新しい低侵襲脊椎後方開創器―低侵襲Love法への臨床応用

New Spinal Retractor Designed to Reduce the Invasiveness of Posterior Spinal Surgery. Clinical Application to Lumbar Discectomy

　小皮切アプローチでも手術操作への干渉を軽減した低侵襲脊椎後方開創器を作製した．これを使用し低侵襲ヘルニア切除術を行った群と，同一術者が行った従来型開創器を使用したLove群を比較検討した．術前，術後3日，1～4週，3カ月の腰痛，下肢痛，下肢しびれVASとSF-36に両群間で有意差を認めなかった．本開創器の使用により，小皮切にもかかわらず，十分な手術操作空間が確保され，手術時間の延長や出血量増加も認めず，従来法同様の手技で手術が可能だった．本開創器は低侵襲脊椎後方手術における有用な支援器具である．

　We have designed a new retractor system for posterior spinal surgery in order to reduce the invasiveness of lumbar discectomy.　In this study we compared the outcomes of less invasive lumbar discectomy with the new retractor system (LI-Love group) and lumbar discectomy by Love's method using a conventional retractor (Love group), with the same surgeon performing all of the discectomies.　The preoperative, 3-day, 1- to 4-week, and 3-month postoperative scores on the SF-36, visual analog scale (VAS) for low back pain, VAS for lower leg pain, and VAS for lower leg numbness all showed no significant differences between the two groups.　The new retractor system enabled us to perform lumbar discectomy through a smaller skin incision than by the conventional method, while allowing similar maneuvers with the surgical instruments.　There was no increase in intraoperative blood loss or operation time as a result of using our retractor system to perform the discectomies.　We therefore found this new retractor system to be a useful support instrument for less invasive posterior spinal surgery.