic procedure for lumbar foraminal stenosis in the future.　In 25 cases (34.2%) cases there was actually no clear perioperative evidence of foraminal stenosis.　We compared the preoperative clinical and imaging findings in the group with perioperative findings and the group without perioperative findings performed a multiple logistic regression analysis to identify factors associated with foraminal stenosis.　We also calculated the odds ratio for the perioperative findings and proposed a foraminal stenosis scoring system.